Transfusion最新文献

{"title":"Identification of a novel Bw allele with c.810C > G missense variation in a Cambodian-origin family.","authors":"Shaoyun Wu, Sujun Jiang, Shiquan Wu, Yafen Lin, Jianxun Zheng, Zhanjuan Yu, Zhenzhen Liu, Xiaozhen Hong, Xianguo Xu","doi":"10.1111/trf.18214","DOIUrl":"https://doi.org/10.1111/trf.18214","url":null,"abstract":"","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143658654","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":"Has the pendulum swung too far? Discretionary single-unit red blood cell transfusion in trauma is associated with infection, thromboembolic events, and mortality.","authors":"Michael David Cobler-Lichter, Khaled Abdul Jawad, D Dante Yeh, Roman Dudaryk, Franklin Dexter, Richard H Epstein","doi":"10.1111/trf.18191","DOIUrl":"https://doi.org/10.1111/trf.18191","url":null,"abstract":"<p><strong>Objectives: </strong>Studies in elective surgery report adverse outcomes with transfusion of a solitary unit of red blood cells (RBC). We quantified the effect of discretionary transfusion of one unit of blood in trauma patients with borderline transfusion indications. We hypothesized that transfusion of a discretionary unit of RBCs would increase complications.</p><p><strong>Methods: </strong>Admitted adults from the 2017-2021 American College of Surgeons Trauma Quality Improvement Program database were included if they had an injury severity score between 10 and 25 and a Glasgow Coma Scale >8: moderately to severely injured patients. Associations between single-unit RBC transfusion in the first 4 h (with no subsequent transfusion) and three primary outcomes (mortality, infection, thromboembolic event) were assessed using inverse probability-weighting propensity matching with regression adjustment.</p><p><strong>Results: </strong>A total of 649,841 patients were included in the study. Approximately 4.2% received one unit of RBC. Propensity matching (with fractional weighting) for transfusion resulted in 307,840.7 cases and 342,000.3 controls. Transfusion of a solitary unit of RBC was independently associated with each outcome: mortality (adjusted odds ratio [aOR] 2.11, 95% CI 1.66-2.69), infection (aOR 3.92, 95% CI 2.91-5.27), and thromboembolic event (aOR 2.02, 95% CI 1.55-2.64).</p><p><strong>Conclusion: </strong>Transfusion of a single unit of RBC within the first 4 h of arrival in trauma patients with no subsequent transfusion during hospitalization was associated with an increased risk of mortality, infection, and a thromboembolic event. When weighing the decision to transfuse trauma patients with equivocal signs of hemorrhage, one needs to balance the potential harm against the likelihood that such transfusion is necessary.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143650965","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":"Predictive model for optimizing prehospital transfusions in an urban EMS system.","authors":"Bo Zeng, Joshua Brown, Zhengsong Lu, Jonathan McMahon, Leonard Weiss, Bopaya Bidanda, Mark Yazer","doi":"10.1111/trf.18209","DOIUrl":"https://doi.org/10.1111/trf.18209","url":null,"abstract":"<p><strong>Background: </strong>Prehospital transfusions might provide a survival benefit for injured patients. Because blood products are a scarce resource, their optimal deployment requires careful consideration. A computer model was built to explore different deployment scenarios for two blood-carrying ambulances (mobile blood banks, MBBs) in the City of Pittsburgh.</p><p><strong>Study design and methods: </strong>Mixed integer programs were used to determine the optimal locations for the bases of the two MBBs from amongst the City's 14 ambulance bases. Then, a discrete-event simulation of dispatching MBBs to attend to patients who would have qualified for prehospital transfusions due to having hypotension following injury was performed using data from one year of calls to the City's emergency services hotline (911 calls).</p><p><strong>Results: </strong>Over the one-year period, there were 238 ambulance dispatches to injured patients with hypotension for their age. The average time to transfusion was significantly lower when the MBB attended to the patient compared with receiving their transfusion at the hospital (average 7.2 ± 0.1 min vs. 36.7 ± 0.2 min, respectively). However, there were diminishing returns when more than four deployed MBBs were simulated; with two MBBs, up to 73% of qualifying patients could be serviced, and when four MBBs were deployed, up to 95% of patients could be serviced. Deploying >4 MBBs did not increase the number of serviced eligible patients. There was minimal improvement in MBB efficiency when the restocking and cleaning time after patient delivery was reduced from 40 to 15 min.</p><p><strong>Conclusion: </strong>Computer modeling can help optimize resources when planning prehospital transfusion programs.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143650966","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":"Automated processing of Meryman-frozen red blood cells: A novel protocol for deglycerolization.","authors":"Audrey Laforce-Lavoie, Jessica Constanzo-Yanez, Marie-Claire Chevrier, Marc Cloutier","doi":"10.1111/trf.18211","DOIUrl":"https://doi.org/10.1111/trf.18211","url":null,"abstract":"<p><strong>Background: </strong>Many blood services maintain large inventories of red blood cell (RBC) units cryopreserved in glycerol using the Meryman method. With the discontinuation of the COBE® 2991 cell processor, an alternative thawing method is needed. We aimed to develop a deglycerolization protocol for Meryman-frozen units using the ACP® 215 cell washer.</p><p><strong>Methods: </strong>In the optimization phase, Meryman-frozen RBC units stored for 10 years were thawed, paired, and divided into two groups: one with a centrifugation step to remove glycerol before deglycerolization (\"volume reduction\") and one without. Biochemical and hematological parameters assessed included hemolysis, hematocrit, hemoglobin, ATP, pH, and osmolality. The protocol was then validated.</p><p><strong>Results: </strong>Hemolysis rates were lower with than without volume reduction (0.4% vs. 0.6%). Centrifuged RBCs also showed higher recovery (72% vs. 63%), increased hematocrit (0.51 L/L vs. 0.40 L/L), and improved pH stability (6.17 vs. 6.11). In the validation phase, six RBC units deglycerolized using the volume reduction step met Canadian Standards Association requirements for hematocrit, hemoglobin, hemolysis, and sterility.</p><p><strong>Discussion: </strong>We optimized and validated a new protocol leveraging the ACP® 215 cell washer to deglycerolize Meryman-frozen RBCs. This method yielded low hemolysis, acceptable pH, and satisfactory recovery, especially with prior glycerol removal by centrifugation. The protocol has been successfully implemented, and Meryman-frozen RBC units have since been reliably thawed, meeting regulatory standards and supporting hospital needs.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626140","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":"Implementation of a novel hybrid cord blood banking model within a private-public-partnership.","authors":"Jessica Laue, L Mariotta, M Fluri, D Castelli, O Kürsteiner, G Nicoloso, A Etter, D Surbek","doi":"10.1111/trf.18179","DOIUrl":"https://doi.org/10.1111/trf.18179","url":null,"abstract":"<p><strong>Background: </strong>Umbilical cord blood (UCB) stem cells can be collected at birth, cryopreserved, and used for transplantation in hematopoietic diseases. Typically, these stem cells are stored in public banks for allogeneic use or in private depositories for potential future utilization by the family. A proposed third option, hybrid cord blood banking, combines elements of both public and private storage. This method allows family-directed UCB to be HLA typed and included in the international registry, making it accessible to compatible patients globally.</p><p><strong>Study design and methods: </strong>We describe the implementation of a novel hybrid cord blood banking model within a private-public partnership involving a university obstetric department, a national stem cell registry, and a private cord blood bank.</p><p><strong>Results: </strong>From 2020 to 2023, 67 UCB units were collected for hybrid banking. Of these, 25 samples (37.3%) met the threshold of 120 grams for public banking. Before processing, 5 samples (7.5%) contained over 1.5 E9 total nucleated cells (TNC); after processing, 15 samples (22.46%) exceeded 1.0 E9 TNC. The viability margin of 85% was surpassed in 42 samples (62.7%). Cytofluorimetric analysis showed 36 samples (53.7%) had over 1.25 E6 CD34+ cells, with 63 samples (94.0%) exceeding 85% viability. For HLA typing and registry entry, 10 samples (14.9%) qualified for hybrid purposes, with one sample deemed unsuitable for processing.</p><p><strong>Discussion: </strong>This study demonstrates the feasibility of the hybrid cord blood banking model within a private-public partnership. This new concept offers an extended option for parents to bank their child's cord blood stem cells.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617341","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":"Effectiveness of prehospital chest decompression in resolving clinical signs of tension pneumothorax.","authors":"Tomer Talmy, Dean Lichter, Cole D Bendor, Irina Radomislensky, Avishai M Tsur, Ofer Almog","doi":"10.1111/trf.18199","DOIUrl":"https://doi.org/10.1111/trf.18199","url":null,"abstract":"<p><strong>Background: </strong>Thoracic injuries are a leading cause of morbidity and mortality in military trauma. Tension pneumothorax (TPX) is a critical diagnosis that can lead to rapid hemodynamic and respiratory collapse if untreated. While timely intervention is essential, prehospital TPX diagnosis is challenging and may lead to unnecessary interventions. This study aimed to assess military prehospital chest injury management, including indications for chest decompression and clinical improvement post-intervention.</p><p><strong>Study design and methods: </strong>Retrospective analysis of the Israel Defense Forces (IDF) Trauma Registry from January 2010 to August 2023 identifying patients who underwent needle or chest tube decompression. Data included demographics, injury mechanisms, vital signs, additional interventions, and prehospital mortality. Chart review evaluated decompression indications and outcomes, with the primary outcome being resolution of decreased oxygen saturation, tachycardia, or hypotension post-decompression.</p><p><strong>Results: </strong>Overall, 224 patients were included, with a median age of 22 years. The most common injury mechanisms were gunshots (36.6%) and motor vehicle accidents (34.4%). Needle chest decompression was performed in 58.5% of cases, chest tubes in 12.5%, and both in 29.0%. Indications included traumatic cardiac arrest (53.1%), profound shock (17.9%), and SpO₂ < 85% (13.8%). In 15.2% of cases, decompression did not meet the IDF guideline criteria. Only three cases (1.3%) showed resolution of tachycardia, hypotension, or low oxygen saturation. In five cases, vital signs briefly returned after traumatic cardiac arrest, but none survived to hospital admission.</p><p><strong>Discussion: </strong>Chest decompression may be overutilized in prehospital military trauma. Future studies should refine criteria to optimize benefits while minimizing iatrogenic risks.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143597930","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":"Have we reached a new baseline for blood collection and transfusion in the United States? National Blood Collection and Utilization Survey, 2023.","authors":"Kelsey McDavid, Rebecca Lien, Joel Chavez Ortiz, Tatiana Bradley, Angelina Luciano, Isabel Griffin, James Berger, Sridhar V Basavaraju, Ian Kracalik","doi":"10.1111/trf.18187","DOIUrl":"https://doi.org/10.1111/trf.18187","url":null,"abstract":"<p><strong>Background: </strong>Data from the National Blood Collection and Utilization Survey (NBCUS) suggest a stabilization in blood collections and transfusions following years of decline. Data from the 2023 NBCUS were analyzed to further understand national trends in US blood availability.</p><p><strong>Study design and methods: </strong>In February 2024, all community-based (53) and hospital-based (104) blood collection centers, and a sample of transfusing hospitals were surveyed. National estimates were calculated for the number of blood and blood components collected, distributed, transfused, rejected on testing, and outdated in 2023, compared with 2021. Weighting and imputation were used for nonresponses and missing data, respectively.</p><p><strong>Results: </strong>Overall, 96% of community-based blood centers and 85.7% of transfusing hospitals responded. During 2023, 11,586,000 units of whole blood and apheresis RBCs were collected (95% confidence interval (CI): 11,180,000-11,991,000), and 10,328,000 (95% CI: 9922,000-10,733,000) were transfused, a 1.7% and 4.1% decline compared with 2021, respectively. The total available supply (after outdates and rejections) declined by 0.5%. Total platelet units distributed (2618,000; 95% CI: 2483,000-2753,000) and transfused (2220,000; 95% CI: 2040,000-2400,000) increased by 3.6% and 2.1%, respectively, since 2021. Transfusion of pathogen-reduced platelet units (1258,000) increased by 49.2% since 2021. Plasma distributions (3032,000; 95% CI: 2764,000-3300,000) and transfusions (1882,000; 95% CI: 1765,000-1998,000) declined since 2021. Overall, 123,000 units were rejected on testing for transfusion-transmitted infections.</p><p><strong>Discussion: </strong>The 2023 NBCUS indicates further stabilization in the blood supply, suggesting the establishment of a new baseline for blood availability.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143597852","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":"Partial REBOA Zone 1 is associated with lower mortality compared to complete REBOA Zone 1 and emergency department thoracotomy: A cohort study using the AORTA registry.","authors":"Morgan G Dewey, Ernest E Moore, Lee Anne Ammons, Isabella M Bernhardt, Angela Sauaia, Meghan L Brenner","doi":"10.1111/trf.18177","DOIUrl":"https://doi.org/10.1111/trf.18177","url":null,"abstract":"<p><strong>Background: </strong>Resuscitative endovascular balloon occlusion of the aorta (REBOA) and emergency department thoracotomy (EDT) are effective methods of aortic occlusion (AO) for life-threatening bleeding; however, complete AO can lead to visceral ischemia. Partial REBOA (P-REBOA) has been proposed as an alternative to the completely occlusive REBOA (C-REBOA) to balance hemorrhage control and perfusion. Using the Aortic Occlusion for Resuscitation in Trauma (AORTA) multicenter, observational registry, we tested the hypothesis that P-REBOA resulted in better outcomes compared to EDT and C-REBOA.</p><p><strong>Study design and methods: </strong>We queried the 2017-2023 AORTA registry for adults who underwent EDT, C-REBOA, or P-REBOA in the emergency department (ED). Patients with chest penetrating injuries were excluded. We compared mortality, ventilator-free-days (VFD), and ICU-free-days (ICUFD) using survival analysis or generalized linear models to adjust for confounders.</p><p><strong>Results: </strong>Overall, 921 patients underwent EDT (n = 613, 66.6%), C-REBOA (n = 224, 24.3%), or P-REBOA (n = 84, 9.1%); 83.1% died. After confounder adjustment, compared to P-REBOA, both C-REBOA and EDT were associated with a lower likelihood of attaining hemodynamic improvement and stability as well as with higher mortality (adjusted hazard ratio, aHR = 1.84; 95% CI: 1.01-1.60 and aHR = 3.32; 95% CI: 1.96-2.78, respectively). EDT patients had less VFD and ICUFD than those undergoing C-REBOA and P-REBOA, but there were no differences between the two endovascular procedures. Among patients who survived >48 h, EDT was more likely to be associated with complications compared to the other two procedures.</p><p><strong>Discussion: </strong>P-REBOA was more likely to be associated with improved hemodynamic stability and reduced mortality compared to C-REBOA and EDT, suggesting this modality may be a better AO procedure for patients with no penetrating thoracic injuries.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586731","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":"Nationwide estimates of potential lives saved with prehospital blood transfusions.","authors":"Daniel T Lammers, Richard Betzold, Reynold Henry, Joshua Dilday, Jeffrey R Conner, James M Williams, John M McClellan, Matthew J Eckert, Jan O Jansen, Jeffrey Kerby, John B Holcomb, Zain G Hashmi","doi":"10.1111/trf.18174","DOIUrl":"https://doi.org/10.1111/trf.18174","url":null,"abstract":"<p><strong>Introduction: </strong>Prehospital blood transfusions result in a significant reduction in mortality risk for injured patients in hemorrhagic shock; however, prehospital blood transfusions have not been widely implemented across the United States. Thus, a paucity of data surrounding the impact of achieving near-complete population-level access to this resource exists. We aimed to determine the number of lives that could potentially have been saved among injured patients in hemorrhagic shock between 2020 and 2023 had prehospital blood products (blood components or whole blood, pBP) been fully implemented.</p><p><strong>Methods: </strong>We performed a retrospective review of the National Emergency Medical Services Information System (NEMSIS) from 2020 to 2023 for all trauma patients ≥16 years. Patients with prehospital systolic blood pressure <90 mmHg and heart rate >108 beats per minute, or a systolic blood pressure <70 mmHg, and who did not receive pBP products were included in the analysis. Potential lives saved were calculated using mortality and risk ratio estimates (RR) from previously published studies, assuming 100% nationwide access to pBP. A series of models were developed incorporating varying RR, mortality rate assumptions, and nationwide access to pBP to encompass a wide range of scenarios.</p><p><strong>Results: </strong>A total of 260,472 patients met our inclusion criteria. Using a 22.1% 24-h mortality rate and an RR of 0.629, 21,356 deaths over the four-year study period could have potentially been saved with the nationwide implementation of pBP.</p><p><strong>Conclusion: </strong>Transfusion of pBP offers the potential to save thousands of injured patients lives. Efforts toward making policy-level interventions aimed at increasing the adoption and availability of pBP should be sought.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587231","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":"Why do people still make anti-D over 50 years after the introduction of Rho(D) immune globulin? A Biomedical Excellence for Safer Transfusion (BEST) Collaborative study.","authors":"Regina M DelBaugh, Michael F Murphy, Julie Staves, Roberta Maria Fachini, Silvano Wendel, Katie Hands, Carolina Bonet-Bub, Jose Mauro Kutner, Claudia S Cohn, Cody A Cox, Cyril Jacquot, Rida A Hasan, Wen Lu, Justin E Juskewitch, Jay S Raval, Marian A Rollins-Raval, Mark K Fung, Alyssa Ziman, Erica J Fermon, Jed B Gorlin, Jessica Peters, Nancy M Dunbar","doi":"10.1111/trf.18202","DOIUrl":"https://doi.org/10.1111/trf.18202","url":null,"abstract":"<p><strong>Background: </strong>Rho(D) immune globulin (RhIg) is used to reduce RhD alloimmunization in pregnancy. This study describes potential causes for RhD alloimmunization after the development and implementation of RhIg.</p><p><strong>Study design and methods: </strong>This retrospective descriptive study investigated RhD-negative patients born in 1965-2005 with anti-D newly identified during 2018-2022. Transfusion, pregnancy, intravenous drug abuse, and transplantation were considered potential alloimmunization sources.</p><p><strong>Results: </strong>There were 1200 study patients (852 females; 348 males) at 30 institutions in 5 countries (USA, Canada, UK, New Zealand, Brazil). Most patients had a single potential source of alloimmunization identified (857/1200, 71%), most commonly pregnancy among females (537/852, 63%) and transfusion among males (180/348, 52%). When multiple potential sources were included, males were more likely than females to have a history of transfusion (235/348 [68%] vs. 149/852 [17%], p < .0001) and confirmed or suspected intravenous drug abuse (100/348 [29%] vs. 138/852 [16%], p < .0001). Among females with a history of pregnancy, 119/718 (17%) had healthcare access issues, 120/718 (17%) had pregnancy in a country where they may not have received RhIg, and 21/718 (3%) refused RhIg. Among patients with a history of transfusion, males were more likely than females to have received RhD-positive red blood cells or whole blood (143/235 [61%] vs. 30/149 [20%], p < .0001) and/or platelets (84/235 [36%] vs. 19/149 [13%], p < .0001).</p><p><strong>Discussion: </strong>Pregnancy was the most frequently identified potential source of RhD alloimmunization among females. Transfusion was most frequent in males. Intravenous drug abuse as a common potential source among patients with RhD alloimmunization merits further study.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586879","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}