Should donor sex influence blood transfusion practices?

Men are more likely to die early if they receive blood from a woman who has been pregnant

Men are more likely to die early if they receive blood from a woman who has been pregnant

The study, published today (Oct. 17) in the journal JAMA, found that men who received blood transfusions from previously pregnant female donors were 13 percent more likely to die during the study period, compared with men who received blood transfusions from male donors.

Research to date on sex-mismatched blood donations has been inconclusive, and the current findings would need to be verified in other patient populations before considering any changes to current transfusion practices that don't consider sex in matching donors with recipients, said Gustaf Edgren, a researcher at the Karolinska Institute in Stockholm who wasn't involved in the study.

The study appears in the October 17 issue of the Journal of the American Medical Association.

The study team examined data on 31,118 patients who received a total of 59,320 red blood cell transfusions at six Dutch hospitals from 2005 to 2015.

However, the risk is unlikely to prompt any immediate change in blood donation policies, said Dr. Louis Katz, chief medical officer for America's Blood Centers.

It found that male recipients who received a transfusion from an ever-pregnant female donor had "a statistically significant increase" in mortality compared with those who received a transfusion from a male donor or from a female donor without a history of pregnancy. The majority of the blood donors were men; just 6 percent were women who had been pregnant in the past, and another 6 percent were women without a history of pregnancy.

Doctors have known that, in rare cases, people who receive a blood transfusion develop a condition called transfusion-related acute lung injury (TRALI), a serious inflammatory reaction in the lungs that can result in death. It has been associated specifically with previously pregnant female donors, the researchers said.

Overall, almost 4,000 participants died during the study period.

Men who receive blood donated by previously pregnant women may face an increased risk of death following the transfusion, a new study from the Netherlands suggests.

"An alternative explanation could be a difference in iron status between ever-pregnant female and male donors".

The reasons are unclear, and the study wasn't focused on explaining them, but senior author Rutger Middelburg of Leiden University Medical Center in The Netherlands and colleagues write in JAMA that it's possible antibodies women develop during pregnancy to protect their growing baby might later trigger unsafe reactions in some male recipients of blood from previously pregnant donors. Therefore, more studies are needed to confirm the results, Cable and Edgren said. But this isn't the first time that transfusion dangers have been associated with blood from women who've been pregnant, Katz and the Dutch researchers said. For example, because the patients in the study received blood transfusions from only one type of donor, these patients tended to receive fewer transfusions than the average transfusion patient.

Most patients require ventilation support.

Notably, the death risk increase disappeared for men over the age of 50, regardless of who the donor was, they add.

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