Standard Issue Transfusion Versus Fresher Red Blood Cell Use in Intensive Care- A Randomised Controlled Trial (TRANSFUSE)

October 19, 2020 updated by: David James Cooper, Australian and New Zealand Intensive Care Research Centre

A Multi-centre Randomised Double Blinded Phase III Trial of the Effect of Standard Issue Red Blood Cell Blood Units on Mortality Compared to Freshest Available Red Blood Cell Units

In Australia, blood for transfusion has a "use by" date of 42 days after collection. The actual age of blood given to patients depends on what is available at the time and the rate of usage. During the last decade, it has been reported that blood transfusion in patients admitted to intensive care was associated with an independent increase of mortality. Some research suggests that transfusion of fresher blood might help patients in the intensive care unit to reach a better recovery. This project will test whether patients who receive 'fresher' blood do better than patients who receive 'standard issue' blood.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Completed

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Detailed Description

Inclusion criteria

•Patients hospitalised in ICU with an anticipated ICU stay of at least 24 hours, in whom the decision has been made by medical staff to transfuse at least one RBC unit.

Exclusion criteria

  • Age younger than 18
  • Previous RBC transfusion during the current hospital admission (including transfusion in another hospital for transferred patients)
  • Diagnosis of transplantation or hematologic diseases
  • Pregnancy
  • Cardiac surgery during the present hospital admission
  • Expected to die imminently (<24hrs)
  • The treating physician believes it is not in the best interest of the patient to be randomised in this trial.
  • Known objection to the administration of human blood products
  • Participation in a competing study

Primary outcome- 90 day mortality

Secondary outcomes

  1. 28 day mortality
  2. Persistent Organ Dysfunction combined with death at 28
  3. Days alive and free of mechanical ventilation at day 90 post randomisation
  4. Day alive and free of renal replacement therapy at day 90 post randomisation
  5. Blood stream infection in ICU (post randomisation) defined using the Center for Disease Control and Prevention/National Healthcare Safety Network criteria
  6. Length of stay in ICU and in hospital post randomisation
  7. Febrile non-haemolytic transfusion reactions
  8. EQ-5D score at Day 90 post randomisation

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Interventional

Enrollment (Actual)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
4994

Phase

Phase

The stage of a clinical trial studying a drug or biological product, based on definitions developed by the U.S. Food and Drug Administration (FDA). The phase is based on the study's objective, the number of participants, and other characteristics. There are five phases: Early Phase 1 (formerly listed as Phase 0), Phase 1, Phase 2, Phase 3, and Phase 4. Not Applicable is used to describe trials without FDA-defined phases, including trials of devices or behavioral interventions.
  • Phase 3

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Australia
      • Adelaide, Australia
        • Royal Adelaide Hospital
      • Adelaide, Australia
        • Lyell McEwin Hospital
      • Adelaide, Australia
        • Queen Elizabeth Hospital
      • Albury, Australia
        • Albury Hospital
      • Bendigo, Australia
        • Bendigo Hospital
      • Brisbane, Australia
        • Mater Adult Hospital
      • Brisbane, Australia
        • Princess Alexandra Hospital
      • Brisbane, Australia
        • Royal Brisbane and Women's Hospital
      • Brisbane, Australia
        • Logan Hospital
      • Brisbane, Australia
        • Mater Private Hospital
      • Canberra, Australia
        • Canberra Hospital
      • Canberra, Australia
        • Calvary Health
      • Dandenong, Australia
        • Dandenong Hospital
      • Geelong, Australia
        • Geelong Hospital
      • Gold Coast, Australia
        • Gold Coast Hospital
      • Gosford, Australia
        • Gosford Hospital
      • Heidelberg, Australia
        • Austin Hospital
      • Hobart, Australia
        • Royal Hobart Hospital
      • Melbourne, Australia
        • Monash Medical Centre
      • Melbourne, Australia
        • Royal Melbourne Hospital
      • Melbourne, Australia
        • St Vincent's Hospital
      • Melbourne, Australia
        • Cabrini Hospital
      • Melbourne, Australia
        • Frankston Hospital
      • Melbourne, Australia
        • Knox Private Hospital
      • Melbourne, Australia
        • Northern Hospital
      • Melbourne, Australia
        • Sunshine Hospital
      • Melbourne, Australia
        • Western Hospital
      • Newcastle, Australia
        • John Hunter Hospital
      • Newcastle, Australia
        • Calvary Mater Newcastle
      • Perth, Australia
        • Royal Perth Hospital
      • Perth, Australia
        • Fiona Stanley Hospital
      • Perth, Australia
        • St John of God Murdoch Hospital
      • Richmond, Australia
        • Epworth Hospital
      • Sydney, Australia
        • Royal Prince Alfred Hospital
      • Sydney, Australia
        • Nepean Hospital
      • Sydney, Australia
        • Blacktown Hospital
      • Sydney, Australia
        • Prince of Wales Hospital
      • Sydney, Australia
        • St George Hospital
      • Sydney, Australia
        • St Vincent's Hospital
      • Tamworth, Australia
        • Tamworth Hospital
      • Wollongong, Australia
        • Wollongong Hospital
    • Victoria
      • Melbourne, Victoria, Australia, 3004
        • The Alfred Hospital
  • Finland
      • Helsinki, Finland
        • Helsinki University Hospital
      • Tampere, Finland
        • Tampere University Hospital
  • Ireland
      • Cork, Ireland
        • Cork University Hospital
      • Dublin, Ireland
        • Beaumont Hospital
      • Dublin, Ireland
        • St James's Hospital
      • Dublin, Ireland
        • St Vincent's University Hospital
      • Galway, Ireland
        • Galway Regional Hospital
      • Limerick, Ireland
        • Limerick Regional Hospital
  • New Zealand
      • Auckland, New Zealand
        • Middlemore Hospital
      • Auckland, New Zealand
        • North Shore Hospital
      • Auckland, New Zealand
        • Auckland City Hospital CVICU
      • Auckland, New Zealand
        • Auckland City Hospital DCCM
      • Christchurch, New Zealand
        • Christchurch Hospital
      • Dunedin, New Zealand
        • Dunedin Hospital
      • Hamilton, New Zealand
        • Waikato Hospital
      • Nelson, New Zealand
        • Nelson Hospital
      • Wellington, New Zealand
        • Wellington Hospital
  • Saudi Arabia
      • Riyadh, Saudi Arabia
        • King Abdulaziz Medical City

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

14 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • Patients hospitalised in ICU with an anticipated ICU stay of at least 24 hours, in whom the decision has been made by medical staff to transfuse at least one RBC unit.

Exclusion Criteria:

  • Age younger than 18
  • Previous RBC transfusion during the current hospital admission (including transfusion in another hospital for transferred patients)
  • Diagnosis of transplantation or hematologic diseases
  • Pregnancy
  • Cardiac surgery during the present hospital admission
  • Expected to die imminently (<24hrs)
  • The treating physician believes it is not in the best interest of the patient to be randomised in this trial.
  • Known objection to the administration of human blood products
  • Participation in a competing study (see below)

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Quadruple

Arms and Interventions

Participant Group / Arm

Participant Group / Arm

A group or subgroup of participants in a clinical trial that receives a specific intervention/treatment, or no intervention, according to the trial's protocol.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
Active Comparator: Standard of care
Blood Transfusion Standard of care- oldest blood.
Other: Blood transfusion
Blood transfusion in ICU patients aged 18 and over.
Other: Arm B
Blood Transfusion Freshest blood.
Other: Blood transfusion
Blood transfusion in ICU patients aged 18 and over.

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Mortality at Day 90
Time Frame: 90 Day
Mortality at Day 90
90 Day

Secondary Outcome Measures

Secondary Outcome Measures

In a clinical study's protocol, a planned outcome measure that is not as important as the primary outcome measure for evaluating the effect of an intervention but is still of interest. Most clinical studies have more than one secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
Mortality at Day 28
Time Frame: 28 day
Mortality at day 28
28 day
Persistent Organ Dysfunction Combined With Death Measured at Day 28
Time Frame: day 28
Persistent Organ Dysfunction combined with death measured at day 28
day 28
Days Alive and Free of Mechanical Ventilation
Time Frame: day 28
Days alive and free of mechanical ventilation
day 28
Day Alive and Free of Renal Replacement Therapy.
Time Frame: day 28
Day alive and free of renal replacement therapy.
day 28
Blood Stream Infection in ICU (Post Randomisation)
Time Frame: While in ICU-Median duration in ICU - short term storage group was 4.2 days (2.0 - 9.3), long term storage group was 4.2 days (1.9 - 9.4)
Blood stream infection in ICU (post randomisation) Time Frame is in Days
While in ICU-Median duration in ICU - short term storage group was 4.2 days (2.0 - 9.3), long term storage group was 4.2 days (1.9 - 9.4)
Length of Stay in ICU and in Hospital Post Randomisation (Days)
Time Frame: Median duration in ICU- short term storage group 4.2 Days (2.0 - 9.3), long term storage group 4.2 Days (1.9 - 9.4). Median duration in Hospital- short term storage group was 14.5 days (7.4 - 27.5), long term storage group was 14.7 days(7.4 - 28.3)
Median duration in ICU - short term storage group was 4.2 (2.0 - 9.3), long term storage group was 4.2 (1.9 - 9.4) Median duration in Hospital - short term storage group was 14.5 (7.4 - 27.5), long term storage group was 14.7 (7.4 - 28.3) In Days
Median duration in ICU- short term storage group 4.2 Days (2.0 - 9.3), long term storage group 4.2 Days (1.9 - 9.4). Median duration in Hospital- short term storage group was 14.5 days (7.4 - 27.5), long term storage group was 14.7 days(7.4 - 28.3)
Proportion of Patients Who Suffer at Least One Febrile Non-haemolytic Transfusion Reaction in ICU
Time Frame: While in ICU-Median duration in ICU - short term storage group was 4.2 days (2.0 - 9.3), long term storage group was 4.2 days (1.9 - 9.4)
Proportion of patients who suffer at least one febrile non-haemolytic transfusion reaction in ICU
While in ICU-Median duration in ICU - short term storage group was 4.2 days (2.0 - 9.3), long term storage group was 4.2 days (1.9 - 9.4)
EuroQol-5Dimension 5 Level (EQ-5D-5L) Score at Day 180 Post Randomisation
Time Frame: Day 180
EuroQol-5Dimension 5 level (EQ-5D-5L) score at day 180 post randomisation - not reported yet
Day 180

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
Australian and New Zealand Intensive Care Research Centre

Collaborators

Collaborators

An organization other than the sponsor that provides support for a clinical study. This support may include activities related to funding, design, implementation, data analysis, or reporting.
University College Dublin
King Abdulaziz Medical City
Australian Red Cross
New Zealand Blood Service
Irish Blood Transfusion Service
Finnish Red Cross Blood Service

Investigators

Investigators

A researcher involved in a clinical study. Related terms include site principal investigator, site sub-investigator, study chair, study director, and study principal investigator.
  • Principal Investigator: D. James Cooper, A.O., M.D., Monash University/Alfred Hospital

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Helpful Links

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
October 1, 2012

Primary Completion (Actual)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
April 1, 2017

Study Completion (Actual)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
June 1, 2017

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
July 9, 2012

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
July 10, 2012

First Posted (Estimate)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
July 11, 2012

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
October 22, 2020

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
October 19, 2020

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
October 1, 2020

More Information

Terms related to this study

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • ANZICRCDJC006

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

Undecided

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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