Grand Rounds Highlight | “Red Blood Cell Transfusion in Cardiac Patients: How low can you go?” — Jeffrey L. Carson, MD, MACP

Feb 28, 2026

The SUNY Downstate Department of Surgery was honored to welcome Jeffrey L. Carson, MD, MACP (Provost–New Brunswick, Rutgers Biomedical Health Sciences; Distinguished Professor of Medicine, Rutgers Robert Wood Johnson Medical School) as our featured Grand Rounds speaker. Dr. Carson delivered a high-impact lecture on contemporary evidence guiding red blood cell transfusion thresholds in cardiac and high-risk patients, tackling the practical question at the center of daily inpatient care: how low is safe—and for whom? 

A nationally recognized leader in transfusion medicine outcomes research, Dr. Carson reviewed key randomized trial data that shaped modern practice around restrictive transfusion strategies, including landmark work in high-risk surgical patients such as the FOCUS trial, which evaluated liberal versus restrictive transfusion approaches in older patients with cardiovascular disease or risk factors after hip fracture surgery. He also discussed areas where the evidence remains most debated—particularly patients with acute coronary syndromes—highlighting recent high-profile trial data in myocardial infarction and anemia that continue to inform guideline discussions and bedside decision-making.  

Across clinical scenarios, Dr. Carson emphasized a disciplined, patient-centered approach: using evidence-based thresholds as the foundation while incorporating symptoms, comorbidity burden, physiologic reserve, and trajectory of illness to individualize transfusion decisions. The session provided a clear framework for balancing transfusion benefits and risks and offered practical takeaways for perioperative, critical care, and consult services. 

Closer to home, Dr. Carson was also a key contributor to Dr. Kougias’s TOP Trial. We sincerely thank Dr. Carson for an outstanding and clinically impactful Grand Rounds presentation, as well as for his continued invaluable support to our department.