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).