The effect of universal leukoreduction on postoperative infections and length of hospital stay in elective orthopedic and cardiac surgery

Llewelyn, Charlotte; Taylor, Rod S; Todd, Alexander D.; Stevens, Warren; Murphy, Mike; Williamson, Lorna M.

doi:10.1111/j.1537-2995.2004.03325.x

Cited by 60 publications

(52 citation statements)

References 35 publications

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“…In different studies, LR has been shown to have no effect on infection rates in colorectal surgery [32], elective orthopedic surgery [30], elective cardiac surgery [30,33], or elective major aortic surgery [25]. In-house mortality and LOS have also been shown to be equivalent in a general inpatient population receiving LR versus non-LR blood [34].…”

Section: Discussionmentioning

confidence: 95%

Leukoreduction Before Red Blood Cell Transfusion Has No Impact on Mortality in Trauma Patients

Phelan

Sperry

Friese

2007

Journal of Surgical Research

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Section: Discussionmentioning

confidence: 95%

Leukoreduction Before Red Blood Cell Transfusion Has No Impact on Mortality in Trauma Patients

Phelan

Sperry

Friese

2007

Journal of Surgical Research

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“…While five of these studies showed implementation of leukoreduction as associated with decreases in mortality, morbidity and/or costs [80,85,[87][88][89], two studies reported no apparent clinical benefit [88,90]. None of these clinical trials demonstrated any significant increase in morbidity, mortality and/or costs with leukoreduction, thus clearly leukoreduction is cost neutral, at worst [91].…”

Section: Blood Product Manipulationsmentioning

confidence: 94%

Transfusion immunomodulation from a clinical perspective: an update

Refaai

Blumberg

2013

Expert Review of Hematology

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Accumulated evidence demonstrates that allogeneic blood transfusions have clinically significant effects on the recipient's immune system. This transfusion immunomodulation effect is associated with an increased rate of cancer recurrence (uncertain causality) and post-operative infection (established causality). The exact mechanisms of transfusion immunomodulation are still unknown. Data suggests that transfusion immunomodulation is a biologic effect strongly associated with the infusion of allogeneic leukocytes. Soluble mediators that accumulate in transfused red cells and platelets during storage are also possible causes of post-transfusion complications. Some approaches can mitigate these effects. Most important is adopting more conservative transfusion practices. Leukoreduction (proven) and plasma depletion (proposed) are other methods to significantly reduce transfusion immunomodulation and its clinical sequela.

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“…No clear statement can be made whether universal leukoreduction was indeed associated with any clinical advantage with regard of overall mortality rate, infection rate, or cancer recurrence [74], [75], [76], [77], [78].…”

Section: Clinical Studies On Transfusion-related Immunomodulationmentioning

confidence: 99%

Transfusion-transmissible infections and transfusion-related immunomodulation

Buddeberg

Schimmer

Spahn

2008

Best Practice & Research Clinical Anaesthesiology

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Transfusion-transmissible infections and transfusion-related immunomodulation AbstractThe risk of acquiring a transfusion-transmitted infection has declined in recent years. However, after human immunodeficiency virus and hepatitis B and C virus transmission were successfully reduced, new pathogens are threatening the safety of the blood supply, especially in the face of rising numbers of immunocompromised transfusion recipients. Despite new standards in the manufacture and storage of blood products, bacterial contamination still remains a considerable cause of transfusion-related morbidity and mortality. Better allograft survival in kidney transplant patients and higher cancer recurrence rate in surgical oncology patients after allogeneic blood transfusions highlighted a previously underestimated side-effect: transfusion-related immunomodulation (TRIM). The precise pathomechanism still remains uncertain; however, its mostly deleterious effects--such as a higher incidence of postoperative or nosocomial infections--is increasingly accepted. Although transfusion-related immunomodulation is thought to be mediated mainly by donor white blood cells, the benefit of leukoreduction on overall mortality and on infectious complications is highly debatable. Transfusion-transmissible infections and Transfusion-related immunomodulation Transfusion-transmissible infections and Transfusion-related immunomodulation AbstractThe risk of acquiring a transfusion-transmitted infection has declined in recent years.

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The effect of universal leukoreduction on postoperative infections and length of hospital stay in elective orthopedic and cardiac surgery

Abstract: Implementation of ULR had no major impact on postoperative infection or LOS in patients undergoing elective surgical procedures who received transfusion(s). Smaller effects, either detrimental or beneficial of ULR, cannot be excluded.

Cited by 60 publications

References 35 publications

Leukoreduction Before Red Blood Cell Transfusion Has No Impact on Mortality in Trauma Patients

Leukoreduction Before Red Blood Cell Transfusion Has No Impact on Mortality in Trauma Patients

Transfusion immunomodulation from a clinical perspective: an update

Transfusion-transmissible infections and transfusion-related immunomodulation

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