Effects of transfusion with red cells filtered to remove leucocytes: randomised controlled trial in patients undergoing major surgery.
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.
van Hilten
Joost A
JA
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
van de Watering
Leo M G
LM
van Bockel
J Hajo
JH
van de Velde
Cornelis J H
CJ
Kievit
Job
J
Brand
Ronald
R
van den Hout
Wilbert B
WB
Geelkerken
Robert H
RH
Roumen
Rudi M H
RM
Wesselink
Ronald M J
RM
Koopman-van Gemert
Ankie W M M
AW
Koning
Jan
J
Brand
Anneke
A
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