5 Future directions

5.1.5 Effect of red cell transfusion on outcomes

Studies evaluating mortality and morbidity were all Level III (i.e. of poor to fair quality) and did not control who received the intervention (i.e. RBC transfusion). Many studies demonstrated a dose-dependent relationship between RBC transfusion and increased risk of morbidity or mortality. However, the design of the studies was such that it was not possible to prove a causal relationship between the intervention and the observed outcomes.

The paucity of evidence in this area to guide clinical practice has been highlighted by the recent publication from the International Consensus Conference on Transfusion Outcomes (ICCTO) group.60

There is a need for well-designed studies on the effect of RBC transfusion on patient outcomes in a perioperative population.