RecentRCT

TRANSPORT

Early red blood cell transfusion strategy in septic shock among patients with cancer: the TRANSPORT randomized controlled trial

Intensive care medicine, 2026 · Multicenter superiority trial; stopped early for safety

Population: 187 adults with cancer, septic shock, lactate >2 and Hb <9 g/dL
Intervention: Hb transfusion threshold 9 g/dL for 48 hours
Comparator: Threshold 7 g/dL
Primary outcome: Twelve-hour lactate reduction
Result: 52% versus 50%; OR 1.07 (95% CI 0.60–1.90), P=.82. Thrombotic events were 13% versus 1%; mortality did not differ significantly.

What the trial found

52% versus 50%; OR 1.07 (95% CI 0.60–1.90), P=.82. Thrombotic events were 13% versus 1%; mortality did not differ significantly.

Clinical interpretation

No superiority of a liberal strategy was demonstrated. Early termination and the thrombotic imbalance preclude a blanket liberal target or a mortality-equivalence claim.

Limitations

Apply only to the source-defined population and outcomes; full protocol/subgroup details were not verified for every report.

Moderate certainty

Clinical Context & Relevant Topics (1)

Disease Reference

Septic Shock

The subset of sepsis with profound circulatory and cellular/metabolic abnormality — clinically identified by a vasopressor requirement to maintain MAP ≥ 65 mmHg plus lactate > 2 mmol/L despite adequate fluid resuscitation.

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