Transfusion with washed versus unwashed red blood cells to reduce morbidity and mortality in infants born less than 28 weeks gestation: a multi-centre, blinded, parallel group, randomised controlled trial. The WashT trial. (WashT)

Research summary

While blood transfusions save lives in the neonatal critical care setting, there is increasing awareness that transfusion of blood products is an independent predictor of adverse outcome. Infants in a neonatal intensive care unit (NICU) are among the most frequently transfused patients with the incidence and severity of major neonatal morbidities known to correlate with the number and volume of red blood cell (RBC) transfusions they receive. The spectrum of post-transfusion effects on organs and tissues which manifest as increased morbidity or mortality has been termed transfusion related immunomodulation (TRIM). Whether transfused cells themselves, the supernatant, or both contribute to poor clinical outcome attributed to TRIM remains open to conjecture. The primary aim of this randomised trial is to evaluate how washed blood affects problems related to preterm birth. This study has been running in Australia since 2020 and is now expanding to the UK, with recruitment taking place from neonatal units at 6 hospital sites in England. To participate, all infants born less than 28 weeks are eligible, if neonatal staff decide a red blood cell transfusion is needed. Each infant/participant will be randomised by a computer-generated schedule with a 50/50 chance of receiving either unwashed red blood cells or an identical pack of washed red blood cells which will be provided from NHS Blood and Transplant (NHSBT). All participation will be subject to consent and all data will be collected by hospital staff trained in the study. The WashT study is funded by the National Health and Medical Research Council (NHMRC) and is due to conclude in 2027.

Principal Investigator

Dr Amit Gupta

Contact us

Email: neonatal.research@ouh.nhs.uk

IRAS number

353111