Donor genetic and nongenetic factors affecting red blood cell transfusion effectiveness

• DOI: 10.1172/jci.insight.152598
• Publication Date: 2021-11-18T17:01:43Z
• Authors: Nareg H. Roubinian; Sarah E. Reese; Hannah Qiao; Colleen Plimier; Fang Fang; Grier P. Page; Ritchard G. Cable; Brian Custer; Mark T. Gladwin; Ruchika Goel; Bob Harris; Jeanne E. Hendric...; Tamir Kanias; Steve Kleinman; Alan E. Mast; Steven R. Sloan; Bryan R. Spencer; Steven L. Spitalnik; Michael P. Busch; Eldad A. Hod
• Keywords: Leukoreduction

BACKGROUNDRBC 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 nongenetic factors affecting effectiveness.METHODSThis is a multicenter retrospective study of 46,705 patients 102,043 evaluable RBC transfusions from 2013 2016 across 12 hospitals. Transfusion was defined as hemoglobin, bilirubin, or creatinine single unit Models incorporated subset donors data on nucleotide polymorphisms osmotic oxidative hemolysis vitro. Mixed modeling accounting for repeated episodes predictors effectiveness.RESULTSBlood (sex, Rh status, fingerstick smoking), component (storage duration, γ irradiation, leukoreduction, apheresis collection, storage solution), BMI, race ethnicity, age) were but not creatinine, transfusions. Increased duration increased bilirubin decreased increments, suggestive vivo Donor G6PD deficiency SEC14L4, HBA2, MYO9B genes increments. SEC14L4 requirements the subsequent 48 hours.CONCLUSIONDonor other factors, such affect by Addressing will provide precision medicine approach improve patient outcomes, particularly chronically transfused recipients, who would most benefit more effective products.FUNDINGFunding provided HHSN 75N92019D00032, 75N92019D00034, 75N92019D00035, 75N92019D00036, 75N92019D00037; R01HL126130; National Institute Child Health Human Development (NICHD).