title: 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.
abstract: 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.
authors.affiliation: Department of Anesthesiology and Laboratory Medicine, Kyorin University School of Medicine, Tokyo, Japan.
authors.forename: Harumasa
authors.initials: H
authors.lastname: Nakazawa
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Ohnishi
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Okazaki
authors.forename: Shiho
authors.initials: S
authors.lastname: Hashimoto
authors.forename: Hajime
authors.initials: H
authors.lastname: Hotta
authors.forename: Takashi
authors.initials: T
authors.lastname: Watanabe
authors.forename: Ryunosuke
authors.initials: R
authors.lastname: Ohkawa
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Yatomi
authors.forename: Kazunori
authors.initials: K
authors.lastname: Nakajima
authors.forename: Yasuhide
authors.initials: Y
authors.lastname: Iwao
authors.forename: Shigeru
authors.initials: S
authors.lastname: Takamoto
authors.forename: Masaru
authors.initials: M
authors.lastname: Shimizu
authors.forename: Takehiko
authors.initials: T
authors.lastname: Iijima
mesh_terms: 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