瑞典卡罗林斯卡研究所Gustaf Edgren等研究人员取得一项新进展。他们探究了供血者性别和既往妊娠情况与红细胞输血受血者死亡率之间的关系。该研究于2019年6月11日发表于国际一流学术期刊《美国医学会杂志》上。

有关献血者性别与输血受血者院内死亡之间相关性的重要证据一直没有定论。为此，该课题组成员分别对3组包含有34662，93724和918996名输血受者的数据进行回顾性队列研究时发现，逐步增长的受者院内死亡事件与女性供血者、既往妊娠者或供血者和受血者性别不一致这三类输血事件之间没有显著关联(每输血单位的风险比率介于0.99到1.01)，不存在输血剂量相关性。 

附：英文原文

Title: Association of Blood Donor Sex and Prior Pregnancy With Mortality Among Red Blood Cell Transfusion Recipients

Author:Gustaf Edgren, MD, PhD; Edward L. Murphy, MD, MPH; Don J. Brambilla, PhD; Matt Westlake, MSc; Klaus Rostgaard, MSc; Catherine Lee, PhD; Ritchard G. Cable, MD; Darrell Triulzi, MD; Roberta Bruhn, PhD; Elizabeth M. St. Lezin, MD; Christian Erikstrup, MD, PhD; Henrik Ullum, MD, PhD; Simone A. Glynn, MD, MPH, MSc; Steve Kleinman, MD; Henrik Hjalgrim, MD, PhD; Nareg H. Roubinian, MD, MPH; for the NHLBI Recipient Epidemiology and Donor Evaluation Study-III (REDS-III) Group

Issue&Volume: Vol 321, No. 22,2019

Abstract

Importance Evidence regarding associations of blood donor sex with mortality among red blood cell transfusion recipients is conflicting.

Objective To study associations of donor sex and prior pregnancy with mortality of transfusion recipients.

Design, Setting, and Participants Data from 3 retrospective cohorts of transfusion recipients (the Kaiser Permanente Northern California [KPNC] and Recipient Epidemiology and Donor Evaluation Study-III [REDS-III] databases of data from January 2013 to December 2016 and the Scandinavian Donations and Transfusions [SCANDAT] database with data from January 2003 to December 2012) were analyzed. Final dates of follow-up were December 31, 2016, for the KPNC and REDS-III cohorts and December 31, 2012, for the SCANDAT cohort. Stratified Cox regression models were used to estimate associations between donor exposure groups with risk of mortality, adjusting for the number of red blood cell unit transfusions.

Exposures The number of transfused red blood cell units from female donors, previously pregnant donors, and sex-discordant donors (male donor and female recipient or female donor and male recipient).

Main Outcomes and Measures In-hospital mortality.

Results The study population included 34?662 patients (mean age, 69 years; 18?652 [54%] women) from the KPNC cohort, 93?724 patients (mean age, 61 years; 48?348 [52%] women) from the REDS-III cohort, and 918?996 patients (mean age, 72 years; 522?239 [57%] women) from the SCANDAT cohort. The median number of red blood cell transfusions per patient was 3 in the KPNC cohort, 2 in the REDS-III cohort, and 3 in the SCANDAT cohort. The percentage of transfusions from previously pregnant or parous donors was 9% in the KPNC cohort, 18% in the REDS-III cohort, and 25% in the SCANDAT cohort. The percentage of transfusions in the 3 cohorts from female donors ranged from 39% to 43%, from previously pregnant or parous donors ranged from 9% to 25%, and from sex-discordant donors ranged from 44% to 50%. There were 3217 in-hospital deaths in the KPNC cohort, 8519 in the REDS-III cohort, and 198?537 in the SCANDAT cohort. There were no statistically significant associations between any of the 3 donor exposures and in-hospital mortality in the 3 cohorts. Hazard ratios for in-hospital mortality per transfused unit from female donors were 0.99 (95% CI, 0.96-1.03) for the KPNC cohort, 1.00 (95% CI, 0.99-1.01) for the REDS-III cohort, and 1.00 (95% CI, 0.99-1.00) for the SCANDAT cohort. For units from previously pregnant or parous female donors, hazard ratios were 1.00 (95% CI, 1.00-1.01) for the KPNC cohort, 1.01 (95% CI, 0.98-1.03) for the REDS-III cohort, and 1.00 (95% CI, 1.00-1.01) for the SCANDAT cohort. For units from sex-discordant transfusions, hazard ratios were 1.02 (95% CI, 0.99-1.05) for the KPNC cohort, 0.99 (95% CI, 0.98-1.00) for the REDS-III cohort, and 1.00 (95% CI, 0.99-1.00) for the SCANDAT cohort.

Conclusions and Relevance Among red blood cell transfusion recipients, transfusions from female, previously pregnant, or sex-discordant donors were not significantly associated with increased mortality.

DOI: doi:10.1001/jama.2019.7084

Source: https://jamanetwork.com/journals/jama/article-abstract/2735501