Blood transfusion from previously pregnant donor deadly for men

Men under the age of 50 are more likely to die if they receive a blood transfusion from women who had been pregnant, a new study states.

Rutger A. Middelburg from Sanquin Research, Leiden, the Netherlands and colleagues conducted a study of first-time transfusion recipients at six major Dutch hospitals to quantify the association between red blood cell transfusion from female donors with and without a history of pregnancy and mortality of red blood cell recipients.

Almost 4,000, or 13%, died after being given blood.

"Blood donations from all our donors are lifesaving, and we continue to encourage donations from women who have previously been pregnant".

The most common cause of transfusion-related mortality is Transfusion-Related Acute Lung Injury (TRALI), which has also been shown to be associated with transfusions from female donors.

The reasons are unclear, and the study wasn't focused on explaining them, but senior author Rutger Middelburg of Leiden University Medical Center in The Netherlands and colleagues write in JAMA that it's possible antibodies women develop during pregnancy to protect their growing baby might later trigger risky reactions in some male recipients of blood from previously pregnant donors.

For female recipients of red blood cell transfusion, mortality rates were 74 versus 62 per 1,000 person-years for an ever-pregnant female versus a male donor (HR, 0.99; 95% CI, 0.87 to 1.13) and 74 versus 62 per 1,000 person-years for a never-pregnant female versus a male donor (HR, 1.01; 95% CI, 0.88 to 1.15).

There was, however, no significant association between pregnancy status of female blood donors and mortality among female recipients of blood transfusions.

Gustaf Edgren, an epidemiology associate professor and haematologist made the point that his own research suggests the sex of a donor does not make a difference to the donor.

Blood transfusions are usually a matter of simply matching blood types.

The study looked at over 30,000 transfusion patients. More importantly, this means that thousands of transfusion patients across the planet may have died without knowing of this risk. "While that concept is good in theory, it is becoming clear that there are clear harms that need to be considered fully". By comparison, women who received transfusions did not seem to have an elevated risk, Scientific American reports.

"No change in transfusion practices is needed now", Cable said by email.

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