RePAST

Reference: TF070
Title: A feasibility randomised controlled trial comparing restrictive versus liberal red cell transfusion strategies in stable children undergoing stem cell transplant to understand clinical outcomes to support further trials
Chief investigator: Dr Helen New

Summary

In the UK, children with haematological malignancies and disorders are the largest group of paediatric red cell (RBC) transfusion recipients.

On a background of growing awareness of non-infectious complications of blood transfusions there is a need for increasing scrutiny of current blood practices in high-use areas such as patients with haematological malignancies and haematopoietic stem cell transplants (HSCT).

In addition, health care costs need to be considered, including the relative differences between restrictive and liberal policies, and the use of more single unit compared to double unit transfusions (or equivalent volumes in paediatrics).

There may be benefits to this study including:

reduced risk of complications associated with use of liberal red cell transfusion policies;
the provision of randomised evidence to address this area of clinical uncertainty;
saving the costs of blood that is not used for transfusion and treatments of complications that are avoided (note: reduction in the risk of iron overload and associated complications are not addressed by this feasibility study due to the length of follow-up that would be required).

This is a feasibility study which could progress into a larger randomised study.