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Warning over blood transfusions

27/11/2007

Red blood cell transfusions given to people having heart surgery could increase the risk of heart attack or stroke, new research has found.

Scientists from the University of Bristol discovered that patients who received a transfusion had a three-fold increase in complications arising from lack of oxygen to key organs.

This finding contradicts the widely-held belief that red cell transfusion improves delivery of oxygen to tissues.

In the UK over half of all heart surgery patients are given blood, with about three per cent of these transfusions given because of life-threatening bleeding.

The study, published today in the journal Circulation, said the increased risk of complications was associated with transfusion even when haemoglobin levels (the oxygen-carrying substance in red blood cells), age, or level of patient disability at the time of transfusion were taken into account.

The study also found that the financial cost of giving transfusions and treating transfusion-related illnesses increased the overall cost of staying in hospital by over 40 per cent.

Gavin Murphy, the study's lead researcher, said: "[Cost implications] are important, particularly in modern health systems where resources are finite, and should encourage the sort of research that will address the major health issues raised in the study."

The researchers plan to carry out a larger study to determine whether changing transfusion guidelines could improve patient outcomes.

In the meantime they suggest that surgeons think twice before giving their patients a transfusion.

Professor Peter Weissberg, medical director at the British Heart Foundation, commented: "Red blood cells carry oxygen around the body to supply vital organs. Not unreasonably therefore, heart surgeons have assumed that patients who have low red blood cell counts after surgery - as a result of blood loss during or shortly after surgery - would benefit from a 'top up' transfusion of donated red blood cells.

"This study shows the importance of putting such widespread beliefs to the test since it suggests that such transfusions may cause more problems than they solve. The results are a step towards making heart surgery even safer by flagging up an issue we can now address through research and improved transfusion guidelines."
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