Donor and unit factors associated with recipient RBC alloimmunization formation
与受者红细胞同种免疫形成相关的供者和单位因素
基本信息
- 批准号:10515205
- 负责人:
- 金额:$ 12.56万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2022
- 资助国家:美国
- 起止时间:2022-08-01 至 2024-07-31
- 项目状态:已结题
- 来源:
- 关键词:AgeAlloimmunizationAntibodiesAntibody FormationAntigensAutoimmunityBase RatiosBloodBlood BanksBlood DonationsBlood TransfusionBlood donorCase-Control StudiesCategoriesCharacteristicsChemicalsCommunitiesComplex AnalysisCooley&aposs anemiaDangerousnessDataData SetDatabasesDevelopmentDiagnosisDiseaseDysmyelopoietic SyndromesElectronic Health RecordErythrocyte TransfusionErythrocytesEthnic OriginEventExposure toFetusFundingGoalsHealthHospitalsHumanIncidenceIndividualInpatientsInstitutionIsoantibodiesLinkModelingMorbidity - disease rateMusNational Heart, Lung, and Blood InstituteNewborn InfantOdds RatioOutcomeOutpatientsPatientsPregnancyPrevalencePublic HealthRaceReactionResearch DesignRiskSafetyScienceServicesSickle Cell AnemiaSmoking HistoryTimeTransfusionUnited StatesVeinsWhole Bloodantibody detectioncase controlcell injuryclinically significanthigh riskinnovationinterestirradiationmortalitypatient populationsecondary analysissextime interval
项目摘要
Red blood cell (RBC) alloimmunization is a leading cause of morbidity and mortality in transfusion and
pregnancy settings, resulting in hemolytic reactions and other adverse sequelae. Alloimmunization occurs in
up to 40% of some patient populations, including those with sickle cell disease (SCD); rates in patients with
myelodysplastic syndrome, thalassemia major, and autoimmunity are also high. Most studies of RBC
alloimmunization to date have focused on incidence/prevalence rates and recipient characteristics/diagnoses,
and few studies have evaluated blood donor or blood unit contributions to RBC alloantibody formation.
The National Heart, Lung, and Blood Institute (NHBLI) funded REDS-III vein-to-vein data set, available for
public use through BioLINCC, allows a unique opportunity to evaluate RBC alloantibodies in diverse recipients
across multiple institutions and to investigate potential blood donor and unit variables involved in transfusion
associated alloantibody formation. This data set contains inpatient and outpatient electronic health
information from four major blood centers and 12 community and academic hospitals in the United States, over
a 4-year time-period from 2013-2017. A query of the data set has shown that there are 651 subjects with a new
RBC antibody formed in the time interval (15 days to 16 weeks) following transfusion over which most
antibodies would be expected to form. The innovation of the current proposal lies in the unique ability to link
blood donor and blood unit characteristics to the recipient outcome of alloimmunization following RBC
transfusion.
Murine studies have shown that more rapid RBC clearance following transfusion is associated with a higher
degree of RBC alloimmunization, regardless of whether that increased clearance is due to longer storage
duration or other causes. As such, we hypothesize that factors associated with poorer RBC storage in
humans, including red cell storage duration, donor sex, or irradiation, will impact the likelihood of alloantibody
formation. We propose to complete a case: control (1:4) study, matching cases and controls for age, sex,
diagnosis, race, and ethnicity. With this study design, we propose: Aim 1) To investigate blood donor
characteristics associated with RBC alloimmunization in transfusion recipients and Aim 2) To investigate RBC
unit characteristics associated with RBC alloimmunization in transfusion recipients.
Long term, any blood donor or RBC unit characteristic associated with alloimmunization could be modified for
RBC units intended for patients at highest risk of RBC alloimmunization. If new antibody formation could be
minimized, transfusion safety will increase.
红细胞(RBC)同种免疫是输血和输血中发病率和死亡率的主要原因
妊娠环境,造成溶血反应等不良后遗症。同种免疫发生于
高达 40% 的某些患者群体,包括镰状细胞病 (SCD) 患者;患者的比率
骨髓增生异常综合征、重型地中海贫血和自身免疫性疾病的发病率也很高。大多数红细胞研究
迄今为止的同种免疫侧重于发病率/患病率和接受者特征/诊断,
很少有研究评估献血者或血液单位对红细胞同种抗体形成的贡献。
美国国家心肺血液研究所 (NHBLI) 资助的 REDS-III 静脉间数据集,可用于
通过 BioLINCC 公开使用,为评估不同接受者的红细胞同种抗体提供了独特的机会
跨多个机构并调查参与输血的潜在献血者和单位变量
相关同种抗体的形成。该数据集包含住院和门诊电子健康
来自美国 4 个主要血液中心以及 12 个社区和学术医院的信息,超过
2013年至2017年为期4年。对该数据集的查询显示,有 651 名受试者具有新的
红细胞抗体在输血后的时间间隔(15天至16周)内形成,在此期间大多数
预计会形成抗体。当前提案的创新在于独特的链接能力
献血者和血液单位特征对 RBC 后同种免疫受者结果的影响
输血。
小鼠研究表明,输血后红细胞清除速度越快,血红蛋白浓度越高。
红细胞同种免疫程度,无论清除率增加是否是由于储存时间较长所致
持续时间或其他原因。因此,我们假设与红细胞储存不良相关的因素
人类,包括红细胞储存时间、供者性别或辐射,将影响同种抗体的可能性
形成。我们建议完成一个病例:对照(1:4)研究,匹配病例和对照的年龄、性别、
诊断、种族和民族。通过本研究设计,我们建议: 目标 1) 调查献血者
与输血受者红细胞同种免疫相关的特征和目标 2) 研究红细胞
与输血受者红细胞同种免疫相关的单位特征。
从长远来看,与同种免疫相关的任何献血者或红细胞单位特征都可以修改为
红细胞单位适用于红细胞同种免疫风险最高的患者。如果新的抗体能够形成
最小化,输血安全性将会提高。
项目成果
期刊论文数量(0)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
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Ronald G. Hauser其他文献
HOSPITAL VARIATIONS IN TROPONIN ORDERING AND ITS ASSOCIATION WITH DOWNSTREAM RESOURCE UTILIZATION WITHIN THE VETERANS HEALTH ADMINISTRATION
- DOI:
10.1016/s0735-1097(19)30786-7 - 发表时间:
2019-03-12 - 期刊:
- 影响因子:
- 作者:
Philip Chui;Lori Bastian;Parul Gandhi;Denise Esserman;Edward Miller;Ronald G. Hauser - 通讯作者:
Ronald G. Hauser
Machine learning to develop a predictive model of pressure injury in persons with spinal cord injury
- DOI:
10.1038/s41393-023-00924-z - 发表时间:
2023-08-19 - 期刊:
- 影响因子:2.200
- 作者:
Stephen L. Luther;Susan S. Thomason;Sunil Sabharwal;Dezon K. Finch;James McCart;Peter Toyinbo;Lina Bouayad;William Lapcevic;Bridget Hahm;Ronald G. Hauser;Michael E. Matheny;Gail Powell-Cope - 通讯作者:
Gail Powell-Cope
SEX DIFFERENCES IN NATRIURETIC PEPTIDE TESTING IN PATIENTS HOSPITALIZED WITH HEART FAILURE
- DOI:
10.1016/s0735-1097(22)01458-9 - 发表时间:
2022-03-08 - 期刊:
- 影响因子:
- 作者:
Parul U. Gandhi;Tessa Runels;Melissa Skanderson;Lori Bastian;Cynthia Brandt;Ronald G. Hauser;Shelli Leore Feder;Benjamin Rodwin;Melissa Farmer;Bevanne Bean-Mayberry;Kathleen Akgun - 通讯作者:
Kathleen Akgun
HOSPITAL VARIATIONS IN THE UTILIZATION OF CARDIAC STRESS TESTING FOR PATIENTS PRESENTING TO THE EMERGENCY DEPARTMENT WITHIN THE VETERANS HEALTH ADMINISTRATION
- DOI:
10.1016/s0735-1097(19)30785-5 - 发表时间:
2019-03-12 - 期刊:
- 影响因子:
- 作者:
Philip Chui;Ronald G. Hauser;Edward Miller;Denise Esserman;Lori Bastian;Parul Gandhi - 通讯作者:
Parul Gandhi
A Multidisciplinary Quality Improvement Project to Improve Appropriate Inherited Thrombophilia Testing at VA Connecticut
- DOI:
10.1182/blood-2022-168044 - 发表时间:
2022-11-15 - 期刊:
- 影响因子:
- 作者:
Jenny J Xiang;Talib Dosani;Ronald G. Hauser;Danielle Cosentino;Naseema Merchant;Michal G. Rose - 通讯作者:
Michal G. Rose
Ronald G. Hauser的其他文献
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{{ truncateString('Ronald G. Hauser', 18)}}的其他基金
Donor and unit factors associated with recipient RBC alloimmunization formation
与受者红细胞同种免疫形成相关的供者和单位因素
- 批准号:
10670887 - 财政年份:2022
- 资助金额:
$ 12.56万 - 项目类别:
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Donor and unit factors associated with recipient RBC alloimmunization formation
与受者红细胞同种免疫形成相关的供者和单位因素
- 批准号:
10670887 - 财政年份:2022
- 资助金额:
$ 12.56万 - 项目类别: