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Cited by 216Blood transfusion and managementTrauma, Hemostasis, Coagulopathy, ResuscitationBlood groups and transfusion

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Appropriateness of Allogeneic Red Blood Cell Transfusion: The International Consensus Conference on Transfusion Outcomes

Shander, Aryeh, Fink, Arlene, Javidroozi, Mazyar, Erhard, Jochen, Farmer, Shannon L., Corwin, Howard, Goodnough, Lawrence Tim, Hofmann, Axel, Isbister, James, Ozawa, Sherri, Spahn, Donat R.·2011·Transfusion Medicine Reviews
DOI 10.1016/j.tmrv.2011.02.001
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Abstract

An international multidisciplinary panel of 15 experts reviewed 494 published articles and used the RAND/UCLA Appropriateness Method to determine the appropriateness of allogeneic red blood cell (RBC) transfusion based on its expected impact on outcomes of stable nonbleeding patients in 450 typical inpatient medical, surgical, or trauma scenarios. Panelists rated allogeneic RBC transfusion as appropriate in 53 of the scenarios (11.8%), inappropriate in 267 (59.3%), and uncertain in 130 (28.9%). Red blood cell transfusion was most often rated appropriate (81%) in scenarios featuring patients with hemoglobin (Hb) level 7.9 g/dL or less, associated comorbidities, and age older than 65 years. Red blood cell transfusion was rated inappropriate in all scenarios featuring patients with Hb level 10 g/dL or more and in 71.3% of scenarios featuring patients with Hb level 8 to 9.9 g/dL. Conversely, no scenario with patient's Hb level of 8 g/dL or more was rated as appropriate. Nearly one third of all scenarios were rated uncertain, indicating the need for more research. The observation that allogeneic RBC transfusions were rated as either inappropriate or uncertain in most scenarios in this study supports a more judicious transfusion strategy. In addition, the large number of scenarios in which RBC transfusions were rated as uncertain can serve as a road map to identify areas in need of further investigation.

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Metadata

Authors
Shander, A., Fink, A., Javidroozi, M., Erhard, J., Farmer, S. L., Corwin, H., Goodnough, L. T., Hofmann, A., Isbister, J., Ozawa, S., & Spahn, D. R.
Affiliations
  • Englewood Hospital and Medical Center (US)
  • Dartmouth–Hitchcock Medical Center (US)
  • Stanford Medicine (US)
  • Royal North Shore Hospital (AU)
  • University Hospital Zurich (CH)
Corresponding author
Shander, Aryeh
ORCID
Venue
Transfusion Medicine Reviews
Publisher
Elsevier BV
Published
2011-07
Volume
25
Issue
3
Pages
232-246.e53
ISSN
0887-7963 (ISSN-L)
DOI
10.1016/j.tmrv.2011.02.001
OpenAlex
W2069058457
Cited by
216
References
0
Citations by year
2026: 6 · 2025: 5 · 2024: 10 · 2023: 7 · 2022: 9 · 2021: 13 · 2020: 5 · 2019: 13 · 2018: 12 · 2017: 17 · 2016: 13 · 2015: 25 · 2014: 27 · 2013: 34 · 2012: 14
FWCI
16.81
Type
journal article
Language
en
Open access
closed
Licence
Locations
  • Transfusion Medicine Reviews (publishedVersion)
  • PubMed (publishedVersion)
  • UWA Profiles and Research Repository (UWA) (submittedVersion)
  • eSpace (Curtin University) (submittedVersion)
  • Zurich Open Repository and Archive (University of Zurich) (submittedVersion)
Funders
  • Eli Lilly and Company
  • AstraZeneca
  • Novo Nordisk
Topics
  • Health Sciences › Medicine › Hematology › Blood transfusion and management
  • Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Trauma, Hemostasis, Coagulopathy, Resuscitation
  • Health Sciences › Medicine › Hematology › Blood groups and transfusion
Keywords
allogeneic red blood cell transfusion, transfusion appropriateness, hemoglobin threshold, transfusion thresholds, comorbidities, elderly patients, transfusion outcomes, expert consensus
MeSH terms
Adult, Age Factors, Aged, Aged, 80 and over, Algorithms, Humans, International Cooperation, Middle Aged, Quality of Health Care, Transplantation, Homologous, Treatment Outcome, Erythrocyte Transfusion

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