Amico F, Efird JT, Briggs GD, Lott NJ, King KL, Hirani R, Balogh ZJ
The Effect of Blood Donor Sex and Age on Transfused Trauma Patients’ Outcome
The population of injured severe trauma patients admitted to hospital is vulnerable to major complications. Post-injury multiple organ failure (MOF) is frequent, highly lethal but potentially preventable and treatable condition among polytrauma patients who survived the first 48 hours after injury. Transfusion of blood products is a frequently practiced lifesaving procedure in this group of patients and its application has been correlated with MOF, thus representing a potentially reversible cause of in hospital mortality and long-term morbidity.
The influence of the age of the blood donors on recipients and sex matching between donor and recipient of blood components is an upcoming focus in transfusion medicine. Trauma care represents the ideal situation to test this novel hypothesis in patients already receiving large volumes of blood components postulating that age and/or sex of the donors could influence the outcomes of the transfusion recipients. We retrospectively analysed a cohort of 229 critically injured patients from our prospective MOF database who received over 4300 transfusions in total over the nine year study period. When testing for trend and interaction we identified a potential role for donor sex, with donor-recipient sex mismatched transfusions of blood components more likely to be associated with MOF. The role of the age of the person donating blood was also tested and compared with the age of the person receiving the transfusion, but not significantly associated with MOF.
Sex and age mismatched transfusion of blood components is routine practice. In current everyday practice clinicians unsuspectingly transfuse blood components without any age or sex matching In fact, this is information is not recorded on the transfusion bags because no concern was ever raised in this regard and infectious surveillance has dominated for decades many primary aspects of transfusions medicine quality control.
We are exploring a fundamentally new concept with potential impact on many transfused patients. Our current findings in collaboration with Australian Red Cross Lifeblood are preliminary, they show only potential association, which need confirming and proof of causation.
Amico F, Efird JT, Briggs GD, Lott NJ, King KL, Hirani R, Balogh ZJ.
Association between Blood Donor Demographics and Post-Injury Multiple Organ Failure after Polytrauma.
Ann Surg. 2021 Jan 22. doi:10.1097/SLA.0000000000004754. Epub ahead of print. PMID: 33491976.