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. 2019 Sep 26;134(13):1003-1013.
doi: 10.1182/blood.2019000773. Epub 2019 Jul 26.

Effect of donor, component, and recipient characteristics on hemoglobin increments following red blood cell transfusion

Nareg H Roubinian  1   2   3 , Colleen Plimier  1 , Jennifer P Woo  4 , Catherine Lee  1 , Roberta Bruhn  2   3 , Vincent X Liu  1 , Gabriel J Escobar  1 , Steven H Kleinman  5 , Darrell J Triulzi  6 , Edward L Murphy  3   2 , Michael P Busch  2   3
Affiliations

Effect of donor, component, and recipient characteristics on hemoglobin increments following red blood cell transfusion

Nareg H Roubinian et al. Blood. .

Abstract

Significant research has focused individually on blood donors, product preparation and storage, and optimal transfusion practice. To better understand the interplay between these factors on measures of red blood cell (RBC) transfusion efficacy, we conducted a linked analysis of blood donor and component data with patients who received single-unit RBC transfusions between 2008 and 2016. Hemoglobin levels before and after RBC transfusions and at 24- and 48-hour intervals after transfusion were analyzed. Generalized estimating equation linear regression models were fit to examine hemoglobin increments after RBC transfusion adjusting for donor and recipient demographic characteristics, collection method, additive solution, gamma irradiation, and storage duration. We linked data on 23 194 transfusion recipients who received one or more single-unit RBC transfusions (n = 38 019 units) to donor demographic and component characteristics. Donor and recipient sex, Rh-D status, collection method, gamma irradiation, recipient age and body mass index, and pretransfusion hemoglobin levels were significant predictors of hemoglobin increments in univariate and multivariable analyses (P < .01). For hemoglobin increments 24 hours after transfusion, the coefficient of determination for the generalized estimating equation models was 0.25, with an estimated correlation between actual and predicted values of 0.5. Collectively, blood donor demographic characteristics, collection and processing methods, and recipient characteristics accounted for significant variation in hemoglobin increments related to RBC transfusion. Multivariable modeling allows the prediction of changes in hemoglobin using donor-, component-, and patient-level characteristics. Accounting for these factors will be critical for future analyses of donor and component factors, including genetic polymorphisms, on posttransfusion increments and other patient outcomes.

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Conflict of interest statement

Conflict-of-interest disclosure: The authors declare no competing financial interests.

Figures

None
Graphical abstract
Figure 1.
Figure 1.
Study flow diagram. Hb, hemoglobin.
See this image and copyright information in PMC

Comment in

References

    1. Ning S, Heddle NM, Acker JP. Exploring donor and product factors and their impact on red cell post-transfusion outcomes. Transfus Med Rev. 2018;32(1):28-35. - PubMed
    1. Kanias T, Gladwin MT. Nitric oxide, hemolysis, and the red blood cell storage lesion: interactions between transfusion, donor, and recipient. Transfusion. 2012;52(7):1388-1392. - PMC - PubMed
    1. Chassé M, Tinmouth A, English SW, et al. . Association of blood donor age and sex with recipient survival after red blood cell transfusion. JAMA Intern Med. 2016;176(9):1307-1314. - PubMed
    1. Vasan SK, Chiesa F, Rostgaard K, et al. . Lack of association between blood donor age and survival of transfused patients. Blood. 2016;127(5):658-661. - PubMed
    1. Heddle NM, Cook RJ, Liu Y, et al. . The association between blood donor sex and age and transfusion recipient mortality: an exploratory analysis. Transfusion. 2019;59(2):482-491. - PubMed

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