title: Effect of storage time and donor sex of transfused red blood cells on 1-year survival in patients undergoing cardiac surgery: an observational study.
abstract: Red blood cell (RBC) storage lesions and RBCs from females transfused into male recipients may have adverse effects on transfusion recipients' survival. We hypothesized that the effect of donor sex and the effect of age of blood on mortality would be most apparent in cardiac surgery patients.
  
  
  
  Using data from French Blood Services and two university hospitals, we conducted a retrospective cohort study on cardiac surgery patients whose first transfusion occurred between 2007 and 2011. The age of blood and donor sex effects on 1-year survival were studied using Cox regression modeling, with time-dependent stratification on the number of RBCs and adjustments for the type of surgery and other products transfused.
  
  
  
  Among the 2715 cardiac surgery patients, 85.1% were alive after 1 year. Age of blood and donor sex were associated with survival before adjustments (p < 0.0001). However, the adjusted hazard ratios (HRs) for patients transfused with blood stored for 29 days or more versus 14 days or less were 0.97 (95% confidence interval [95% CI], 0.69-1.35; p = 0.98) and 1.22 (95% CI, 0.81-1.82) for patients who received only sex-mismatched RBCs versus all matched units (p = 0.27). For males transfused solely with female RBCs, the HR was 0.96 (95% CI, 0.57-1.61; p = 0.69); in females transfused only with male RBCs, it was 2.03 (95% CI, 0.87-4.73; p = 0.17).
  
  
  
  In this first study of survival after transfusion in France, there was no significant effect for age of blood or donor sex. Contrary to previously reported data, female RBCs appear to be safe for male recipients.
authors.affiliation: Centre d'Investigation Clinique, INSERM CIC 1431, University Hospital of Besançon, Besançon, France.
authors.forename: Maxime
authors.initials: M
authors.lastname: Desmarets
authors.affiliation: Etablissement Français du Sang (EFS) Pyrénées Méditerranée, Toulouse, France.
authors.forename: Laurent
authors.initials: L
authors.lastname: Bardiaux
authors.affiliation: Service de Biostatistiques et Informatique Médicale (DIM), University Hospital of Dijon, Dijon, France.
authors.forename: Eric
authors.initials: E
authors.lastname: Benzenine
authors.affiliation: Département d'Information Médicale, University Hospital of Besançon.
authors.forename: Alain
authors.initials: A
authors.lastname: Dussaucy
authors.affiliation: Centre d'Investigation Clinique, INSERM CIC 1431, University Hospital of Besançon, Besançon, France.
authors.forename: Delphine
authors.initials: D
authors.lastname: Binda
authors.affiliation: UMR 1098, INSERM, Université de Franche-Comté, Etablissement Français du Sang, Besançon, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Tiberghien
authors.affiliation: Service de Biostatistiques et Informatique Médicale (DIM), University Hospital of Dijon, Dijon, France.|Centre d'Investigation Clinique, INSERM CIC 1432, University Hospital of Dijon.|UMR 1181, Biostatistiques, biomathématiques, pharmacoépidémiologie et maladies infectieuses (BP2PHI), INSERM Université de Bourgogne, Dijon, France.
authors.forename: Catherine
authors.initials: C
authors.lastname: Quantin
authors.affiliation: Centre d'Investigation Clinique, INSERM CIC 1431, University Hospital of Besançon, Besançon, France.|EA 4266, Agents Pathogènes et Inflammation, Université de Franche-Comté, Besançon, France.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Monnet
mesh_terms: D000368:Aged; D001782:Blood Donors; D001793:Blood Preservation; D006348:Cardiac Surgical Procedures / Q000379:methods / Q000401:mortality; D017707:Erythrocyte Transfusion / Q000009:adverse effects* / Q000401:mortality; D005260:Female; D005602:France; D006085:Graft Survival; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012737:Sex Factors; D016019:Survival Analysis; D013997:Time Factors