Universal leukocyte reduction of transfused red cells does not provide benefit to patients undergoing cardiac surgery.
OBJECTIVE
A policy of universal leukocyte reduction of the blood supply in Finland was implemented at the beginning of 2003. The aim of the present evaluation was to determine the potential role of leukocyte-reduced red blood cells in decreasing postoperative infections.


METHODS
A retrospective cohort study.


METHODS
A major university clinic.


METHODS
Consecutive patients undergoing cardiac surgery during the years 2002 and 2003.


METHODS
Transfused patients received either buffy-coat-depleted red blood cells before leukocyte reduction (n = 782) or leukocyte-reduced red blood cells after leukocyte reduction (n = 632).


RESULTS
The evaluated outcome parameters were culture-proven postoperative infections, 90-day mortality, and length of stay in the intensive care unit. The percentage of patients transfused with red blood cells (56% v 53%, p = 0.16) and amounts of transfused red blood cells (4.3 +/- 6.7 [3.0] units v 4.3 +/- 6.6 [2.0] units, means +/- standard deviation [median], p = 0.48) were comparable between the study groups (buffy-coat-depleted group and leukocyte-reduced group, respectively). The 90-day mortality (6.6% v 6.3%, p = 0.28), the length of intensive care stay (3.6 +/- 4.7 [2.0] days v 4.3 +/- 7.1 [2.0] days, p = 0.34), and the number of patients with culture-proven infections (8.8% v 10.9%, p = 0.19) were unchanged after universal leukocyte reduction. In multivariate comparisons, the leukocyte reduction was not associated with culture-proven postoperative infections and 90-day mortality.


CONCLUSIONS
No beneficial effect of the universal leukocyte reduction in cardiac surgery was found for culture-positive infection rates, 90-day mortality, or length of intensive care stay.
Capraro
Leena
L
Department of Anaesthesiology and Intensive Care Medicine, Helsinki University Central Hospital, Helsinki, Finland.
Kuitunen
Anne
A
Vento
Antti E
AE
Suojaranta-Ylinen
Raili
R
Kolho
Elina
E
Pettilä
Ville
V
D000368:Aged; D016470:Bacteremia / Q000453:epidemiology / Q000209:etiology; D006348:Cardiac Surgical Procedures / Q000401:mortality; D017707:Erythrocyte Transfusion / Q000009:adverse effects; D005260:Female; D005387:Finland; D006331:Heart Diseases / Q000601:surgery; D006801:Humans; D007362:Intensive Care Units; D007902:Length of Stay / Q000706:statistics & numerical data; D047589:Leukocyte Reduction Procedures; D016015:Logistic Models; D008297:Male; D008480:Mediastinitis / Q000453:epidemiology / Q000209:etiology; D008875:Middle Aged; D015999:Multivariate Analysis; D011014:Pneumonia / Q000453:epidemiology / Q000209:etiology; D012107:Research Design; D012189:Retrospective Studies; D013530:Surgical Wound Infection / Q000453:epidemiology / Q000209:etiology; D016019:Survival Analysis; D017211:Treatment Failure