捐赠者怀孕和输血接受者死亡率:红细胞储存的作用?
Sarah J Valk1,2, Camila Caram-Deelder2, Dorothea Evers3
1Jon J van Rood Center for Clinical Transfusion Research, Sanquin/LUMC, Leiden, The Netherlands.
Vox sanguinis
|November 3, 2023
概括
从曾经怀孕过的捐赠者的新鲜红细胞输血没有显示出与男性患者死亡率增加的统计学上显著联系. 需要进一步的研究来了解捐赠者的特征.
科学领域:
- 输血医学 输血医学
- 患者研究成果研究结果
- 免疫学 免疫学 免疫学
背景情况:
- 捐赠者的特征,包括性别和妊娠史,可能会影响输血相关的不良事件.
- 红细胞储存时间对患者的结果的影响正在调查中,与新鲜产品相关的潜在风险.
- 以前的研究表明,特定的供体因素与患者死亡率之间可能存在联系.
研究的目的:
- 调查假设,从永远怀孕的捐赠者获得的新鲜红细胞产品与男性患者的死亡率增加有关.
- 检查捐赠者妊娠史和红细胞储存时间对患者存活时间的综合影响.
- 为了确定血液产品的储存时间是否调解了永远怀孕的供体单位和患者死亡率之间的任何观察到的关联.
主要方法:
- 在荷兰,2005年至2015年期间接受首次输血的成人患者的队列研究.
- 分析了来自五种暴露类别的输血数据:从未怀孕的女性 (短期/长期储存),一直怀孕的女性 (短期/长期储存) 和男性 (短时间储存).
- 考克斯的比例危险模型被用来比较死亡风险与参考组:男性献血者存储血液>10天.
主要成果:
- 该研究包括42,456名患者,在随访期间有13,948人 (33%) 死亡.
- 从永远怀孕的捐赠者获得的新鲜红细胞单位 (存储≤10天) 显示男性患者的死亡率与非统计学上显著的相关性 (HR 1.39,95% CI 0.97-1.99).
- 敏感性分析没有证实观察到的关联,表明缺乏一致的证据.
结论:
- 这些发现并没有为永远怀孕的供体单位和患者死亡率之间的关联提供一致的支持.
- 这项研究表明,血液产品的储存时间似乎并不能调解永远怀孕的供体单位与死亡率之间的潜在关联.
- 需要进一步的研究,以充分阐明捐赠者特征和输血结果之间的复杂关系.
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