title: Clinical effects of blood donor characteristics in transfusion recipients: protocol of a framework to study the blood donor-recipient continuum.
abstract: BACKGROUND
  When used appropriately, transfusion of red blood cells (RBCs) is a necessary life-saving therapy. However, RBC transfusions have been associated with negative outcomes such as infection and organ damage. Seeking explanations for the beneficial and deleterious effects of RBC transfusions is necessary to ensure the safe and optimal use of this precious resource. This study will create a framework to analyse the influence of blood donor characteristics on recipient outcomes.
  
  
  METHODS
  We will conduct a multisite, longitudinal cohort study using blood donor data routinely collected by Canadian Blood Services, and recipient data from health administrative databases. Our project will include a thorough validation of primary data, the linkage of various databases into one large longitudinal database, an in-depth epidemiological analysis and a careful interpretation and dissemination of the results to assist the decision-making process of clinicians, researchers and policymakers in transfusion medicine. Our primary donor characteristic will be age of blood donors and our secondary donor characteristics will be donor-recipient blood group compatibility and blood donor sex. Our primary recipient outcome will be a statistically appropriate survival analysis post-RBC transfusion up to a maximum of 8 years. Our secondary recipient outcomes will include 1-year, 2-year and 5-year mortality; hospital and intensive care unit length of stay; rehospitalisation; new cancer and cancer recurrence rate; infection rate; new occurrence of myocardial infarctions and need for haemodialysis.
  
  
  BACKGROUND
  Our results will help determine whether we need to tailor transfusion based on donor characteristics, and perhaps this will improve patient outcome. Our results will be customised to target the different stakeholders involved with blood transfusions and will include presentations, peer-reviewed publications and the use of the dissemination network of blood supply organisations. We obtained approval from the Research Ethics boards and privacy offices of all involved institutions.
authors.affiliation: Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
authors.forename: Michaël
authors.initials: M
authors.lastname: Chassé
authors.affiliation: Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
authors.forename: Lauralyn
authors.initials: L
authors.lastname: McIntyre
authors.affiliation: Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
authors.forename: Alan
authors.initials: A
authors.lastname: Tinmouth
authors.affiliation: Centre for Innovation, Canadian Blood Services, Edmonton, Alberta, Canada.
authors.forename: Jason
authors.initials: J
authors.lastname: Acker
authors.affiliation: Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada Department of Medicine (Critical Care), University of Ottawa, Ottawa, Ontario, Canada.
authors.forename: Shane W
authors.initials: SW
authors.lastname: English
authors.affiliation: Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
authors.forename: Greg
authors.initials: G
authors.lastname: Knoll
authors.affiliation: Ottawa Hospital, Ottawa, Ontario, Canada.
authors.forename: Alan
authors.initials: A
authors.lastname: Forster
authors.affiliation: Department of Medicine and Laboratory Medicine and Pathobiology, University of Toronto, Mount Sinai Hospital, Toronto, Ontario, Canada.
authors.forename: Nadine
authors.initials: N
authors.lastname: Shehata
authors.affiliation: Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada Institute for Clinical Evaluative Sciences, Ottawa, Ontario, Canada.
authors.forename: Kumanan
authors.initials: K
authors.lastname: Wilson
authors.affiliation: Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
authors.forename: Carl
authors.initials: C
authors.lastname: van Walraven
authors.affiliation: Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada Institute for Clinical Evaluative Sciences, Ottawa, Ontario, Canada.
authors.forename: Robin
authors.initials: R
authors.lastname: Ducharme
authors.affiliation: Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
authors.forename: Dean A
authors.initials: DA
authors.lastname: Fergusson
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001782:Blood Donors; D001789:Blood Group Antigens; D002170:Canada; D015331:Cohort Studies; D017707:Erythrocyte Transfusion / Q000009:adverse effects* / Q000401:mortality; D004912:Erythrocytes; D005260:Female; D006648:Histocompatibility; D006760:Hospitalization; D006801:Humans; D007239:Infections / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology*; D009369:Neoplasms / Q000209:etiology*; D006435:Renal Dialysis; D012107:Research Design; D012737:Sex Factors; D016019:Survival Analysis; D055815:Young Adult
chemical_list: D001789:Blood Group Antigens
keywords: EPIDEMIOLOGY; HAEMATOLOGY