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Pregnancy history of red-blood-cell donors not linked to higher mortality in transfusion recipients

Large National Institutes of Health study of more than 1 million transfusion recipients, including Kaiser Permanente Northern California data, does not suggest a need for change in red-blood-cell donation practices

A large new study has found that the sex or pregnancy history of red blood cell donors does not influence the risk of death among patients who receive their blood.

Nareg Roubinian, MD, Division of Research adjunct scientist

Funded by the National Heart, Lung, and Blood Institute (NHLBI), the research analyzed 3 large blood donor-transfusion recipient databases for a total of more than 1 million transfusion recipients between 2003 and 2016. Division of Research investigators participated in the multi-institution collaborative analysis, which supported the safety of current transfusion practice within Kaiser Permanente’s network of community hospitals.

“We looked at three donor exposures, and after careful adjustment for the number of transfusions, we didn’t find any evidence of an association,” said Nareg Roubinian, MD, MPH, senior study author and adjunct scientist at the Kaiser Permanente Division of Research. “Given the diversity in size, geographic location, and clinical settings of the cohorts, this finding was very consistent and convincing.”

“Association of blood donor sex and prior pregnancy with mortality among red blood cell transfusion recipients,” by Edgren et. al, was published today in the Journal of the American Medical Association (JAMA).

Catherine Lee, PhD, Division of Research biostatistician

Previous studies have suggested that women with a history of pregnancy should be excluded from donating blood products such as plasma, the liquid portion of the blood, because it contains antibodies that pregnant women develop when exposed to fetal blood. The plasma of previously pregnant women has been linked to a potentially lethal complication called transfusion-related acute lung injury (TRALI).

The current study of red-blood-cell transfusions — not plasma — found no higher risk of death in recipients of red blood cells from once-pregnant women.

“Using Kaiser Permanente data, we were able to contribute to analyses of both in-hospital mortality and long-term deaths,” said study co-author Catherine Lee, PhD, biostatistician with the Division of Research. “Findings based on our data are generalizable to other ethnically and socioeconomically diverse insured populations.”

Click here to read the NHLBI press release.

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