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Leucorreducción para la prevención de las reacciones adversas de la transfusión de sangre alogénica

Appendices

Appendix 1. Non‐infectious adverse reactions

Term

Definition

Reference

Allergic reactions

Allergic reactions are probably the most frequent, occurring in 1% to 2% of all transfusion reactions. The symptoms range from local or diffuse pruritus, urticaria, erythema and cutaneous flushing to anaphylactic allergic reactions occurring within minutes of the transfusion. Anaphylactoid reactions fall in between the two ends of the spectrum.

Uncomplicated allergic reactions are associated with increased histamine (increased during storage), cytokines, mast cell activators (i.e. leukotrienes), and other vasoactive substances (C3a and C5a) produced by donor leukocytes during storage.

Tenorio 2007

Febrile non‐haemolytic transfusion reactions (FNHTR)

FNHTR are defined as a temperature rise of at least 1°C in association with a transfusion or up to 4h after that may be accompanied by chills or rigors. Such reactions are due to acquired antibodies to donor leukocyte antigens or pyrogenic cytokines (IL‐1, IL‐6, IL‐8 and TNF‐D) elaborated by leukocytes present in the blood components or products.

Tenorio 2007

Transfusion‐related acute lung injury (TRALI) (clinical definition)

The earliest definition of TRALI included all patients who developed acute respiratory distress, moderate to severe hypoxaemia (PaO2 30 to 50 mmHg), rapid onset of pulmonary edema, mild to moderate hypotension, and fever (defined as a 18°C to 28°C rise in body temperature from pre‐transfusion baseline) within 6 hours of receiving a plasma‐containing blood transfusion. The definition excluded patients if they had underlying cardiac or respiratory disease.

Goldman 2005Toy 2005

TRALI (histopathological definition)

As evidenced by interstitial lung leak and lung histology that showed septal thickening, with inflammatory infiltrate consisting mainly of granulocytes was observed in mice transfused with large amounts (4.5 mg/kg) of a murine IgG subclass II.

Looney 2006

Non‐hemolytic febrile transfusion reaction (NHFTR)

Leukocyte apoptosis or monocyte activation, or both, may cause cytokines to accumulate in the blood products during storage. Symptoms/signs: fever, chills.

Heddle 1999King 2004Hoffman 2008

Transfusion‐associated graft‐versus‐host disease (TA‐GVHD)

When viable immunological T cells present in blood products are introduced into an immuno‐incompetent host who cannot destroy the donor lymphocytes. Symptoms/signs: nausea, vomiting, anorexia, fever, watery diarrhoea, liver function abnormality, bone marrow aplasia, skin rash, icterus and renal failure.

Hoffman 2008Rühl 2009

Appendix 2. Search strategies

Cochrane Injuries Group Specialised Register

"blood transfusion" AND (leuk* OR leuc* OR plasmapheresis OR cytapheres OR apheresis)

Cochrane Central Register of Controlled Trials (CENTRAL, the Cochrane Library)

#1MeSH descriptor Blood Component Removal explode all trees
#2MeSH descriptor Leukocyte Reduction Procedures explode all trees
#3MeSH descriptor Cytapheresis explode all trees
#4(plasmapheresis or cytapheres* or apheresis or plateletpheresis or pheresis or phereses or aphereses or leukapheresis or leucapheresis)
#5(Leukoreduc* or leukodeplet* or leukofilt* or leukocyte‐reduc* or leucoreduc* or leucodeplet* or leucofilt* or desleucotizat*)
#6buffy coat‐depleted
#7leukocyte count or leukocyte free or leucocyte count or leucocyte free
#8((Blood or white blood cell* or WBC or plasma) NEAR/3 (reduc* or deplet* or replete* or remov* or filtrat* or filter* or cytapheresis))
#9((leukocyte* or leucocyte*) NEAR/3 (reduc* or deplet* or replete* or remov* or filtrat* or filter*))
#10(#1 OR #2 OR #3 OR #4 OR #5 OR #6 OR #7 OR #8 OR #9)
#11MeSH descriptor Blood Transfusion explode all trees
#12((allogenic or allogeneic) NEAR/3 blood transfusion*)
#13(blood component* NEAR/3 transfusion*)
#14((erythrocyte* or leukocyte* or platelet* or RBC or red blood cell* or WBC or white blood cell* or thrombocyte* or blood) NEAR/3 Transfusion*)
#15(#11 OR #12 OR #13 OR #14)
#16(#10 AND #15)

Medline (OvidSP)

1.exp Blood Component Removal/
2.exp Leukocyte Reduction Procedures/
3.exp cytapheresis/
4.(plasmapheresis or cytapheres* or apheresis or plateletpheresis or pheresis or phereses or aphereses or leukapheresis or leucapheresis).ab,ti.
5.(Leukoreduc* or leukodeplet* or leukofilt* or leukocyte‐reduc* or leucoreduc* or leucodeplet* or leucofilt* or desleucotizat*).mp.
6.buffy coat‐depleted.ab,ti.
7.(leukocyte count or leukocyte free or leucocyte count or leucocyte free).ab,ti.
8.((Blood or white blood cell* or WBC or plasma) adj3 (reduc* or deplet* or replete* or remov* or filtrat* or filter* or cytapheresis)).ab,ti.
9.((leukocyte* or leucocyte*) adj3 (reduc* or deplet* or replete* or remov* or filtrat* or filter*)).ab,ti.
10.or/1‐9
11.exp Blood Transfusion/
12.((allogenic or allogeneic) adj3 blood transfusion*).ab,ti.
13.(blood component* adj3 transfusion*).ab,ti.
14.((erythrocyte* or leukocyte* or platelet* or RBC or red blood cell* or WBC or white blood cell* or thrombocyte* or blood) adj3 Transfusion*).ab,ti.
15.or/11‐14
16.10 and 15
17.randomi?ed.ab,ti.
18.randomized controlled trial.pt.
19.controlled clinical trial.pt.
20.placebo.ab.
21.clinical trials as topic.sh.
22.randomly.ab.
23.trial.ti.
24.17 or 18 or 19 or 20 or 21 or 22 or 23
25.(animals not (humans and animals)).sh.
26.24 not 25
27.26 and 16

Embase + Embase Classic (OvidSP)

1. exp Blood Component Removal/
2. exp Leukocyte Reduction Procedures/
3. exp cytapheresis/
4. (plasmapheresis or cytapheres* or apheresis or plateletpheresis or pheresis or phereses or aphereses or leukapheresis or leucapheresis).ti,ab.
5. (Leukoreduc* or leukodeplet* or leukofilt* or leukocyte‐reduc* or leucoreduc* or leucodeplet* or leucofilt* or desleucotizat*).ti,ab.
6. buffy coat‐depleted.ti,ab.
7. (leukocyte count or leukocyte free or leucocyte count or leucocyte free).ti,ab.
8. ((Blood or white blood cell* or WBC or plasma) adj3 (reduc* or deplet* or replete* or remov* or filtrat* or filter* or cytapheresis)).ti,ab.
9. ((leukocyte* or leucocyte*) adj3 (reduc* or deplet* or replete* or remov* or filtrat* or filter*)).ti,ab.
10. 1 or 2 or 3 or 4 or 5 or 6 or 7 or 8 or 9
11. exp blood transfusion/
12. ((allogenic or allogeneic) adj3 blood transfusion*).ti,ab.
13. (blood component* adj3 transfusion*).ti,ab.
14. ((erythrocyte* or leukocyte* or platelet* or RBC or red blood cell* or WBC or white blood cell* or thrombocyte* or blood) adj3 Transfusion*).ti,ab.
15. 11 or 12 or 13 or 14
16. 10 and 15
17. exp Randomized Controlled Trial/
18. exp controlled clinical trial/
19. placebo.ab.
20. randomi?ed.ti,ab.
21. *Clinical Trial/
22. randomly.ab.
23. trial.ti.
24. 17 or 18 or 19 or 20 or 21 or 22 or 23
25. exp animal/ not (exp human/ and exp animal/)
26. 24 not 25
27. 16 and 26

CINAHL Plus (EBSCO)

S1 (MH "Blood Component Removal+")
S2 (MH "Cytapheresis+")
S3 TX plasmapheresis or cytapheres* or apheresis or plateletpheresis or pheresis or phereses or aphereses or leukapheresis or leucapheresis
S4 TX Leukoreduc* or leukodeplet* or leukofilt* or leukocyte‐reduc* or leucoreduc* or leucodeplet* or leucofilt* or desleucotizat
S5 TX buffy coat‐depleted
S6 TX leukocyte count or leukocyte free or leucocyte count or leucocyte free
S7 TX (Blood or white blood cell* or WBC or plasma) N3 (reduc* or deplet* or replete* or remov* or filtrat* or filter* or cytapheresis)
S8 TX (leukocyte* or leucocyte*) N3 (reduc* or deplet* or replete* or remov* or filtrat* or filter*)
S9 S1 or S2 or S3 or S4 or S5 or S6 or S7 or S8
S10(MH "Blood Transfusion+")
S11 TX (allogenic or allogeneic) N3 blood transfusion*
S12 TX blood component* N3 transfusion*
S13 TX (erythrocyte* or leukocyte* or platelet* or RBC or red blood cell* or WBC or white blood cell* or thrombocyte* or blood) N3 Transfusion*
S14 S10 or S11 or S12 or S13
S15 S9 and S14
S16 (MH "Clinical Trials")
S17 PT clinical trial*
S18 TX clinical N3 trial*
S19 TI ( (singl* N3 blind*) or (doubl* N3 blind*) or (trebl* N3 blind*) or (tripl* N3 blind*) ) or TI ( (singl* N3 mask*) or (doubl* N3 mask*) or (trebl* N3 mask*) or (tripl* N3 mask*) ) or AB ( (singl* N3 blind*) or (doubl* N3 blind*) or (trebl* N3 blind*) ) or AB ( (singl* N3 mask*) or (doubl* N3 mask*) or (trebl* N3 mask*) or (tripl* N3 mask*) )
S20 TX randomi?ed N3 control* N3 trial*
S21 (MH "Placebos")
S22 TX placebo*
S23(MH "Random Assignment")
S24 TX random* N3 allocat* ‐
S25 MH quantitative studies ‐
S26 S16 or S17 or S18 or S19 or S20 or S21 or S22 or S23 or S24 or S25 ‐
S27 S15 and S26 Limiters ‐ Exclude MEDLINE records

LILACS

((Pt randomized controlled trial OR Pt controlled clinical trial OR Mh randomized controlled trials OR Mh random allocation OR Mh double‐blind method OR Mh single‐blind method) AND NOT (Ct animal AND NOT (Ct human and Ct animal)) OR (Pt clinical trial OR Ex E05.318.760.535$ OR (Tw clin$ AND (Tw trial$ OR Tw ensa$ OR Tw estud$ OR Tw experim$ OR Tw investiga$)) OR ((Tw singl$ OR Tw simple$ OR Tw doubl$ OR Tw doble$ OR Tw duplo$ OR Tw trebl$ OR Tw trip$) AND (Tw blind$ OR Tw cego$ OR Tw ciego$ OR Tw mask$ OR Tw mascar$)) OR Mh placebos OR Tw placebo$ OR (Tw random$ OR Tw randon$ OR Tw casual$ OR Tw acaso$ OR Tw azar OR Tw aleator$) OR Mh research design) AND NOT (Ct animal AND NOT (Ct human and Ct animal)) OR (Ct comparative study OR Ex E05.337$ OR Mh follow‐up studies OR Mh prospective studies OR Tw control$ OR Tw prospectiv$ OR Tw volunt$ OR Tw volunteer$) AND NOT (Ct animal AND NOT (Ct human and Ct animal))) AND (Medicina Transfusional or la transfusión or As transfusões or blood transfusion or Transfusión Sanguínea)

Clinicaltrials.gov

( leuk* OR leuc* OR plasmapheresis OR cytapheres OR apheresis ) [DISEASE] AND transfusion [TREATMENT]

WHO Clinical Trials Registry Platform Search Portal (http://apps.who.int/trialsearch/)

Condition: leuk* OR leuc* OR plasmapheresis OR cytapheres OR apheresis

Recruitment status: ALL

Appendix 3. Study authors contacted

Trial author

Date of contact

Reply

Dr. Boshkov and Dr and Dr. Van Winkle ([email protected]; [email protected])

Study: "Prestorage Leukoreduction of Transfuesed Red Cells Is Associated with Significant Ongoing 2‐12 Month Survival Benefit in Cardiac Surgery Patients".

08 October 2014

None yet

Dr Morris ([email protected]) and Dr. Van Winkle ([email protected]; [email protected])

Study: "Prestorage Leukoreduction of Transfused Red Cells Is Associated with Significant Ongoing 2–12 Month Survival Benefit in Cardiac Surgery Patients" (Blood journal as one of the abstracts from the ASH Annual Meeting (2006 108: Abstract 578). Study included (Boshkov 2006). Data extraction from abstract only.

08 October 2014

None yet

Dr. Nelson ([email protected]) and Dr. Aldea ([email protected]).

Study: "Immunomodulation Following Transfusion" (ClinicalTrials.gov NCT00810810)

04 December 2014

None yet

Dr. van de Watering ([email protected], [email protected])

Study: van de Watering 1998

22 May 2015

The author provided more details about follow‐up

Dr. van Hilten ([email protected])

Poster “Characterization of the effects of leukocyte‐filtered red blood cell transfusions in major surgery” related to the study van Hilten 2004

22 May 2015

The author clarified the relation between two references

Dr. Waghmare and Dr. Desai (no email found, we contacted through ResearchGate)

Poster: "Open Labeled, Randomized, Controlled Trial Comparing Leukodepleted (Filtered) Blood Transfusion and Non‐Leukodepleted (Unfiltered) Blood Transfusion in Cases of Severe Falciparum Malaria." Published in Chest 10/2012; 142(4_MeetingAbstracts):232A.

23 May 2015

None yet

Dr. Zhao ([email protected] and through ResearchGate)

Study: "Clinical assessment of preventing febrile nonhaemolytic transfusion reaction by leukocyte‐depleted blood transfusion". And the poster "Prevention and reduction of febrile nonhaemolytic transfusion reaction by leucocyte filtration blood transfusion"

25 July 2015

None yet

Study flow diagram.
Figures and Tables -
Figure 1

Study flow diagram.

'Risk of bias' graph: review authors' judgements about each 'Risk of bias' item presented as percentages across all included studies.
Figures and Tables -
Figure 2

'Risk of bias' graph: review authors' judgements about each 'Risk of bias' item presented as percentages across all included studies.

'Risk of bias' summary: review authors' judgements about each 'Risk of bias' item for each included study.
Figures and Tables -
Figure 3

'Risk of bias' summary: review authors' judgements about each 'Risk of bias' item for each included study.

TSA calculated to reliably detect a 25% relative change in the incidence of death from any cause, assuming a control group event rate of 9.34% with a power of 80% at an alpha of 5%
Figures and Tables -
Figure 4

TSA calculated to reliably detect a 25% relative change in the incidence of death from any cause, assuming a control group event rate of 9.34% with a power of 80% at an alpha of 5%

Funnel plot of comparison: 1 Leukoreduced PRBC versus non‐leukoreduced PRBC. Main Analysis (Randomised patients), outcome: 1.3 Infection. Number of events of the total of randomised patients reported.
Figures and Tables -
Figure 5

Funnel plot of comparison: 1 Leukoreduced PRBC versus non‐leukoreduced PRBC. Main Analysis (Randomised patients), outcome: 1.3 Infection. Number of events of the total of randomised patients reported.

TSA calculated to reliably detect a 25% relative change in the incidence of infection from any cause, assuming a control group event rate of 20.4% with a power of 80% at an alpha of 5%.
Figures and Tables -
Figure 6

TSA calculated to reliably detect a 25% relative change in the incidence of infection from any cause, assuming a control group event rate of 20.4% with a power of 80% at an alpha of 5%.

TSA calculated to reliably detect a 25% relative change in the incidence of fever, assuming a control group event rate of 38.7% with a power of 80% at an alpha of 5%.
Figures and Tables -
Figure 7

TSA calculated to reliably detect a 25% relative change in the incidence of fever, assuming a control group event rate of 38.7% with a power of 80% at an alpha of 5%.

Comparison 1 Leukoreduced PRBC versus non‐leukoreduced PRBC. Main analysis (randomised patients), Outcome 1 TRALI. Number of events of the total of randomised patients reported.
Figures and Tables -
Analysis 1.1

Comparison 1 Leukoreduced PRBC versus non‐leukoreduced PRBC. Main analysis (randomised patients), Outcome 1 TRALI. Number of events of the total of randomised patients reported.

Comparison 1 Leukoreduced PRBC versus non‐leukoreduced PRBC. Main analysis (randomised patients), Outcome 2 Death. Number of events of the total of randomised patients reported.
Figures and Tables -
Analysis 1.2

Comparison 1 Leukoreduced PRBC versus non‐leukoreduced PRBC. Main analysis (randomised patients), Outcome 2 Death. Number of events of the total of randomised patients reported.

Comparison 1 Leukoreduced PRBC versus non‐leukoreduced PRBC. Main analysis (randomised patients), Outcome 3 Infection. Number of events of the total of randomised patients reported.
Figures and Tables -
Analysis 1.3

Comparison 1 Leukoreduced PRBC versus non‐leukoreduced PRBC. Main analysis (randomised patients), Outcome 3 Infection. Number of events of the total of randomised patients reported.

Comparison 1 Leukoreduced PRBC versus non‐leukoreduced PRBC. Main analysis (randomised patients), Outcome 4 Adverse events. Number of events of the total of randomised patients reported.
Figures and Tables -
Analysis 1.4

Comparison 1 Leukoreduced PRBC versus non‐leukoreduced PRBC. Main analysis (randomised patients), Outcome 4 Adverse events. Number of events of the total of randomised patients reported.

Comparison 2 Leukoreduced PRBC versus non‐leukoreduced PRBC. Secondary analysis (transfused patients), Outcome 1 TRALI. Number of events of the total of transfused patients reported.
Figures and Tables -
Analysis 2.1

Comparison 2 Leukoreduced PRBC versus non‐leukoreduced PRBC. Secondary analysis (transfused patients), Outcome 1 TRALI. Number of events of the total of transfused patients reported.

Comparison 2 Leukoreduced PRBC versus non‐leukoreduced PRBC. Secondary analysis (transfused patients), Outcome 2 Death. Number of events of the total of transfused patients reported.
Figures and Tables -
Analysis 2.2

Comparison 2 Leukoreduced PRBC versus non‐leukoreduced PRBC. Secondary analysis (transfused patients), Outcome 2 Death. Number of events of the total of transfused patients reported.

Comparison 2 Leukoreduced PRBC versus non‐leukoreduced PRBC. Secondary analysis (transfused patients), Outcome 3 Infection. Number of events of the total of transfused patients reported.
Figures and Tables -
Analysis 2.3

Comparison 2 Leukoreduced PRBC versus non‐leukoreduced PRBC. Secondary analysis (transfused patients), Outcome 3 Infection. Number of events of the total of transfused patients reported.

Comparison 2 Leukoreduced PRBC versus non‐leukoreduced PRBC. Secondary analysis (transfused patients), Outcome 4 Adverse events. Number of events of the total of transfused patients reported.
Figures and Tables -
Analysis 2.4

Comparison 2 Leukoreduced PRBC versus non‐leukoreduced PRBC. Secondary analysis (transfused patients), Outcome 4 Adverse events. Number of events of the total of transfused patients reported.

Summary of findings for the main comparison. Leukoreduced PRBCs versus non‐leukoreduced PRBCs for preventing adverse reaction from allogeneic blood transfusion

Leukoreduced PRBCs versus non‐leukoreduced PRBCs for preventing adverse reaction from allogeneic blood transfusion

Patient or population: Patients receiving RBC transfusion
Settings: Any
Intervention: Leukoreduced PRBCs
Comparison: Non‐leukoreduced PRBCs

Outcomes

Illustrative comparative risks* (95% CI)

Relative effect
(95% CI)

Number of participants
(studies)

Quality of the evidence
(GRADE)

Comments

Assumed risk

Corresponding risk

Non‐leukoreduced packed RBCs

Leukoreduced packed RBCs

TRALI
Follow‐up: mean 28 days

Study population

RR 0.96
(0.67 to 1.36)

1864
(1 study)

⊕⊕⊝⊝
low1

TSA yielded an inconclusive result.

63 per 1000

61 per 1000
(42 to 86)

Death due to any cause
Follow‐up: median 2.5 months

Study population

RR 0.81
(0.58 to 1.12)

6485
(9 studies)

⊕⊝⊝⊝
very low2

TSA yielded an inconclusive
result.

93 per 1000

76 per 1000
(54 to 104)

Infection from any cause
Follow‐up: mean 2.5 months

Study population

RR 0.80
(0.62 to 1.03)

6709
(10 studies)

⊕⊝⊝⊝
very low3

TSA yielded an inconclusive
result.

204 per 1000

163 per 1000
(127 to 210)

Adverse events
Follow‐up: mean 3 months

Study population

RR 0.81
(0.64 to 1.02)

634
(2 studies)

⊕⊕⊝⊝
low4

TSA yielded an inconclusive
result.

387 per 1000

314 per 1000
(248 to 395)

Non‐infectious complication

Study population

Not estimable

No trial assessed this outcome.

Not estimable

Not estimable

*The basis for the assumed risk was the median control group risk across studies. The corresponding risk (and its 95% CI) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).
CI: Confidence interval; RR: Risk ratio; TRALI: Transfusion‐related acute lung injury; RBC: Red blood cell; PRBC: Packed red blood cell; DARIS: Diversity‐adjusted required information size.

GRADE Working Group grades of evidence
High quality: Further research is very unlikely to change our confidence in the estimate of effect.
Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.
Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.
Very low quality: We are very uncertain about the estimate.

1Downgraded by two due to imprecision: small sample size as compared with the calculated DARIS and the wide CI overlapping zones of no effect, as well as potential harm or benefit, or both. Few events reported.
2Downgraded due to: high risk of bias (Six of nine included studies have high or unclear risk of bias. ‐1); important heterogeneity (I² statistic: 63%, ‐1); and imprecision as reflected in the wide CI and an insufficient accrued information size compared with the DARIS (‐1).

3Downgraded due to: high risk of bias (Seven of 10 included studies were at high or unclear risk of bias, ‐1); important heterogeneity (I² statistic: 84%, ‐2); and imprecision due to the CI crossing the threshold of meaningful effect and an insufficient sample size as compared with the DARIS (‐1)

4Downgraded due to: high risk of bias (All included studies evaluated were at high risk of bias, ‐1) and imprecision due to the CI crossing the threshold of meaningful effect and an insufficient sample size as compared with the DARIS (‐1).

Figures and Tables -
Summary of findings for the main comparison. Leukoreduced PRBCs versus non‐leukoreduced PRBCs for preventing adverse reaction from allogeneic blood transfusion
Comparison 1. Leukoreduced PRBC versus non‐leukoreduced PRBC. Main analysis (randomised patients)

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 TRALI. Number of events of the total of randomised patients reported Show forest plot

1

1864

Risk Ratio (M‐H, Random, 95% CI)

0.96 [0.67, 1.36]

2 Death. Number of events of the total of randomised patients reported Show forest plot

9

6485

Risk Ratio (M‐H, Random, 95% CI)

0.81 [0.58, 1.12]

3 Infection. Number of events of the total of randomised patients reported Show forest plot

10

6709

Risk Ratio (M‐H, Random, 95% CI)

0.80 [0.62, 1.03]

4 Adverse events. Number of events of the total of randomised patients reported Show forest plot

2

634

Risk Ratio (M‐H, Fixed, 95% CI)

0.81 [0.64, 1.02]

4.1 Fever

2

634

Risk Ratio (M‐H, Fixed, 95% CI)

0.81 [0.64, 1.02]

Figures and Tables -
Comparison 1. Leukoreduced PRBC versus non‐leukoreduced PRBC. Main analysis (randomised patients)
Comparison 2. Leukoreduced PRBC versus non‐leukoreduced PRBC. Secondary analysis (transfused patients)

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 TRALI. Number of events of the total of transfused patients reported Show forest plot

1

268

Risk Ratio (M‐H, Random, 95% CI)

0.98 [0.74, 1.29]

2 Death. Number of events of the total of transfused patients reported Show forest plot

10

4060

Risk Ratio (M‐H, Random, 95% CI)

0.80 [0.60, 1.07]

3 Infection. Number of events of the total of transfused patients reported Show forest plot

10

3557

Risk Ratio (M‐H, Random, 95% CI)

0.76 [0.58, 1.00]

4 Adverse events. Number of events of the total of transfused patients reported Show forest plot

2

544

Risk Ratio (M‐H, Fixed, 95% CI)

0.75 [0.60, 0.94]

4.1 Fever

2

544

Risk Ratio (M‐H, Fixed, 95% CI)

0.75 [0.60, 0.94]

Figures and Tables -
Comparison 2. Leukoreduced PRBC versus non‐leukoreduced PRBC. Secondary analysis (transfused patients)