Corrigendum to "Effect of age of red cells for transfusion on patient outcomes: a systematic review and meta-analysis" [Transfus Med Rev 32/2 (2018) 77-88] (Transfusion Medicine Reviews (2018) 32(2) (77-88), (S0887796317301591), (10.1016/j.tmrv.2018.02.002)).

Abstract

We are writing regarding our previously published systematic review: "Effect of age of red cells for transfusion on patient outcomes: a systematic review and meta-analysis" [1]. Since publication of our review, there has been a correction to the results of the Standard Issue Transfusion versus Fresher Red-Cell Use in Intensive Care (TRANSFUSE) trial issued [2,3], which impacts on the findings of our systematic review and meta-analysis. This correction did not affect the primary outcome (90-day mortality) of the trial, but did change the results of two of the secondary outcomes. In the corrected report, there was an increase in new bloodstream infections in the group that received fresher red blood cells (RBC), and not febrile transfusion reactions as was originally reported. We have updated our systematic review and meta-analysis to incorporate the corrected TRANSFUSE results. In our original review, we reported moderate quality evidence of a higher risk of infection (RR 1.08, 95% CI 1.00-1.17; P = .05; I2 = 0%) and transfusion reactions (relative risk [RR] 1.35, 95% CI 1.04-1.76; P = .02; I2 = 0%). We now report higher quality evidence of an increased risk of infection with fresher red cells (RR 1.12, 95% CI 1.02-1.22; P = .01; I2 = 13%, high quality evidence Fig 1) and no difference in risk of transfusion reactions (RR 0.87, 95% CI 0.57-1.33; P = .52; I2 = 0%, moderate quality evidence Fig 2). Prior to the publication of TRANSFUSE, systematic review and meta-analyses of trials comparing transfusion of RBCs of different ages showed low certainty evidence of an increase in risk of infection with transfusion of fresher RBCs (RR 1.09, 95% CI 1.00-1.18, P = .04) [4]. The inclusion of the corrected TRANSFUSE results have increased the strength of evidence for an increased risk of infection with fresher compared with older RBCs. Taken together with the lack of evidence of a mortality benefit for transfusion of fresher RBCs [1], these findings support current practice of allocating oldest available, compatible RBCs for transfusion. The conclusion from our systematic review remains unchanged-it is very unlikely that further studies comparing fresher RBCs with standard issue or older RBCs will demonstrate benefit with regards to mortality from fresher RBCs, but a small potential for harm from fresher RBCs remains.Copyright © 2018 Elsevier Inc.