TRANSFUSE-RCT (STandaRd Issue TrANsfusion versuS Fresher red blood cell Use in intenSive carE (TRANSFUSE) – a randomised controlled trial)

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TRANSFUSE-RCT is a multi-centre, randomised, controlled trial, testing the effect of the freshest available red blood cell (RBC) unit compared to standard practice, on mortality in critically ill patients who require RBC transfusion.

Goal: The hypothesis was that in critically ill patients who require a RBC transfusion, compared to standard practice, administration of the freshest available compatible RBC decreased 90-day patient mortality. Patients were randomised to either the "Freshest available blood group" or the "Standard care group". Freshest available blood group: These patients received the freshest available group-specific compatible RBC unit in the transfusion service. Standard care group: These patients received standard practice, which was the oldest available group-specific compatible RBC unit in the transfusion service.

Rationale: RBC transfusion is a very common and potentially life-saving treatment in intensive care units (ICUs). However, RBC transfusion has also been associated with an increased risk of morbidity and/or mortality in critically ill patients. Although this association may reflect a variety of factors, attention has increasingly focused on the possible adverse impact of transfusing RBCs stored for a prolonged time, and have developed a so called "storage lesion". The term "storage lesion" refers to the fact that during the 42-days storage, in a way that increases over time, red cells develop important biochemical and structural derangements. These age-related changes in transfused RBCs may have important clinical consequences. However, clinical studies on this fascinating topic remain observational, often retrospective and have very conflicting results. Moreover, systematic reviews were inconclusive.

Study Progress: The TRANSFUSE-RCT commenced in 2012, with a recruitment target of 5,000 patients. The trial was conducted in 59 sites in Australia, New Zealand, Ireland, Finland and Saudi Arabia. The TRANSFUSE-RCT protocol and statistical analysis plan was published in 2014:

Kaukonen M, Bailey M, Ady B, Aubron C, French C, Gantner D, Irving D, Murray L, Nichol A, Pettila V, McQuilten Z, Cooper DJ. A randomised controlled trial of standard transfusion versus fresher red blood cell use in intensive care (TRANSFUSE): protocol and statistical analysis plan. Crit Care Resusc 2014;16:255-61.

Patient recruitment was completed in December 2016, and results published in 2017:

Cooper DJ, McQuilten ZK, Nichol A, Ady B, Aubron C, Bailey M, Bellomo R, Gantner D, Irving DO, Kaukonen KM, McArthur C, Murray L, Pettila V, French C. Age of Red Cells for Transfusion and Outcomes in Critically Ill Adults. N Engl J Med 2017;377:1858-67.

Trial Registration: ClinicalTrials.gov NCT01638416, ANZCTR 12612000453886.

Contact: For further information about this study, please contact the ANZIC-RC TRANSFUSE Project Manager Bridget Ady by email.

Photo of Bridget Ady

Protocol:

TRANSFUSE-RCT Protocol

Calculator:

APACHE III and RoD Calculator

Newsletters:

TRANSFUSE Newsletter Issue 1 (PDF, 171KB)

TRANSFUSE Newsletter Issue 2 (PDF, 122KB)

TRANSFUSE Newsletter Issue 3 (PDF, 165KB)

TRANSFUSE Newsletter Issue 4 (PDF, 208KB)

TRANSFUSE Newsletter Issue 5 (PDF, 327KB)

TRANSFUSE Newsletter Issue 6 (PDF, 311KB)

TRANSFUSE Newsletter Issue 7 (PDF, 569KB)

TRANSFUSE Newsletter Issue 8 (PDF, 662KB)

TRANSFUSE Newsletter Issue 9 (PDF, 573KB)

TRANSFUSE Newsletter Issue 10 (PDF, 593KB)

TRANSFUSE Newsletter Issue 11 (PDF, 2MB)

TRANSFUSE Newsletter Issue 12 (PDF, 889KB)