Effects of blood transfusion with leucocyte depletion on length of hospital stay, respiratory assistance and survival after curative surgery for colorectal cancer

Purpose. To investigate effects of blood transfusion, with/without leucocyte depletion, on duration of hospital stay, need for respiratory support, mortality and long-term survival after curative surgery for colorectal cancer. Methods. The trial was a prospective, randomised, multicenter study. Six hundred and forty two patients with colorectal cancer were included. Blood transfusion was given when needed during and/or after operation, randomised to packed red blood cells (RBC) or leucocyte-depleted red blood cells (LDB) using leucocyte filtration. Assisted ventilation in ICU, hospital stay, malignant and non-malignant specific mortality and overall survival were outcome measures. Results. The RBC group had higher need for assisted ventilation post-operatively (8.1% vs. 3.6%) and significantly higher proportion of patients with prolonged (>20 days) hospital stay. After median follow-up time of 99.5 months there was no significant difference in mortality or long-term survival between the groups. The median cumulative survival time of 55 months in LDB vs. 36 months in RBC group did not reach significance level. Non-transfused patients had a significantly lower proportion of prolonged hospital stay, and significantly increased survival, compared to transfused patients. Conclusion. Leucocyte depleted transfusions improved the postoperative course following surgery for colorectal cancer, compared with packed red blood cell transfusions.