Blood transfusion: the epidemic continues.

SJ. Effect of blood transfusion on long-term survival after cardiac operation. Transfusion in coronary artery bypass grafting is associated with reduced long-term survival. Schönberger JPAM et al. Transfusion of red blood cells: the impact on short-term and long-term survival after coronary artery bypass grafting, a ten-year follow-up. The association of perioperative red blood cell transfusions and decreased long-term survival after cardiac surgery. Infectious complications after cardiac surgery: lack of association with fresh frozen plasma or platelet transfusions. transfusion in cardiac surgery does not confer increased risk for adverse morbid outcomes. function point-of-care tests in post-bypass cardiac surgery: are they rele-during cardiopulmonary bypass evaluated by a laser light-scattering method. transfusions during coronary artery bypass graft surgery are associated with serious adverse outcomes. [21] Blumberg N. Deleterious clinical effects of transfusion immunomodula-tion: proven beyond a reasonable doubt. A. Is increased mortality associated with post-operative infections after leukocytes containing red blood cell transfusions in cardiac surgery? An extended analysis. Transfus Med 2007;17:304–11. [23] van de Watering LM, Hermans J, Houbiers JG, van den Broek PJ, Bouter HBoer F et al. Beneficial effects of leukocyte depletion of transfused blood on postoperative complications in patients undergoing cardiac surgery: a randomized clinical trial. Circulation 1998;97:562–8. [24] Vamvakas EC. Meta-analysis of randomized controlled trials investigating the risk of postoperative infection in association with white blood cell-containing allogeneic blood transfusion: the effects of the type of trans-fused red blood cell product and surgical setting. Universal leukocyte reduction of transfused red cells does not provide benefit to patients undergoing cardiac surgery. There have been many advances in transfusion medicine over recent decades. There is also an increasing body of evidence relating to adverse effects of transfusion impacting on short-and long-term outcomes after cardiac surgery [1] This has also been reported in critically ill patients, those with acute coronary syndrome and trauma patients. Blood transfusion undoubtedly saves lives, but at what cost? Bhaskar recently reviewed the evidence relating to adverse outcomes , at the same time providing a foundation for transfusion practice, especially with regard to red cell transfusion [2]. Rawn commented on the silent risks of transfusion and characterized the impact of adverse events related to the disease processes noted above, referring to it as an epidemic [3]. Like any lifesaving therapy, there are risks and benefits. The risk–benefit equation relates to: • the benefit outweighing the risks, both short term (infection, survival , transfusion-related acute lung injury (TRALI), …