Donor genetic and nongenetic factors affecting red blood cell transfusion effectiveness
| Autor: | Jeanne E. Hendrickson, Eldad A. Hod, Mark T. Gladwin, Alan E. Mast, Ruchika Goel, Steve Kleinman, Bryan R. Spencer, Ritchard G. Cable, Nareg Roubinian, Fang Fang, Michael P. Busch, Hannah Qiao, Colleen Plimier, Steven R. Sloan, Steven L. Spitalnik, Grier P. Page, Brian Custer, Tamir Kanias, Bob Harris, Sarah E. Reese |
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| Rok vydání: | 2022 |
| Předmět: |
Adult
Male medicine.medical_specialty Bilirubin Fingerstick Blood Donors Clinical practice Hemolysis Hemoglobins chemistry.chemical_compound Internal medicine medicine Humans Genetic variation Aged Retrospective Studies Hematology business.industry General Medicine Middle Aged medicine.disease Red blood cell Glucosephosphate Dehydrogenase Deficiency medicine.anatomical_structure Leukoreduction Apheresis chemistry Female Hemoglobin Clinical Medicine Erythrocyte Transfusion business |
| Zdroj: | JCI Insight |
| ISSN: | 2379-3708 |
| DOI: | 10.1172/jci.insight.152598 |
| Popis: | BACKGROUND RBC transfusion effectiveness varies due to donor, component, and recipient factors. Prior studies identified characteristics associated with variation in hemoglobin increments following transfusion. We extended these observations, examining donor genetic and nongenetic factors affecting transfusion effectiveness. METHODS This is a multicenter retrospective study of 46,705 patients and 102,043 evaluable RBC transfusions from 2013 to 2016 across 12 hospitals. Transfusion effectiveness was defined as hemoglobin, bilirubin, or creatinine increments following single RBC unit transfusion. Models incorporated a subset of donors with data on single nucleotide polymorphisms associated with osmotic and oxidative hemolysis in vitro. Mixed modeling accounting for repeated transfusion episodes identified predictors of transfusion effectiveness. RESULTS Blood donor (sex, Rh status, fingerstick hemoglobin, smoking), component (storage duration, γ irradiation, leukoreduction, apheresis collection, storage solution), and recipient (sex, BMI, race and ethnicity, age) characteristics were associated with hemoglobin and bilirubin, but not creatinine, increments following RBC transfusions. Increased storage duration was associated with increased bilirubin and decreased hemoglobin increments, suggestive of in vivo hemolysis following transfusion. Donor G6PD deficiency and polymorphisms in SEC14L4, HBA2, and MYO9B genes were associated with decreased hemoglobin increments. Donor G6PD deficiency and polymorphisms in SEC14L4 were associated with increased transfusion requirements in the subsequent 48 hours. CONCLUSION Donor genetic and other factors, such as RBC storage duration, affect transfusion effectiveness as defined by decreased hemoglobin or increased bilirubin increments. Addressing these factors will provide a precision medicine approach to improve patient outcomes, particularly for chronically transfused RBC recipients, who would most benefit from more effective transfusion products. FUNDING Funding was provided by HHSN 75N92019D00032, HHSN 75N92019D00034, 75N92019D00035, HHSN 75N92019D00036, and HHSN 75N92019D00037; R01HL126130; and the National Institute of Child Health and Human Development (NICHD). |
| Databáze: | OpenAIRE |
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