Transfusion最新文献

Background: Immunomodulatory consequences of transfusion, known as transfusion-related immune modulation (TRIM), impact patients but are not captured by hemovigilance systems. This study's objective is to explore TRIM impacts of production changes made by the blood supplier.

Methods: We included all transfused and non-transfused adult inpatients from 2002 to 2022 in Hamilton, Canada. Non-transfused patients served as controls to identify confounding temporal trends. We captured data from the Transfusion Research Utilization Surveillance and Tracking (TRUST) database and recorded TRIM outcomes including: sepsis, respiratory failure, venous thrombosis, organ dysfunction and in-hospital mortality using International Classification of Diseases codes, Canadian Classification of Health Interventions codes, and laboratory parameters, where applicable. The blood supplier provided data on production changes and quality control assessments. We used time series trend graphs to summarize aggregate data and the rolling window E-Divisive with Medians to detect change. A transparent and replicable point system approach identified changes in blood production most likely to have TRIM impacts.

Results: A cohort of 568,991 non-transfused and 102,446 transfused hospital admissions were included. We generated 40 time series TRIM trend graphs for transfused (n = 35) and non-transfused patients (n = 5). The blood supplier independently identified 12 key product policy, collection, or production changes. Consolidation of production in Ontario and introduction of buffy coat manufacturing were identified as having high TRIM impacts for patients transfused with any blood components.

Conclusion: Using a novel hypothesis generating data mining design, consolidation of blood production and buffy coat manufacturing are identified as changes with possible TRIM impacts among transfused hospitalized patients.

Background: This retrospective study investigated blood product transfusions and neonatal morbidity and mortality in preterm infants with birth weights <1500 g and gestational ages <32 weeks.

Study design and methods: We conducted a retrospective cohort study of 291 preterm infants admitted to our neonatal intensive care unit between January 2020 and December 2022. Data were collected on transfusion exposure, including packed red blood cells (RBC), fresh frozen plasma (FFP), and platelets. Clinical outcomes included mortality and major neonatal morbidities: bronchopulmonary dysplasia (BPD), intraventricular hemorrhage (IVH), and necrotizing enterocolitis (NEC). Univariate analyses were performed, followed by multivariable logistic regression to adjust for confounding factors including birth weight and gestational age.

Results: 80% of infants received RBC transfusion, 37.8% received FFP, and 16.1% received platelets. Transfused infants had lower gestational ages and birth weights. RBC, FFP, and platelet transfusions were associated with higher rates of BPD, IVH, NEC, and mortality in univariate analyses. In multivariable analysis, birth weight alone predicted mortality, suggesting extreme prematurity and illness severity were primary drivers. RBC transfusion independently predicted NEC and BPD, while FFP and platelet transfusions were linked to BPD. Total transfusions correlated with higher BPD, NEC, and mortality rates. Early transfusions were linked to impaired survival.

Discussion: These findings suggest transfusions may not be independently associated with mortality, but may instead reflect underlying illness severity. However, they remain associated with serious morbidities in extremely preterm infants. The results emphasize the importance of judicious transfusion practices, evidence-based thresholds, and research to clarify potential causal relationships.

Expression of concern: Y. Chetouane , G. Dubourg , P. Gallian , C. Flaudrops , J. Chiaroni , E. Chabrière , D. Raoult , and L. Camoin-Jau , "Rapid Identification of Microorganisms from Platelet Concentrates by Matrix-Assisted Laser Desorption Ionization Time-of-Flight Mass Spectrometry after Short-Term Incubation on Liquid Medium," Transfusion 58, no. 3 (2018): 766-773, https://doi.org/10.1111/trf.14430. This Expression of Concern is for the above article, published online on 28 November 2017 in Wiley Online Library (wileyonlinelibrary.com), and has been issued by agreement between the journal Editor-in-Chief, Richard M. Kaufman; the Association for the Advancement of Blood & Biotherapies (AABB); and John Wiley & Sons, Inc. The Expression of Concern has been agreed due to questions raised about the study's adherence to French legal and ethical requirements for research involving human subjects. The investigation into these concerns is ongoing. Therefore, the journal has decided to issue an Expression of Concern to inform and alert readers.

Expression of concern: Y. Chetouane , P. Gallian , K. Chetouane , G. Dubourg , J. Chiaroni , D. Raoult , and L. Camoin-Jau , "Comparing Two Blood Culture Systems for the Detection of Bacterial Contamination in Platelet Concentrates," Transfusion 58, no. 11 (2018): 2604-2610, https://doi.org/10.1111/trf.14911. This Expression of Concern is for the above article, published online on 7 October 2018 in Wiley Online Library (wileyonlinelibrary.com), and has been issued by agreement between the journal Editor-in-Chief, Richard M. Kaufman; the Association for the Advancement of Blood & Biotherapies (AABB); and John Wiley & Sons, Inc. The Expression of Concern has been agreed due to questions raised about the study's adherence to French legal and ethical requirements for research involving human subjects. The investigation into these concerns is ongoing. Therefore, the journal has decided to issue an Expression of Concern to inform and alert readers.

Since the identification of hematopoietic stem cells (HSCs) in umbilical cord blood (CB) by Broxmeyer in the 1980s,¹ the primary clinical use of CB remains as an unrelated donor source for hematopoietic stem cell transplantation (HSCT). However, the presence of additional progenitor cells and growth factors in CB and cord tissue also makes them readily available sources of cells and biomaterials potentially suitable for use as starting material to manufacture a wide range of evolving biotherapies. CB banks, with their existing infrastructure and readily available inventory of fully characterized CB units, are well-positioned to contribute to the development and implementation of CB and cord-tissue based biotherapies.