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Impact of fresh‐frozen plasma from male‐only donors versus mixed‐sex donors on postoperative respiratory function in surgical patients: a prospective case‐controlled study
Author(s) -
Nakazawa Harumasa,
Ohnishi Hiroaki,
Okazaki Hitoshi,
Hashimoto Shiho,
Hotta Hajime,
Watanabe Takashi,
Ohkawa Ryunosuke,
Yatomi Yutaka,
Nakajima Kazunori,
Iwao Yasuhide,
Takamoto Shigeru,
Shimizu Masaru,
Iijima Takehiko
Publication year - 2009
Publication title -
transfusion
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.045
H-Index - 132
eISSN - 1537-2995
pISSN - 0041-1132
DOI - 10.1111/j.1537-2995.2009.02321.x
Subject(s) - medicine , prospective cohort study , respiratory system , surgery , fresh frozen plasma , anesthesia , platelet
BACKGROUND: To reduce the risk of transfusion‐related acute lung injury (TRALI), plasma products are mainly made from male donors in some countries because of the lower possibility of alloimmunization; other countries are considering this policy. The advantage of male‐only fresh‐frozen plasma (FFP) should be examined in a prospective case‐control study. STUDY DESIGN AND METHODS: This study compared pulmonary function after the transfusion of FFP derived from either male donors only (FFP‐male) or mixed donors (FFP‐mixed) in informed surgical patients treated at a tertiary university hospital in Japan. The factors contributing to pulmonary distress (PD) after transfusion were then statistically examined. RESULTS: Eighty‐two patients participated in this study (FFP‐male, n = 55; FFP‐mixed, n = 27). Nineteen patients developed PD (PaO 2 /FiO 2 ratio [P/F] < 300) within 6 hours after transfusion: seven had congestive pulmonary edema (transfusion‐associated circulatory overload), five had permeability pulmonary edema (possible TRALI), and seven had no apparent pulmonary edema. A multivariate logistic regression analysis revealed that the use of cardiopulmonary bypass and preoperative liver dysfunction were significantly associated with a P/F of less than 300 (odds ratios [ORs], 8.95 [p = 0.004] and 6.54 [p = 0.005], respectively), while the use of FFP‐male was significantly associated with the absence of PD (OR, 0.219; p = 0.022). All the patients with possible TRALI had received either white blood cell or granulocyte antibody‐positive FFP. The lysophosphatidylcholine level was not correlated with PD. CONCLUSIONS: Our data suggests that the use of FFP derived from male donors may be advantageous for posttransfusion pulmonary function, although PD is also determined by background characteristics.