In a double-blind, randomized, placebo-controlled trial, we evaluated the ability of epoetin beta (recombinant human erythropoietin) to avoid allogeneic blood transfusions (ABT) and the associated risks in patients undergoing primary elective open-heart surgery and in whom autologous blood donation (ABD) was contraindicated. Five deaths were reported (case-fatality ratio of 2%), resulting in a mortality from acute HTR of 1 per 1.8 million transfused RBC units.31  This is similar to the figures calculated from 1994 to 1999 French hemovigilance2  (1 per 1.8 million transfused RBCs) and SHOT3  data (1 per 1.4 million components issued for transfusion). Silliman et al proposed that ABT may exercise a neutrophil-priming effect mediated by bioactive lipids that accumulate during storage.57  They postulated that rapidly deteriorating WBCs in stored RBCs release cytotoxic enzymes that may act on fragmented RBC membranes to produce mediators responsible for neutrophil priming and endothelial-cell activation.

Cox proportional hazard modeling was used to examine the association between the prognostic factors and the study endpoint.

A model of the health and economic impact of post-transfusion hepatitis C: application to cost-effectiveness analysis of further expansion of HCV screening protocols.

Such methods included multiple-reagent dipsticks to detect lowered glucose and pH secondary to bacterial metabolism, and visual inspection of components for poor platelet viability (due to low pH) reflected in absent or decreased platelet “swirling.”75  These methods had species-specific sensitivities in the order of 105 to 108 and more than 107 cfu/mL, respectively,75  thus meeting the letter—but not the spirit—of the 2004 AABB standard.

Eder et al reviewed 550 reports of suspected TRALI, including 72 fatalities, submitted to ARC in 2003 to 2005.24  Thirty-eight fatalities were categorized as probable TRALI, and 24 (63%) of them had occurred after FFP transfusion. The hemodynamic response to chronic anemia. Although the definitions of causes of ABT-related deaths and the proportion of reported adverse events have evolved since 1996, the SHOT data show no death definitely attributed to TRALI after 2004.4  It may be noteworthy that in October 2003 the United Kingdom started using fresh frozen plasma (FFP) primarily or exclusively from male donors,4  discarding plasma from female donors as the latter is sometimes implicated in TRALI1,3  because it may contain WBC antibodies due to alloimmunization during previous pregnancies.4  None of the 12 probable TRALI cases reported to SHOT in 2007 was associated with the transfusion of FFP.4  SHOT concluded that the reduction in TRALI observed in 2006 and 2007—when the lowest TRALI mortality rate was recorded since SHOT began—was “likely” due to the United Kingdom decision to change to preferential use of male plasma in 2003/2004.4. Calculation of sample size and statistical analyses.A retrospective review of 70 consecutive patients contraindicated for preoperative ABD suggested that approximately 70% of placebo patients would require ABT.

Many post-operative transfusions in this study were not compliant with accepted transfusion threshold guidelines. Use appropriate surgical techniques. Little research has been done about the effects of allogeneic blood transfusion (ABT) on the recurrence and prognosis in the cases with childhood acute lymphocytic leukemia (cALL). Aside from these established complications of ABT, randomized controlled trials comparing recipients of non–white blood cell (WBC)–reduced versus WBC-reduced blood components in cardiac surgery have documented increased mortality in association with the use of non-WBC–reduced ABT. Efficacy of different dosing regimens for recombinant human erythropoietin in a simulated perisurgical setting — The importance of iron availability in optimizing response. Poor response to treatment of renal anaemia with erythropoietin corrected by iron given intravenously. Copyright © 2020 Elsevier B.V. or its licensors or contributors. Multiple logistic regression analysis performed with the current data available on the day of surgery (without the inclusion of treatment group and blood loss as factors) suggests that preoperative Hct (P = .0004) and age (P = .0185) are independent predictors for the need for ABT in this model.

Fifteen epoetin beta and 21 placebo patients had 1 contraindication. Such investigations would have to show whether the preoperative rhEPO therapy without ABD was of importance in all elective surgical procedures, not just for the avoidance of ABT in heart surgery. Reduction in the risk of transmission of the 4 most frequently transmitted, potentially fatal, transfusion-acquired infections in the United States since the mid-1980s. Safety.All patients who received the trial medications at least once (n = 76) were analyzed for safety.

Only one patient (placebo) was below the transfusion threshold (Hb <6.9 g/dL or Hct <0.21).

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