Transfusion from male-only versus female donors in critically ill recipients of high plasma volume components

Ognjen Gajic, Murat Yilmaz, Remzi Iscimen, Daryl J Kor, Jeffrey L. Winters, S. Breanndan Moore, Bekele Afessa

Research output: Contribution to journalArticle

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Abstract

OBJECTIVE: To reduce the incidence of transfusion-related acute lung injury (ALI), the American Association of Blood Banks recently recommended rapid implementation of strategies to minimize transfusion of high plasma volume components, fresh frozen plasma and apheresis platelets, from potentially alloimmunized donors, especially females. The objective of this study was to evaluate the effect of transfusing components from male-only vs. female donors on development of ALI, gas exchange, and outcome in critically ill patients. DESIGN: In this retrospective case-control study, we identified patients who received high plasma volume components from male-only donors and compared them with patients matched by severity of illness, postoperative state, and number of transfusions but who received high plasma volume components from female donors. SETTING: Four intensive care units at a tertiary medical center. PATIENTS: Critically ill patients who received >2 units of fresh frozen plasma or apheresis platelets. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: From a database of 3,567 patients who received a total of 46,101 units of fresh frozen plasma and 6,251 units of apheresis platelets, we identified 112 patients who received three or more male-only donor components and 112 matched controls. Baseline characteristics, ALI risk factors, and development of ALI were similar between the two groups. Arterial oxygenation (Pao2/Fio2) worsened after the female (mean difference -52, 95% confidence interval -14 to -91, p = .008) but not after male-only donor product transfusion (mean difference 22, 95% confidence interval -23 to 67, p = .325). Male-only component recipients had more ventilator-free days (median 28 vs. 27, p = .006) and a trend toward lower hospital mortality rates (14% vs. 24%, p = .054). CONCLUSIONS: In critically ill recipients of high plasma volume components, gas exchange worsened significantly after transfusion of female but not male donor components. Prospective studies are needed to evaluate the effect of recommendations by the American Association of Blood Banks on outcome of transfused critically ill patients.

Original languageEnglish (US)
Pages (from-to)1645-1648
Number of pages4
JournalCritical Care Medicine
Volume35
Issue number7
DOIs
StatePublished - Jul 2007

Fingerprint

Plasma Volume
Critical Illness
Tissue Donors
Acute Lung Injury
Blood Component Removal
Blood Platelets
Gases
Confidence Intervals
Mechanical Ventilators
Hospital Mortality
Intensive Care Units
Case-Control Studies
Databases
Prospective Studies
Mortality
Incidence

Keywords

  • Adult
  • Cohort study
  • Fresh frozen plasma
  • Outcome
  • Platelet transfusion
  • Prevention
  • Respiratory distress

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

Cite this

Transfusion from male-only versus female donors in critically ill recipients of high plasma volume components. / Gajic, Ognjen; Yilmaz, Murat; Iscimen, Remzi; Kor, Daryl J; Winters, Jeffrey L.; Moore, S. Breanndan; Afessa, Bekele.

In: Critical Care Medicine, Vol. 35, No. 7, 07.2007, p. 1645-1648.

Research output: Contribution to journalArticle

Gajic, Ognjen ; Yilmaz, Murat ; Iscimen, Remzi ; Kor, Daryl J ; Winters, Jeffrey L. ; Moore, S. Breanndan ; Afessa, Bekele. / Transfusion from male-only versus female donors in critically ill recipients of high plasma volume components. In: Critical Care Medicine. 2007 ; Vol. 35, No. 7. pp. 1645-1648.
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AU - Yilmaz, Murat

AU - Iscimen, Remzi

AU - Kor, Daryl J

AU - Winters, Jeffrey L.

AU - Moore, S. Breanndan

AU - Afessa, Bekele

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N2 - OBJECTIVE: To reduce the incidence of transfusion-related acute lung injury (ALI), the American Association of Blood Banks recently recommended rapid implementation of strategies to minimize transfusion of high plasma volume components, fresh frozen plasma and apheresis platelets, from potentially alloimmunized donors, especially females. The objective of this study was to evaluate the effect of transfusing components from male-only vs. female donors on development of ALI, gas exchange, and outcome in critically ill patients. DESIGN: In this retrospective case-control study, we identified patients who received high plasma volume components from male-only donors and compared them with patients matched by severity of illness, postoperative state, and number of transfusions but who received high plasma volume components from female donors. SETTING: Four intensive care units at a tertiary medical center. PATIENTS: Critically ill patients who received >2 units of fresh frozen plasma or apheresis platelets. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: From a database of 3,567 patients who received a total of 46,101 units of fresh frozen plasma and 6,251 units of apheresis platelets, we identified 112 patients who received three or more male-only donor components and 112 matched controls. Baseline characteristics, ALI risk factors, and development of ALI were similar between the two groups. Arterial oxygenation (Pao2/Fio2) worsened after the female (mean difference -52, 95% confidence interval -14 to -91, p = .008) but not after male-only donor product transfusion (mean difference 22, 95% confidence interval -23 to 67, p = .325). Male-only component recipients had more ventilator-free days (median 28 vs. 27, p = .006) and a trend toward lower hospital mortality rates (14% vs. 24%, p = .054). CONCLUSIONS: In critically ill recipients of high plasma volume components, gas exchange worsened significantly after transfusion of female but not male donor components. Prospective studies are needed to evaluate the effect of recommendations by the American Association of Blood Banks on outcome of transfused critically ill patients.

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