Transfusion最新文献

{"title":"Hospitalizations with blood transfusions and transfusion-related adverse events in US acute care hospitals, 2016-2020.","authors":"Sophia V Kazakova, Opal L Reddy, Isabel Griffin, Lauri A Hicks, Ian Kracalik, Sridhar V Basavaraju","doi":"10.1111/trf.18229","DOIUrl":"https://doi.org/10.1111/trf.18229","url":null,"abstract":"<p><strong>Background: </strong>National data on transfusion-related adverse events (TAEs) in the United States are limited. Administrative and payment-related data may augment hemovigilance systems to assess transfusion safety.</p><p><strong>Study design and methods: </strong>A nationwide administrative database was analyzed to characterize transfusion-related hospitalizations and TAEs by trends, patient/hospital characteristics, and outcomes. Transfusions and TAEs were identified using medical codes and charges. Generalized estimating equations (GEE) modeled transfusion trends, while logistic regression assessed transfusion-associated circulatory overload (TACO) and transfusion-related acute lung injury (TRALI) risk factors.</p><p><strong>Results: </strong>During 2016-2020, 8.4% of hospitalizations involved transfusions, with red blood cell (RBC) transfusion being most common (5.2%). In 2020, compared to 2016, hospitalizations with RBC transfusion decreased by 2% (Rate Ratio (RR) 0.98; 95% CI: 0.97-0.99), while plasma transfusion hospitalizations increased by 13% (RR 1.13; 95% CI: 1.08-1.19). TAEs occurred in 0.35% of hospitalizations (3.5/1000 transfusion hospitalizations). Among the TAEs included in the study, TACO, febrile nonhemolytic reactions, and TRALI were most common. In 27% of cases, the specific TAE was unidentified. TAEs were associated with higher inpatient mortality and longer lengths of stay. Variability in TAE rates was observed by patient and hospital characteristics. Risk factors for TACO included age >64, female sex, teaching hospitals, rural location, and Northeast region. TRALI risk was higher in teaching hospitals and those with >200 beds.</p><p><strong>Conclusion: </strong>Administrative data provide insights into transfusion practices and associated morbidity and mortality but have limitations. Linking administrative, electronic health record, and blood bank data may enhance TAE identification.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143773256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How do I analyze the role of red blood cell transfusions on clinical outcome in anemic patients? Disentangling the effect of red blood cell transfusions from pre-operative anemia on post-operative outcome.","authors":"Dylana Loobeek, Lenka Pacnerová, Jos Twisk, Cynthia So-Osman","doi":"10.1111/trf.18224","DOIUrl":"https://doi.org/10.1111/trf.18224","url":null,"abstract":"<p><strong>Background: </strong>Preoperative anemia is associated with worse clinical postoperative outcomes and a higher risk of receiving red blood cell (RBC) transfusions. It is challenging to disentangle the effect of preoperative anemia from the effect of receiving RBC transfusions on postoperative clinical outcomes such as length of hospital stay (LOS). When analyzing the association of preoperative anemia on LOS, it is important to be able to analyze RBC transfusions as a mediator in this relationship. In this paper, the background and application of mediation analysis is outlined as a statistical methodology in transfusion medicine research.</p><p><strong>Study design and methods: </strong>To explain the methodology of mediation analysis, a database from a previously reported clinical study was used (So-Osman C. et al. 2014) with anemia as the exposure variable and LOS as the primary outcome. Both the product-of-coefficients method and the change-in-coefficients method are used for mediation analysis, and linear regression models were used.</p><p><strong>Results: </strong>In the example of a simplified analysis, two-thirds of the effect could be attributed to mediation. This result was obtained by both the product-of-coefficients method and the change-in-coefficients method.</p><p><strong>Discussion: </strong>Mediation is assessed in a similar way as confounding, but the interpretation of the results is totally different. It is, therefore, of critical importance to distinguish between potential mediators and potential confounders in transfusion research. Since the calculation reported in the results is merely used as an example to show the methodology, e.g. ignoring confounding, the result should not be interpreted as scientific research data.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781211","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From shortages to solutions: Liquid plasma as a practical alternative to whole blood for prehospital trauma resuscitation.","authors":"Aashish Rajesh, Randall M Schaefer, Jon R Krohmer, Eric A Bank, John B Holcomb, Donald H Jenkins","doi":"10.1111/trf.18183","DOIUrl":"https://doi.org/10.1111/trf.18183","url":null,"abstract":"<p><p>Trauma-induced hemorrhagic shock remains a leading cause of preventable mortality, necessitating timely and effective resuscitation strategies. While low-titer O whole blood (LTOWB) is the preferred choice for prehospital resuscitation due to its balanced composition and ease of use, overall widespread implementation is hindered by persistent supply chain issues and daily logistical challenges of access and deployment. Platelets, containing plasma as a component, are considered the next best alternative to LTOWB but are constrained by their short shelf life and ongoing scarcity, and ongoing storage compliance, rendering their use impractical. This review evaluates plasma-based alternatives, particularly liquid plasma (LP), as a viable and cost-effective substitute therapeutic modality. LP offers a 26-day refrigerated shelf life compared to the 5-day limit of thawed fresh frozen plasma (FFP) and eliminates the challenges associated with freezing and thawing while maintaining clinical efficacy. Preliminary economic analyses further underscore the advantages of LP, demonstrating reduced wastage and lower costs compared to LTOWB, especially when partnering with a hospital system. Acknowledging the barriers in implementing prehospital blood transfusion programs due to blood supply and costs, we advocate for emergency medical service (EMS) adoption of LP, highlighting its availability, comparable efficacy to LTOWB, and cost-effectiveness. Until LTOWB becomes more accessible, LP should be prioritized in prehospital care to optimize outcomes for trauma patients in hemorrhagic shock.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Collaboration is key: Case report of suspected Pseudomonas fluorescens transfusion-associated infection.","authors":"Nancy El Beayni, Octavio Martinez, YanYun Wu, Peter Hosein, Jordan Colson","doi":"10.1111/trf.18226","DOIUrl":"https://doi.org/10.1111/trf.18226","url":null,"abstract":"<p><strong>Background: </strong>We report a case of suspected Pseudomonas fluorescens transfusion-transmitted infection in a 64-year-old female patient with pancreatic adenocarcinoma. The patient developed a biliary obstruction necessitating a drainage catheter, which was complicated by an arterial hemorrhage. Following the transfusion of 1 RBC unit, the patient developed flank pain, chills, and tachycardia.</p><p><strong>Study design and methods: </strong>The transfusion reaction workup was negative for hemolytic transfusion reaction. However, Gram stains of the implicated RBC unit revealed Gram-negative rods. Fortunately, the patient was already receiving broad-spectrum antibiotics, and preliminary investigation results were available early enough to alert the medical team and adjust antibiotic coverage. The patient was hospitalized in the ICU where she had elevated WBC counts that normalized after the addition of cefepime. The blood collection center was notified.</p><p><strong>Results: </strong>Both aerobic and anaerobic cultures incubated at 35°C were negative for growth. A subculture and incubation at room temperature (25°C) demonstrated sufficient growth for the identification of Pseudomonas fluorescens by both Vitek-MS MALDI-TOF and Vitek2 biochemical methods.</p><p><strong>Discussion: </strong>Pseudomonas fluorescens is a Gram-negative rod-shaped bacterium, well-studied as an environmental microbe. It can cause opportunistic infections in humans and was implicated in previous fatal septic transfusion reactions. This report highlights the importance of both standardization in blood product culture protocols and the need for collaboration between microbiology laboratories and transfusion practitioners to optimize the recovery of potentially clinically important fastidious organisms.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143773109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Kaposi's sarcoma herpesvirus seroprevalence among blood donors in Uganda.","authors":"Tait Huso, Jodie L White, Dorothy Kyeyune, Angela D'Adamo, Nazzarena Labo, Wendell Miley, Ezra Musisi, Khan Moses, Ronnie Kasirye, Irene Lubega, Hellen Wambongo Musana, Priscilla Eroju, Mahnaz Motevalli, Raymond Goodrich, M Kate Grabowski, Thomas C Quinn, Paul M Ness, Heather A Hume, Henry Ddungu, Aggrey Dhabangi, Evan M Bloch, Mary Glenn Fowler, Philippa Musoke, Denise Whitby, Aaron A R Tobian","doi":"10.1111/trf.18236","DOIUrl":"https://doi.org/10.1111/trf.18236","url":null,"abstract":"<p><strong>Background: </strong>Kaposi's sarcoma herpesvirus (KSHV) causes a life-long infection that can progress to several types of KSHV-associated diseases. There is evidence for transfusion transmission of KSHV. In endemic regions, such as sub-Saharan African, KSHV seroprevalence is >40%. However, previous studies of blood donors utilized immunoassays that detect KSHV-associated disease-specific antigens, which may underestimate the true burden of KSHV in a healthy population.</p><p><strong>Study design and methods: </strong>We utilized samples from an on-going transfusion transmitted infection clinical trial to estimate the seroprevalence of KSHV among 4921 blood donations from healthy donors in Uganda collected between October 2019 and December 2022. A multiplexed bead-based assay was used to measure plasma IgG against five antigens encoded by the K8.1, K10.5, ORF73, ORF38, and ORF25 genes of KSHV. Significant associations between donor characteristics and seroprevalence were assessed by chi-square tests.</p><p><strong>Results: </strong>Overall, KSHV seroprevalence was 69.1%. Seroprevalence was higher in units collected from older donors compared with younger donors and male donors (71.9% [95% confidence interval (CI) = 70.4%-73.3%]) compared with female donors (61.3% [95% CI = 58.6%-64.0%]; p < .001). KSHV seroprevalnce was higher among units collected from donors positive for T. pallidum (82.5% [95% CI = 73.8%-89.3%]) compared with units collected from donors who were negative (68.8% [95% CI = 67.5%-70.1%]; p < .001). KSHV seroprevalence was higher in units that tested positive for HIV, HBV, or HCV, though these results were not statistically significant.</p><p><strong>Conclusion: </strong>Given the high seroprevalence and limited availability of lab assays that detect active KSHV infections, methods such as leukoreduction or pathogen reduction should be considered to potentially reduce the risk of transfusion transmission of KSHV.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765113","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinics and genetics of hyperhemolysis syndrome in patients with sickle cell disease.","authors":"Barbara Malta, Mina Cintho Ozahata, Isabel Cristina Gomes Moura, Luiz Amorim, Alessandra Ferraz, André Rolim Belisário, Carolina Miranda, Shannon Kelly, Brian Custer, Ester C Sabino, Carla L Dinardo","doi":"10.1111/trf.18232","DOIUrl":"https://doi.org/10.1111/trf.18232","url":null,"abstract":"<p><strong>Background: </strong>Hyperhemolysis syndrome (HHS) is a severe transfusion-related complication with a complex immune pathophysiology, primarily affecting individuals with sickle cell disease (SCD). Limited research has investigated the clinical and molecular risk factors for HHS, which could help identify at-risk patients. This study aimed to assess clinical factors associated with HHS and identify genetic variations that increase susceptibility using a candidate-gene approach.</p><p><strong>Methods: </strong>Data were obtained from the REDS-III SCD cohort, comprising 2793 patients who underwent whole-genome sequencing as part of the Trans-Omics for Precision Medicine (TOPMed) program. Clinical and laboratory data were retrospectively collected. Patients with HHS were compared to matched controls (1:4) based on clinical variables and the frequency of single nucleotide variations (SNVs) associated with HHS, autoimmunity, and red blood cell (RBC) alloimmunization.</p><p><strong>Results: </strong>HHS was identified in 13 patients (prevalence: 1.13%), the majority of whom had the HbSS genotype (69.2%). The most affected age group was 11-20 years (46.2%), and 61.5% of patients had RBC alloantibodies. Pain crisis was the most common indication for transfusion leading to HHS (41.7%). Three significant genetic variants were identified: rs10748663 (C > T) on chromosome 10 (BLNK gene), rs936469 (G > A) on chromosome 11 (PHRF1 gene), and rs6503691 (C > T) on chromosome 17 (STAT5B gene).</p><p><strong>Conclusion: </strong>HHS primarily affects adolescents and young adults with RBC alloantibodies, often following episodic transfusions. Genetic variations in STAT5B and the IRF7-PHRF1 region suggest that the B-cell receptor signaling pathway, which is essential for B-cell differentiation, may play a critical role in HHS pathophysiology.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transfusion probability as an alternative measure of lab-guided medical decision-making.","authors":"Malcolm Risk, Jeannie Callum, Kevin Trentino, Kevin Murray, Lili Zhao, Xu Shi, Amol Verma, Fahad Razak, Sheharyar Raza","doi":"10.1111/trf.18235","DOIUrl":"https://doi.org/10.1111/trf.18235","url":null,"abstract":"<p><strong>Background: </strong>The clinical decision to transfuse is strongly influenced by laboratory results. Analysis of transfusion decision-making through pre-transfusion laboratory results (e.g. pre-transfusion hemoglobin) is a common yet misleading approach to studying transfusion practice.</p><p><strong>Study design and methods: </strong>We introduce \"Transfusion Probability\", an alternative method overcoming many limitations of pre-transfusion lab result analyses. Under this approach, we estimate the probability of transfusion after results at a specific value (e.g. hemoglobin 7.4 g/dL) or in a range of values (e.g. 7.0-7.9 g/dL) using the proportion of tests followed by transfusion. We provide a comprehensive methodology for causal inference on the effect of patient characteristics and other variables of interest.</p><p><strong>Results: </strong>Analyses using pre-transfusion and transfusion probability were compared through a retrospective cohort study of hospitalized patients (N = 525,032). We found red blood cell transfusion probabilities of 76.2% in the 6.0-6.9 g/dL, 18.9% in the 7.0-7.9 g/dL, and 4.5% in the 8.0-8.9 g/dL hemoglobin ranges. After confounder adjustment, gastrointestinal bleeding patients were more likely to be transfused, with risk differences ranging from 6.6% in the 8.0-8.9 g/dL range to 13.8% in the 6.0-6.9 g/dL range. Pre-transfusion hemoglobin results showed minimal differences between gastrointestinal bleeding patients and other patients in unadjusted (0.00 g/dL) and adjusted analyses (-0.03 g/dL).</p><p><strong>Discussion: </strong>In contrast to pre-transfusion result analysis, transfusion probability offers a nuanced account of transfusion practice and natural comparisons between patient groups. Wider use of our approach can provide actionable insights for clinical decision-making.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of non-qualifying umbilical cord blood units to support research and quality assurance by the Canadian Blood Services Cord Blood Bank.","authors":"David S Allan, Matthew D Seftel, An Duong, Harinad Maganti, Kathy Ganz, Nicholas Dibdin, Meagan Green, Jennifer Laycock, Subh Sarkar, Charlene Ropp, Tanya Petraszko, Jelena L Holovati","doi":"10.1111/trf.18231","DOIUrl":"https://doi.org/10.1111/trf.18231","url":null,"abstract":"<p><strong>Background: </strong>Umbilical cord blood units collected by Canadian Blood Services for public banking at selected collection hospitals may not meet stringent criteria for release to the bank's inventory and can be used to support research. The Cord Blood for Research Program (CB4RP) was established when the CBS bank was established, but the breadth of research activity supported by the CB4RP has not been previously described.</p><p><strong>Methods: </strong>Records of projects and units requested to support research were reviewed and summarized from September 2014 to October 2024.</p><p><strong>Results: </strong>A total of 34 projects have been supported by the CB4RP, with a total of 2901 units requested (85.4 units per project, range 6-540). To date, 1505 fresh units and 28 frozen units have been shipped to researchers. Areas of research supported by the CB4RP include hematopoietic cell transplant research, regenerative therapy, immunology research, cancer research, transfusion research, and other categories.</p><p><strong>Conclusion: </strong>Distributing non-qualifying cord blood units for research leverages the public investments implicated in establishing the CBS CBB and supports the development of expertise across a broad range of research areas.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of red blood cells storage duration on the development of acute kidney injury: A secondary analysis of the TRANSFUSE multicenter randomized controlled trial.","authors":"Cécile Aubron, Elizabeth M Moore, Bridget Ady, Eldho Paul, Maija Kaukonen, Lynne Murray, Jonathan Barrett, Matthew Bailey, Timothy Bowles, Sean Kelly, Claire Cattigan, David Cooper, David Ernest, David Evans, Jason Fletcher, Craig French, David Gattas, Dhaval Ghelani, Seton Henderson, Alex Kazemi, Bruce King, Peter Kruger, Janet Liang, Christopher MacIsaac, Colin McArthur, Alistair Nichol, Sandra Peake, Michael C Reade, Brent Richards, John Santamaria, Paul Young, Michael Bailey, Rinaldo Bellomo, D James Cooper, Zoe K McQuilten","doi":"10.1111/trf.18230","DOIUrl":"https://doi.org/10.1111/trf.18230","url":null,"abstract":"<p><strong>Background: </strong>Red blood cell (RBC) transfusion is associated with an increased risk of acute kidney injury (AKI). The extent to which RBC storage affects this association is unclear. We aimed to evaluate the association between storage duration and the occurrence or worsening of any degree of AKI in critically ill patients.</p><p><strong>Study design and methods: </strong>In this pre-planned sub-study of the Standard Issue Transfusion versus Fresher Red-Cell Use in Intensive Care (TRANSFUSE) trial, which compared mortality of critically ill patients receiving either the freshest available allogenic RBC unit or standard availability RBC, patients hospitalized in one of the 31 participating sites and who did not have Stage 3 AKI according to the Kidney Disease Improving Global Outcomes (KDIGO) classification were eligible. The primary outcome was the cumulative proportion of patients who developed any degree of new AKI.</p><p><strong>Results: </strong>A total of 899 patients were included. The mean (SD) RBC storage duration was 22.4 (7.4) versus 11.9 (5.4) days in the standard issue RBC and short-storage RBC groups, respectively (p < 0.01). The percentage of patients who developed any stage of new AKI was similar between groups (24.8% in the standard issue RBC group versus 26.1% in the short-storage RBC group; p = 0.66) (Relative Risk 0.95, [95% confidence intervals 0.76-1.19]). There was no difference in secondary outcomes.</p><p><strong>Discussion: </strong>In this pre-planned sub-study of the TRANSFUSE trial, compared with using standard issue RBC, the transfusion of the freshest available RBC was not associated with a decrease in AKI.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143743124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"O blood usage trends in the pediatric population 2015-2019: A multi-institutional analysis.","authors":"K Annen, S Andani, G Bosma, D Abbott, S Arinsburg, F Nguyen, N Ibeh, K Nicol, P Hernandez, R Jackups, M Delaney, B Bahar, Y Mo, B Alexander, D K Noland, T E Wong, J Andrews","doi":"10.1111/trf.18225","DOIUrl":"https://doi.org/10.1111/trf.18225","url":null,"abstract":"<p><strong>Background: </strong>In 2019, AABB released the bulletin \"Recommendations on the Use of Group O Red Blood Cells\" in which the recommendations about pediatric and neonatal blood transfusions were limited. Eight U.S. pediatric hospitals sought to determine trends in pediatric group O blood use and clarify which pediatric populations receive group O blood transfusions despite a non-group O blood type.</p><p><strong>Study design and methods: </strong>Eight U.S.-based institutions serving a pediatric population provided data from their respective Electronic Health Records. Data submitted included unit blood type, patient blood type, patient age, sex, and discharge diagnosis. If the discharge diagnosis was not available, the admitting diagnosis was substituted. GPT-4 was used to sort diagnoses into categories for analysis. Data were visualized using a series of alluvial plots, spaghetti plots, and tables. Tables were stratified on variables of interest (blood type, age, sex, diagnosis) to explore O blood type distribution among different patient populations.</p><p><strong>Results: </strong>A total of 142,227 discrete transfusion events were identified, of which 52,731 recipients were non-O blood type. Overall, 35,575 transfusion events of O blood went to A, B, or AB blood type recipients (67%). Additionally, 26% of Rh(D) negative transfusion events went to recipients who were Rh(D) positive. Top diagnostic categories for receiving O blood type were cardiovascular disorders (22%) and sickle cell anemia (15%).</p><p><strong>Discussion: </strong>This study highlights opportunities to address O blood supply challenges by identifying where non-O blood may be utilized safely in the vulnerable pediatric population.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143731932","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}