Featured Research

from universities, journals, and other organizations

Restrictions on female plasma may not be warranted

Date:
February 13, 2010
Source:
Duke University Medical Center
Summary:
Three years after the US blood banking industry issued recommendations that discourage transfusing plasma from female donors because of a potential antibody reaction, researchers discovered that female plasma actually may have advantages.

Three years after the U.S. blood banking industry issued recommendations that discourage transfusing plasma from female donors because of a potential antibody reaction, Duke University Medical Center researchers discovered that female plasma actually may have advantages.

Related Articles


The Duke team conducted a retrospective study of Red Cross donor and hospital data from a period when female plasma wasn't restricted. They examined heart surgery outcomes for lung problems, and prolonged length of hospital stay or death. Cardiac surgery patients use about one-fifth of all transfused blood products.

They found that patients receiving female-donor plasma did significantly better than similar patients receiving male-donor plasma.

"Our findings raise the possibility of unanticipated effects of restricting female donor plasma use," said Mark Stafford-Smith, M.D., a Duke professor of anesthesiology and senior author of a study appearing in the Journal of Thoracic and Cardiovascular Surgery on Feb. 11.

Blood products, such as red cells and plasma, are manufactured from blood collected from volunteer donors, and both male and female donors are still encouraged to donate whole blood, which is then separated into different components.

The recommendations to restrict plasma transfusions were based on evidence tying female-donor plasma to a serious lung injury called transfusion-related acute lung injury (TRALI). Antibodies that may cause TRALI are more common in women who have been pregnant, and the antibodies may form as a reaction to their fetus. The more pregnancies a woman has had, the greater the chance that she has these antibodies.

The AABB (formerly the American Association of Blood Banks) recommended in late 2006 that blood banks adopt measures to reduce the risk of TRALI, such as avoiding use of female donor plasma for transfusion due to the higher risk antibodies associated with TRALI.

"We were very surprised by the results, because when we began the study, we expected to see data that supported the idea that female-donor plasma would be riskier," said Mark Stafford-Smith. "In fact, we found just the opposite. At first, we thought we might have switched our data somehow, but careful re-examination confirmed that recipients of male-donor plasma had worse outcomes."

The study identified 1,069 patients who had received plasma exclusively from female donors or male donors, and put them into pairs for comparison that were matched for the number of units transfused and surgery date.

Recipients of female-donor plasma had a lower incidence of pulmonary dysfunction (5.9 percent vs. 10.8 percent) and death within 30 days of surgery or hospitalization longer than 10 days (9 percent vs. 16.4 percent). The two groups had similar long-term survival rates.

Co-author Nicholas Bandarenko, M.D., medical director of Duke Transfusion Services and associate professor of pathology, said the blood banking community has been focused locally and nationally on reducing the significant morbidity and mortality from TRALI. However, TRALI is a relatively rare event that happens in roughly every 1 in 3,000 transfusions.

"This study suggests more subtle but still clinically significant outcomes and morbidity may be occurring," Bandarenko said. "As required, regulatory policies are now in place to minimize the risk of severe TRALI, but there appears to be a spectrum of pulmonary (lung) injuries that may be associated with blood transfusion and these may not all be impacted by the policies that restrict plasma collection to male donors exclusively."

The study did not specifically address the catastrophic lung problem. "It may be true that with enough patients we would have observed fewer TRALI incidents in the male-donor plasma recipients, but our data suggests that any gain from avoiding a small number of catastrophic occurrences may require subjecting patients to other potentially worrisome effects of male-donor plasma," Stafford-Smith said.

He stressed that the Duke study findings need to be re-evaluated in prospective studies. There isn't enough data yet to support or refute the policy to exclude female-donor plasma as a way to avoid catastrophic TRALI.

The finding cannot be generalized across all types of patients getting plasma transfusions either, he said. "We studied cardiac surgery patients, because this is the subset of patients that we care for. This study provides one more tool to aid in policy decisions, and more studies, including prospective studies, will be needed to improve our understanding of the male- versus female-donor question."

Other members of the team were lead author Ian Welsby, Barbara Philips-Bute and Joseph P. Mathew of the Duke Department of Anesthesiology, and Marla Troughton of the University of Alabama Department of Pathology. Mary Lee Campbell and Rebecca Ramsey from the Carolinas region of the American Red Cross and Duke Perioperative Services were also a part of the research analysis.


Story Source:

The above story is based on materials provided by Duke University Medical Center. Note: Materials may be edited for content and length.


Cite This Page:

Duke University Medical Center. "Restrictions on female plasma may not be warranted." ScienceDaily. ScienceDaily, 13 February 2010. <www.sciencedaily.com/releases/2010/02/100211084836.htm>.
Duke University Medical Center. (2010, February 13). Restrictions on female plasma may not be warranted. ScienceDaily. Retrieved October 25, 2014 from www.sciencedaily.com/releases/2010/02/100211084836.htm
Duke University Medical Center. "Restrictions on female plasma may not be warranted." ScienceDaily. www.sciencedaily.com/releases/2010/02/100211084836.htm (accessed October 25, 2014).

Share This



More Health & Medicine News

Saturday, October 25, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

IKEA Desk Converts From Standing to Sitting With One Button

IKEA Desk Converts From Standing to Sitting With One Button

Buzz60 (Oct. 24, 2014) IKEA is out with a new convertible desk that can convert from a sitting desk to a standing one with just the push of a button. Jen Markham explains. Video provided by Buzz60
Powered by NewsLook.com
Ebola Protective Suits Being Made in China

Ebola Protective Suits Being Made in China

AFP (Oct. 24, 2014) A factory in China is busy making Ebola protective suits for healthcare workers and others fighting the spread of the virus. Duration: 00:38 Video provided by AFP
Powered by NewsLook.com
WHO: Millions of Ebola Vaccine Doses by 2015

WHO: Millions of Ebola Vaccine Doses by 2015

AP (Oct. 24, 2014) The World Health Organization said on Friday that millions of doses of two experimental Ebola vaccines could be ready for use in 2015 and five more experimental vaccines would start being tested in March. (Oct. 24) Video provided by AP
Powered by NewsLook.com
Doctor in NYC Quarantined With Ebola

Doctor in NYC Quarantined With Ebola

AP (Oct. 24, 2014) An emergency room doctor who recently returned to the city after treating Ebola patients in West Africa has tested positive for the virus. He's quarantined in a hospital. (Oct. 24) Video provided by AP
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:

Strange & Offbeat Stories


Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins