Transfusion Medicine最新文献

Objective: The objective of this study is to critically assess the diverse indications for HAS administration over the past 8 years at a prominent tertiary care institution in the United Kingdom.

Background: This is timely and relevant, given recent developments in the field. The International Collaborative Transfusion Medicine Group (ICTMG) issued updated guidance on intravenous albumin use in March 2024, reflecting a shift towards more stringent criteria for its application, which necessitates a re-evaluation of current practices.

Method: We conducted a retrospective analysis of the usage of HAS from August 2015 to March 2023. Records of all patients who received HAS during this study period were extracted from the Electronic Patient Records (EPR) of Guys and St Thomas' NHS Foundation Trust London (GSTFT). Data analysis was performed using SPSS version 20.

Results: A total of 4816 patients received HAS during the audit period, with 21 231 HAS infusions. The majority of infusions were for 20% HAS, with 16 772 (79% of total) infusions for 20% HAS in 4145 patients. A total of 4459 (21%) infusions were recorded for 4.5 and 5% HAS.

Conclusion: Our study provides a comprehensive analysis of albumin utilisation and TPE indications over the past 8 years at our institution, establishing a crucial baseline for refining our practices.

Background and objectives: Blood safety is the top priority in transfusion medicine. However, patients in Vietnam are only transfused with ABO and RhD compatible blood products, which could pose a threat to induce alloimmunization. This study was performed to provide information about the frequencies of antigens and phenotypes of clinically significant blood groups in Vietnamese donors.

Materials and methods: Blood samples were taken from donors to identify red cell antigens by column agglutination tests. Antigen and phenotype frequencies were calculated and expressed as percentages. Gene frequencies were calculated under the standard assumption of Hardy-Weinberg equilibrium.

Results: Among the Rh antigens, e was the most common (96.96%) followed by D (96.72%), C (92.86%), c (43.10%), and E (32.59%) with D+C+E-c-e+(54.02%) being the most common phenotype. In the Lewis and Duffy blood group system, the major phenotypes found were Le (a-b+) (60.43%) and Fy (a+b-) (85.39%), respectively. In the Kell and Lutheran blood group system, k and Lu^b were present in 100% of the donors, respectively. The most common phenotypes in the Kidd and MNS blood group system were Jk (a+b+) (47.62%) and M + N+(46.63%), S-s+ (94.42%), respectively. Mi^a was seen in 9.20% of the donors. The frequency of P1 was 22.25%.

Conclusion: This study shows the frequencies of 21 blood group antigens in Northern Vietnam donors. Knowledge of red cell antigen phenotype frequencies can help prepare indigenous cell panels, provide antigen-negative blood to patients with multiple alloantibodies, and prevent alloimmunisation.

Objectives: To report a delayed case of severe haemolytic disease of the foetus and newborn (HDFN) due to Anti-Ce.

Background: HDFN due to maternal antibodies is potentially fatal. As a result, antibody levels and foetal anaemia are periodically monitored and risk assessed throughout pregnancy. HDFN due to Anti-Ce is rare.

Case report: A 29-year-old Caucasian female with low titre Anti-Ce and Anti-e antenatally delivered a term baby girl that required multiple transfusions and hospital admissions early in life. The apparent clinical severity of HDFN resulted in investigative testing of a maternal admission sample at delivery for titre levels. Anti-Ce was identified as the cause of HDFN in this case, following an eightfold increase in titre levels from week 28 gestation (titre = 4) to term (titre = 32).

Discussion: The severe HDFN outlined in this case was unexpected due to the antibody specificity and low titres antenatally. The Anti-Ce with a titre of 32 implicated in this study is on the threshold for specialist foetal team involvement and vigilant monitoring as per BSH guidelines.

Conclusion: Anti-Ce titre monitoring beyond 28 weeks gestation and specialist foetal team involvement early in pregnancy should be considered despite current BSH Guidelines, along with extended neonatal monitoring.

Aim: This cross-sectional study aimed to determine the impact of a severe earthquake on blood donation as per blood safety and donation behaviour.

Materials and methods: This retrospective cross-sectional study included a total of 263 779 whole-blood donors at the Turkish Red Crescent during two periods: before (25 January 2023 - 5 February 2023) and after (6 February 2023 - 17 February 2023) the earthquake that occurred on 6 February 2023. Demographic data describing the donors, donor types, the number of blood donations by province, blood donations by blood groups, hospital demand, and transfusion transmissible infection (TTI) rates according to donor type were evaluated.

Results: There was a 129% increase in blood donations after the earthquake. his increase was significant among female donors, younger age groups, and first-time donors. However, a significant increase in TTI rates was not detected in either first time donors or repeat donors.

Conclusion: Our study focuses on blood banking activities of the Turkish Red Crescent during the 2023 Türkiye earthquake. While previous disasters have shown excess blood collection, we emphasise the need for a balanced approach to avoid wastage and shortages. Our study emphasises the importance of efficient blood utilisation and the necessity of regular, voluntary blood donations to ensure a stable supply, especially for high-demand blood groups like O Rh (-).

Background and objectives: There is concern about sustaining the O negative blood supply, especially in areas with many rural/remote hospitals like British Columbia. Red blood cells are perishable, making inventory management challenging. Demand must be met without wasting this precious resource. Inventory management challenges stem from data scarcity and human factors. Transfusion medicine technologists, who manage inventory daily, are key to understanding the human factors in inventory management. We conducted a qualitative study to understand technologists' inventory management perspectives and experiences, particularly for group O negative red blood cells, aiming to inform future inventory modelling to address human factors.

Materials and methods: We interviewed transfusion laboratory technologists and technical leads from all health authorities and a blood product supplier representative for the Province of British Columbia. Thematic analysis of the interview transcripts was conducted.

Results: We found five themes that influence technologist decision-making on RBC inventory management, key challenges for O-negative RBCs, and identified inventory management strategies. We compare the top three inventory practices from our results with literature.

Conclusions: Our findings help bridge the knowledge gap concerning human factors in RBC inventory management, with potential generalizability to other jurisdictions. They hold promise for informing the safeguarding of donors' altruistic contributions.

Introduction: Due to the non-availability of formal training during residency for clinicians in transfusion medicine, there is a prevalent knowledge gap for transfusion practices, which leads to increased patient risks and elevated healthcare costs. There is no indigenous questionnaire available, which could be used for knowledge assessment. This study aims to develop and validate an Indigenous questionnaire to assess clinicians' knowledge of transfusion medicine and bedside transfusion practices.

Materials and methods: The questionnaire was designed using a nominal group technique involving subject experts, considering the type of information required, themes, appropriate wording, layout, and presentation. The questionnaire consisted of 25 knowledge-based questions and 4 general questions. Piloting of the questionnaire was done to check for feasibility, validation, and reliability. Content validity was assessed by six experts using the Content Validity Index (CVI). Reliability was assessed using test-retest and split-half methods, with a sample of 56 participants. Cronbach's alpha and Kappa statistics were used to measure internal consistency and agreement, respectively.

Results: The questionnaire displayed acceptable feasibility with a mean difficulty score of 6.93 on a scale of 1-10, with test-retest responses showing near-perfect agreement (kappa value 0.8-0.99). All experts gave more than 70% agreement on the relevance of content, with a mean CVI of 85%. Test-retest reliability showed near-perfect agreement (Kappa 0.8-0.99, p = 0.008) and good internal consistency (Cronbach's α = 0.806). The split-half method yielded a Cronbach's α of 0.89 and an intraclass correlation coefficient of 0.88 (95% CI 0.57, 0.97, p = 0.001) Construct validity was confirmed through factor analysis.

Conclusion: The developed indigenous questionnaire is a reliable and valid tool for assessing the knowledge of clinicians towards transfusion medicine and bedside transfusion practices. The detailed, methodical strategy used to prepare and validate the questionnaire ensures its applicability and relevance in various clinical settings and can be easily adopted by others intending to prepare similar questionnaires. The questionnaire is available with the author and, on demand, may be provided for knowledge assessment.

Background: Anaemia remains the main cause of deferral in blood donation. However, in Morocco, pre-donation haemoglobin measurement is not systematic.

Objectives: The aim of this study was to determine the prevalence of anaemia and associated factors such as sex, age and iron deficiency among blood donors in eastern Morocco in order to improve donor management practices.

Methods/materials: The study involved 2013 blood donors from the BRO Biobank. Blood samples were analysed using an automatic blood cell analyser for complete blood counts. Serum ferritin was measured by chemical and immunological analyser. Anaemia was defined as haemoglobin levels less than 13 g/dL in men and 12 g/dL in women, according to the WHO recommendation.

Results: The overall prevalence of anaemia in eastern Morocco was 9.84% and it varied significantly by region. The majority of anaemic individuals were iron-deprived (88.64%). Anaemia was much higher in females (14.74%) than in males (5.46%). The highest prevalence of anaemia among females was in the age group of 18-20 years (25.2%), while among males it was in the age group of 61-65 years (18.52%).

Conclusions: The high prevalence of anaemia among blood donors in eastern Morocco highlights the need to implement pre-donation haemoglobin assessment in donor selection guidelines and to consider optional ferritin testing for at-risk populations. Moreover, educating donors about iron deficiency and iron-rich diets is essential for sustaining donor health and eligibility.

Background: Red blood cell (RBC) alloimmunization is rarely reported in infants less than 4-6 months of age.

Methods/materials: Blood group and antibody screening used the gel card technique. All blood products were leukoreduced. All RBC doses transfused were group O, E-neg, K-neg but the pooled platelets transfused on day 45 and 61 included donors who were K-pos, and that transfused on day 61 also included an E-pos donor.

Results: We report a group O neonate with haemophagocytic lymphohistiocytosis (HLH) who developed alloantibodies to E and K antigens at 65 days (9 weeks) of age.

Conclusion: HLH is an inflammatory, 'hyperimmune' state, and alloimmunization is more likely when inflammation is present. If significant inflammation is present, transfusions should be avoided if possible.

Background/objectives: No erythrocyte elution method developed is uniformly successful or allows elution/phenotyping together. We previously developed an elution method using deionised formamide. We modified it to be universal for various cell types and call it modified formamide-method (Fm-method). It also preserves cells for phenotyping after elution.

Materials and methods: Fm-method reagent contains deionised formamide, buffered high salt, EDTA, TE. Elution-reagent is removed by column centrifugation. Blood samples were used for development and validation. Results compared to commercial/common antibody elution/phenotyping methods.

Results: Fm-method eluted antibodies, complement, other proteins, and nucleic acids and works with erythrocytes, leukocytes, other cells. It worked better than commercial kits used for elution/phenotyping with no false positives/negatives. It did not denature Kell and Lewis antigens and could be repeated as needed on samples to recover more antibodies and clean cells for phenotyping. Western blotting, PAGE and FCM demonstrated eluted proteins were not degraded and cells remained intact.

Conclusion: Fm-method is excellent for elution and phenotyping and permits elution and phenotyping with one method and sample. It is useful for studies of various bound molecules and cell surface structures. It should be possible to elute various simple and complex carbohydrates as well. The Fm-method is efficient, inexpensive, scalable, uses common reagents. It should have excellent applications in various clinical, research, commercial settings.

To compare the historical development of blood transfusion in Britain and a former British West Indian colony. International transfusion bodies recommend national coordination and exclusively voluntary non-remunerated donation as essential pre-requisites for blood safety. These ideals have been achieved in high-income countries including Great Britain, the United States of America and Canada. However, most West Indian countries have fragmented, hospital-based blood services that rely on family replacement and remunerated donors. Comparative historical analysis of blood transfusion service development in Great Britain and Trinidad and Tobago was undertaken to provide insight into their dichotomous development and inform policy decisions to bridge the gap between the two types of transfusion service. The British National Blood Transfusion service was based on voluntary non-remunerated blood donation from its inception but achieved national coordination over 50 years that included a period of regional control during which incoordination contributed to a tainted blood scandal. Failure to establish community voluntary non-remunerated donation in Trinidad and Tobago during the colonial period, before independence in 1962, allowed regionally-controlled family replacement and remunerated blood donation to become entrenched then perpetuated by path dependence. A university-led programme has recently used historically-proven methods, drawing on the experiences of the British National Blood Transfusion Service, to establish a model for developing a voluntary non-remunerated programme. The programme aims to avoid historical pitfalls during its national extension. Historical analysis provided information for introducing voluntary non-remunerated blood donation and planning a nationally-coordinated blood transfusion service.