Leukocyte-Reduced Transfusions in Cardiac Surgery

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Abstract
An implementation trial of leukocyte-reduced transfusions in cardiac surgery (primary coronary artery bypass graft and valve replacement) was performed from July to December 1998; comparisons were made with data from the same period in 1997. Patients from both periods were similar in important preoperative and intraoperative variables (age, sex, weight, number of units of RBCs transfused, ejection fraction). The mean total number of complications was statistically significantly decreased from 0.26 complications per patient in the non–leukocyte-reduced to 0.19 in the leukocyte-reduced recipients. Overall, the mean ± 1SD costs of care per patient decreased from 1997 ($27,615 ± $33,973) to 1998 ($27,038 ± $24,107). Mean costs decreased $1,700 per patient for recipients of leukocyte-reduced blood in 1998 compared with recipients of non–leukocyte-reduced blood in 1997. Mean costs increased $4,000 per patient in patients who did not receive transfusions in 1998 compared with 1997. Hospitalization costs decreased when leukocyte-reduced transfusions were implemented for patients undergoing cardiac surgery in our institution. Implementation of leukocyte reduction may be cost neutral or cost saving in at least some settings.