Comparison of efficacy of packed red blood cell transfusion based on its hemoglobin content versus the standard transfusion practice in thalassemia major patients (HEMOCON study)

Department of Transfusion Medicine, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India. Department of Transfusion Medicine, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India. Electronic address: ashishjain16@gmail.com. Department of Pediatrics, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.

Transfusion and apheresis science : official journal of the World Apheresis Association : official journal of the European Society for Haemapheresis. 2020;:102736
PICO Summary

Population

Thalassemia major patients (n=160).

Intervention

ABO/RhD identical packed red blood cell (PRBCs) after determining its Hb content (>/=50 g) group I, (n = 80).

Comparison

Randomly selected ABO/RhD identical PRBCs group II ,(n = 80).

Outcome

The mean Hb content of the PRBC units was significantly higher in group I (67.86 +/- 8.07 g; range: 50.80-92.13 g) than group II (60.92 +/- 8.29 g; range: 40.86-86.76 g). The mean Hb increment was also significantly higher in group I patients. In both the groups, there was a significant negative correlation between Hb increment and weight, age, body surface area and blood volume. There was a significant positive correlation between Hb increment and Hb dose adjusted for body surface area as well as blood volume. PRBC transfusion was more efficacious in patients who were transfused with PRBCs having a Hb content >/=50 g as compared to those who received randomly selected PRBCs.
Abstract
The hemoglobin (Hb) content of packed red blood cell (PRBC) units is heterogenous. The efficacy of a transfusion episode can be assessed if the Hb content of the PRBC is known and the patient's post-transfusion Hb increment is also determined. This prospective study compared the efficacy of PRBC transfusion based on its Hb content versus the standard transfusion practice. A total of 160 thalassemia major patients were enrolled and randomly divided into two equal groups: Group I (n = 80) - they received ABO/RhD identical PRBCs after determining its Hb content (≥50 g); and Group II (n = 80) - they received randomly selected ABO/RhD identical PRBCs. Hb estimation and a direct antiglobulin test were performed on the post-transfusion sample (1 h). The mean Hb content of the PRBC units was significantly higher (p = 0.000) in group I (67.86 +/- 8.07 g; range: 50.80-92.13 g) than group II (60.92 +/- 8.29 g; range: 40.86-86.76 g). The mean Hb increment was also significantly higher in group I patients (p = 0.04). In both the groups, there was a significant negative correlation between Hb increment and weight, age, body surface area and blood volume (p < 0.05). There was a significant positive correlation between Hb increment and Hb dose adjusted for body surface area as well as blood volume (p < 0.05). PRBC transfusion was more efficacious in patients who were transfused with PRBCs having a Hb content ≥50 g as compared to those who received randomly selected PRBCs.
Study details
Language : eng
Credits : Bibliographic data from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine