Female donor plasma may aid heart surgery

LOS ANGELES – Three years after the U.S. blood banking industry recommended against transfusing plasma from female donors because of a potentially life-threatening antibody reaction, researchers have found that plasma from women may actually be better, not worse, for heart surgery patients.

In a study of patients treated before the new guidelines were implemented, those receiving plasma from women were only half as likely to suffer lung complications from the surgery and were 45 percent less likely to be hospitalized or die in the 10 days after surgery, a Duke University team reported.

The long-term survival rates, however, were the same whether plasma came from men or women.

The findings, published in the Journal of Thoracic and Cardiovascular Surgery, were a surprise to the researchers. They had expected that their results would support the informal restrictions on plasma use, said co-author Dr. Nicholas Bandarenko, medical director of Duke Transfusion Services.

The findings suggest that, in an effort to minimize the risk of catastrophic lung injury, surgeons may be shifting to problems that are not as serious, but substantially more common.

The concern about plasma from women arises from a rare phenomenon known as transfusion-related acute lung injury, commonly known as TRALI. TRALI affects as many as one in 3,000 patients who receive a plasma transfusion, killing an estimated 200 people in the United States each year. It is responsible for about half of all transfusion-related deaths.

TRALI usually occurs within six hours of a transfusion and is thought to be caused by certain antibodies in the plasma that react with immune cells of the body into which they are transfused.