BACKGROUND: To reduce the risk of transfusion-related acute lung injury (TRALI), plasma products are mainly made from male donors in some countries because of the lower possibility of alloimmunization; other countries are considering this policy. The advantage of male-only fresh-frozen plasma (FFP) should be examined in a prospective case-control study. STUDY DESIGN AND METHODS: This study compared pulmonary function after the transfusion of FFP derived from either male donors only (FFP-male) or mixed donors (FFP-mixed) in informed surgical patients treated at a tertiary university hospital in Japan. The factors contributing to pulmonary distress (PD) after transfusion were then statistically examined. RESULTS:Eighty-two patients participated in this study (FFP-male, n = 55; FFP-mixed, n = 27). Nineteen patients developed PD (PaO(2)/FiO(2) ratio [P/F] < 300) within 6 hours after transfusion: seven had congestive pulmonary edema (transfusion-associated circulatory overload), five had permeability pulmonary edema (possible TRALI), and seven had no apparent pulmonary edema. A multivariate logistic regression analysis revealed that the use of cardiopulmonary bypass and preoperative liver dysfunction were significantly associated with a P/F of less than 300 (odds ratios [ORs], 8.95 [p = 0.004] and 6.54 [p = 0.005], respectively), while the use of FFP-male was significantly associated with the absence of PD (OR, 0.219; p = 0.022). All the patients with possible TRALI had received either white blood cell or granulocyte antibody-positive FFP. The lysophosphatidylcholine level was not correlated with PD. CONCLUSIONS: Our data suggests that the use of FFP derived from male donors may be advantageous for posttransfusion pulmonary function, although PD is also determined by background characteristics.
RCT Entities:
BACKGROUND: To reduce the risk of transfusion-related acute lung injury (TRALI), plasma products are mainly made from male donors in some countries because of the lower possibility of alloimmunization; other countries are considering this policy. The advantage of male-only fresh-frozen plasma (FFP) should be examined in a prospective case-control study. STUDY DESIGN AND METHODS: This study compared pulmonary function after the transfusion of FFP derived from either male donors only (FFP-male) or mixed donors (FFP-mixed) in informed surgical patients treated at a tertiary university hospital in Japan. The factors contributing to pulmonary distress (PD) after transfusion were then statistically examined. RESULTS: Eighty-two patients participated in this study (FFP-male, n = 55; FFP-mixed, n = 27). Nineteen patients developed PD (PaO(2)/FiO(2) ratio [P/F] < 300) within 6 hours after transfusion: seven had congestive pulmonary edema (transfusion-associated circulatory overload), five had permeability pulmonary edema (possible TRALI), and seven had no apparent pulmonary edema. A multivariate logistic regression analysis revealed that the use of cardiopulmonary bypass and preoperative liver dysfunction were significantly associated with a P/F of less than 300 (odds ratios [ORs], 8.95 [p = 0.004] and 6.54 [p = 0.005], respectively), while the use of FFP-male was significantly associated with the absence of PD (OR, 0.219; p = 0.022). All the patients with possible TRALI had received either white blood cell or granulocyte antibody-positive FFP. The lysophosphatidylcholine level was not correlated with PD. CONCLUSIONS: Our data suggests that the use of FFP derived from male donors may be advantageous for posttransfusion pulmonary function, although PD is also determined by background characteristics.
Authors: Alexander B Benson; James R Burton; Gregory L Austin; Scott W Biggins; Michael A Zimmerman; Igal Kam; Susan Mandell; Christopher C Silliman; Hugo Rosen; Marc Moss Journal: Liver Transpl Date: 2011-02 Impact factor: 5.799
Authors: Rutger A Middelburg; Daniëlle Van Stein; Barbara Zupanska; Małgorzata Uhrynowska; Ognjen Gajic; Eduardo Muñiz-Diaz; Nuria Nogués Galvez; Christopher C Silliman; Tom Krusius; Jonathan P Wallis; Jan P Vandenbroucke; Ernest Briët; Johanna G Van Der Bom Journal: Transfusion Date: 2010-11 Impact factor: 3.157
Authors: Alexander B Benson; Gregory L Austin; Mary Berg; Kim K McFann; Sila Thomas; Gina Ramirez; Hugo Rosen; Christopher C Silliman; Marc Moss Journal: Intensive Care Med Date: 2010-07-24 Impact factor: 17.440
Authors: Alexander P J Vlaar; Pearl Toy; Mark Fung; Mark R Looney; Nicole P Juffermans; Juergen Bux; Paula Bolton-Maggs; Anna L Peters; Christopher C Silliman; Daryl J Kor; Steve Kleinman Journal: Transfusion Date: 2019-04-16 Impact factor: 3.157