Blood transfusion in the care of patients with visceral leishmaniasis: a review of practices in therapeutic efficacy studies

By Dahal P, Singh-Phulgenda S, Wilson J, Cota G, Ritmeijer K, Musa A, Alves F, Kasia Stepniewska K, Philippe J, Guerin PJ. Transactions of The Royal Society of Tropical Medicine and Hygiene 2024, trae018. doi: 10.1093/trstmh/trae018

Summary: Blood transfusion is an important aspect of patient management in visceral leishmaniasis, but practice in clinical trials is poorly reported. This review summarises transfusion practices in efficacy studies for visceral leishmaniasis from 1980 to 2021 using the Infectious Diseases Data Observatory clinical trials library. A description of blood transfusion was presented in just 16 of the 160 studies. In nine studies, transfusion was initiated solely based on haemoglobin measurement, in three studies this was combined with an additional condition (epistaxis/poor health/clinical instability), while in four studies the criteria was not mentioned. The haemoglobin threshold for triggering transfusion ranged from 3 to 8 g/dL. The authors recommend thorough reporting of transfusion episodes and adoption of standardised methodology to allow for a reliable risk-benefit assessment.

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