Please select the eligibility criteria that correspond to the clinical trial below.
Title: Transfusion of Red Cells in Hematopoietic Stem Cell Transplantation: The TRIST Study
Brief Summary: Transfusion of red blood cells (RBCs) is important for the care of patients undergoing stem cell transplantation. Stem cell transplants are used to treat blood cancers and bone marrow disorders. This involves the use of high doses of chemotherapy and/or radiation to kill cancer cells; but this damages the marrow and blood system. Blood stem cells are transplanted by infusing into the recipient and blood counts recover over 2-3 weeks. Before bone marrow recovery, RBCs are needed to support the patient. Higher hemoglobin in these high risk patients may have benefits such as better energy and organ function. However, research in other areas of medicine suggests that a higher red cell count may be dangerous. Taken together, it is unclear whether having a lower or higher red cell count is better for patients having a blood stem cell transplant. The investigators plan to study this by randomly assigning patients having a transplant to be transfused with RBCs either at a higher or lower hemoglobin level. In this way, the investigators will be able to accurately find out if there are any benefits or harms in having a lower or higher red cell count during the recovery period after blood stem cell transplantation.


Options:
A: Inclusion Criteria:

* Age 18 or older
* Planned cardiac surgery using cardiopulmonary bypass
* Informed consent obtained
* Preoperative European System for Cardiac Operative Risk Evaluation (EuroSCORE I) of 6 or more

Exclusion Criteria:

* Patients who are unable to receive or who refuse blood products
* Patients who are involved in a preoperative autologous pre-donation program
* Patients who are having a heart transplant or having surgery solely for an insertion of a ventricular assist device
* Pregnancy or lactation (a negative pregnancy test must be obtained prior to randomization for women of childbearing potential.)
* Patients who are unable to receive or who refuse blood products
B: Inclusion Criteria:

* The patient remains in the ICU after 96 hours (4 days) or more following ICU admission
* The patient has required mechanical ventilation via an endotracheal tube or tracheostomy tube for 96 hours or more
* The patient is expected to require ≥24 hours of further mechanical ventilation at the time of assessment
* The patient is aged ≥55 years of age
* The patient has a Hb value of 90g/L or less at the time of assessment

Exclusion Criteria:

* Patient with active bleeding at the time of screening
* Patient with traumatic brain injury as presenting diagnosis
* Patient with intracranial haemorrhage as presenting diagnosis
* Patient not expected to survive the next 48 hours at the time of assessment.
* Patient objects to RBC transfusion
* Patient receiving concurrent treatment with erythropoietin or similar erythropoietic agent
* Follow up is not feasible
* Already enrolled in another RCT with similar clinical endpoints
C: Inclusion Criteria:

* 18 years or older
* Patients undergoing replacement of hip arthroplasty
* Be legally competent
* Read and understand Danish

Exclusion Criteria:

* Present malignant disease
* Known heart disease with functionality equivalent to NYHA II or CCS II or worse
D: Inclusion Criteria:

* Patients are aged 16-70 undergoing either an autologous or allogeneic HSCT for any hematologic malignancy

Exclusion Criteria:

* Pregnant or lactating at the time of enrollment
* Already received red cell transfusion after HSCT but prior to enrollment
* Unable/unwilling to provide informed consent.
* Patients receiving HSCT for non-malignancy

Answer: D