{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,28]],"date-time":"2026-02-28T06:48:51Z","timestamp":1772261331460,"version":"3.50.1"},"reference-count":29,"publisher":"S. Karger AG","issue":"2","license":[{"start":{"date-parts":[[2021,11,24]],"date-time":"2021-11-24T00:00:00Z","timestamp":1637712000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2021,11,24]],"date-time":"2021-11-24T00:00:00Z","timestamp":1637712000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Transfus Med Hemother"],"published-print":{"date-parts":[[2022]]},"abstract":"<b><i>Background:<\/i><\/b> Observational studies suggest that sex-mismatched transfusion is associated with increased mortality. Mechanisms driving mortality are not known but may include endothelial activation. The aim of this study is to investigate the effects of sex-mismatched red blood cell (RBC) transfusions on endothelial cell activation markers in critically ill patients. <b><i>Study Design and Methods:<\/i><\/b> In patients admitted to the intensive care unit who received a single RBC unit, blood samples were drawn before (T<sub>0<\/sub>), 1 h after (T<sub>1<\/sub>), and 24 h after transfusion (T<sub>24<\/sub>) for analysis of soluble syndecan-1, soluble intercellular adhesion molecule-1, soluble thrombomodulin (sTM), von Willebrand factor antigen, interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF\u03b1). Changes in the levels of these factors were compared between sex-matched and sex-mismatched groups. <b><i>Results:<\/i><\/b> Of 69 included patients, 32 patients were in the sex-matched and 37 patients were in the sex-mismatched group. Compared to baseline, sex-matched transfusion was associated with significant reduction in sTM level (<i>p<\/i> value = 0.03). Between-group comparison showed that levels of syndecan-1 and sTM were significantly higher in the sex-mismatched group compared to the sex-matched group at T<sub>24<\/sub> (<i>p<\/i> value = 0.04 and 0.01, respectively). Also, TNF\u03b1 and IL-6 levels showed a statistically marginal significant increase compared to baseline in the sex-mismatched group at T<sub>24<\/sub> (<i>p<\/i> value = 0.06 and 0.05, respectively), but not in the sex-matched group. <b><i>Discussion:<\/i><\/b> Transfusion of a single sex-mismatched RBC unit was associated with higher syndecan-1 and sTM levels compared to transfusion of sex-matched RBC unit. These findings may suggest that sex-mismatched RBC transfusion is associated with endothelial activation. <\/jats:p>","DOI":"10.1159\/000520651","type":"journal-article","created":{"date-parts":[[2021,11,24]],"date-time":"2021-11-24T22:00:57Z","timestamp":1637791257000},"page":"98-106","source":"Crossref","is-referenced-by-count":9,"title":["The Effect of Sex-Mismatched Red Blood Cell Transfusion on Endothelial Cell Activation in Critically Ill Patients"],"prefix":"10.1159","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4679-8068","authenticated-orcid":false,"given":"Abdulrahman","family":"Alshalani","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lisa","family":"van 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