Can we be certain that storage duration of transfused red blood cells does not affect patient outcomes?

Red cell transfusion is one of the most common forms of medical intervention in hospitals. Optimal practice continues to be defined through randomised trials, with evidence then pooled in meta-analyses. Prolonged storage of red blood cells is associated with cellular and biochemical changes,1 2 and...

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Main Authors: Trivella, M, Stanworth, S, Brunskill, S, Dutton, P, Altman, D
Format: Journal article
Language:English
Published: BMJ Publishing Group 2019
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author Trivella, M
Stanworth, S
Brunskill, S
Dutton, P
Altman, D
author_facet Trivella, M
Stanworth, S
Brunskill, S
Dutton, P
Altman, D
author_sort Trivella, M
collection OXFORD
description Red cell transfusion is one of the most common forms of medical intervention in hospitals. Optimal practice continues to be defined through randomised trials, with evidence then pooled in meta-analyses. Prolonged storage of red blood cells is associated with cellular and biochemical changes,1 2 and this has led to numerous studies exploring whether the age of red blood cells might influence clinical outcomes. Establishing clinical consequences of storage effects on red blood cells would be of major importance for blood transfusion services. The four most recent randomised trials (ABLE,3 RECESS,4 INFORM,5 and TRANSFUSE6 ; box 1) analysed nearly 30 000 patients who received transfusions, reporting neither benefit nor harm from cells with different storage durations. These results should provide adequate reassurance that storage duration has no clinical impact. Several older and smaller trials,7-21 as well as recent meta-analyses,22-24 have reported similar conclusions. However, clinical, methodological, and statistical problems may have affected the analysis and interpretation of trial results. Here, we discuss the difficulties in analysing the trials and suggest some solutions.
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spelling oxford-uuid:5c45da29-7b04-4d66-ba57-a4ae20bef91a2022-03-26T17:27:07ZCan we be certain that storage duration of transfused red blood cells does not affect patient outcomes?Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:5c45da29-7b04-4d66-ba57-a4ae20bef91aEnglishSymplectic Elements at OxfordBMJ Publishing Group2019Trivella, MStanworth, SBrunskill, SDutton, PAltman, DRed cell transfusion is one of the most common forms of medical intervention in hospitals. Optimal practice continues to be defined through randomised trials, with evidence then pooled in meta-analyses. Prolonged storage of red blood cells is associated with cellular and biochemical changes,1 2 and this has led to numerous studies exploring whether the age of red blood cells might influence clinical outcomes. Establishing clinical consequences of storage effects on red blood cells would be of major importance for blood transfusion services. The four most recent randomised trials (ABLE,3 RECESS,4 INFORM,5 and TRANSFUSE6 ; box 1) analysed nearly 30 000 patients who received transfusions, reporting neither benefit nor harm from cells with different storage durations. These results should provide adequate reassurance that storage duration has no clinical impact. Several older and smaller trials,7-21 as well as recent meta-analyses,22-24 have reported similar conclusions. However, clinical, methodological, and statistical problems may have affected the analysis and interpretation of trial results. Here, we discuss the difficulties in analysing the trials and suggest some solutions.
spellingShingle Trivella, M
Stanworth, S
Brunskill, S
Dutton, P
Altman, D
Can we be certain that storage duration of transfused red blood cells does not affect patient outcomes?
title Can we be certain that storage duration of transfused red blood cells does not affect patient outcomes?
title_full Can we be certain that storage duration of transfused red blood cells does not affect patient outcomes?
title_fullStr Can we be certain that storage duration of transfused red blood cells does not affect patient outcomes?
title_full_unstemmed Can we be certain that storage duration of transfused red blood cells does not affect patient outcomes?
title_short Can we be certain that storage duration of transfused red blood cells does not affect patient outcomes?
title_sort can we be certain that storage duration of transfused red blood cells does not affect patient outcomes
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AT duttonp canwebecertainthatstoragedurationoftransfusedredbloodcellsdoesnotaffectpatientoutcomes
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