Objective

The REDWASH Trial proposes to test the hypothesis that that the severity of the postoperative inflammatory response will be less and post-operative recovery faster if patients undergoing cardiac surgery with CPB who are at risk of massive RBC transfusion receive stored allogenic RBC that are washed prior to transfusion when compared to standard care where stored RBC are administered without washing.

Methods

REDWASH is a multi-centre, randomised, single blinded parallel group, randomised controlled trial of washing of RBC prior to transfusion versus standard care (no washing). Patient population included adult cardiac surgery patients undergoing cardiac surgery with blood cardioplegia who at high risk of massive blood transfusion as estimated by using a modified risk score. Each unit of RBC in the intervention group was washed using a centrifugal Fresenius CATS device and immediately administered.

Results

Out of 1448 patients 126 were eligible and 60 recruited and randomised into standard and washing groups. 28 patients in the standard gr. and 27 in the washing gr. received transfusion, out of which 1 patient in the washing gr. received unwashed RBC and 5 patients received 1 unwashed unit. Analysis indicated no difference in the MOD score and PiO2/FiO2 between the groups. Significant differences were detected when comparing troponin levels and incidence of AKI that were higher in the washing gr.

Conclusion

The results of the trail reject the original hypothesis that RBC washing is beneficial for patients. Instead it increases the risk of AKI and worsens heart function.