REDWASH: a randomised controlled trial of red cell washing for the attenuation of transfusion associated organ injury in cardiac surgery

Principal Investigator: Professor Gavin Murphy
Study Start: May 2012

Cardiac surgery is one of the main users of allogeneic blood nationally. Blood transfusion may have unwanted side effects that increase the risk of inflammation and complications after cardiac surgery which typically affect the kidneys, heart and lungs. We believe that this may be due to the release of chemicals and microscopic particles by the red blood cells during storage that collect in the blood bag (the so-called storage lesion). Currently these by-products are transfused to patients along with the donor blood.

Blood BagREDWASH, a large multi-centre randomised controlled trial funded by the NIHR, investigates whether removing the storage by-products by washing blood cells immediately prior to transfusion will improve these common complications in cardiac surgery.

Study participants are randomly allocated to receive either unwashed (standard practice in the UK) or washed RBC units, if they require a blood transfusion during or immediately after surgery. The presence and intensity of inflammation and complications in both treatment groups are compared by measuring certain biomarkers in the blood (cytokines) and urine. The study also aims to identify the underlying mechanisms of organ dysfunction and the role of micro-particles in transfusion associated injury.

You can now calculate the likelihood of receiving a blood transfusion during or after heart operation. The MBT calculator will indicate the percentage risk for a patient to require 4 or more units of red blood cells peri-operatively, whereas the ABT calculator will indicate the percentage risk of any transfusion requirement.

The calculators are easy to use and produce accurate predictions, particularly in high risk patients. Both calculators are useful tools that may assist in clinical decision making and blood management. 

For more information about the REDWASH study, please contact Tracy Kumar (Trial Coordinator) or Lathishia Joel-David (Research Nurse)

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