Construction of a decision model for donor testing in cases of suspected antibody-mediated transfusion-related-acute-lung-injury.

Autor: Latham T; NHS Blood and Transplant, Bristol, UK., Bentley A; Manchester Academic Health Sciences Centre, University of Manchester, Manchester, UK., Grey S; Blackpool Teaching Hospitals NHS Foundation Trusts, Blackpool, UK., Malhotra P; Mersey and West Lancashire Hospitals NHS Trust, Ormskirk., Davis PJ; University Hospitals Bristol and Weston NHS Trust, Bristol, UK., Clarkson J; NHS Blood and transplant, Barnsley, UK., Poles A; NHS Blood and Transplant, Bristol, UK., Narayan S; NHS Blood and Transplant, Manchester, UK.
Jazyk: angličtina
Zdroj: Transfusion medicine (Oxford, England) [Transfus Med] 2024 Oct; Vol. 34 (5), pp. 405-412. Date of Electronic Publication: 2024 Aug 26.
DOI: 10.1111/tme.13073
Abstrakt: Objective: To propose a rational basis for donor testing in cases of suspected antibody-mediated transfusion-related lung injury (AMT).
Background: Anti-leukocyte antibodies in donated blood are established causes of transfusion-related lung injury (TRALI). However, the question of whether to test donors for antibodies is not identical to whether the case meets definition criteria for TRALI. There is a balance between the potential benefits of testing and the costs of donor deferral and investigation. We propose that a decision-making process based on optimising the balance between risk and benefit requires a subjective choice of the relative value of different outcomes of testing.
Methods: We have developed a formal decision model to illustrate how these choices affect testing decisions.
Results: Using a Bayesian probability model, we show that the diagnostic benefit and TRALI prevention benefit of testing donors have a complex interrelationship with the number of implicated donors and clinical suspicion of antibody-mediated TRALI (AMT) and that rational testing choices vary according to value assigned to outcomes.
Conclusions: The challenges to the use of a formal decision model for clinical testing are discussed and conclude that a formal model is a useful consensus-building tool for improving consistency and openness in decision making.
(© 2024 The Author(s). Transfusion Medicine published by John Wiley & Sons Ltd on behalf of British Blood Transfusion Society.)
Databáze: MEDLINE
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