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CARDIOVASCULAR ANESTHESIA

The Effect of Universal Leukodepletion of Packed Red Blood Cells on Postoperative Infections in High-Risk Patients Undergoing Abdominal Aortic Surgery

Jean-François Baron, MD^*, Maximilien Gourdin, MD^*, Michèle Bertrand, MD^*, Anne Mercadier, MD, Josée Delort, MD, Edouard Kieffer, MD, and Pierre Coriat, MD^*

*Department of Anesthesiology, Pitié-Salpétrière Hospital; EFS, Site Pitié-Salpétrière, Pitié-Salpétrière Hospital; and Department of Vascular Surgery, Pitié-Salpétrière Hospital, Paris, France

Address correspondence and reprint requests to Prof. Jean-François Baron, Département d’Anesthésie Réanimation, Hôpital Pitié-Salpétrière, 47-83 Bd. de l’Hôpital, 75013 Paris, France. Address e-mail to jfbaron{at}club-internet.fr

We evaluated, by using a before-and-after study, the influence of leukoreduction by filtration on postoperative infections and adverse outcomes in patients undergoing elective major aortic surgery. From January 1995 to October 2000, all patients who underwent elective abdominal aortic surgery were included in the analysis. Before the introduction of systematic leukodepletion of packed red blood cells (RBCs), on April 1, 1998, 192 patients received standard or buffy-coat-depleted packed RBCs. Then, 195 patients were transfused with exclusively filtered leukodepleted packed RBCs. No major significant difference was observed between the groups of patients with regard to preoperative cardiac and pulmonary status, anesthetic and surgical techniques, or transfusion policy. No significant difference in mortality was observed between the two groups. The incidence of postoperative infections was 31% (95% confidence interval, 25%–38%) in the Control group versus 27% (95% confidence interval, 21%–33%) in the Leukodepleted group; severe infectious complications and pneumonia were not significantly different between the two groups of patients. Cardiovascular and respiratory outcomes were not significantly different between the groups. Data from this study suggest that the effect of using leukodepleted RBC on postoperative infections is not of obvious importance.

IMPLICATIONS: We evaluated the influence of leukocyte reduction by filtration of packed red blood cells (RBC) on postoperative infections and adverse outcomes in patients undergoing elective major aortic surgery by comparing two epochs with and without filtration. Data from this study suggest that the effect of using filtered RBC on postoperative infections is not of obvious importance.

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