Blood transfusion thresholds tested to save elderly surgical patients
NCT ID NCT03369210
First seen Jul 07, 2026 · Last updated Jul 22, 2026 · Updated 3 times
Summary
This study tests whether giving blood transfusions more liberally (when hemoglobin drops to 9 g/dL) versus more restrictively (when it drops to 7.5 g/dL) reduces death and serious complications like heart attack, stroke, or kidney injury in patients aged 70 and older undergoing non-cardiac surgery. The trial randomly assigns participants to one of the two transfusion strategies and follows them for 90 days after surgery. The goal is to find the safest approach for managing anemia in this vulnerable population.
What this could mean
Our plain-language read of the trial. This is informational only, not medical advice or a prediction.
- Active substance
- red blood cell transfusion
- What this could lead to
- If liberal transfusion proves superior, it could establish a new standard for managing anemia in elderly surgical patients, potentially reducing deaths and complications.
- What could go wrong
- The trial is large but results may not apply to all surgeries or hospitals. Liberal transfusion carries risks like fluid overload or transfusion reactions.
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Study facts
What this study's own registry entry says, in plain language.
- Phase
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Phase 3
Large-scale testing in a bigger group. Usually the last step before a treatment can be approved.
- Participants
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4,456 people
The number who actually took part.
- Started
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Jan 2018
- Finished
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Apr 2026
- Lead sponsor
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Other sponsor
The registry's catch-all category, for sponsors it does not file as a company, a government agency, or a research network.
Who can take part
This study's own entry requirements. Only the study team can say for certain whether you qualify.
- Ages
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70 years and older
- Sex
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Anyone
- Healthy volunteers
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Not accepted
This study is not open to healthy volunteers. The entry requirements below say who it is open to.
Show the full entry requirements Hide the full entry requirements
Copied word for word from the study's registry entry, so the wording is the study team's rather than ours.
Inclusion Criteria: * Patients ≥ 70 years of age scheduled for intermediate- or high-risk non-cardiac surgery will be registered * Registered patients will be randomised only if they indeed develop severe anaemia (if Hb level falls ≤ 9 g/dl) during surgery (=day 0) or day 1, 2, or 3 after surgery Exclusion Criteria: * preoperative Hb level ≤ 9 g/dl * chronic kidney disease requiring dialysis * suspected lack of compliance with follow-up procedures * participation in other interventional trials * expected death within 3 months * inability to provide informed consent with absence of a legally authorised representative/ legal guardian * temporary inability to provide informed consent * previous participation in our trial * patients who are prevented from having blood and blood products according to a system of beliefs (e.g. Jehovah's Witnesses) * preoperative autologous blood donation.
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Conditions
The condition(s) this trial relates to.
As listed by the trial registrant
The condition terms exactly as the trial's registrant entered them.
Contacts and locations
Locations
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Berlin Charite CCM
Berlin, Germany
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Charite Berlin CBF
Berlin, Germany
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Klinikum Dortmund
Dortmund, Germany
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St. Franziskus Hospital Münster
Münster, Germany
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University Hospital Augsburg
Augsburg, Germany
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University Hospital Bonn
Bonn, Germany
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University Hospital Frankfurt
Frankfurt, Germany
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University Hospital Giessen
Giessen, Germany
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University Hospital Greifswald
Greifswald, Germany
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University Hospital Hamburg
Hamburg, Germany
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University Hospital Jena
Jena, Germany
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University Hospital Mainz
Mainz, Germany
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University Hospital Münster
Münster, Germany
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University Hospital RWTH
Aachen, Germany
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University Hospital Regensburg
Regensburg, Germany
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University Hospital Schleswig-Holstein
Kiel, Germany
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University Hospital Würzburg
Würzburg, 97080, Germany
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