The safety and efficacy of transfusing red blood cells stored for different durations: a systematic review and meta-analysis of randomized controlled trials.

Fu Cheng, Dongmei Yang, Jie Chen, Li Qin, Bin Tan
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Abstract

Objective: The aim of this work was to resolve the uncertainty of whether transfusion of fresher red blood cells (RBCs) is better or not with regard to the safety and efficacy.

Methods: This systematic review was performed in accordance with our protocol registered on PROSPERO (https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022379183).

Results: After a literature search, 13,247 records were identified, and 26 randomized controlled trials (RCTs) involving 53,859 participants were eligible and included in this review. The results in our review suggested that there was no significant effect of fresher vs older RBCs on mortality (relative risk [RR] = 1.04; 95% CI, 0.99-1.09; P = .39; I2 = 0%), transfusion reactions (RR = 0.87; 95% CI, 0.57-1.33; P = .64; I2 = 0%). However, the transfusion of fresher RBCs might increase the risk of nosocomial infection (RR = 1.11; 95% CI, 1.02-1.20; P = .02; I2 = 0%), whereas there was no significant difference in the fresh vs old subgroup (RR = 0.87; 95% CI, 0.68 to 1.12; P = .28; I2 = 0%).

Conclusion: Our study updated and reinforced the evidence of previously published systematic reviews that support the safety and efficiency of current practice of issuing the oldest available RBCs in the blood bank inventory.

输注储存不同时间的红细胞的安全性和有效性:随机对照试验的系统回顾和荟萃分析。
目的这项工作旨在解决输注新鲜红细胞(RBC)在安全性和有效性方面是否更好的不确定性:这项系统性综述是根据我们在 PROSPERO(https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022379183)上注册的协议进行的:经过文献检索,共找到 13,247 条记录,符合条件并纳入本次综述的随机对照试验(RCT)有 26 项,涉及 53,859 名参与者。综述结果表明,新鲜 RBC 与陈旧 RBC 相比,对死亡率(相对风险 [RR] = 1.04;95% CI,0.99-1.09;P = .39;I2 = 0%)、输血反应(RR = 0.87;95% CI,0.57-1.33;P = .64;I2 = 0%)没有显著影响。然而,输注较新鲜的红细胞可能会增加院内感染的风险(RR = 1.11;95% CI,1.02-1.20;P = .02;I2 = 0%),而新鲜与陈旧亚组没有显著差异(RR = 0.87;95% CI,0.68-1.12;P = .28;I2 = 0%):我们的研究更新并加强了之前发表的系统性综述的证据,这些证据支持目前发放血库库存中最陈旧的红细胞的做法的安全性和效率。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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