Animal models for transfusion-related adverse reactions: a systematic review and subgroup meta-analysis
10.13303/j.cjbt.issn.1004-549x.2026.05.016
- VernacularTitle:输血相关不良反应动物模型的系统评价与亚组荟萃分析
- Author:
Biao YANG
1
;
Hong FENG
1
;
Zhenxin YANG
1
;
Shudan ZHENG
1
;
Jiao YANG
1
;
Yunkai HU
1
;
Yangping WU
1
Author Information
1. Department of Blood Transfusion, Fuwai Yunnan Hospital, Chinese Academy of Medical Sciences, Affiliated Cardiovascular Hospital of Kunming Medical University, Kunming 650102, China
- Publication Type:Journal Article
- Keywords:
transfusion reaction;
animal model;
modeling method;
systematic review
- From:
Chinese Journal of Blood Transfusion
2026;39(5):682-688
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To systematically review the modeling strategies, primary outcomes, and quantifiable effects in animal models of transfusion-related acute lung injury (TRALI), transfusion-associated circulatory overload (TACO), acute hemolytic transfusion reaction (AHTR), and related transfusion paradigms. Subgroup meta-analysis was designated as the primary analytical framework, with the overall pooled effect treated as exploratory. Methods: We searched PubMed, Embase, Web of Science, and the Cochrane Central Register of Controlled Trials (CENTRAL) from inception to December 30, 2025. Eligible studies utilized animal models to simulate transfusion-related adverse reactions and provided extractable quantitative outcomes. The SYRCLE tool was used to assess the risk of bias. Random-effects models were employed to calculate odds ratios (ORs) and 95% confidence intervals (CIs). Prespecified subgroup analyses were conducted for TRALI, TACO, AHTR, and donor sex-related transfusion paradigms. Additional analyses included funnel plots, Egger/Begg tests, leave-one-out sensitivity analyses, and meta-regression based on publication year. Results: Twenty-one studies comprising 24 independent comparisons were included in the quantitative synthesis. The overall pooled estimate was OR=1.07 (95% CI:0.69-1.66), with substantial heterogeneity (I
=96%). Subgroup analyses yielded the following estimates: TRALI, OR=0.83 (95%CI:0.57-1.21, I
=97%); TACO, OR=1.85 (95%CI:0.54-6.34, I
=93%); donor sex-related paradigms, OR=1.49 (95%CI:1.02-2.17, I
=85%); and AHTR, OR=0.26 (95%CI:0.10-0.64, I
=0%). Between-subgroup differences were statistically significant (P<0.000 1). Publication year was positively correlated with effect size (P=0.001 4). Most studies demonstrated unclear risk of bias across several SYRCLE domains due to incomplete methodological reporting. Conclusion: Animal models of transfusion-related adverse reactions exhibit significant structural heterogeneity across syndrome categories. Therefore, subgroup-specific and narrative syntheses are recommended as the primary presentation framework, rather than relying on a single overall pooled effect. Complement-targeted interventions in AHTR models demonstrated a consistent protective signal. In contrast, TRALI and TACO models require greater standardization in modeling protocols and endpoint definitions to reduce methodological variability.
