Leicester academic leads study published today in the New England Journal of Medicine
Professor Gavin Murphy (pictured), British Heart Foundation (BHF) Professor of Cardiac Surgery in our Department of Cardiovascular Sciences at Leicester is the lead author of a new study that has shown that patients having heart surgery do not benefit if doctors wait until a patient has become substantially anaemic before giving a transfusion.
In the UK, about half of all patients having cardiac surgery are given a red blood cell transfusion after the operation, using up to ten per cent of the nation’s blood supply. The proportion of patients having a transfusion is high because blood loss and severe anaemia are common after cardiac surgery and transfusion is the preferred treatment. Blood loss causes anaemia which doctors detect by measuring the red cell count or haemoglobin level – a low level triggers transfusion.
Cardiac surgery patients who receive blood transfusions are believed to have more complications such as infections, heart attacks and strokes, and this has led to speculation that avoidance of transfusion will improve clinical outcomes.
Professor Murphy said: “Existing national and international transfusion guidelines recommend that blood transfusions only be given to patients who develop very low haemoglobin concentrations. We have shown that this strategy may increase the number of deaths in cardiac surgery.
"This was the largest randomised trial ever conducted in the UK in a surgical or cardiac surgery population. It was the largest trial ever conducted that has considered indications for transfusion in cardiac surgery, and recruited over twice the number of patients recruited in all the previous trials put together. It was a pragmatic effectiveness trial that recruited patients from the majority of NHS cardiac surgery centres in the UK and therefore reflects current UK practice and is relevant to UK patients.”