Transfusion in adults: 10-year survival of red cell, plasma and platelet recipients following transfusion.
OBJECTIVE
To determine the long-term survival of adult recipients (>16 years) transfused with red blood cells (RBC), platelets (PLT) and fresh frozen plasma (FFP) in England and Wales.


METHODS
The EASTR study (Epidemiology and Survival of Transfusion Recipients) was a national multi-centre epidemiological study with cross-sectional sampling from 29 representative hospitals in England supplied by NHS Blood and Transplant (NHSBT). Three separate groups of RBC (n = 9142), FFP (n = 4232) and PLT (3584) recipients were sampled over 1 year (1 October 2001-30 September 2002), with prospective survival monitoring for 10 years. This study presents the data for adult recipients (>16 years of age).


RESULTS
The median age interquartile range (IQR) of adult transfusion recipients was RBC 70 (54-79), FFP 66 (51-76), PLT 62 (48-72). The 10-year survival for adult RBC, FFP and PLT recipients was highest for RBC recipients at 36% confidence interval (CI 35-37%, n = 8675), compared with 30% for both FFP (CI 29-32%, n = 3849) and PLT (CI 28-30%, n = 3110) recipients. In all groups, post-transfusion survival decreased with age, and a risk-adjusted analysis showed that reason for transfusion, transfusion type (surgical or medical) and cancer diagnosis (presence or absence) were all significantly associated with survival. Older patients with cancer receiving a medical rather than surgical transfusion had the highest hazard of death.


CONCLUSIONS
This study shows that survival following transfusion in England is broadly similar to that reported in other wealthy nations. More than 70% of recipients die within 10 years of transfusion, but long-term survival is common in younger patients (>80% 10-year survival in RBC recipients aged 16-39 years).
Cambridge Blood Centre, NHS Blood and Transplant, Cambridge, UK. slm38@cam.ac.uk.
S L
SL
Morley
Cambridge Blood Centre, NHS Blood and Transplant, Cambridge, UK.
C L
CL
Hudson
Cambridge Blood Centre, NHS Blood and Transplant, Cambridge, UK.
C A
CA
Llewelyn
Scottish National Blood Transfusion Service, Edinburgh, UK.
A W
AW
Wells
MRC Clinical Trials Unit, University College London, London, UK.
A L
AL
Johnson
Cambridge Blood Centre, NHS Blood and Transplant, Cambridge, UK.
L M
LM
Williamson
D000293:Adolescent; D000328:Adult; D000368:Aged; D017707:Erythrocyte Transfusion / Q000401:mortality*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010949:Plasma; D017713:Platelet Transfusion / Q000401:mortality*; D012189:Retrospective Studies; D015996:Survival Rate; D013997:Time Factors
blood transfusion; epidemiology; survival