The effect of universal leukodepletion of packed red blood cells on postoperative infections in high-risk patients undergoing abdominal aortic surgery.
We evaluated, by using a before-and-after study, the influence of leukoreduction by filtration on postoperative infections and adverse outcomes in patients undergoing elective major aortic surgery. From January 1995 to October 2000, all patients who underwent elective abdominal aortic surgery were included in the analysis. Before the introduction of systematic leukodepletion of packed red blood cells (RBCs), on April 1, 1998, 192 patients received standard or buffy-coat-depleted packed RBCs. Then, 195 patients were transfused with exclusively filtered leukodepleted packed RBCs. No major significant difference was observed between the groups of patients with regard to preoperative cardiac and pulmonary status, anesthetic and surgical techniques, or transfusion policy. No significant difference in mortality was observed between the two groups. The incidence of postoperative infections was 31% (95% confidence interval, 25%--38%) in the Control group versus 27% (95% confidence interval, 21%--33%) in the Leukodepleted group; severe infectious complications and pneumonia were not significantly different between the two groups of patients. Cardiovascular and respiratory outcomes were not significantly different between the groups. Data from this study suggest that the effect of using leukodepleted RBC on postoperative infections is not of obvious importance.


CONCLUSIONS
We evaluated the influence of leukocyte reduction by filtration of packed red blood cells (RBC) on postoperative infections and adverse outcomes in patients undergoing elective major aortic surgery by comparing two epochs with and without filtration. Data from this study suggest that the effect of using filtered RBC on postoperative infections is not of obvious importance.
Baron
Jean-François
JF
Department of Anesthesiology, Pitié-Salpétrière Hospital, Paris, France. jfbaron@club-internet.fr
Gourdin
Maximilien
M
Bertrand
Michèle
M
Mercadier
Anne
A
Delort
Josée
J
Kieffer
Edouard
E
Coriat
Pierre
P
D000328:Adult; D000368:Aged; D001012:Aorta, Abdominal / Q000601:surgery*; D017707:Erythrocyte Transfusion; D005260:Female; D005374:Filtration; D006801:Humans; D007239:Infections / Q000209:etiology*; D007937:Leukapheresis; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology*