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Donor sex, age may affect red blood cell transfusion outcomes

Red blood cell transfusions that involved younger or female donors were associated with increased mortality, according to data published in JAMA Internal Medicine.

Michael Chassé, MD, PhD, FRCPC, from Universite Laval in Quebec, Canada, noted growing evidence indicating that characteristics of blood donors, such as aging, may influence recipient outcomes.

"Transfusion of a blood component is analogous to solid organ transplantation because it involves the retrieval of an organ (blood) from a donor, postdonation processing and storage, and ‘transplantation’ (transfusion) into a recipient," they wrote. "Understanding that current evidence (although limited) suggests that blood donor characteristics may influence transfusion recipient outcomes, the 2015 National Heart, Lung, and Blood Institute State of the Science in Transfusion Medicine meeting identified donor factors, such as age and sex, as ‘compelling questions necessitating additional basic, translational or clinical research.’"

Researchers conducted a longitudinal cohort study of 30,503 transfusion recipients who received 187,960 red blood cell transfusions from 80,755 unique donors. They linked data from four academic hospitals to data from a blood collection agency.

Results showed that recipients who received blood from donors aged 17 to 19.9 years had an 8% increased risk for mortality compared with recipients who received blood from donors aged 40 to 49 years (adjusted HR = 1.08; 95% CI, 1.06-1.1; P < .001).

In addition, recipients who received blood from female donors had an 8% increased risk for death compared with male donors (adjusted HR = 1.08; 95% CI, 1.06-1.09; P < .001)

"Cumulative [red blood cell] transfusions from young donors and from female donors were statistically significantly associated with an increased risk of death in a large cohort of transfused recipients," Chassé and colleagues concluded. "These findings suggest that blood donor characteristics may affect transfusion recipient outcome, and clinical trials are warranted."

In an accompanying commentary, Harvey G. Klein, MD, from the department of transfusion medicine at the NIH, wrote that while the "findings should be considered hypotheses," the conclusions "are tantalizing and clearly merit further exploration."

Klein concluded: "Combining clinical trials research with database analysis should provide a powerful tool for tackling fundamental questions regarding blood transfusion, providing rapid responses to emerging transfusion issues and informing blood policy decisions that affect patient care." – by Chelsea Frajerman Pardes

Disclosures: The researchers report no relevant financial disclosures.