Though not universal, many hospitals and health authorities have already implemented this as much as possible, but a consistent lack of male donors limits their abilities. Similarly, there are increasing calls to exclude AFAB blood from use in plasma transfusions for anyone of any assigned sex, (something Rowling’s study actually did), due to the increased risk of transfusion-related acute lung injury (TRALI) as a result of these immunological changes and the antibodies that result. Moreover, these immune system differences already impact how blood donation and transfusion is handled-the NHS doesn’t give AFAB blood to newborn babies in need of a whole blood transfusion because of the risks associated with it. Similar, but less extreme, immune responses are formed in the bodies of those who carried a fetus with a Y chromosome, and it’s possible that this may well be what’s causing that rise in mortality among AMAB patients who have received blood from a formerly pregnant donor. One of the best known examples is Rhesus disease, where exposure to the Rhesus antigen via the fetus sensitizes the immune system in Rhesus-negative patients, necessitating an immunoglobulin shot to prevent the immune system from attacking that fetus or potential future pregnancies. It’s well established that pregnancy causes immunological changes in a person, even when that pregnancy only has a short duration.
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