Sex-mismatched transfusions and recipient mortality

Background

Our group has previously found that sex-mismatch (males patients receiving blood from female donors and female patients receiving blood from male donors) increases recipient mortality (Middelburg, et al. 2011). In the present project we aim to confirm or refute these findings in an independent larger cohort.

Rationale

The primary objectives of Sanquin Blood Supply include stimulating the safe and effective use of blood products and performing research that will help to reach this objective. If a true effect of donor sex-mismatch on recipient mortality is confirmed, this should lead to a change in donor-recipient matching strategies and logistics, leading to further optimization of the safe and effective use of blood products.

Methodology

We are performing a study based on data recorded in existing databases from several hospitals in the Netherlands. Hospitals provide data on all blood transfusions (red cells, plasma and platelets) and on characteristics of the patients who received those transfusions. Through the unit identification number these data are then linked to the donor and donation data from the Sanquin Blood Supply. The primary outcome is mortality within 90 days.
Sex-mismatched transfusions, measured both as cumulative absolute number and as proportion of all transfusions are compared to sex-matched transfusions. The effect on mortality is estimated using time-varying cox regression. This analysis method allows modelling the relation between exposure (sex-mismatch), outcome (mortality), and confounders (total number of transfusions, year of transfusion, ABO and Rh blood type, sex of the patient, and hospital) taking into account that exposure and confounders vary over time.

Research Staff 

Johanna (Anske) van der Bom1,2,3
Camila Caram-Deelder1,2,3
Rutger Middelburg1,2,3

1Center for Clinical Transfusion Research, Sanquin Research, Leiden, The Netherlands
2Jon J van Rood Center for Clinical Transfusion Research, Sanquin-Leiden University Medical Center, Leiden, The Netherlands
3Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands

Collaborators

Bert Mesman1 
Jaap Jan Zwaginga2,3,4
Jan Molenaar5
Karen MK de Vooght6
Karen van Brussel2,3,7
Saskia le Cessie7,8
Saurabh Zalpuri2,3,7
Daan van de Kerkhof9
Otto Visser10

1CD-I Sanquin, Utrecht
2Jon J van Rood Center for Clinical Transfusion Research, Sanquin-Leiden University Medical Center, Leiden, The Netherlands
3Center for Clinical Transfusion Research, Sanquin Research, Leiden, The Netherlands
4Department of Immunohematology and Blood Transfusion, Leiden University Medical Center, Leiden, The Netherlands
5Medische Administratie - Leiden University Medical Centre, Leiden, The Netherlands
6Department of Clinical Chemistry and Haematology, University Medical Center Utrecht, Utrecht, The Netherlands
7Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
8Department of Medical Statistics, Leiden University Medical Center, Leiden, The Netherlands
9Clinical Laboratory, Catharina Hospital, Eindhoven, the Netherlands
10Department of Haematology, VU University Medical Center, Amsterdam, The Netherlands

Reference

Middelburg RA, Briët E, van der Bom JG. Mortality after transfusions, relation to donor sex. Vox Sanguinis 2011; 101:221–229. doi: 10.1111/j.1423-0410.2011.01487.x.

Last edited on: 29 August 2013