{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,13]],"date-time":"2026-06-13T05:40:26Z","timestamp":1781329226351,"version":"3.54.1"},"reference-count":42,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2019,5,23]],"date-time":"2019-05-23T00:00:00Z","timestamp":1558569600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Vox Sanguinis"],"published-print":{"date-parts":[[2019,7]]},"abstract":"<jats:sec><jats:title>Background and Objectives<\/jats:title><jats:p>Selection of a compatible red blood cell (<jats:styled-content style=\"fixed-case\">RBC<\/jats:styled-content>) unit does not include matching for donor sex. This systematic review and meta\u2010analysis aims to summarize the evidence examining the impact of sex\u2010mismatched <jats:styled-content style=\"fixed-case\">RBC<\/jats:styled-content> transfusion on recipient mortality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>Ovid <jats:styled-content style=\"fixed-case\">MEDLINE<\/jats:styled-content>, Ovid <jats:styled-content style=\"fixed-case\">EMBASE<\/jats:styled-content>,<jats:styled-content style=\"fixed-case\"> CINAHL<\/jats:styled-content>, PubMed, Web of Science and the Cochrane Database of Systematic Reviews were searched from inception up to 23 November 2018. Randomized controlled trials and observational studies were included in the search. Eligible studies reported on the impact of sex\u2010matched compared to sex\u2010mismatched <jats:styled-content style=\"fixed-case\">RBC<\/jats:styled-content> transfusion on recipient mortality. Two investigators independently extracted data and assessed study quality. A three\u2010level meta\u2010analytic model was applied to emphasize the unknown dependence among the effect sizes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Five retrospective observational studies (<jats:italic>n<\/jats:italic>\u00a0=\u00a086\u00a0737) were included; no <jats:styled-content style=\"fixed-case\">RCT<\/jats:styled-content>s were found. Sex\u2010mismatched <jats:styled-content style=\"fixed-case\">RBC<\/jats:styled-content> transfusions were associated with a higher risk of death compared with sex\u2010matched transfusions (pooled hazard ratio [<jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content>]: 1\u00b713; 95% confidence interval [<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>]: 1\u00b702\u20131\u00b724). In the subgroup of cardiovascular surgery (<jats:italic>n<\/jats:italic>\u00a0=\u00a057\u00a0712), there was no significant increase in mortality with sex\u2010mismatched transfusions (pooled <jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content>: 1\u00b708; 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>: 0\u00b795\u20131\u00b722). The data were prone to confounding, selection bias and reporting bias. Certainty of the evidence was very low.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Sex\u2010mismatched <jats:styled-content style=\"fixed-case\">RBC<\/jats:styled-content> transfusions were associated with an increased risk of death in this pooled analysis. However, the certainty of the evidence was very low from observational studies. The need to match donor and recipient sex for transfusions requires further investigation because of the potential widespread impact.<\/jats:p><\/jats:sec>","DOI":"10.1111\/vox.12783","type":"journal-article","created":{"date-parts":[[2019,5,24]],"date-time":"2019-05-24T06:00:01Z","timestamp":1558677601000},"page":"505-516","source":"Crossref","is-referenced-by-count":34,"title":["Sex\u2010mismatched red blood cell transfusions and mortality: A systematic review and meta\u2010analysis"],"prefix":"10.1111","volume":"114","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6489-6980","authenticated-orcid":false,"given":"Michelle P.","family":"Zeller","sequence":"first","affiliation":[{"name":"McMaster Centre for Transfusion Research McMaster University Hamilton ON Canada"},{"name":"Canadian Blood Services, Medical Office Hamilton ON Canada"},{"name":"Division of Hematology and Thromboembolism Department of Medicine McMaster University Hamilton ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bram","family":"Rochwerg","sequence":"additional","affiliation":[{"name":"Division of Critical Care Department of Medicine McMaster University Hamilton ON Canada"},{"name":"Department of Health Research Methods, Evidence &amp; Impact McMaster University Hamilton ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erin","family":"Jamula","sequence":"additional","affiliation":[{"name":"McMaster Centre for Transfusion Research McMaster University Hamilton ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Na","family":"Li","sequence":"additional","affiliation":[{"name":"McMaster Centre for Transfusion Research McMaster University Hamilton ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Hillis","sequence":"additional","affiliation":[{"name":"McMaster Centre for Transfusion Research McMaster University Hamilton ON Canada"},{"name":"Department of Oncology McMaster University Hamilton ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason P.","family":"Acker","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine and Pathology University of Alberta Edmonton AB Canada"},{"name":"Centre for Innovation Canadian Blood Services Edmonton AB Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan J. R.","family":"Runciman","sequence":"additional","affiliation":[{"name":"McMaster Centre for Transfusion Research McMaster University Hamilton ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shannon J.","family":"Lane","sequence":"additional","affiliation":[{"name":"McMaster Centre for Transfusion Research McMaster University Hamilton ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naveen","family":"Ahmed","sequence":"additional","affiliation":[{"name":"McMaster Centre for Transfusion Research McMaster University Hamilton ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donald M.","family":"Arnold","sequence":"additional","affiliation":[{"name":"McMaster Centre for Transfusion Research McMaster University Hamilton ON Canada"},{"name":"Division of Hematology and Thromboembolism Department of Medicine McMaster University Hamilton ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nancy M.","family":"Heddle","sequence":"additional","affiliation":[{"name":"McMaster Centre for Transfusion Research McMaster University Hamilton ON Canada"},{"name":"Division of Hematology and Thromboembolism Department of Medicine McMaster University Hamilton ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,5,23]]},"reference":[{"key":"e_1_2_8_2_1","unstructured":"PfuntnerA WierLM StocksC:Most Frequent Procedures Performed in U.S. Hospitals 2010. 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