Although blood from previously pregnant female donors has been shown to be associated with transfusion-related acute lung injury (TRALI), the relationship between donor history of pregnancy and red blood cell (RBC) transfusion mortality has remained elusive. In order to better understand this relationship, researchers in the Netherlands retrospectively evaluated a cohort of 31,118 first-time transfusion recipients (52% female with a median age of 65 years) that were transfused RBCs collected from three types of donors: male (88%), females without a history of pregnancy (6%), and females with a history of pregnancy (6%). Male transfusion recipients had an increased risk of death after transfusion with RBCs collected from females with a history of pregnancy compared to RBCs from male donors (Hazard Ratio=1.13; 95% CI, 1.01-1.26). However, this trend was not observed in female recipients. Furthermore, upon stratification by age, the results only remained significant for male transfusion recipients 50 years and younger. Given the differences by age and gender and poor understanding of a possible mechanism, the results from this study are tentative and require further study.
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