Leukodepleted Packed Red Blood Cells Transfusion in Patients Undergoing Major Cardiovascular Surgical Procedure: Systematic Review and Meta-Analysis
Background. Leukocytes contained in the allogeneic packed red blood cell (PRBC) are the cause of certain adverse reactions associated with blood transfusion. Leukoreduction consists of eliminating leukocytes in all blood products below the established safety levels for any patient type. In this syst...
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| Format: | Article |
| Language: | English |
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Wiley
2019-01-01
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| Series: | Cardiology Research and Practice |
| Online Access: | http://dx.doi.org/10.1155/2019/7543917 |
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| author | Daniel Simancas-Racines Ingrid Arevalo-Rodriguez Gerard Urrutia Diana Buitrago-Garcia Solange Núñez-González María José Martínez-Zapata Eva Madrid Xavier Bonfill Ricardo Hidalgo-Ottolenghi |
| author_facet | Daniel Simancas-Racines Ingrid Arevalo-Rodriguez Gerard Urrutia Diana Buitrago-Garcia Solange Núñez-González María José Martínez-Zapata Eva Madrid Xavier Bonfill Ricardo Hidalgo-Ottolenghi |
| author_sort | Daniel Simancas-Racines |
| collection | DOAJ |
| description | Background. Leukocytes contained in the allogeneic packed red blood cell (PRBC) are the cause of certain adverse reactions associated with blood transfusion. Leukoreduction consists of eliminating leukocytes in all blood products below the established safety levels for any patient type. In this systematic review, we appraise the clinical effectiveness of allogeneic leukodepleted (LD) PRBC transfusion for preventing infections and death in patients undergoing major cardiovascular surgical procedures. Methods. We searched randomized controlled trials (RCT), enrolling patients undergoing a major cardiovascular surgical procedure and transfused with LD-PRBC. Data were extracted, and risk of bias was assessed according to Cochrane guidelines. In addition, trial sequential analysis (TSA) was used to assess the need of conducting additional trials. Quality of the evidence was assessed using the GRADE approach. Results. Seven studies met the eligibility criteria. Quality of the evidence was rated as moderate for both outcomes. The risk ratio for death from any cause comparing the LD-PRBC versus non-LD-PRBC group was 0.69 (CI 95% = 0.53 to 0.90; I2 = 0%). The risk ratio for infection in the same comparison groups was 0.77 (CI 95% = 0.66 to 0.91; I2 = 0%). TSA showed a conclusive result in this outcome. Conclusions. We found evidence that supports the routine use of leukodepletion in patients undergoing a major cardiovascular surgical procedure requiring PRBC transfusion to prevent death and infection. In the case of infection, the evidence should be considered sufficient and conclusive and hence indicated that further trials would not be required. |
| format | Article |
| id | doaj-art-1c721b6ae16c48b0b86d565ede3cd892 |
| institution | Kabale University |
| issn | 2090-8016 2090-0597 |
| language | English |
| publishDate | 2019-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Cardiology Research and Practice |
| spelling | doaj-art-1c721b6ae16c48b0b86d565ede3cd8922025-02-03T01:28:42ZengWileyCardiology Research and Practice2090-80162090-05972019-01-01201910.1155/2019/75439177543917Leukodepleted Packed Red Blood Cells Transfusion in Patients Undergoing Major Cardiovascular Surgical Procedure: Systematic Review and Meta-AnalysisDaniel Simancas-Racines0Ingrid Arevalo-Rodriguez1Gerard Urrutia2Diana Buitrago-Garcia3Solange Núñez-González4María José Martínez-Zapata5Eva Madrid6Xavier Bonfill7Ricardo Hidalgo-Ottolenghi8Cochrane Ecuador, Centro de Investigación en Salud Pública y Epidemiología Clínica (CISPEC), Facultad de Ciencias de la Salud Eugenio Espejo, Universidad UTE, Quito 170129, EcuadorCochrane Ecuador, Centro de Investigación en Salud Pública y Epidemiología Clínica (CISPEC), Facultad de Ciencias de la Salud Eugenio Espejo, Universidad UTE, Quito 170129, EcuadorCIBER Epidemiología y Salud Pública (CIBERESP), Iberoamerican Cochrane Centre Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona 08041, SpainCochrane Ecuador, Centro de Investigación en Salud Pública y Epidemiología Clínica (CISPEC), Facultad de Ciencias de la Salud Eugenio Espejo, Universidad UTE, Quito 170129, EcuadorCochrane Ecuador, Centro de Investigación en Salud Pública y Epidemiología Clínica (CISPEC), Facultad de Ciencias de la Salud Eugenio Espejo, Universidad UTE, Quito 170129, EcuadorCIBER Epidemiología y Salud Pública (CIBERESP), Iberoamerican Cochrane Centre Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona 08041, SpainCentro Interdisciplinario de Estudios en Salud (CIESAL), Escuela de Medicina, Universidad de Valparaíso, Cochrane Chile, Valparaíso 2391415, ChileCIBER Epidemiología y Salud Pública (CIBERESP), Iberoamerican Cochrane Centre Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona 08041, SpainCochrane Ecuador, Centro de Investigación en Salud Pública y Epidemiología Clínica (CISPEC), Facultad de Ciencias de la Salud Eugenio Espejo, Universidad UTE, Quito 170129, EcuadorBackground. Leukocytes contained in the allogeneic packed red blood cell (PRBC) are the cause of certain adverse reactions associated with blood transfusion. Leukoreduction consists of eliminating leukocytes in all blood products below the established safety levels for any patient type. In this systematic review, we appraise the clinical effectiveness of allogeneic leukodepleted (LD) PRBC transfusion for preventing infections and death in patients undergoing major cardiovascular surgical procedures. Methods. We searched randomized controlled trials (RCT), enrolling patients undergoing a major cardiovascular surgical procedure and transfused with LD-PRBC. Data were extracted, and risk of bias was assessed according to Cochrane guidelines. In addition, trial sequential analysis (TSA) was used to assess the need of conducting additional trials. Quality of the evidence was assessed using the GRADE approach. Results. Seven studies met the eligibility criteria. Quality of the evidence was rated as moderate for both outcomes. The risk ratio for death from any cause comparing the LD-PRBC versus non-LD-PRBC group was 0.69 (CI 95% = 0.53 to 0.90; I2 = 0%). The risk ratio for infection in the same comparison groups was 0.77 (CI 95% = 0.66 to 0.91; I2 = 0%). TSA showed a conclusive result in this outcome. Conclusions. We found evidence that supports the routine use of leukodepletion in patients undergoing a major cardiovascular surgical procedure requiring PRBC transfusion to prevent death and infection. In the case of infection, the evidence should be considered sufficient and conclusive and hence indicated that further trials would not be required.http://dx.doi.org/10.1155/2019/7543917 |
| spellingShingle | Daniel Simancas-Racines Ingrid Arevalo-Rodriguez Gerard Urrutia Diana Buitrago-Garcia Solange Núñez-González María José Martínez-Zapata Eva Madrid Xavier Bonfill Ricardo Hidalgo-Ottolenghi Leukodepleted Packed Red Blood Cells Transfusion in Patients Undergoing Major Cardiovascular Surgical Procedure: Systematic Review and Meta-Analysis Cardiology Research and Practice |
| title | Leukodepleted Packed Red Blood Cells Transfusion in Patients Undergoing Major Cardiovascular Surgical Procedure: Systematic Review and Meta-Analysis |
| title_full | Leukodepleted Packed Red Blood Cells Transfusion in Patients Undergoing Major Cardiovascular Surgical Procedure: Systematic Review and Meta-Analysis |
| title_fullStr | Leukodepleted Packed Red Blood Cells Transfusion in Patients Undergoing Major Cardiovascular Surgical Procedure: Systematic Review and Meta-Analysis |
| title_full_unstemmed | Leukodepleted Packed Red Blood Cells Transfusion in Patients Undergoing Major Cardiovascular Surgical Procedure: Systematic Review and Meta-Analysis |
| title_short | Leukodepleted Packed Red Blood Cells Transfusion in Patients Undergoing Major Cardiovascular Surgical Procedure: Systematic Review and Meta-Analysis |
| title_sort | leukodepleted packed red blood cells transfusion in patients undergoing major cardiovascular surgical procedure systematic review and meta analysis |
| url | http://dx.doi.org/10.1155/2019/7543917 |
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