470 - Association of Blood Donor Sex and Age with Outcomes in Transfused Very Low Birth Weight Infants

Poster Board #: 470
Publication #: 4908-HP-QA.470

Background: There are conflicting data on the effect of blood donor characteristics on transfused recipient outcomes.


Objective: To estimate the association of donor sex and age on mortality or serious morbidity in very low birth weight (VLBW) infants receiving red blood cell (RBC) transfusion.


Design/Methods: Retrospective cohort study using prospectively collected data at 3 neonatal intensive care units in Atlanta, Georgia. The study included VLBW infants (≤1500g at birth) who received RBC transfusion from exclusively male or female donors. Infants who received transfusions from both male and female donors were excluded. The main study exposures were female donor and mean donor age and the primary outcome was a composite of death, necrotizing enterocolitis (Bell stage 2 or greater), retinopathy of prematurity (stage 3 or greater) or moderate-to-severe bronchopulmonary dysplasia. We used modified Poisson regression, with consideration of covariate interactions, to estimate the association between donor sex and age with the primary outcome with adjustment for the total number of transfusions and birth weight.


Results: We evaluated 181 infants, with 56 (31%) infants receiving RBCs from female donors and the remainder from male donors. The mean (± SD) donor age was 47 ± 14 years (range 17 to 74 years). The primary outcome occurred in 68 (37.6%) infants. We detected significant interactions between female donor and donor age (P=0.005) as well as female donor and number of transfusions (P<0.001). For the typical infant receiving a median of 2 RBC transfusions at the mean donor age, RBC transfusion from exclusively female donors, compared to male donors, was associated with a lower risk of the primary outcome (RR 0.29; 95% CI 0.16-0.54). The protective association between female donor and the primary outcome increased in strength as the donor age increased, but diminished as the number of transfusions increased (Figure 1).

Conclusion(s): RBC transfusion from female donors, particularly among those of older age, was associated with a lower risk of death or serious morbidity in transfused VLBW infants. Studies examining potential mechanisms underlying these associations are warranted.


Figure 1. Relative risk of death of serious morbidity comparing infants receiving RBC transfusions from only female donors vs male donors by number of transfusions and mean donors age. Values less than 1 (red line) indicate a protective female donor effect. The relative risks are calculated at the 25th, 50th, and 75th quantiles of the mean donor age of exposure.

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Authors/Institutions: Ravi M. Patel, Emory University School of Medicine, Atlanta, Georgia, United States; Joshua Lukemire, Emory University School of Public Health, Atlanta, Georgia, United States; Neeta Shenvi, Emory University School of Public Health, Atlanta, Georgia, United States; Kirk A. Easley, Emory University, Atlanta, , Georgia; Ying Guo, Emory University School of Public Health, Atlanta, Georgia, United States; Cassandra D. Josephson, Emory University School of Medicine, Atlanta, Georgia, United States