title: Postoperative complications associated with transfusion of platelets and plasma in cardiac surgery.
abstract: BACKGROUND
  Studies in cardiac surgery have reported increased postoperative morbidity and mortality after allogeneic red blood cell (RBC) transfusions. Whether platelet (PLT) and/or plasma transfusions are a marker for more concomitant RBC transfusions or are independently associated with complications after cardiac surgery is unknown.
  
  
  METHODS
  Data from two randomized controlled studies were combined to analyze the effects of PLT and/or plasma transfusions on postoperative infections, length of stay in the intensive care unit (ICU), all-cause mortality, and mortality in the presence or absence of infections in the postoperative period.
  
  
  RESULTS
  After adjusting for confounding factors, plasma units and not RBC transfusions were associated with all-cause mortality. White blood cell (WBC)-containing RBC transfusions and PLT transfusions were associated with mortality occurring in the presence of or after infections. The number of (WBC-containing) RBC transfusions was also significantly associated with postoperative infections and with ICU stay for 4 or more days.
  
  
  CONCLUSIONS
  Although it is difficult to separate the effects of blood components, we found that in cardiac surgery, perioperative plasma transfusions are independently associated with all-cause mortality. WBC-containing RBC transfusions and PLT transfusions are independently associated with mortality in the presence of infections in the postoperative period. Future transfusion studies in cardiac surgery should concomitantly consider the possible adverse effects of all the various transfused blood components.
authors.affiliation: Department of Immunohematology and Blood Transfusion and Cardiothoracic Surgery, Leiden University Medical Center, Leiden, The Netherlands. bilginyavuz@hotmail.com
authors.forename: Yavuz M
authors.initials: YM
authors.lastname: Bilgin
authors.forename: Leo M G
authors.initials: LM
authors.lastname: van de Watering
authors.forename: Michel I M
authors.initials: MI
authors.lastname: Versteegh
authors.forename: Marinus H J
authors.initials: MH
authors.lastname: van Oers
authors.forename: Eleftherios C
authors.initials: EC
authors.lastname: Vamvakas
authors.forename: Anneke
authors.initials: A
authors.lastname: Brand
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D006348:Cardiac Surgical Procedures / Q000401:mortality*; D005260:Female; D006801:Humans; D007239:Infections / Q000209:etiology / Q000401:mortality; D008297:Male; D008875:Middle Aged; D010949:Plasma; D017713:Platelet Transfusion / Q000401:mortality*; D011183:Postoperative Complications / Q000401:mortality*