Red Cell Storage Duration Study

Red Cell Storage Duration Study

The RECESS study will compare the effects of transfusing red blood cell units stored <= 10 days vs. red blood cell units stored >= 21 days, in patients who are undergoing complex cardiac surgery and are likely to need a red blood cell transfusion. The primary hypothesis is that there is a clinically important difference between the effects of shorter-storage red cell units and longer-storage red cell units on clinical outcomes and mortality risk.

Inclusion Criteria:

• >= 12 years old
• >= 40 kg body weight
• Scheduled complex cardiac surgery with planned use of median sternotomy.
• Patients ≥ 18 years must have a Transfusion Risk Understanding Scoring Tool (TRUST) probability score ≥ 3

Exclusion Criteria:

• Refusal of blood products
• Planned surgery is minimally invasive
• Known transfusion reaction history
• Requirement for washed products, volume reduced products, or products with additive solution removed
• Expected residual cyanosis with O2 saturation < 90
• Left ventricular assist device (LVAD) or Extracorporeal membrane oxygenation (ECMO) support pre-operatively or planned need post-operatively
• Cardiogenic shock requiring pre-operative placement of an Intra-aortic balloon pump (IABP) (IABP done for unstable angina or prophylactically for low ejection fraction is not excluded)
• Planned Deep Hypothermic Circulatory Arrest (DHCA)
• Renal dysfunction requiring pre-operative renal replacement therapies such as hemodialysis (HD) or continuous venovenous hemofiltration (CVVH)
• Planned use of alternative to heparin, e.g. bivalirudin
• Planned use of autologous or directed donations
• Prior RBC transfusion during hospitalization for the study-qualifying surgery
• Prior randomization into the RECESS study