POSSIBILITIES AND PROSPECTS OF PRESERVING PERITONEAL DIALYSIS IN CKD PATIENTS REQUIRING SURGICAL INTERVENTIONS ON ABDOMINAL ORGANS afgm2011@gmail.com

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POSSIBILITIES AND PROSPECTS OF PRESERVING PERITONEAL DIALYSIS IN CKD PATIENTS REQUIRING SURGICAL INTERVENTIONS ON ABDOMINAL ORGANS

3

Colombia

Oral or Poster

Hemorrhage remains a leading cause of preventable death in trauma despite advances in surgery, transfusion, and critical care. Conventional hemostatic resuscitation with blood components in a 1:1:1 ratio has logistical and physiological limitations. Whole blood transfusion provides balanced hemostatic properties and operational advantages, but its impact in civilian trauma care is still uncertain.

The WEBSTER trial is an open-label, prospective, single-center randomized controlled study conducted at a level I trauma center in Colombia. Two hundred-twenty adult patients with traumatic hemorrhagic shock requiring transfusion are randomized in a 1:1:1 ratio to receive either three units of whole blood or a standard blood component package consisting of three red blood cells, three plasma and half an apheresis platelet unit. A second intervention with the same allocation is administered if further transfusion is required. The primary outcome is a hierarchical composite endpoint of 28-day mortality and the change in organ dysfunction, assessed as the SOFA score difference between days 1 and 5. Secondary outcomes include transfusion requirements, coagulation profile, intensive care and hospital-free days, and complications. Safety outcomes include transfusion and trauma-related adverse events.

Recruitment is underway and should be completed in the first half of 2026. We anticipate results that will clarify whether whole blood improves survival and reduces multiorgan dysfunction compared with blood components, providing high-quality evidence for its role in civilian trauma resuscitation.

The WEBSTER trial will inform transfusion strategies in trauma and may reshape hemostatic resuscitation practices in both high- and limited-resource settings. Trial registration: ClinicalTrials.gov: NCT05634109