title: Association of Blood Donor Age and Sex With Recipient Survival After Red Blood Cell Transfusion.
abstract: While red blood cells (RBCs) are administered to improve oxygen delivery and patient outcomes, they also have been associated with potential harm. Unlike solid organ transplantation, the clinical consequences of donor characteristics on recipients have not been evaluated in transfusion medicine.
  
  
  
  To analyze the association of RBC donor age and sex with the survival of transfusion recipients.
  
  
  
  We established a longitudinal cohort by linking data from a blood collection agency with clinical and administrative data at 4 academic hospitals.
  
  
  
  Cox proportional hazards regression models were fitted to evaluate the risk of donor age and sex on transfusion recipient survival.
  
  
  
  Between October 25, 2006, and December 31, 2013, a total of 30 503 RBC transfusion recipients received 187 960 RBC transfusions from 80 755 unique blood donors. For recipients receiving an RBC unit from younger donors, the risk of death was increased compared with recipients receiving an RBC unit from a donor 40 to 49.9 years old (adjusted hazard ratio, 1.08; 95% CI, 1.06-1.10; P < .001 for donor age range 17-19.9 years and 1.06; 95% CI, 1.04-1.09; P < .001 for donor age range 20-29.9 years). Receiving an RBC transfusion from a female donor was associated with an 8% statistically significant increased risk of death compared with receiving an RBC transfusion from a male donor (adjusted hazard ratio, 1.08; 95% CI, 1.06-1.09; P < .001).
  
  
  
  Red blood cell transfusions from younger donors and from female donors were statistically significantly associated with increased mortality. These findings suggest that donor characteristics may affect RBC transfusion outcomes.
authors.affiliation: Department of Anesthesiology and Critical Care, Université Laval, Quebec, Quebec, Canada.
authors.forename: Michaël
authors.initials: M
authors.lastname: Chassé
authors.affiliation: Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada3Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
authors.forename: Alan
authors.initials: A
authors.lastname: Tinmouth
authors.affiliation: Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada3Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
authors.forename: Shane W
authors.initials: SW
authors.lastname: English
authors.affiliation: Centre for Innovation, Canadian Blood Services, Edmonton, Alberta.
authors.forename: Jason P
authors.initials: JP
authors.lastname: Acker
authors.affiliation: Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada3Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
authors.forename: Kumanan
authors.initials: K
authors.lastname: Wilson
authors.affiliation: Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada3Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
authors.forename: Greg
authors.initials: G
authors.lastname: Knoll
authors.affiliation: Department of Medicine, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Nadine
authors.initials: N
authors.lastname: Shehata
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, Canada3Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
authors.forename: Alan J
authors.initials: AJ
authors.lastname: Forster
authors.affiliation: Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
authors.forename: Timothy
authors.initials: T
authors.lastname: Ramsay
authors.affiliation: Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada3Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
authors.forename: Lauralyn A
authors.initials: LA
authors.lastname: McIntyre
authors.affiliation: Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada3Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
authors.forename: Dean A
authors.initials: DA
authors.lastname: Fergusson
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D001782:Blood Donors / Q000706:statistics & numerical data*; D002170:Canada / Q000453:epidemiology; D015331:Cohort Studies; D015897:Comorbidity; D017707:Erythrocyte Transfusion; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009026:Mortality; D016016:Proportional Hazards Models; D012737:Sex Factors; D016019:Survival Analysis; D055815:Young Adult