Patients with heart disease who receive transfusions during surgeries do just as well with smaller amounts of blood and face no greater risk of dying from other diseases than patients who received more blood, according to a new Rutgers study. The research, published in the journal Lancet, measures overall mortality and mortality from cardiovascular disease, cancer, and severe infection, and offers new validation of a recent trend toward smaller transfusions.
For the study, led by Jeffrey Carson, chief of the Division of Internal Medicine at Rutgers Robert Wood Johnson Medical School, researchers followed 2,016 patients for as long as four years. Half received larger quantities of transfused blood; half received transfusions that were smaller by as much as two thirds. Carson and his team found no evidence of increased mortality from cardiovascular disease, cancer, or severe infection due to the amount of the blood given after surgery.
“There has been a steady decline in the amount of blood in transfusions given to patients in the past three to five years,” Carson says. “I think it is very reassuring that we have found that using less blood is okay not just from a short-term perspective, but also a long-term perspective.”
Clinicians have worried that larger amounts of transfused blood might suppress immune function—which could lead to death from infection or cancer—and that smaller transfusions might worsen a patient’s chronic heart disease by depriving the heart of oxygen and other nutrients that it might have absorbed by pumping more blood. But in both instances Carson found no difference in long-term death rates regardless of the number of transfusions.
Read the article summary at the Lancet website
