Transfusion最新文献

Background: Understanding factors that influence return for subsequent donation in new compared to repeat blood donors is essential to recruiting and maintaining the blood donor base.

Study design and methods: The current research assessed self-reported attitudes, social norms, perceived behavioral control, intentions to donate, experiences during a current donation, and subsequent blood donation during the next 6 months, in a Canadian sample that included both new and repeat donors.

Results: Both new and repeat donors had similar positive impressions of a novel blood donor questionnaire (DQ) that assessed individual sexual risk behavior as a basis for donor eligibility. Attitudes, norms, and perceived behavioral control predicted intentions and sureness to donate in the next 6 months, and intentions/sureness to donate were moderately predictive of subsequent donation within this time frame. New donors (compared to repeat donors) and participants who indicated that some aspect of their donation day experience could prevent them from returning for a subsequent donation, were significantly less likely to make a future donation within the next 6 months.

Discussion: Findings provide guidance for the support of new and repeat donors returning for subsequent blood donation.

Background: Vasovagal reactions (VVRs; faintness or fainting) can harm donor health and retention. Higher VVR rates are often observed in first-time donors and donors with VVR histories. We quantified associations between donation history (including donation experience, donation frequency, and VVR history) and VVR symptom reports in donors in England and assessed their mediation by venipuncture pain and donation anxiety.

Methods: In 60,026 STRIDES BioResource study participants recruited from 2019 to 2022, donation history was obtained from blood service records, while venipuncture pain, donation anxiety, and VVR symptoms were reported via post-donation questionnaires. We conducted causal mediation analyses estimating risk ratios (RRs) for indirect effects of donation history on VVR symptom reports through pain and anxiety while quantifying exposure-mediator interaction.

Results: Adjusted RRs for VVR symptoms were 1.24 (95% confidence interval: 1.19, 1.30) for newer/lapsed donors, 1.19 (1.13, 1.25) for less frequent donors, and 1.82 (1.71, 1.94) for donors with VVR histories. Pain and anxiety were associated with up to 1.28 and 1.60 times the risk of symptom reporting. Anxiety mediated 19.0% and 11.2% of associations with donation experience and frequency, whereas pain mediated no associations. Associations of pain and anxiety with VVR symptoms were only observed among donors without, not with, VVR histories.

Discussion: Our findings suggest that differences in venipuncture pain and donation anxiety do not primarily explain differences in VVR symptoms by blood donation history. While intervening on pain and anxiety may fail to equalize symptom disparities linked to donation history, interventions may reduce VVR burden in donors without VVR histories.

Background: Restrictive red blood cell transfusion strategies are widely recommended for acute anemia but may not adequately address the needs of chronically anemic patients with transfusion-dependent myelodysplastic syndromes or myeloproliferative neoplasms. For these patients with chronic anemia, alleviating symptoms and improving quality of life are key objectives. This study evaluates the impact of additional red blood cell (RBC) transfusions administered alongside standard-of-care transfusions on heart rate, physical activity, quality of life, and cognitive function.

Study design and methods: This interim analysis of a randomized, multicenter, within-subject, cross-over trial evaluated 12 transfusion-dependent patients receiving three transfusion regimens: standard-of-care, standard-of-care + 1 additional unit, and standard-of-care + 2 additional units. The primary outcome was heart rate, and secondary outcomes were physical activity, quality of life, and cognitive performance. Heart rate and activity were continuously monitored, while questionnaires and cognitive tasks assessed outcomes at predefined visits.

Results: Greater hemoglobin augmentation was associated with significant reductions in heart rate, with the largest decrease in patients receiving the standard-of-care + 2 regimen. Quality of life and fatigue measures showed transient improvements with more red blood cells transfused, though these changes were not statistically significant. Cognitive performance trends suggested possible benefits, but findings were inconsistent. Physical activity, as measured by daily step count, was unaffected by transfusions.

Conclusions: This interim analysis suggests that higher post-transfusion hemoglobin is associated with lower heart rate, reflecting enhanced oxygen delivery. Wearable monitoring was sensitive to these changes. Nonsignificant, hypothesis-generating trends toward improved QoL, fatigue, and cognition were observed.

Background: Anemia in pregnancy is associated with maternal hemorrhage-related morbidity and mortality, neonatal neurodevelopmental effects, and postnatal neonatal anemia. This study evaluates how the timing of IV iron therapy prior to delivery impacts maternal and fetal outcomes and to better understand how neighborhood context impacts the timing of IV iron administration.

Study design: This retrospective cohort study included pregnant patients who received antenatal IV iron therapy for anemia from January 2017 through November 2023. Timing of IV iron administration in relation to the delivery date was analyzed. The primary outcome was hemorrhage-associated morbidity. The Area Deprivation Index (ADI) was used as a surrogate of socioeconomic disadvantage to understand how neighborhood context impacts IV iron administration in relation to the delivery date.

Results: Of 183 included pregnancies with iron deficiency anemia (IDA), 128 (69.9%) received IV iron therapy more than 10 days prior to delivery, while 55 (30.1%) received IV iron therapy fewer than 10 days before delivery. Pregnant patients who received their final transfusion of IV iron >10 days before delivery had significantly higher hemoglobin at delivery admission (11.1 vs. 9.7, p < .001) and were less likely to receive a blood transfusion (p = .03), have a preterm delivery (p = .003), or receive uterotonics during delivery (all p ≤ .05). Additionally, in patients who received IV iron, neighborhood disadvantage did not contribute to late diagnosis or treatment of IDA.

Discussion: Patients who received IV iron more than 10 days before delivery had improved maternal and fetal outcomes, including fewer maternal blood transfusions and preterm births.

Background: Considering the increase of West Nile virus (WNV) circulation in Europe, blood banks perform WNV Nucleic Acid Test testing to ensure transfusion safety during the WNV transmission season. Usutu virus (USUV), an arbovirus related to WNV, has relevant molecular and serological cross-reactivity with WNV.

Study design and methods: During the 2024 WNV season in Europe, 15,957 blood donations from the Balearic Islands Blood Bank and 79,400 from the Catalonia Blood Bank were tested for WNV using the Cobas WNV real-time PCR (Roche Diagnostics, USA) and the Procleix WNV/Procleix ArboPlex transcription-mediated assays (Grifols Diagnostic Solutions Inc., USA), respectively. Serological tests for flavivirus, PCR using USUV- and WNV-specific primers, sequencing of viral RNA, and neutralization tests (NT) were performed to confirm positive results.

Results: We identified three donors with USUV infection. In July, the first donor was detected in Majorca (Balearic Islands), whose infection was confirmed by NT. In September, two donors with USUV Africa 3 lineage were identified by RT-PCR and sequencing in Catalonia. There were three USUV-positive cases in 95,357 donations (1 in 31,786; 95% CI: 1 in 10,877 to 1 in 154,083) during the 2024 WNV season in Spain.

Discussion: We report three cases of autochthonous USUV infection in blood donors from the Balearic Islands and Catalonia, two of which were infected by the USUV Africa 3 lineage. Health authorities should be aware that positive WNV screening may be due to USUV, an emerging zoonotic virus that can be underreported.

Background: Platelet transfusion refractoriness (PTR) is a clinically important condition. The Human Leukocyte Antigen and Human Platelet Antigen (HLA/HPA) Platelet Program at Canadian Blood Services (CBS) provides platelet products to support such patients. This study provides a blood operator perspective on the provision of products for the management of immune-mediated PTR (iPTR), including the evaluation of patient data to determine trends in the prevalence and diagnoses associated with iPTR.

Study design and methods: A retrospective observational study of patients enrolled in the CBS HLA/HPA Platelet Program between April 2021 and March 2025. Patient demographics and platelet product issuance were extracted from internal electronic records. Descriptive statistics were utilized for baseline characteristics and linear regression for temporal trends.

Results: We identified 788 cases representing 688 unique patients. Median patient age was 60.5 years. The most frequent diagnoses were acute leukemia (44%) and myelodysplastic syndrome (15%). HLA/HPA platelet issuance showed a statistically significant upward trend (average increase 23 units/quarter, p = .004). Platelet requests strongly predicted units issued (R² = 0.92, p < .001), whereas the number of cases was a weak predictor for the number of platelets issued.

Discussion: The CBS HLA/HPA Platelet Program has experienced a rise in product demand. The strong relationship between product requests and issuance demonstrates the responsiveness of this program, though variability in fill rates and the limited predictive value of case counts highlight ongoing operational challenges. These findings can inform strategies for donor recruitment, inventory management, and case management to ensure reliable access to compatible platelets for sensitized patients.