{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T15:06:32Z","timestamp":1779116792783,"version":"3.51.4"},"reference-count":26,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T00:00:00Z","timestamp":1769990400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T00:00:00Z","timestamp":1769990400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100000014","name":"Canadian Blood Services","doi-asserted-by":"publisher","award":["IG2019\u2010SN"],"award-info":[{"award-number":["IG2019\u2010SN"]}],"id":[{"id":"10.13039\/501100000014","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transfusion"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>The immunomodulatory consequences of blood transfusion, known as transfusion\u2010related immune modulation (TRIM), are often not captured by hemovigilance systems. Changes to blood product manufacturing processes may impact patient outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design and Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective study of hospitalized adults (\u226518\u2009years) in Hamilton, ON, who received \u22651 red blood cell (RBC) transfusion(s) between 2010 and 2014. Primary outcome was in hospital mortality; TRIM outcomes included respiratory failure, organ dysfunction, and sepsis. We evaluated outcomes before and after the change made by Canadian Blood Services (2012) to consolidate manufacturing of blood products in Ontario. Exclusions included autologous, washed, or deglycerolized RBC transfusions, RBCs manufactured outside select regional sites, or patients who received both pre\u2010\/post\u2010consolidation RBCs. Data was obtained from the TRUST database. Logistic regression adjusted for key covariates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 9871 pre\u2010 and 7871 post\u2010consolidation patients met inclusion criteria. Multivariate analysis demonstrated no change in in\u2010hospital mortality (odds ratio [OR] 1.00, 95% confidence interval [CI] 0.89\u20131.14,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.95), respiratory failure (OR 0.83, CI 0.65\u20131.06,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.14) or organ dysfunction (OR 0.95, 95% CI 0.84\u20131.08,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.42) comparing post to pre\u2010consolidation. However, hospital\u2010onset sepsis was lower post\u2010consolidation (OR 0.59, 95% CI 0.48\u20130.73,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Consolidation of blood production in Ontario was not associated with changes in rates of in\u2010hospital mortality, respiratory failure, or organ dysfunction among transfusion recipients, but may be associated with a lower risk of sepsis. TRIM and the clinical impacts of changes to blood processing require further study.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/trf.70088","type":"journal-article","created":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T09:54:36Z","timestamp":1770026076000},"page":"491-506","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["<scp>Exploring the immunomodulatory impacts of blood manufacturing consolidation<\/scp>"],"prefix":"10.1111","volume":"66","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4846-6806","authenticated-orcid":false,"given":"Amanda","family":"Kauffman","sequence":"first","affiliation":[{"name":"Temerty Faculty of Medicine University of Toronto  Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6489-6980","authenticated-orcid":false,"given":"Michelle P.","family":"Zeller","sequence":"additional","affiliation":[{"name":"Michael G. DeGroote Centre for Transfusion Research, Department of Medicine McMaster University  Hamilton Ontario Canada"},{"name":"Department of Pathology and Molecular Medicine McMaster University  Hamilton Ontario Canada"},{"name":"Department of Medicine McMaster Centre for Transfusion Research, McMaster University  Hamilton Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yang","family":"Liu","sequence":"additional","affiliation":[{"name":"Michael G. DeGroote Centre for Transfusion Research, Department of Medicine McMaster University  Hamilton Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1445-827X","authenticated-orcid":false,"given":"Jason P.","family":"Acker","sequence":"additional","affiliation":[{"name":"Innovation and Portfolio Management Canadian Blood Services  Edmonton Alberta Canada"},{"name":"Department of Laboratory Medicine and Pathology University of Alberta  Edmonton Alberta Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Donald M.","family":"Arnold","sequence":"additional","affiliation":[{"name":"Michael G. DeGroote Centre for Transfusion Research, Department of Medicine McMaster University  Hamilton Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nancy","family":"Heddle","sequence":"additional","affiliation":[{"name":"Michael G. DeGroote Centre for Transfusion Research, Department of Medicine McMaster University  Hamilton Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chris","family":"Hillis","sequence":"additional","affiliation":[{"name":"Department of Oncology McMaster University  Hamilton Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Na","family":"Li","sequence":"additional","affiliation":[{"name":"Michael G. DeGroote Centre for Transfusion Research, Department of Medicine McMaster University  Hamilton Ontario Canada"},{"name":"Department of Community Health Sciences University of Calgary  Calgary Alberta Canada"},{"name":"Department of Computing and Software McMaster University  Hamilton Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bram","family":"Rochwerg","sequence":"additional","affiliation":[{"name":"Department of Medicine McMaster Centre for Transfusion Research, McMaster University  Hamilton Ontario Canada"},{"name":"Department of Health Research Methods, Evidence and Impact McMaster University  Hamilton Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kayla","family":"Lucier","sequence":"additional","affiliation":[{"name":"Michael G. DeGroote Centre for Transfusion Research, Department of Medicine McMaster University  Hamilton Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Summer","family":"Syed","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, Associate Clinical Professor McMaster University  Hamilton Ontario Canada"},{"name":"Department of Anesthesia Halton Health Care  Oakville Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7675-4058","authenticated-orcid":false,"given":"Shuoyan","family":"Ning","sequence":"additional","affiliation":[{"name":"Michael G. DeGroote Centre for Transfusion Research, Department of Medicine McMaster University  Hamilton Ontario Canada"},{"name":"Department of Pathology and Molecular Medicine McMaster University  Hamilton Ontario Canada"},{"name":"Department of Medicine McMaster Centre for Transfusion Research, McMaster University  Hamilton Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,2,2]]},"reference":[{"key":"e_1_2_11_2_1","unstructured":"PfuntnerA WierLM StocksC.Most frequent procedures performed in U.S. Hospitals 2011: statistical brief #165. Agency for Healthcare Research and Quality (US).2013 http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/24354027"},{"key":"e_1_2_11_3_1","unstructured":"American Red Cross.Blood Facts and Satistics. 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