Donor pregnancies and transfusion recipient mortality: A role for red blood cell storage?

Author:

Valk Sarah J.12ORCID,Caram‐Deelder Camila2ORCID,Evers Dorothea3,de Vooght Karen M. K.4,van de Kerkhof Daan5,Wondergem Marielle J.6,Péquériaux Nathalie C. V.7,Hudig Francisca8ORCID,Zwaginga Jaap Jan19,de Korte Dirk1011,van de Watering Leo M. G.112,Middelburg Rutger A.213,van der Bom Johanna G.2

Affiliation:

1. Jon J van Rood Center for Clinical Transfusion Research Sanquin/LUMC Leiden The Netherlands

2. Department of Clinical Epidemiology Leiden University Medical Center Leiden The Netherlands

3. Department of Haematology Radboudumc Nijmegen The Netherlands

4. Central Diagnostic Laboratory University Medical Center Utrecht Utrecht The Netherlands

5. Department of Clinical Chemistry and Haematology Catharina Hospital Eindhoven The Netherlands

6. Department of Haematology Amsterdam UMC, Location VUmc Amsterdam The Netherlands

7. Department of Clinical Chemistry and Haematology Jeroen Bosch Hospital 's‐Hertogenbosch The Netherlands

8. LabWest, Haga Teaching Hospital The Hague The Netherlands

9. Department of Haematology Leiden University Medical Center Leiden The Netherlands

10. Department of Product and Process Development, Sanquin Blood Bank Amsterdam The Netherlands

11. Department of Blood Cell Research, Sanquin Research, and Landsteiner Laboratory University of Amsterdam Amsterdam The Netherlands

12. Department of Transfusion Medicine Sanquin Blood Bank Amsterdam The Netherlands

13. Department of Public Health and Primary Care Leiden University Medical Center Leiden The Netherlands

Abstract

AbstractBackground and ObjectivesDonor characteristics have been implicated in transfusion‐related adverse events. Uncertainty remains about whether sex, and specifically pregnancy history of the blood donor, could affect patient outcomes. Whether storage duration of the blood product could be important for patient outcomes has also been investigated, and a small detrimental effect of fresh products remains a possibility. Here, we hypothesize that fresh red blood cell products donated by ever‐pregnant donors are associated with mortality in male patients.Materials and MethodsWe used data from a cohort study of adult patients receiving a first transfusion between 2005 and 2015 in the Netherlands. The risk of death after receiving a transfusion from one of five exposure categories (female never‐pregnant stored ≤10 days, female never‐pregnant stored >10 days, female ever‐pregnant stored ≤10 days, female ever‐pregnant stored >10 days and male stored for ≤10 days), compared to receiving a unit donated by a male donor, which was stored for >10 days (reference), was calculated using a Cox proportional hazards model.ResultsThe study included 42,456 patients who contributed 88,538 person‐years in total, of whom 13,948 died during the follow‐up of the study (33%). Fresh units (stored for ≤10 days) from ever‐pregnant donors were associated with mortality in male patients, but the association was not statistically significant (hazard ratio 1.39, 95% confidence interval 0.97–1.99). Sensitivity analyses did not corroborate this finding.ConclusionThese findings do not consistently support the notion that the observed association between ever‐pregnant donor units and mortality is mediated by blood product storage.

Funder

Stichting Sanquin Bloedvoorziening

Publisher

Wiley

Subject

Hematology,General Medicine

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