Blood Transfusions Linked to Surgery Complications

The study raises another red flag about transfusions, an ancient medical practice that some doctors now believe is overused. “For 100 years we’ve assumed blood transfusions are good for people, but most of these clinical practices grew before we had the research to support it,” said co-author Neil Blumberg, M.D., professor of Pathology and Laboratory Medicine and director of Transfusion Medicine at the University of Rochester Medical Center.

In the current study, Blumberg and corresponding author Mary Rogers, Ph.D., of the University of Michigan, Department of Internal Medicine, analyzed the data of 380 adult Rochester, N.Y., patients who had primary coronary artery bypass graft surgery, primary valve replacement, or both, in 1997 or 1998 at Strong Memorial Hospital. Researchers looked at in-hospital deaths, lengths of stay, number of days of infection and fever, and whether any patients developed pulmonary dysfunction, a serious side effect of heart surgery.

Sixty percent of the patients were men and about 40 percent were women. However, the women were 44.6 percent more likely to receive a blood transfusion than the men. Of the 150 women studied, 149 (99 percent) received donor blood during their hospitalization, compared to 77 percent of the men. Reasons for the gender gap are unclear. Doctors typically measure a patient’s hematocrit value, or red blood cell count, before ordering a blood transfusion. Women tend to have lower concentrations of red blood cells than men throughout their lives, Blumberg said. This does not always warrant a transfusion, as the red cell concentration alone does not determine the likelihood of complications from anemia.

The study showed that when men and women had equivalent, normal preoperative red blood counts, 99 percent of the women still received transfusions, compared to 62 percent of the men. This suggests a reliance on the red cell concentration as the prime factor in determining when a transfusion is given, the authors said. Although a direct connection between blood transfusions and infections is being debated among scientists, several studies support the notion that donor blood can provoke a negative response from the patient’s immune system.; Source: University of Rochester Medical Center