title: Forum for debate: Safety of allogeneic blood transfusion alternatives in the surgical/critically ill patient.
abstract: In recent years, several safety alerts have questioned or restricted the use of some pharmacological alternatives to allogeneic blood transfusion in established indications. In contrast, there seems to be a promotion of other alternatives, based on blood products and/or antifibrinolytic drugs, which lack a solid scientific basis. The Multidisciplinary Autotransfusion Study Group and the Anemia Working Group España convened a multidisciplinary panel of 23 experts belonging to different healthcare areas in a forum for debate to: 1) analyze the different safety alerts referred to certain transfusion alternatives; 2) study the background leading to such alternatives, the evidence supporting them, and their consequences for everyday clinical practice, and 3) issue a weighted statement on the safety of each questioned transfusion alternative, according to its clinical use. The members of the forum maintained telematics contact for the exchange of information and the distribution of tasks, and a joint meeting was held where the conclusions on each of the items examined were presented and discussed. A first version of the document was drafted, and subjected to 4 rounds of review and updating until consensus was reached (unanimously in most cases). We present the final version of the document, approved by all panel members, and hope it will be useful for our colleagues.
authors.affiliation: Medicina Transfusional Perioperatoria, Facultad de Medicina, Universidad de Málaga, Málaga, España. Electronic address: mmunoz@uma.es.
authors.forename: M
authors.initials: M
authors.lastname: Muñoz Gómez
authors.affiliation: Servicio de Anestesiología y Reanimación, Hospital Universitario del Mar, Barcelona, España.
authors.forename: E
authors.initials: E
authors.lastname: Bisbe Vives
authors.affiliation: Servicio de Anestesiología y Reanimación, Hospital Clínic, Barcelona, España.
authors.forename: M
authors.initials: M
authors.lastname: Basora Macaya
authors.affiliation: Servicio de Transfusión, Hospital San Jorge, Huesca, España.
authors.forename: J A
authors.initials: JA
authors.lastname: García Erce
authors.affiliation: Servicio de Anestesiología y Reanimación, Hospital Universitario Virgen de la Victoria, Málaga, España.
authors.forename: A
authors.initials: A
authors.lastname: Gómez Luque
authors.affiliation: Servicio de Cuidados Críticos y Urgencias, Hospital Virgen del Rocío, Sevilla, España.
authors.forename: S R
authors.initials: SR
authors.lastname: Leal-Noval
authors.affiliation: Servicio de Anestesiología y Reanimación, Hospital Universitario Vall d'Hebron, Barcelona, España.
authors.forename: M J
authors.initials: MJ
authors.lastname: Colomina
authors.affiliation: Servicio de Cardiología, Hospital Universitario del Mar, Barcelona, España.
authors.forename: J
authors.initials: J
authors.lastname: Comin Colet
authors.affiliation: Banc de Sang i Teixits, Hospital Universitari de Tarragona Joan XXIII, Tarragona, España.
authors.forename: E
authors.initials: E
authors.lastname: Contreras Barbeta
authors.affiliation: Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario Miguel Servet, Zaragoza, España.
authors.forename: J
authors.initials: J
authors.lastname: Cuenca Espiérrez
authors.affiliation: Servicio de Medicina Intensiva, Hospital Universitario La Paz, Madrid, España.
authors.forename: A
authors.initials: A
authors.lastname: Garcia de Lorenzo Y Mateos
authors.affiliation: Servicio de Gastroenterología, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España.
authors.forename: F
authors.initials: F
authors.lastname: Gomollón García
authors.affiliation: Servicio de Farmacia, Hospital Miguel Servet, Zaragoza, España.
authors.forename: M
authors.initials: M
authors.lastname: Izuel Ramí
authors.affiliation: Servicio de Anestesiología, Reanimación y Tratamiento del Dolor, Hospital de la Santa Creu i Sant Pau, Barcelona, España.
authors.forename: M V
authors.initials: MV
authors.lastname: Moral García
authors.affiliation: Servicio de Farmacia, Hospital Universitario Vall d'Hebron, Barcelona, España.
authors.forename: J B
authors.initials: JB
authors.lastname: Montoro Ronsano
authors.affiliation: Servicio de Hematología, Clínica Universidad de Navarra, Pamplona, España.
authors.forename: J A
authors.initials: JA
authors.lastname: Páramo Fernández
authors.affiliation: Servicio de Hemoterapia y Hemostasia, Hospital Clínic de Barcelona, Barcelona, España.
authors.forename: A
authors.initials: A
authors.lastname: Pereira Saavedra
authors.affiliation: Servicio de Medicina Intensiva, Hospital Universitario La Paz, Madrid, España.
authors.forename: M
authors.initials: M
authors.lastname: Quintana Diaz
authors.affiliation: Servicio de Laboratorio de Hematología, Hospital de la Santa Creu i Sant Pau, Barcelona, España.
authors.forename: Á
authors.initials: Á
authors.lastname: Remacha Sevilla
authors.affiliation: Territorial Banc de Sang i Teixits Catalunya Central, Barcelona, España.
authors.forename: R
authors.initials: R
authors.lastname: Salinas Argente
authors.affiliation: Servicio de Anestesiología y Reanimación, Hospital General Universitario de Elda, Elda, Alicante, España.
authors.forename: C
authors.initials: C
authors.lastname: Sánchez Pérez
authors.affiliation: Unidad de Cuidados Intensivos, Hospital Royo Villanova, Zaragoza, España.
authors.forename: G
authors.initials: G
authors.lastname: Tirado Anglés
authors.affiliation: Unidad de Cuidados Intensivos, Hospital Universitario Germans Trías i Pujol, Badalona, Barcelona, España.
authors.forename: P
authors.initials: P
authors.lastname: Torrabadella de Reinoso
mesh_terms: D000740:Anemia / Q000188:drug therapy / Q000628:therapy*; D000933:Antifibrinolytic Agents / Q000009:adverse effects / Q000627:therapeutic use; D007611:Aprotinin / Q000009:adverse effects / Q000627:therapeutic use; D001779:Blood Coagulation Factors / Q000009:adverse effects / Q000627:therapeutic use; D001803:Blood Transfusion / Q000592:standards; D002986:Clinical Trials as Topic; D016638:Critical Illness / Q000628:therapy*; D000077324:Crystalloid Solutions; D004921:Erythropoietin / Q000009:adverse effects / Q000627:therapeutic use; D006397:Hematinics / Q000009:adverse effects / Q000627:therapeutic use; D006470:Hemorrhage / Q000628:therapy*; D006801:Humans; D006895:Hydroxyethyl Starch Derivatives / Q000009:adverse effects / Q000627:therapeutic use; D007501:Iron / Q000009:adverse effects / Q000627:therapeutic use; D007552:Isotonic Solutions / Q000009:adverse effects / Q000627:therapeutic use; D015201:Meta-Analysis as Topic; D064887:Observational Studies as Topic; D010952:Plasma Substitutes / Q000009:adverse effects / Q000627:therapeutic use; D011994:Recombinant Proteins / Q000009:adverse effects / Q000627:therapeutic use; D014148:Tranexamic Acid / Q000009:adverse effects / Q000627:therapeutic use; D065227:Transfusion Reaction
chemical_list: D000933:Antifibrinolytic Agents; D001779:Blood Coagulation Factors; D000077324:Crystalloid Solutions; C554270:EPO protein, human; D006397:Hematinics; D006895:Hydroxyethyl Starch Derivatives; D007552:Isotonic Solutions; D010952:Plasma Substitutes; D011994:Recombinant Proteins; D004921:Erythropoietin; C025667:prothrombin complex concentrates; D014148:Tranexamic Acid; D007611:Aprotinin; D007501:Iron
keywords: Allogeneic transfusion; Coloides; Criterios restrictivos de transfusión; Eritropoyesis; Erythropoiesis; Hydroxyethyl starch; Procoagulantes; Procoagulants; Restrictive transfusion criteria; Safety; Seguridad; Transfusión alogénica