Do Transfusions from Female Donors Increase Mortality in Male Recipients?

Immunologic reactions due to donor–recipient mismatch occasionally complicate blood transfusions and are usually prevented by meticulous red cell typing and cross-matching. But is it safe for male recipients to receive blood from female donors that might contain cytotoxic antibodies from previous pregnancies?

To answer this question, investigators conducted a retrospective review of 31,118 patients (median age, 65 years; 52% female) in six Dutch hospitals who received a total of 59,320 red cell transfusions. The red cells were from one of three types of donors: men (88%), women with previous pregnancies (6%), and women who had never been pregnant (6%). All units were leukocyte-reduced and ABO-rhD identical.

At a median follow-up of 245 days, …