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@article{George:2022:10.1016/S2214-109X(21)00565-9,
author = {George, EC and Uyoga, S and M'baya, B and Byabazair, DK and Kiguli, S and Olupot-Olupot, P and Opoka, RO and Chagaluka, G and Alaroker, F and Williams, TN and Bates, I and Mbanya, D and Gibb, DM and Walker, AS and Maitland, K and TRACT, trail study group},
doi = {10.1016/S2214-109X(21)00565-9},
journal = {The Lancet Global Health},
pages = {e360--e368},
title = {Whole blood versus red cell concentrates for children with severe anaemia: a secondary analysis of the Transfusion and Treatment of African Children (TRACT) trial},
url = {http://dx.doi.org/10.1016/S2214-109X(21)00565-9},
volume = {10},
year = {2022}
}

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TY  - JOUR
AB  - Background:The  multicentre  Transfusion  and  Treatment  of  African  Children  (TRACT)  trial  established  best evidence on the timing of transfusion in children with uncomplicated anaemia (haemoglobin 4-6g/dl) and optimal volume (20 versus 30ml/kg whole blood (or 10 vs 15ml/kg red cell concentrates) for  transfusion  in  children  hospitalised  with  severe  anaemia  (Hb  <6g/dl)  on  Day  28  mortality (primary endpoint) and secondary endpoints including safety.  As evidence on the safety of blood components is limited we undertook a secondary analysis comparing children receiving whole blood versus red cell concentrates as their initial transfusion on clinical outcomes.    Methods :This analysis includes 3188 children with severe anaemia (Hb <6g/dl) who received either whole blood  or red cell concentrates. Whole blood or cell concentrates were issued routinely by the blood transfusion services, but not prespecified on the request form. The impact of blood pack type on haematological  correction,  re-transfusion,  and  other  clinical  endpoints  was  explored  using multivariate regression models.   Findings:1632/3992 (41%) transfusions in 3188 children were whole blood. Compared with whole blood, children receiving cell concentrates in their first transfusion had less haemoglobin recovery at 8 hours (packed cells mean(95%CI): -1.3(-1.5,-1.0) 20ml/kg arm,-1.4(-1.6,-1.1) 30ml/kg; settled cells mean(95%CI) -1.1g/dl(-1.2,-0.9) 20ml/kg arm, -1.5g/dl(-1.7,-1.3) 30ml/kg arm; p<0.001 for pack type comparisons, p=0.003 heterogeneity by arm), higher odds of receiving a second transfusion [ORs 2.32  (95%CI  1.30,4.12)  and  2.97  (2.18,4.05)  respectively;  p<0.001],  and  had  a  longer  time  to discharge  [sub-Hazard  Ratios  0.94  (95%CI  0.81,1.10)  and  0.86  (95%  CI  0.79,0.94)  respectively; p=0.002]. No child developed features of cardio-pulmonary overload.  Interpretation:  Whole blood is safe to use in children, resulting in superior aematologic
AU  - George,EC
AU  - Uyoga,S
AU  - M'baya,B
AU  - Byabazair,DK
AU  - Kiguli,S
AU  - Olupot-Olupot,P
AU  - Opoka,RO
AU  - Chagaluka,G
AU  - Alaroker,F
AU  - Williams,TN
AU  - Bates,I
AU  - Mbanya,D
AU  - Gibb,DM
AU  - Walker,AS
AU  - Maitland,K
AU  - TRACT,trail study group
DO  - 10.1016/S2214-109X(21)00565-9
EP  - 368
PY  - 2022///
SN  - 2214-109X
SP  - 360
TI  - Whole blood versus red cell concentrates for children with severe anaemia: a secondary analysis of the Transfusion and Treatment of African Children (TRACT) trial
T2  - The Lancet Global Health
UR  - http://dx.doi.org/10.1016/S2214-109X(21)00565-9
UR  - http://hdl.handle.net/10044/1/93175
VL  - 10
ER  -

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