Is Transfusion Associated With Graft Occlusion After Cardiac Operations?

Effects of Blood Transfusion on Cause-Specific Late Mortality After Coronary Artery Bypass Grafting—Less Is More

“…We have previously reported that blood transfusions are associated with a 21% higher risk coronary artery graft failure [18], a possible mechanism for the observed increased mortality in the current analysis. Indirect supportive evidence for this hypothesis is that a similar increased risk of death was not noted among patients undergoing non-CABG cardiac valve operations [26].…”

“…Numerous studies, over more than 2 decades, have shown deleterious effects of transfusion after cardiac surgery including on intermediate to late survival [7,[9][10][11][12] and long-term health-related quality of life [13], in addition to the increased incidence of perioperative complications, some of which are directly linked to transfusion [14][15][16][17][18][19]. Studies investigating the deleterious effects of packed RBC transfusions, in particular long term, have been limited to analyses of all-cause mortality [7,[9][10][11][12], and that has not allowed objective conclusions regarding the possible mechanisms proposed for these transfusion effects.…”

The ACTA PORT-score for predicting perioperative risk of blood transfusion for adult cardiac surgery

“…The risk of transfusion may also be helpful for planning blood supply in the nearest (hospital) blood bank, and for aiding decisions about reserving blood specifically, which can again reduce costs associated with surgery, e.g. no need to cross match blood if ACTA-PORT score <15. shown to be associated with increased morbidity related to ischaemia, 20 infection, [21][22][23][24] renal impairment, 25 post-CABG graft occlusion 26 and acute lung injury. 27 With respect to longer term outcomes, Engoren and colleagues found that blood transfusion during cardiac surgery was associated with a doubling of the risk of death at 5 years.…”

Blood transfusion is associated with increased risk of perioperative complications and prolonged hospital duration of stay among patients undergoing amputation

“…44,46 Transfusion of banked blood has been shown to induce a state of relative procoagulation perhaps secondary to increases in tissue factor and plasminogen activator inhibitor, as well as a decrease in fibrinolytic activity. [47][48][49] Storage of red cells also can be associated with reduction in plasma fibrinogen and an increase red cell aggregability. 50 Another possible explanation is that systemic inflammation in response to blood transfusion can be associated with venous or graft thrombosis.…”