Relationship of postoperative septic complications and blood transfusions in patients with Crohn's disease

Deleterious clinical effects of transfusion-associated immunomodulation: fact or fiction?

“…Observational studies comparing patients with and without transfusion, and using multivariate analysis to adjust for the effects of confounding factors, almost uniformly support the hypothesis of an increased risk of postoperative infection in the transfusion group. 71,72,[74][75][76][77]79 However, in most of these studies, the reported allogeneic transfusion effects were not adjusted for the effects of illness severity and risk factors for postoperative infection at specific sites. 19,61 Reported RCTs investigating the association of perioperative allogeneic blood transfusion with postoperative infection were either unblinded or single-blind (Table 1), and no double-blind RCTs have been reported.…”

“…61 Until recently, observational studies reporting an association between allogeneic blood transfusion and postoperative infection did not adjust for the effects of severity of illness and/or risk factors for postoperative infection at specific sites. Some teams of investigators secured partial control for the effects of these variables by excluding UTIs from the definition of postoperative infection 69,71 ; by limiting the outcome variable to postoperative wound infection [72][73][74] ; or by adjusting for the effects of serum albumin, 75,76 insertion of a urinary catheter, 77,78 or presence of chronic systemic illness, 70 or diabetes mellitus. 79 However, adjustment for the effects of all these factors in combination has rarely been presented in the literature.…”

Transfusion-related bacterial sepsis

“…Numerous clinical studies have linked perioperative transfusion and an increased incidence of postsurgical bacterial infection (33,34,35,43,52,67,86,93,97,102,135,137 (136). In a prospective clinical study by Jensen and colleagues, the presence of donor leukocytes and platelets in transfused blood was highly correlated with increased incidence of bacterial infection of patients undergoing colorectal surgery (67).…”

Perioperative haemotherapy: II. Risks and complications of blood transfusion

“…[84][85][86][87][88][89][90][91][92][93] As in the cancer outcome studies, interpretation of the results is complicated by their retrospective nature and by the lack of consistent patient populations, methodology and outcome variables across the studies. These analyses are further limited because many of the independent variables are not independent at all.…”