Impact of the Composition of Packed Red Blood Cell Supernatant on Renal Dysfunction and Posttransfusion Immunomodulation

Exclusion Criteria

• •Heart and/or lung transplant surgery;
• •Emergency surgery to be performed within 24 hours;
• •Patient \<18 years old;
• •Pregnant woman
• •Protected adult
• •Adult incapable of expressing his/her non-opposition
• •Opposition expressed by the patient on recording his/her data;
• •No French social security;
• •Patient who underwent a transfusion in the 3 months prior to surgery;
• •Surgery due to endocarditis or suspected endocarditis;
• •Myocardial infarction \< 15 days;
• •Patient receiving inotropic or vasopressor prior to surgery;
• •Patient receiving immunosuppressant treatment;
• •Patient receiving corticosteroids for 21 days or more;
• •Seropositive patient known to be suffering from HIV, hepatitis B virus (HBV) or hepatitis C virus (HCV)
• •Currently taking antibiotics (except permitted peri-surgical antibiotic prophylaxis );
• •History of advancing cancer;
• •Clearance \< 40 ml/min/m2 according to the Modification of Diet in Renal Disease (MDRD) during the pre-surgical assessment;
• •Positive irregular antibody test warranting a cross-match prior to transfusion.
• •Patients with indwelling urinary catheter preoperatively
• •preoperative positive urine culture
• •Urinary tract infection \<21 days before surgery
• •Background gesture on the upper or lower urinary tract
• •In the renal insufficient group: Patient transfused plasma (s) Fresh Frozen (s) (PFCs) or concentrate (s) platelet (s) (CP) after the balance sheet T6 (6 hours after arrival in the ICU) and before the diagnosis of ARF,
• •strict anuric patient not to achieve a 50 ml urine sample at least
• •Reversal surgery requiring CEC before the 48th hour
• •Surgical Complication could explain the acute renal failure (IRA)