The Negative Influence and Adverse Outcome of Red Blood Cell Transfusion in Contemporary Percutaneous Coronary...

Despite many technological improvements and therapeutic advances in interventional cardiology, contemporary percutaneous coronary intervention (PCI) is still associated with cardiovascular thrombotic events, increased risks of bleeding, and red blood cell (RBC) transfusion. This narrative review describes the shortage of RBC packages for transfusion in hospital blood banks. Blood donations have significantly diminished mainly because of decreasing number of qualified donors. Moreover, there is compelling evidence indicating that RBC transfusion is excessive and sometimes unnecessary, leading to blood banks depletion. Although, alternatives to RBC transfusion and other treatment options exist, they are seldom utilized. Evidently, there is a necessity to implement a wiser utilization of RBC transfusion to diminish its unnecessary use. It was demonstrated that one unit of RBC transfusion in the PCI setting is significantly associated with immediate and long-term adverse outcomes, including increased infection, myocardial infarction, stroke, renal failure, prolonged ventilation and hospital stay, atrial fibrillation, multi-organ failure and death, as well as, increased overall hospital healthcare costs. There is a clear medicine based evidence of the shortcomings of RBC transfusion in PCI. The evidence that RBC transfusion carries significant risks points out to avoid it when possible. Therefore, it is paramount to better comprehend the rationale for a better management of blood supply and a wiser utilization of RBC transfusion. This is a significant warning to the medical community, and a scientific motivation to perform a conscious revision of our routine medical practice towards a better utilization of RBC transfusion in contemporary PCI.