Premium
Intensive red blood cell transfusions and risk of alloimmunization
Author(s) -
Zalpuri Saurabh,
Middelburg Rutger A.,
Schonewille Henk,
Vooght Karen M.K.,
Cessie Saskia,
Bom Johanna G.,
Zwaginga Jaap Jan
Publication year - 2014
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/trf.12312
Subject(s) - medicine , interquartile range , hazard ratio , confidence interval , blood transfusion , proportional hazards model , cohort , cohort study , retrospective cohort study
Background Exposure to allogenic red blood cells ( RBCs ) may lead to formation of antibodies against nonself‐antigens in transfused patients. While alloimmunization rates are known to increase with the number of transfusions, the transfusion course in patients can vary from receiving multiple units during a single transfusion event or getting them dispersed over a long(er) period. In this study we compared the immunization risk between different transfusion intensities. Study Design and Methods An incident new‐user cohort study was conducted among consecutive transfused patients at two university medical centers. All patients who received their first RBC transfusion within the study period from J anuary 2005 to D ecember 2011 were eligible. Intensive transfusions were defined as at least 5, at least 10, and at least 20 RBC units within 48 hours. Alloimmunization hazard ratios ( HRs ), comparing patients receiving intensive transfusions to patients never receiving intensive transfusions, were estimated. Results The study cohort was composed of 5812 patients who had received a median of 7 (interquartile range, 4‐12) units. RBC alloantibodies were formed by 156 patients. The adjusted C ox regression HRs for alloimmunization, with number of units as the time covariate and adjusted for patient age, sex, and follow‐up time after first transfusion, ranged from 0.8 to 1.2 (95% confidence interval, 0.4‐2.6). Conclusion The occurrence of RBC alloimmunization in patients receiving intensive transfusions did not differ significantly from patients receiving nonintensive transfusions.