Blood Transfusions Double risk of infection for Heart Bypass Patients

Doctors warn that while blood transfusions can save lives some patients are receiving them unnecessarily, putting them at risk of infection. They were also five times more likely to die in hospital and three times more likely to die within a month of the surgery as patients not given extra blood. Doctors warn that while blood transfusions can save lives some patients are receiving them unnecessarily, putting them at risk of infection.

Overall, the study found that 16 per cent of patients developed an infection after the surgery. But only seven seven per cent of patients who did not have a blood transfusion went on to have an infection, compared to 18 per cent of those who did receive blood from someone else. The vast majority of patients, more than eight in 10, did have some form of transfusion, researchers found.

The results of the study, which looked at almost 25,000 patients who had undergone a coronary artery bypass graft (CABG) over three years, also found that transfusion practices varied considerably between hospitals. Mary Rogers, from the University of Michigan, who led the team which carried out the study, warned that some patients were receiving blood transfusions unnecessarily. She said: “Clearly, blood transfusions are vital in the treatment of some conditions, such as life-threatening bleeding.

“However, over the past several decades a body of evidence has accumulated that indicates various adverse effects in patients who receive transfusions.” She added: “The safety of patients undergoing (bypass surgery) will likely be improved if hospitals carefully review current guidelines, closely adhere to such guidelines, and institute interventions to reduce inappropriate use of blood transfusions in recipients of CABG.”

Ellen Mason, senior cardiac nurse with the British Heart Foundation, said: “These findings raise questions about infection but clear conclusions about the risk from blood transfusion can’t be drawn because the study has limitations.

“Patients weren’t compared like-for-like and the methods of heart support during and after surgery aren’t specified – some techniques, such as a balloon pump, increase the risk of infections.

“In Britain we have a lower rate of blood transfusion during heart surgery than in America – where this study took place – and we are fortunate to have a highly regarded national blood transfusion service with a good standard of screening to ensure that donated blood is as safe as possible.

“There is no doubt that transfusions save lives when people have lost large volumes of blood during surgery or from an injury.

“However, it is now widely thought that ‘top-up’ transfusions during surgery can carry risks, and our researchers are working to clarify exactly when those risks outweigh benefits for patients.”

The findings were published in the journal BMC Medicine.