输注红细胞的储存时间和供体性别对心脏手术患者1年生存率的影响：一项观察性研究。

Effect of storage time and donor sex of transfused red blood cells on 1-year survival in patients undergoing cardiac surgery: an observational study.

作者信息

Desmarets Maxime, Bardiaux Laurent, Benzenine Eric, Dussaucy Alain, Binda Delphine, Tiberghien Pierre, Quantin Catherine, Monnet Elisabeth

机构信息

Centre d'Investigation Clinique, INSERM CIC 1431, University Hospital of Besançon, Besançon, France.

Etablissement Français du Sang (EFS) Pyrénées Méditerranée, Toulouse, France.

出版信息

Transfusion. 2016 May;56(5):1213-22. doi: 10.1111/trf.13537. Epub 2016 Mar 2.

DOI:10.1111/trf.13537

PMID:26935140

Abstract

BACKGROUND

Red blood cell (RBC) storage lesions and RBCs from females transfused into male recipients may have adverse effects on transfusion recipients' survival. We hypothesized that the effect of donor sex and the effect of age of blood on mortality would be most apparent in cardiac surgery patients.

STUDY DESIGN AND METHODS

Using data from French Blood Services and two university hospitals, we conducted a retrospective cohort study on cardiac surgery patients whose first transfusion occurred between 2007 and 2011. The age of blood and donor sex effects on 1-year survival were studied using Cox regression modeling, with time-dependent stratification on the number of RBCs and adjustments for the type of surgery and other products transfused.

RESULTS

Among the 2715 cardiac surgery patients, 85.1% were alive after 1 year. Age of blood and donor sex were associated with survival before adjustments (p < 0.0001). However, the adjusted hazard ratios (HRs) for patients transfused with blood stored for 29 days or more versus 14 days or less were 0.97 (95% confidence interval [95% CI], 0.69-1.35; p = 0.98) and 1.22 (95% CI, 0.81-1.82) for patients who received only sex-mismatched RBCs versus all matched units (p = 0.27). For males transfused solely with female RBCs, the HR was 0.96 (95% CI, 0.57-1.61; p = 0.69); in females transfused only with male RBCs, it was 2.03 (95% CI, 0.87-4.73; p = 0.17).

CONCLUSIONS

In this first study of survival after transfusion in France, there was no significant effect for age of blood or donor sex. Contrary to previously reported data, female RBCs appear to be safe for male recipients.

摘要

背景

红细胞（RBC）储存损伤以及女性捐献的红细胞输注给男性受血者可能会对输血受者的生存产生不利影响。我们推测供者性别和血液储存时间对死亡率的影响在心脏手术患者中最为明显。

研究设计与方法

利用法国血液服务机构和两家大学医院的数据，我们对2007年至2011年间首次输血的心脏手术患者进行了一项回顾性队列研究。使用Cox回归模型研究血液储存时间和供者性别对1年生存率的影响，并根据红细胞数量进行时间依赖性分层，同时对手术类型和其他输注产品进行调整。

结果

在2715例心脏手术患者中，85.1%在1年后存活。在进行调整之前，血液储存时间和供者性别与生存率相关（p<0.0001）。然而，与储存14天或更短时间的血液相比，输注储存29天或更长时间血液的患者的调整后风险比（HR）为0.97（95%置信区间[95%CI]，0.69 - 1.35；p = 0.98），对于仅接受性别不匹配红细胞的患者与所有匹配单位的患者，HR为1.22（95%CI，0.81 - 1.82）（p = 0.27）。对于仅输注女性红细胞的男性，HR为0.96（95%CI，0.57 - 1.61；p = 0.69）；对于仅输注男性红细胞的女性，HR为2.03（95%CI，0.87 - 4.73；p = 0.17）。