Sex of Blood Donor not linked to mortality risk among recipients after red cell transfusion: NEJM

There is a lack of data and conflicting evidence regarding the association between the sex of red cell donors and mortality among transfusion recipients.

The data remains constricted to inform transfusion practice, and policy is limited.

The question here is, Does the sex of the blood donor affect the outcomes in recipients of red cell transfusion?

Considering this background and investigating further, researchers intervened in 13,047 patients undergoing/ anticipated to experience a minimum of one red cell transfusion. These patients were assigned to receive red cells from either male or female donors. Survival was the primary outcome measured.

The study result included the following points:

• Before transfusion, 8719 patients, with a mean age of 66 years, underwent randomization, with 5190 patients in the male donor group and 3529 in the female donor group.

The first transfusion setting was as an inpatient in 6969 patients, of whom 2942 had been admitted under a surgical service.

• The baseline haemoglobin level before transfusion was 79.5±19.7 g per litre.
• The patients received a mean of 5.4±10.5 units and 5.1±8.9 units of red cells in the female and male donor groups, respectively, with a difference of 0.3 units.
• One thousand one hundred forty-one patients and 1712 patients in the female and male donor group died.
• The adjusted hazard ratio or aHR for death was 0.98.
• The male donor group was used as the reference group.

Concluding further, they said that based on the findings of our study, there is no significant difference in survival between a transfusion strategy involving red-cell units from female and male donors.

As acknowledged, the study was funded by the Canadian Institutes of Health Research. Further reading: Effect of Donor Sex on Recipient Mortality in Transfusion. N Engl J Med 2023; 388:1386-1395 DOI: 10.1056/NEJMoa2211523