Association of blood transfusion with acute kidney injury after transcatheter aortic valve replacement: A meta-analysis

Table 1 Main characteristics of the studies included in this meta-analysis

Ref.	Country1	Year	n	Transfusion definition	AKI definition (changes in baseline)	RR for AKI	Confounder adjustment	S, C, O2
Sinning et al[25]	Germany	2010	77	RBC in 2 d post-procedure	Increase in SCr of ≥ 0.3 mg/dL or ≥ 50% or U output < 0.5 mL/kg per hour for > 6 h in 48 h post procedure	1.19 (0.43-3.31)	None	3, 0, 3
Bagur et al[15]	Canada	2010	213	Peri-procedural blood	Decrease in eGFR of > 25% at 48 h post procedure or hemodialysis needed during index hospitalization	3.47 (1.30-9.29)	HTN, COPD	3, 1, 3
Van Linden et al[18]	Germany	2011	261	Blood > 4 u in 7 d post-operative	Decrease in eGFR of > 25% or increase in SCr of 50% in 7 d post procedure	AKI 3.7 (1.7-7.9) RRT 8.8 (1.7-45.6)	None	3, 0, 3
Nuis et al[29]	Netherlands	2011	118	Peri-procedural RBC	Increase in SCr of ≥ 0.3 mg/dL or ≥ 50% in 72 h post procedure	1.29 (1.01-1.70)	Previous MI, leukocyte count, logistic EuroScore	3, 1, 3
Elhmidi et al[24]	Germany	2011	234	Post-operative blood	Decrease in eGFR of > 25% or increase in SCr of 50% in 7 d post procedure	0.43 (0.15-1.23)	Baseline creatinine, STS score, DM	3, 2, 3
Madershahian et al[14]	Germany	2012	50	RBC	Increase in SCr of ≥ 0.5 mg/dL or ≥ 25% from baseline within 48 h post procedure	8.92 (1.34-59.26)	COPD and contrast amount	3, 1, 3
Kong et al[23]	Australia	2012	52	Peri-procedural RBC	SCr criteria of RIFLE classification in 48 h post procedure	2.4 (2.0-3.1)	TA, history of HTN	3, 1, 3
Tchetche et al[22]	France, Netherlands, Italy	2012	743	RBC	Increase in SCr of ≥ 0.3 mg/dL or ≥ 50% in 72 h post procedure	2.34 (1.72-3.18)	None	3, 0, 3
Barbash et al[16]	United States	2012	165	Post procedure blood	Increase in SCr of ≥ 0.3 mg/dL or ≥ 50% in 72 h post procedure	2.58 (1.05-6.29)	None	3, 0, 3
Nuis et al[28]	Netherlands, Canada, Germany, Belgium, Columbia	2012	995	RBC in 24 h post procedure	Increase in SCr of ≥ 0.3 mg/dL or ≥ 50% in 72 h post procedure	1-2 u, 1.47 (0.98-2.22); 3-4 u, 3.05 (1.24-7.53); ≥ 5 u, 4.81 (1.45-15.95)	PVD, CHF, maximal leukocyte count, logistic EuroScore	3, 2, 3
Saia et al[17]	Italy	2013	102	Peri-procedural RBC	Increase in SCr of ≥ 0.3 mg/dL or ≥ 50% in 72 h post procedure	2.28 (1.02-5.10)	None	3, 0, 3
Konigstein et al[20]	Israel	2013	251	Blood	Increase in SCr of ≥ 0.3 mg/dL or ≥ 50% in 72 h post procedure	2.00 (1.01-3.97)	Gender, HTN, DM, dyslipidemia, PVD, CHF, stroke, COPD, PHTN, VC, CKD, valve type and size	3, 2, 3
Yamamoto et al[19]	France	2013	415	RBC	Increase in SCr of ≥ 0.3 mg/dL or ≥ 50% in 72 h post procedure	3.01 (1.54-6.15)	Contrast amount and LVEF	3, 1, 3
Généreux et al[26]	United States	2013	218	Blood	VARC-modified RIFLE stage 2 or 3 until discharge	2.22 (0.83-5.92)	None	3, 0, 3
Thongprayoon et al[21]	United States	2015	386	Intra-operative RBC	Increase in SCr of ≥ 0.3 mg/dL in 48 h or ≥ 50% in 7 d post procedure	2.03 (1.28-3.23)	None	3, 0, 3
van Rosendael et al[27]	Netherlands	2015	210	Peri-procedural RBC	Increase in SCr of ≥ 0.3 mg/dL or ≥ 50% in 7 d post procedure	1.09 (0.54-2.22)	None	3, 0, 3

¹Countrys are listed by their three letter country code;

²Quality Assessment Newcastle-Ottawa scale: S: Selection; C: Comparability; O: Outcome. AKI: Acute kidney injury; CHF: Congestive heart failure; CKD: Chronic kidney disease; COPD: Chronic obstructive pulmonary disease; DM: Diabetes mellitus; eGFR: Estimated glomerular filtration rate; HTN: Hypertension; LVEF: Left ventricular ejection fraction; MI: Myocardial infraction; PHTN: Pulmonary hypertension; PVD: Peripheral vascular disease; RIFLE: Risk, injury, failure, loss of kidney function, and end-stage kidney disease; SCr: Serum creatinine; STS: Society of thoracic surgeons; TA: Transapical approach; VARC: Valve academic research consortium; VC: Vascular complication; RBC: Red blood cell.