シークル細胞疾患における術前輸血代替療法 (TAPS) 試験:ランダム化され,制御され,多センター臨床試験
Jo Howard1, Moira Malfroy, Charlotte Llewelyn
1Department of Haematology, Guy's and St Thomas' Hospital, London, UK. jo.howard@gstt.nhs.uk
Lancet (London, England)
|January 29, 2013
まとめ
術前の輸血は,手術を受ける状細胞疾患患者の手術後の合併症を大幅に軽減しました. この介入は,低リスクから中リスクの処置を受けるヘモグロビンSSを有する個人に有益である可能性があります.
科学分野:
- 血液学 ヘマトロジ
- 外科腫瘍学外科腫瘍学
- 輸血医学とは
背景:
- 状細胞病 (SCD) の治療における術前輸血の有効性は,依然として議論されている.
- 術前輸血がSCD患者における術後の合併症率に与える影響を評価する.
研究 の 目的:
- 手術前輸血が,状細胞病の患者における手術前合併症率を変化させるかどうかを評価する.
主な方法:
- 1歳以上の状細胞疾患 (ヘモグロビンSSまたはSβ0タラセミア) の患者を対象とした多センターランダム化試験です.
- 患者は,手術前の10日以内に輸血を受けないか,輸血を受けることをランダムに割り当てられました.
- 主なアウトカムは,治療の意図によって分析された,ランダム化から手術後30日までの臨床的に重要な合併症の割合でした.
主要な成果:
- 術前輸血を受けていない患者の39%が合併症を経験し,輸血を受けた患者の15% (p=0.023) が合併症を経験しました.
- 重篤な有害事象は,患者の30% (輸血なし) と3% (輸血) で発生しました.
- 急性胸部症候群は重篤な有害事象で,輸血群では9例,輸血群では1例でした.
結論:
- 術前輸血は,状細胞疾患の患者における術後の合併症の減少と関連しています.
- この戦略は,低リスクおよび中リスクの手術を受けるヘモグロビンSS患者の潜在的な利益を示しています.
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