title: Effects of transfusion with red cells filtered to remove leucocytes: randomised controlled trial in patients undergoing major surgery.
abstract: OBJECTIVE
  To compare postoperative complications in patients undergoing major surgery who received non-filtered or filtered red blood cell transfusions.
  
  
  METHODS
  Prospective, randomised, double blinded trial.
  
  
  METHODS
  19 hospitals throughout the Netherlands (three university; 10 clinical; six general).
  
  
  METHODS
  1051 evaluable patients: 79 patients with ruptured aneurysm, 412 patients undergoing elective surgery for aneurysm, and 560 undergoing gastrointestinal surgery.
  
  
  METHODS
  The non-filtered products had the buffy coat removed and were plasma reduced. The filtered products had the buffy coat removed, were plasma reduced, and filtered before storage to remove leucocytes.
  
  
  METHODS
  Mortality and duration of stay in intensive care. Secondary end points were occurrence of multi-organ failure, infections, and length of hospital stay.
  
  
  RESULTS
  No significant differences were found in mortality (odds ratio for filtered v non-filtered 0.80, 95% confidence interval 0.53 to 1.21) and in mean stay in intensive care (- 0.4 day, - 1.6 to 0.6 day). In the filtered group the mean length of hospital stay was 2.4 days shorter (- 4.8 to 0.0 day; P = 0.050) and the incidence of multi-organ failure was 30% lower (odds ratio 0.70, 0.49 to 1.00; P = 0.050). There were no differences in rates of infection (0.98, 0.73 to 1.32).
  
  
  CONCLUSIONS
  The use of filtered transfusions in some types of major surgery may reduce the length of hospital stay and the incidence of postoperative multi-organ failure.
authors.affiliation: Department of Immunohaematology and Blood Transfusion, Leiden University Medical Center and Sanquin Blood Supply, PO Box 9600, 2300 RC Leiden, Netherlands. J.A.van_Hilten@lumc.nl
authors.forename: Joost A
authors.initials: JA
authors.lastname: van Hilten
authors.forename: Leo M G
authors.initials: LM
authors.lastname: van de Watering
authors.forename: J Hajo
authors.initials: JH
authors.lastname: van Bockel
authors.forename: Cornelis J H
authors.initials: CJ
authors.lastname: van de Velde
authors.forename: Job
authors.initials: J
authors.lastname: Kievit
authors.forename: Ronald
authors.initials: R
authors.lastname: Brand
authors.forename: Wilbert B
authors.initials: WB
authors.lastname: van den Hout
authors.forename: Robert H
authors.initials: RH
authors.lastname: Geelkerken
authors.forename: Rudi M H
authors.initials: RM
authors.lastname: Roumen
authors.forename: Ronald M J
authors.initials: RM
authors.lastname: Wesselink
authors.forename: Ankie W M M
authors.initials: AW
authors.lastname: Koopman-van Gemert
authors.forename: Jan
authors.initials: J
authors.lastname: Koning
authors.forename: Anneke
authors.initials: A
authors.lastname: Brand
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001014:Aortic Aneurysm / Q000601:surgery; D001019:Aortic Rupture / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D003422:Critical Care / Q000706:statistics & numerical data; D004311:Double-Blind Method; D017707:Erythrocyte Transfusion / Q000379:methods*; D005260:Female; D005767:Gastrointestinal Diseases / Q000601:surgery; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007902:Length of Stay / Q000706:statistics & numerical data; D007937:Leukapheresis / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000209:etiology; D010865:Pilot Projects; D011183:Postoperative Complications / Q000209:etiology* / Q000401:mortality; D011446:Prospective Studies