Efficacy and safety of autologous blood pleurodesis versus talc pleurodesis in symptomatic pleural effusions: A randomized trial
Muzaffer Metintas1, Huseyin Yildirim2, AK Guntulu1, Gulden Sari3, Selma Metintas4
1 Department of Chest Diseases, Medical Faculty, Eskisehir Osmangazi University; Lung and Pleural Cancers Research and Clinical Center, Eskisehir Osmangazi University, Eskisehir, Turkey
2 Department of Chest Diseases, Medical Faculty, Eskisehir Osmangazi University, Eskisehir, Turkey
3 Department of Occupational Diseases, Ataturk Chest Diseases and Thoracic Surgery Education Research Hospital, University of Health Sciences, Ankara, Turkey
4 Lung and Pleural Cancers Research and Clinical Center, Eskisehir Osmangazi University; Department of Public Health, Medical Faculty, Eskisehir Osmangazi University, Eskisehir, Turkey
Department of Chest Disease, Medical Faculty, Lung and Pleural Cancers Research and Clinical Center, Eskisehir Osmangazi University, Eskisehir
Source of Support: None, Conflict of Interest: None
PURPOSE: This study aimed to compare the efficacy and safety of autologous blood pleurodesis with talc pleurodesis in patients with symptomatic pleural effusion.
METHODS: This is a prospective, randomized, noninferiority trial. The smallest sample size was determined as 26 for each group by power analyses. For pleurodesis, 5 g of talc and 2 ml/kg blood were administered through the chest catheter. The success rate and complication were recorded in the 1st month after the procedures. The effect of the procedure on the successful pleurodesis was analyzed by univariate and then multivariate logistic regression analysis.
RESULTS: A total of 60 patients were randomized. After randomization, 6 patients withdrew from the study. The overall success rate of pleurodesis was 72.0% in the autologous blood group and 69.0% in the talc group (P = 0.903). The most common complications were fever and pain, and both were higher in the talc group (P = 0.030 and P = 0.001, respectively). For successful pleurodesis, complete lung expansion and catheter duration (<7 days) were important factors in the talc group and in the autologous blood group, respectively (P = 0.001 and P = 0.034). The effect of the procedure on pleurodesis success was not significant (odds ratio [95% confidence interval): 1.51 [0.40–5.77]; P = 0.548) after adjustment for lung expansion and catheter duration.
CONCLUSION: Autologous blood pleurodesis is a simple, inexpensive, effective procedure and no related to significant adverse events for patients with recurrent symptomatic pleural effusion. Especially, it can be preferred in patients with incomplete lung expansion. Further studies are required to confirm the results of this study.