Female sex of older patients is an independent risk factor for red blood cell alloimmunization after transfusion

Background More women than men are encountered with red blood cell (RBC) antibodies. It is not clear whether this difference is explained by more immunizing events in women or by a different acting immune system. To assess whether there is a difference in the posttransfusion RBC alloimmunization rat...

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Bibliographic Details
Published in:Transfusion (Philadelphia, Pa.) Pa.), 2015-06, Vol.55 (6pt2), p.1478-1485
Main Authors: Verduin, Esther P., Brand, Anneke, Middelburg, Rutger A., Schonewille, Henk
Format: Article
Language:English
Subjects:
Age Factors
Aged
Aged, 80 and over
Blood Group Incompatibility - epidemiology
Blood Group Incompatibility - etiology
Erythrocyte Transfusion - adverse effects
Erythrocyte Transfusion - statistics & numerical data
Erythrocytes - immunology
Female
Follow-Up Studies
Humans
Isoantibodies - blood
Male
Middle Aged
Risk Factors
Sex Factors
Sex Ratio
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Summary:Background More women than men are encountered with red blood cell (RBC) antibodies. It is not clear whether this difference is explained by more immunizing events in women or by a different acting immune system. To assess whether there is a difference in the posttransfusion RBC alloimmunization rate between women and men, a study on RBC alloimmunization during a 5‐year period was conducted in patients with at least one antibody follow‐up more than 14 days after transfusion. Study design and methods Data on transfusion and antibody follow‐up characteristics in female and male transfusion recipients from the Leiden University Medical Center laboratory database were collected. Hazard ratios of alloimmunization, according to sex of the transfusion recipient, were estimated using Cox proportional hazards regression models taking possible confounders into account. Results From a total of 1699 women and 1969 men who were eligible, 4.2% of women and 3.4% of men (relative risk, 1.3; 95% confidence interval [CI], 0.9‐1.8) developed posttransfusion antibodies. Adjustment for confounders resulted in a relative 80% higher risk in women older than 45 years of age. Conclusion Elder women beyond childbearing age have a higher risk of posttransfusion antibody formation compared to men.
ISSN:0041-1132
1537-2995
DOI:10.1111/trf.13111