Leukocyte filtration and postoperative infections

Area of Science:

• Transfusion Medicine
• Surgical Outcomes Research
• Immunology

Background:

• Leukocyte filtration of blood transfusions is theorized to mitigate postoperative infections by reducing immunosuppression.
• Clinical evidence on the efficacy of leukocyte filtration remains debated.
• This meta-analysis examines the impact of leukocyte-filtered blood transfusions on postoperative infection rates in adult surgical patients.

Purpose of the Study:

• To investigate the impact of allogeneic and autologous leukocyte-filtered blood transfusions on postoperative infection incidence.
• To analyze the effect of leukocyte filtration on length of hospital stay and mortality.
• To resolve conflicting literature regarding the clinical benefits of leukocyte filtration.

Main Methods:

• A systematic literature search was conducted across PubMed, Google Scholar, and Cochrane Central Registry of Controlled Trials (1966-2016).
• Included were randomized controlled trials (RCTs) evaluating leukocyte-filtered blood transfusions in adult surgical patients.
• Data on postoperative infections (as-per-protocol and intention-to-treat), length of stay, and mortality were analyzed.

Main Results:

• Sixteen RCTs involving 6586 patients were analyzed.
• Leukocyte-filtered blood demonstrated a 26% risk reduction in postoperative infections (as-per-protocol) and 22% (intention-to-treat).
• Significant reductions were observed in length of stay and all-cause mortality.

Conclusions:

• Leukocyte-filtered blood transfusions are associated with significantly lower postoperative infection rates.
• Leukocyte filtration shortens hospital stays and decreases all-cause mortality in surgical patients.
• Consideration of leukocyte filtration for all surgical patients is recommended to improve outcomes.