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.
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.


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.
Nakazawa
Harumasa
H
Department of Anesthesiology and Laboratory Medicine, Kyorin University School of Medicine, Tokyo, Japan.
Ohnishi
Hiroaki
H
Okazaki
Hitoshi
H
Hashimoto
Shiho
S
Hotta
Hajime
H
Watanabe
Takashi
T
Ohkawa
Ryunosuke
R
Yatomi
Yutaka
Y
Nakajima
Kazunori
K
Iwao
Yasuhide
Y
Takamoto
Shigeru
S
Shimizu
Masaru
M
Iijima
Takehiko
T
D055371:Acute Lung Injury / Q000209:etiology / Q000517:prevention & control; D000368:Aged; D000369:Aged, 80 and over; D001803:Blood Transfusion / Q000379:methods*; D016022:Case-Control Studies; D005260:Female; D013502:General Surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D010949:Plasma; D011446:Prospective Studies; D011654:Pulmonary Edema / Q000209:etiology; D065227:Transfusion Reaction