Lu Hua, Wu Li-Fang, Li Jing-Jing, Gao Qi, Xu Gui-Ping
Department of Blood Transfusion, the Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Department of Laboratory Medicine, the Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
BMC Anesthesiol. 2025 Aug 8;25(1):400. doi: 10.1186/s12871-025-03238-0.
Gamma-ray irradiation accelerates the release of red blood cell (RBC)-derived microparticles with procoagulant function, and further promotes the formation of microthrombosis. The use of irradiated RBCs in trauma patients is usually not prohibited. At present, the association that irradiated RBC transfusion and incidence of deep vein thrombosis (DVT) remains unclear.
This retrospective cohort study included 251 trauma patients between January 2019 and April 2023 at the Second Affiliated Hospital of Chongqing Medical University. The cohort included 147 patients who were only transfused with nonirradiated RBCs (nonirradiation group) and 104 patients who were transfused with irradiated RBCs with or without nonirradiated RBCs (irradiation group). Univariate and multivariate logistic regression analysis was used to analyze the risk factors for DVT.
The incidence of DVT was higher in the irradiation group than in the nonirradiation group (38.5% vs. 22.4%, p = 0.006), and irradiated RBC transfusion was associated with an increased incidence of DVT in the univariate analysis (OR 2.16, 95% CI: 1.25-3.77, p = 0.006). After adjusting for potential confounders by multivariate analysis, irradiated RBC transfusion appeared to be a risk factor for DVT (OR 2.48, 95% CI: 1.34-4.65, p = 0.004). Subgroup analysis revealed that the median storage days of irradiated RBCs and the percentage of irradiated RBCs in total transfused RBCs were positively association with the incidence of DVT (OR 2.95 and 3.19, respectively, both p < 0.05).
Irradiated RBC transfusion was associated with an increased incidence of DVT in trauma patients. Irradiated RBC transfusion in trauma patients might need to be reconsidered.
γ射线照射会加速具有促凝功能的红细胞（RBC）衍生微粒的释放，并进一步促进微血栓形成。创伤患者通常不禁止使用辐照红细胞。目前，辐照红细胞输血与深静脉血栓形成（DVT）发生率之间的关联尚不清楚。
这项回顾性队列研究纳入了2019年1月至2023年4月在重庆医科大学附属第二医院就诊的251例创伤患者。该队列包括147例仅接受未辐照红细胞输血的患者（未辐照组）和104例接受辐照红细胞输血（无论是否同时接受未辐照红细胞输血）的患者（辐照组）。采用单因素和多因素logistic回归分析来分析DVT的危险因素。
辐照组DVT的发生率高于未辐照组（38.5%对22.4%，p = 0.006），单因素分析显示辐照红细胞输血与DVT发生率增加相关（OR 2.16，95%CI：1.25 - 3.77，p = 0.006）。在多因素分析中对潜在混杂因素进行校正后，辐照红细胞输血似乎是DVT的一个危险因素（OR 2.48，95%CI：1.34 - 4.65，p = 0.004）。亚组分析显示，辐照红细胞的中位储存天数以及辐照红细胞在总输注红细胞中的百分比与DVT发生率呈正相关（OR分别为2.95和3.19，均p < 0.05）。
创伤患者接受辐照红细胞输血与DVT发生率增加相关。创伤患者的辐照红细胞输血可能需要重新考虑。
