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

AIM: To assess red blood cell (RBC) transfusion effects on acute kidney injury (AKI) after transcatheter aortic valve replacement (TAVR). METHODS: A literature search was performed using MEDLINE, EMBASE, Cochrane Database of Systematic Reviews, and clinicaltrials.gov from the inception of the databases through December 2015. Studies that reported relative risk, odds ratio or hazard ratio comparing the risks of AKI following TAVR in patients who received periprocedural RBC transfusion were included. Pooled risk ratio (RR) and 95%CI were calculated using a random-effect, generic inverse variance method. RESULTS: Sixteen cohort studies with 4690 patients were included in the analyses to assess the risk of AKI after TAVR in patients who received a periprocedural RBC transfusion. The pooled RR of AKI after TAVR in patients who received a periprocedural RBC transfusion was 1.95 (95%CI: 1.56-2.43) when compared with the patients who did not receive a RBC transfusion. The meta-analysis was then limited to only studies with adjusted analysis for confounders assessing the risk of AKI after TAVR; the pooled RR of AKI in patients who received periprocedural RBC transfusion was 1.85 (95%CI: 1.29-2.67). CONCLUSION: Our meta-analysis demonstrates an association between periprocedural RBC transfusion and a higher risk of AKI after TAVR. Future studies are required to assess the risks of severe AKI after TAVR requiring renal replacement therapy and mortality in the patients who received periprocedural RBC transfusion.