Blood transfusion and blood conservation (techniques or strategiesto avoid the need for blood) are complementary activities thatconstitute the clinical arena of transfusion medicine. Recentimprovements in the safety of the blood supply and the increasingcosts associated with transfusion therapies have led to a reevaluationof the clinical practices of blood transfusion and blood conservation.Among the issues that have been reevaluated are the thresholdfor transfusion at which the benefits outweigh the risks andthe identification of patients most likely to benefit from bloodconservation. This review summarizes recent developments intransfusion medicine that have affected the . . . [Full Text of this Article]
Trends in Blood Use and Collection
Risks of Blood Transfusion
Transmission of HIV
Transmission of HBV and HBC
Transmission of Other Viruses
Hemolytic Reactions
Contamination of Red Cells
Contamination of Platelets
Transfusion-Related Acute Lung Injury
Transfusion-Mediated Immunomodulation
Indications for Transfusion
Utilization Review
Intensive Care
Surgery
Guidelines for Transfusion
Conclusions
Source Information
From the Departments of Medicine and Pathology, Washington University School of Medicine, St. Louis (L.T.G.); the Departments of Pathology and Laboratory Medicine, University of North Carolina, Chapel Hill (M.E.B.); the Department of Pathology, Southern California Permanente Medical Group, Woodland Hills, Calif. (M.H.K.); and the Department of Pathology, DartmouthHitchcock Medical Center, Lebanon, N.H. (J.P.A.).
Address reprint requests to Dr. Goodnough at Washington University School of Medicine, Division of Laboratory Medicine, Box 8118, 660 S. Euclid Ave., St. Louis, MO 63110-1093.
References
Related Letters:
Transfusion Medicine
Valeri C. R., Pivacek L. E., Crowley J. P., Vandenberghe P., Peerlinck K., Popovsky M. A., Kelly J. S., Prielipp R. C., Goodnough L. T., Brecher M. E., Kanter M. H., AuBuchon J. P.
Extract |
Full Text
N Engl J Med 1999;
341:124-127, Jul 8, 1999.
Correspondence
Juneja, V., Keegan, P., Gootenberg, J. E., Rothmann, M. D., Shen, Y. L., Lee, K. Y., Weiss, K. D., Pazdur, R.
(2008). Continuing Reassessment of the Risks of Erythropoiesis-Stimulating Agents in Patients with Cancer. Clin. Cancer Res.
14: 3242-3247
[Abstract][Full Text]
Levy, J. H., Adkinson, N. F. Jr
(2008). Anaphylaxis During Cardiac Surgery: Implications for Clinicians. Anesth. Analg.
106: 392-403
[Abstract][Full Text]
Weber, R. S., Jabbour, N., Martin, R. C. G. II
(2008). Anemia and Transfusions in Patients Undergoing Surgery for Cancer. Ann. Surg. Oncol.
15: 34-45
[Abstract][Full Text]
Martinez, V., Monsaingeon-Lion, A., Cherif, K., Judet, T., Chauvin, M., Fletcher, D.
(2007). Transfusion strategy for primary knee and hip arthroplasty: impact of an algorithm to lower transfusion rates and hospital costs. Br J Anaesth
99: 794-800
[Abstract][Full Text]
Proudfit, C. L., Atta, E., Doyle, N. M.
(2007). Hemolytic Transfusion Reaction After Preoperative Prophylactic Blood Transfusion for Sickle Cell Disease in Pregnancy. Obstet Gynecol
110: 471-474
[Abstract][Full Text]
Nilsson, K. R., Berenholtz, S. M., Garrett-Mayer, E., Dorman, T., Klag, M. J., Pronovost, P. J.
(2007). Association Between Venous Thromboembolism and Perioperative Allogeneic Transfusion. Arch Surg
142: 126-132
[Abstract][Full Text]
DeBellis, R. J.
(2007). Anemia in critical care patients: Incidence, etiology, impact, management, and use of treatment guidelines and protocols. Am J Health Syst Pharm
64: S14-S21
[Abstract][Full Text]
Klumpp, T. R., Siegel, D. L.
(2007). Transfusion medicine. ASH-SAP
2007: 408-443
[Full Text]
Hogue, C. W., London, M. J.
(2006). Aprotinin Use During Cardiac Surgery: A New or Continuing Controversy?. Anesth. Analg.
103: 1067-1070
[Full Text]
O'Connor, P. J., Hanson, J., Finucane, B. T.
(2006). Induced hypotension with epidural/general anesthesia reduces transfusion in radical prostate surgery: [L'hypotension controlee, pendant l'anesthesie peridurale et generale combinee pour la prostatectomie radicale, reduit la necessite de transfusion].. Canadian J. Anesthesia
53: 873-880
[Abstract][Full Text]
Tang, Y.-D., Katz, S. D.
(2006). Anemia in Chronic Heart Failure: Prevalence, Etiology, Clinical Correlates, and Treatment Options. Circulation
113: 2454-2461
[Full Text]
Corwin, H. L., Eckardt, K.-U.
(2005). Erythropoietin in the critically ill: what is the evidence?. Nephrol Dial Transplant
20: 2605-2608
[Full Text]
Silver, M. R.
(2005). Anemia in the Long-term Ventilator-Dependent Patient With Respiratory Failure. Chest
128: 568S-575S
[Abstract][Full Text]
Ouellette, D. R.
(2005). The Impact of Anemia in Patients With Respiratory Failure. Chest
128: 576S-582S
[Abstract][Full Text]
Madjdpour, C., Spahn, D. R.
(2005). Allogeneic red blood cell transfusions: efficacy, risks, alternatives and indications. Br J Anaesth
95: 33-42
[Abstract][Full Text]
Leonard, R. C., Untch, M., Von Koch, F.
(2005). Management of anaemia in patients with breast cancer: role of epoetin. Ann Oncol
16: 817-824
[Abstract][Full Text]
Massicotte, L., Sassine, M.-P., Lenis, S., Seal, R. F., Roy, A.
(2005). Survival rate changes with transfusion of blood products during liver transplantation: [Le taux de survie change avec la transfusion de produits sanguins pendant la transplantation hepatique]. Canadian J. Anesthesia
52: 148-155
[Abstract][Full Text]
Linenberger, M. L., Price, T. H.
(2005). Use of Cellular and Plasma Apheresis in the Critically Ill Patient: Part 1: Technical and Physiological Considerations. J Intensive Care Med
20: 18-27
[Abstract]
Raghavan, M., Marik, P. E.
(2005). Anemia, Allogenic Blood Transfusion, and Immunomodulation in the Critically Ill. Chest
127: 295-307
[Abstract][Full Text]
Szegedi, L. L., Van der Linden, P., Ducart, A., Cosaert, P., Poelaert, J., Vermassen, F., Mortier, E. P., d'Hollander, A. A.
(2005). The Effects of Acute Isovolemic Hemodilution on Oxygenation During One-Lung Ventilation. Anesth. Analg.
100: 15-20
[Abstract][Full Text]
Spiess, B. D.
(2004). Transfusion of Blood Products Affects Outcome in Cardiac Surgery. SEMIN CARDIOTHORAC VASC ANESTH
8: 267-281
[Abstract]
Ali, Z. A., Lim, E., Motalleb-Zadeh, R., Ali, A. A., Callaghan, C. J., Gerrard, C., Vuylsteke, A., Foweraker, J., Tsui, S.
(2004). Allogenic Blood Transfusion Does Not Predispose to Infection After Cardiac Surgery. Ann. Thorac. Surg.
78: 1542-1546
[Abstract][Full Text]
Arora, R. C., Legare, J.-F., Buth, K. J., Sullivan, J. A., Hirsch, G. M.
(2004). Identifying Patients at Risk of Intraoperative and Postoperative Transfusion in Isolated CABG: Toward Selective Conservation Strategies. Ann. Thorac. Surg.
78: 1547-1554
[Abstract][Full Text]
Felker, G.M., Adams, K. F. Jr, Gattis, W. A., O'Connor, C. M.
(2004). Anemia as a risk factor and therapeutic target in heart failure. J Am Coll Cardiol
44: 959-966
[Abstract][Full Text]
Marcucci, C., Madjdpour, C., Spahn, D. R.
(2004). Allogeneic blood transfusions: benefit, risks and clinical indications in countries with a low or high human development index. Br Med Bull
70: 15-28
[Abstract][Full Text]
Bombeli, T., Spahn, D. R.
(2004). Updates in perioperative coagulation: physiology and management of thromboembolism and haemorrhage. Br J Anaesth
93: 275-287
[Abstract][Full Text]
Pierson, J. L., Hannon, T. J., Earles, D. R.
(2004). A Blood-Conservation Algorithm to Reduce Blood Transfusions After Total Hip and Knee Arthroplasty. JBJS
86: 1512-1518
[Abstract][Full Text]
Couvret, C., Laffon, M., Baud, A., Payen, V., Burdin, P., Fusciardi, J.
(2004). A Restrictive Use of Both Autologous Donation and Recombinant Human Erythropoietin Is an Efficient Policy for Primary Total Hip or Knee Arthroplasty. Anesth. Analg.
99: 262-271
[Abstract][Full Text]
Espinosa, G, Bucciarelli, S, Cervera, R, Lozano, M, Reverter, J-C, de la Red, G, Gil, V, Ingelmo, M, Font, J, Asherson, R A
(2004). Thrombotic microangiopathic haemolytic anaemia and antiphospholipid antibodies. Ann Rheum Dis
63: 730-736
[Abstract][Full Text]
Marret, E., Bonnin, P., Mazoyer, E., Riou, B., Jacobs, T., Coriat, P., Samama, C.-M.
(2004). The Effects of a Polymerized Bovine-Derived Hemoglobin Solution in a Rabbit Model of Arterial Thrombosis and Bleeding. Anesth. Analg.
98: 604-610
[Abstract][Full Text]
Cheng, D.C.H., Mazer, C. D., Martineau, R., Ralph-Edwards, A., Karski, J., Robblee, J., Finegan, B., Hall, R. I., Latimer, R., Vuylsteke, A.
(2004). A phase II dose-response study of hemoglobin raffimer (Hemolink) in elective coronary artery bypass surgery. J. Thorac. Cardiovasc. Surg.
127: 79-86
[Abstract][Full Text]
Nahum, E., Ben-Ari, J., Schonfeld, T.
(2004). Blood Transfusion Policy among European Pediatric Intensive Care Physicians. J Intensive Care Med
19: 38-43
[Abstract]
Saldivar, E., Cabrales, P., Tsai, A. G., Intaglietta, M.
(2003). Microcirculatory changes during chronic adaptation to hypoxia. Am. J. Physiol. Heart Circ. Physiol.
285: H2064-H2071
[Abstract][Full Text]
Ririe, D. G., David, L. R., Glazier, S. S., Smith, T. E., Argenta, L. C.
(2003). Surgical Advancement Influences Perioperative Care: A Comparison of Two Surgical Techniques for Sagittal Craniosynostosis Repair. Anesth. Analg.
97: 699-703
[Abstract][Full Text]
Nissenson, A. R., Goodnough, L. T., Dubois, R. W.
(2003). Anemia: Not Just an Innocent Bystander?. Arch Intern Med
163: 1400-1404
[Full Text]
Massicotte, L.
(2003). LIVER TRANSPLANTS: SHOULD WE TRANSFUSE?. Canadian J. Anesthesia
50: A88-88
[Full Text]
Lutz, J. T., Valentin-Gamazo, C., Gorlinger, K., Malago, M., Peters, J.
(2003). Blood-Transfusion Requirements and Blood Salvage in Donors Undergoing Right Hepatectomy for Living Related Liver Transplantation. Anesth. Analg.
96: 351-355
[Abstract][Full Text]
Corwin, H. L., Gettinger, A., Pearl, R. G., Fink, M. P., Levy, M. M., Shapiro, M. J., Corwin, M. J., Colton, T., for the EPO Critical Care Trials Group,
(2002). Efficacy of Recombinant Human Erythropoietin in Critically Ill Patients: A Randomized Controlled Trial. JAMA
288: 2827-2835
[Abstract][Full Text]
Carson, J. L.
(2002). Should Patients in Intensive Care Units Receive Erythropoietin?. JAMA
288: 2884-2886
[Full Text]
Chow, E. J., Holly, E. A.
(2002). Blood Transfusions and Non-Hodgkin's Lymphoma. Epidemiol Rev
24: 269-279
[Full Text]
Keating, E. M., Meding, J. B.
(2002). Perioperative Blood Management Practices in Elective Orthopaedic Surgery. J Am Acad Orthop Surg
10: 393-400
[Abstract][Full Text]
McLellan, S. A., Walsh, T. S., McClellan, D. B. L.
(2002). Editorial II: Should we demand fresh red blood cells for perioperative and critically ill patients?. Br J Anaesth
89: 537-540
[Full Text]
Corwin, H. L., Hampers, M. D., Surgenor, S. D.
(2002). Blood Transfusion Issues in the Critically Ill. SEMIN CARDIOTHORAC VASC ANESTH
6: 271-278
[Abstract]
Vansteenkiste, J., Pirker, R., Massuti, B., Barata, F., Font, A., Fiegl, M., Siena, S., Gateley, J., Tomita, D., Colowick, A. B., Musil, J.
(2002). Double-Blind, Placebo-Controlled, Randomized Phase III Trial of Darbepoetin Alfa in Lung Cancer Patients Receiving Chemotherapy. JNCI J Natl Cancer Inst
94: 1211-1220
[Abstract][Full Text]
Casati, V., Sandrelli, L., Speziali, G., Calori, G., Grasso, M. A., Spagnolo, S.
(2002). Hemostatic effects of tranexamic acid in elective thoracic aortic surgery: A prospective, randomized, double-blind, placebo-controlled study. J. Thorac. Cardiovasc. Surg.
123: 1084-1091
[Abstract][Full Text]
Horowitz, N. S., Gibb, R. K., Menegakis, N. E., Mutch, D. G., Rader, J. S., Herzog, T. J.
(2002). Utility and Cost-Effectiveness of Preoperative Autologous Blood Donation in Gynecologic and Gynecologic Oncology Patients. Obstet Gynecol
99: 771-776
[Abstract][Full Text]
Chow, E. J., Holly, E. A.
(2002). Blood Transfusions as a Risk Factor for Non-Hodgkin's Lymphoma in the San Francisco Bay Area: A Population-based Study. Am J Epidemiol
155: 725-731
[Abstract][Full Text]
Couture, D. E., Ellegala, D. B., Dumont, A. S., Mintz, P. D., Kassell, N. F.
(2002). Blood Use in Cerebrovascular Neurosurgery. Stroke
33: 994-997
[Abstract][Full Text]
Sprung, J., Kindscher, J. D., Wahr, J. A., Levy, J. H., Monk, T. G., Moritz, M. W., O'Hara, P. J.
(2002). The Use of Bovine Hemoglobin Glutamer-250 (Hemopure(R)) in Surgical Patients: Results of a Multicenter, Randomized, Single-Blinded Trial. Anesth. Analg.
94: 799-808
[Abstract][Full Text]
Couvret, C., Tricoche, S., Baud, A., Dabo, B., Buchet, S., Palud, M., Fusciardi, J.
(2002). The Reduction of Preoperative Autologous Blood Donation for Primary Total Hip or Knee Arthroplasty: The Effect on Subsequent Transfusion Rates. Anesth. Analg.
94: 815-823
[Abstract][Full Text]
Despotis, G. J., Avidan, M. S., Hogue, C. W. Jr
(2001). Mechanisms and attenuation of hemostatic activation during extracorporeal circulation. Ann. Thorac. Surg.
72: S1821-1831
[Abstract][Full Text]
Spiess, B. D.
(2001). Blood transfusion: the silent epidemic. Ann. Thorac. Surg.
72: S1832-1837
[Abstract][Full Text]
Goodnough, L. T., Bach, R. G.
(2001). Anemia, Transfusion, and Mortality. NEJM
345: 1272-1274
[Full Text]
Ciaravino, V, McCullough, T, Dayan, A D
(2001). Pharmacokinetic and toxicology assessment of INTERCEPT (S-59 and UVA treated) platelets. Hum Exp Toxicol
20: 533-550
[Abstract]
Kottke-Marchant, K., Sapatnekar, S.
(2001). Hemostatic Abnormalities in Cardiopulmonary Bypass: Pathophysiologic and Transfusion Considerations. SEMIN CARDIOTHORAC VASC ANESTH
5: 187-206
[Abstract]
Skubas, N. J., Despotis, G. J.
(2001). Optimal Management of Bleeding Complications After Cardiac Surgery. SEMIN CARDIOTHORAC VASC ANESTH
5: 217-228
[Abstract]
Cross, M H
(2001). Autotransfusion in cardiac surgery. Perfusion
16: 391-400
[Abstract]
Sonzogni, V., Crupi, G., Poma, R., Annechino, F., Ferri, F., Filisetti, P., Bellavita, P.
(2001). Erythropoietin therapy and preoperative autologous blood donation in children undergoing open heart surgery. Br J Anaesth
87: 429-434
[Abstract][Full Text]
Innerhofer, P., Wiedermann, F. J., Tiefenthaler, W., Schobersberger, W., Klingler, A., Velik-Salchner, C., Oswald, E., Salner, E., Irschick, E., Kuhbacher, G.
(2001). Are Leukocytes in Salvaged Washed Autologous Blood Harmful for the Recipient? The Results of a Pilot Study. Anesth. Analg.
93: 566-572
[Abstract][Full Text]
Kuter, D. J., Goodnough, L. T., Romo, J., DiPersio, J., Peterson, R., Tomita, D., Sheridan, W., McCullough, J.
(2001). Thrombopoietin therapy increases platelet yields in healthy platelet donors. Blood
98: 1339-1345
[Abstract][Full Text]
Protheroe, R., Nolan, J.
(2001). Which fluid to give?. Trauma
3: 151-160
[Abstract]
Mungai, M., Tegtmeier, G., Chamberland, M., Parise, M.
(2001). Transfusion-Transmitted Malaria in the United States from 1963 through 1999. NEJM
344: 1973-1978
[Abstract][Full Text]
Cerhan, J. R., Wallace, R. B., Dick, F., Kemp, J., Parker, A. S., Zheng, W., Sellers, T. A., Folsom, A. R.
(2001). Blood Transfusions and Risk of Non-Hodgkin's Lymphoma Subtypes and Chronic Lymphocytic Leukemia. Cancer Epidemiol. Biomarkers Prev.
10: 361-368
[Abstract][Full Text]
Yokota, K., Fujii, T., Kimura, K., Toriumi, T., Sari, A.
(2001). Life-Threatening Hypoxemic Respiratory Failure After Repair of Acute Type A Aortic Dissection: Successful Treatment with Venoarterial Extracorporeal Life Support Using a Prosthetic Graft Attached to the Right Axillary Artery. Anesth. Analg.
92: 872-876
[Full Text]
Quillen, K.
(2000). Hypotensive Transfusion Reactions in Patients Taking Angiotensin-Converting-Enzyme Inhibitors. NEJM
343: 1422-1423
[Full Text]
O'Connor, M. F., Apfelbaum, J. L.
(2000). Update on Transfusion Therapy. SEMIN CARDIOTHORAC VASC ANESTH
4: 236-243
[Abstract]
Dahmani, S., Orliaguet, G. A., Meyer, P. G., Blanot, S., Renier, D., Carli, P. A.
(2000). Perioperative blood salvage during surgical correction of craniosynostosis in infants. Br J Anaesth
85: 550-555
[Abstract][Full Text]
Groves, F. D., Linet, M. S., Travis, L. B., Devesa, S. S.
(2000). Cancer Surveillance Series: Non-Hodgkin's Lymphoma Incidence by Histologic Subtype in the United States From 1978 Through 1995. JNCI J Natl Cancer Inst
92: 1240-1251
[Abstract][Full Text]
Despotis, G. J., Goodnough, L. T.
(2000). Management approaches to platelet-related microvascular bleeding in cardiothoracic surgery. Ann. Thorac. Surg.
70: S20-32
[Abstract][Full Text]
Murkin, J. M., Haig, G. M., Beer, K. J., McCutchen, J., Comunale, M. E., Hall, R., Ruzicka, B. B.
(2000). Aprotinin Decreases Exposure to Allogeneic Blood During Primary Unilateral Total Hip Replacement. JBJS
82: 675-675
[Abstract][Full Text]
Bifano, E. M.
(2000). Traditional and Nontraditional Approaches to the Prevention and Treatment of Neonatal Anemia. NeoReviews
1: e69-73
[Full Text]
HATZIDAKIS, A. M., MENDLICK, M. R., McKILLIP, T., REDDY, R. L., GARVIN, K. L.
(2000). Preoperative Autologous Donation for Total Joint Arthroplasty. An Analysis of Risk Factors for Allogenic Transfusion. JBJS
82: 89-100
[Abstract][Full Text]
Zohar, E., Fredman, B., Ellis, M., Luban, I., Stern, A., Jedeikin, R.
(1999). A Comparative Study of the Postoperative Allogeneic Blood-Sparing Effect of Tranexamic Acid Versus Acute Normovolemic Hemodilution After Total Knee Replacement. Anesth. Analg.
89: 1382-1382
[Abstract][Full Text]
Corwin, H. L.
(1999). Blood Transfusion : First, Do No Harm!. Chest
116: 1149-1150
[Full Text]
Groopman, J. E., Itri, L. M.
(1999). Chemotherapy-Induced Anemia in Adults: Incidence and Treatment. JNCI J Natl Cancer Inst
91: 1616-1634
[Abstract][Full Text]
Valeri, C. R., Pivacek, L. E., Crowley, J. P., Vandenberghe, P., Peerlinck, K., Popovsky, M. A., Kelly, J. S., Prielipp, R. C., Goodnough, L. T., Brecher, M. E., Kanter, M. H., AuBuchon, J. P.
(1999). Transfusion Medicine. NEJM
341: 124-127
[Full Text]
Ely, E. W., Bernard, G. R.
(1999). Transfusions in Critically Ill Patients. NEJM
340: 467-468
[Full Text]