Review Red blood cell transfusion policy: a critical literature review Massimo Franchini1,2, Giuseppe Marano1, Carlo Mengoli1, Simonetta Pupella1, Stefania Vaglio1,3, Manuel Muñoz4, Giancarlo M. Liumbruno1 1 Italian National Blood Centre, National Institute of Health, Rome, Italy; 2Department of Haematology and Transfusion Medicine, "Carlo Poma" Hospital, Mantua, Italy; 3Department of Clinical and Molecular Medicine, "Sapienza" University of Rome, Rome, Italy; 4Perioperative Transfusion Medicine, Department of Surgical Sciences, Biochemistry and Immunology, School of Medicine, Málaga, Spain

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however, this arbitrary transfusion trigger has gradually been lowered towards a more "restrictive" one (RTT; haemoglobin level between 7 and 8 g/dL), due to the lack of clinical evidence demonstrating an improved outcome with liberal RBC transfusion practice and with the aim of reducing transfusion-related complications and costs4. Accordingly, a number of randomised clinical trials (RCT) have been conducted to compare the effects of giving RBC with a RTT (haemoglobin concentration