Transfusion medicine- The role of donor sex on red blood cell transfusion outcomes

The role of donor-related factors in transfusion outcomes is controversial in transfusion medicine due to the limited number of studies focusing on this problem. In particular, it is not clear whether female red blood cells (RBCs) or donor-recipient sex-mismatched transfusion is a key player in mediating adverse outcomes. This thesis took a translational approach to increase our understanding of the impact of donor sex on transfusion outcomes. Clinical studies were done using two clinical databases that have been previously collected at the intensive care units (ICUs) of two academic hospitals. The key aims of the clinical studies were to investigate the impact of donor sex on post-transfusion mortality, hospital-acquired complications, and endothelial activation. Furthermore, to study biological mechanisms underlining the role of donor factors on transfusion outcomes, this thesis investigated the impact of donor sex and RBC age-subpopulations on the host immune response using various in vitro experimental models and an in vivo biotinylated animal transfusion model.