The effect of perioperative blood transfusion in adult cardiac surgery on postoperative infection complications was studied prospectively in 10 centers (5158 patients) in the United States and Canada. Within 65 days, infectious complications appeared with a strong relationship to transfusion and consisted mainly of pneumonia and bloodstream infections, to a lesser extend of C. difficile colitis, whereas surgical site infections were uncommon. There was a dose-related association between leukocyte depleted RBC transfusion (29% with each unit) and platelet transfusion. Above 7 units of RBC, platelet transfusion was associated with less infections, which is explained by the authors as an effect of cotransfusion of immunoglobulin with platelet-rich plasma.
– Thomas Frietsch