Liberal transfusion no better than restrictive in cancer septic shock

The TRANSPORT trial, a multicenter French randomized controlled trial, compared liberal (hemoglobin threshold 9.0 g/dL) versus restrictive (7.0 g/dL) red blood cell transfusion strategies in cancer patients with septic shock and elevated lactate. The trial reported no significant difference in 12-hour lactate reduction between groups and no significant difference in 28-day mortality, but found more arterial or venous thrombotic events in the liberal transfusion arm (13% vs 1%); the trial was stopped early for safety concerns before reaching planned enrollment. The authors state that the findings do not support routine preference of either transfusion strategy over the other.

Most relevant for: Patients with hematological or solid malignancies presenting with septic shock and anemia requiring transfusion decisions during early resuscitation.

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