Transfusion of sex-mismatched and non–leukocyte-depleted red blood cells in cardiac surgery increases mortality Henrik Bjursten, MD, PhD, Alain Dardashti,

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Presentation transcript:

Transfusion of sex-mismatched and non–leukocyte-depleted red blood cells in cardiac surgery increases mortality Henrik Bjursten, MD, PhD, Alain Dardashti, MD, PhD, Jonas Björk, PhD, Per Wierup, MD, PhD, Lars Algotsson, MD, PhD, Per Ederoth, MD, PhD The Journal of Thoracic and Cardiovascular Surgery Volume 152, Issue 1, Pages 223-232.e1 (July 2016) DOI: 10.1016/j.jtcvs.2015.12.022 Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 Kaplan-Meier curve comparing patients receiving only sex-matched blood (blue line) with only sex mismatched red blood cells (red line). Shaded area represents 95% confidence interval. The Journal of Thoracic and Cardiovascular Surgery 2016 152, 223-232.e1DOI: (10.1016/j.jtcvs.2015.12.022) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 Forest plot for RBC transfusion risk (0-12 years) in categories with HR (95% CI). RBC, Red blood cell; non-LD, non–leukocyte-depleted RBC unit; LD, leukocyte-depleted RBC unit; HR, hazard ratio. The Journal of Thoracic and Cardiovascular Surgery 2016 152, 223-232.e1DOI: (10.1016/j.jtcvs.2015.12.022) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

Figure 3 Forest plot for excess mortality risk for sex-mismatched RBCs expressed as HR (95% CI) for different time intervals and sex of recipient (0-12 years). HR, Hazard ratio. The Journal of Thoracic and Cardiovascular Surgery 2016 152, 223-232.e1DOI: (10.1016/j.jtcvs.2015.12.022) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

Figure 4 Forest plot for RBC transfusion risk (0-12 years) in categories with HR (95% CI) without preoperative laboratory parameters (eGFR, CRP, hemoglobin, and leukocytes) and sex mismatched blood in the Cox analysis. RBC, Red blood cell; non-LD, non–leukocyte-depleted RBC unit; LD, leukocyte-depleted RBC unit; HR, hazard ratio. The Journal of Thoracic and Cardiovascular Surgery 2016 152, 223-232.e1DOI: (10.1016/j.jtcvs.2015.12.022) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

Figure E1 Distribution during the study period of number of CABG (blue bar), AVR (red bar), and AVR + CABG (green bar). Transfusion rate as percent of patients receiving RBC transfusion (dark red line). The Journal of Thoracic and Cardiovascular Surgery 2016 152, 223-232.e1DOI: (10.1016/j.jtcvs.2015.12.022) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

Figure E2 Percentage of sex mismatched RBC transfusion (green line), and percentage non leukocyte depleted RBC (red line). The Journal of Thoracic and Cardiovascular Surgery 2016 152, 223-232.e1DOI: (10.1016/j.jtcvs.2015.12.022) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

Categorized hazard ratio for leukocyte-depleted and non–leukocyte-depleted blood. The Journal of Thoracic and Cardiovascular Surgery 2016 152, 223-232.e1DOI: (10.1016/j.jtcvs.2015.12.022) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions