• Andreas Koster, Armin Zittermann, Jochen Börgermann, Cornelius Knabbe, Jürgen Diekmann, Uwe Schirmer, and Jan F Gummert.
• Institute for Anesthesiology, Heart and Diabetes Center, NRW, Bad Oeynhausen, Ruhr-University Bochum, Bad Oeynhausen, Germany akoster@hdz-nrw.de.
• Eur J Cardiothorac Surg. 2016 Mar 1; 49 (3): 931-6.

ObjectivesIn cardiac surgery, the association between red blood cell (RBC) transfusion and clinical outcome is elusive. We investigated in a large cohort of patients who underwent isolated coronary artery bypass grafting (CABG) the effect of transfusion of 1-2 units of leucocyte-depleted RBCs on mortality and multiorgan failure.MethodsThe investigation included all patients from July 2009 to June 2014 who underwent CABG at our institution and received no (n = 1478) or 1-2 units of RBCs (n = 1528). The primary end-point was 30-day mortality; secondary end-points were major organ dysfunction. A subgroup analysis assessed the effect of the duration of RBC storage on patient outcome. Statistical analysis was performed using propensity score (PS) adjustment.ResultsThe 30-day mortality rate was 0.3% in the RBC- group and 0.2% in the RBC+ group. Compared with the RBC- group, PS-adjusted odds ratio (OR) of 30-day mortality in the RBC+ group was 0.29 [95% confidence interval (CI): 0.06-1.50; P = 0.14]. PS-adjusted OR of a 'prolonged intensive care unit (ICU) stay' (>48 h) was significantly higher in the RBC+ group than in the RBC- group [OR 1.49 (95% CI: 1.14-1.95); P = 0.004], but major clinical complications such as low cardiac output syndrome, stroke, haemofiltration, wound infection and prolonged mechanical ventilator support (>24 h) did not differ significantly between groups. Duration of blood storage was not independently associated with clinical outcome.ConclusionsOur data do not indicate a transfusion-related increase in mortality and multiorgan failure in patients undergoing isolated CABG.© The Author 2015. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

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