Donor genetic and nongenetic factors affecting red blood cell transfusion effectiveness

Abstract

Background: Red blood cell (RBC) 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 and non-genetic factors affecting transfusion effectiveness.Methods: This is a multicenter retrospective study of 46,705 patients, and 102,043 evaluable RBC transfusions from 2013-2016 across 12 hospitals. Transfusion effectiveness was defined as hemoglobin, bilirubin, or creatinine increments following single RBC unit transfusion. Models incorporated a subset of donors with data on single nucleotide polymorphisms associated with osmotic and oxidative hemolysis in vitro. Mixed modelling accounting for repeated transfusion episodes identified predictors of transfusion effectiveness.Results: Blood donor (sex, Rh status, fingerstick hemoglobin, smoking), component (storage duration, gamma irradiation, leukoreduction, apheresis collection, storage solution), and recipient (sex, body mass index, race, age) characteristics were associated with hemoglobin and bilirubin but not creatinine increments following RBC transfusions. Increased storage duration was associated with increased bilirubin and decreased hemoglobin increments, suggestive of in vivo hemolysis following transfusion. Donor G6PD-deficiency and polymorphisms in SEC14L4, HBA2, and MYO9B genes were associated with decreased hemoglobin increments. Donor G6PD-

The Recipient Epidemiology and Donor Evaluation Study‐IV‐Pediatric (REDS‐IV‐P): A research program striving to improve blood donor safety and optimize transfusion outcomes across the lifespan

“…This multicenter retrospective study investigated 46,705 patients and 102,043 evaluable RBC transfusions from 2013 to 2016 across 12 hospitals. The study found that donor genetics and other factors, such as RBC storage duration, affect transfusion effectiveness 32 …”

“…The study found that donor genetics and other factors, such as RBC storage duration, affect transfusion effectiveness. 32…”

Innate Variability in Physiological and Omics Aspects of the Beta Thalassemia Trait-Specific Donor Variation Effects

“…For instance, stored RBCs from donors with elevated glycosylated Hb present increased susceptibility to lysis, phosphatidylserine (PS) externalization and non-reversible shape modifications ( Li et al, 2022 ). Moreover, polymorphisms in HbA2 gene are associated with a reduced hemoglobin increment ( Roubinian et al, 2022 ), and sickle cell trait with increased storage hemolysis and removal in animal models of transfusion ( Osei-Hwedieh et al, 2016 ).…”

Storage-Induced Micro-Erythrocytes Can Be Quantified and Sorted by Flow Cytometry

“…Suboptimal transfusion recovery is expected to increase the number of red blood cell concentrates needed to restore hemoglobin concentration. Along this line, transfusion-induced hemoglobin increments are significantly decreased when red cell concentrates are stored for longer durations ( Hunsicker et al, 2018 ; Roubinian et al, 2019 ; Rydén et al, 2019 ) and may be associated with donor genetic factors ( Roubinian et al, 2022 ). Pretransfusion control of SME, and elimination of lower-quality products, would be particularly beneficial to chronically transfused patients with sickle cell disease, thalassemia or myelodysplastic syndromes.…”