Vox Sanguinis最新文献

Background and objectives: At the Hospital Universitari Arnau de Vilanova Lleida, Spain, nursing staff utilize different transfusion safety systems (TSSs) depending on their clinical unit. These range from a basic model involving wristband-based patient identification to a more advanced system incorporating a Personal Digital Assistant (PDA), location beacon, physical barriers, specific wristbands and personal identification. This study aimed to compare nursing staff satisfaction across the various TSSs used.

Materials and methods: In March 2025, nursing staff were invited to voluntarily and anonymously complete an online, self-designed questionnaire assessing their perceptions of the systems in use.

Results: A total of 120 nurses participated, representing 15.6% of the total population. While overall satisfaction did not differ significantly by system type, 40.6% of respondents reported a negative perception. Users of the basic system felt less safe (65.4%) and considered it less effective at preventing errors (64.1%) than those using the complex system (87.2% and 92.8%, respectively). However, the complex system was associated with more frequent technical or usability issues (66.7%) compared with the basic system (34.6%), which contributed notably to dissatisfaction.

Conclusion: Although specific factors influencing satisfaction were identified, no clear preference emerged regarding overall system satisfaction. The variability in responses may reflect the subjective nature of satisfaction. An optimal TSS would combine adaptability to staff needs, perceived safety, ease of use, intuitive visual cues, time efficiency and high reliability with minimal technical complications.

Background and objectives: The discovery of circulating fetal DNA in maternal plasma enabled non-invasive prenatal testing (NIPT) for targeted anti-D prophylaxis. In 2019, Ireland implemented an in-house test to guide this care. Here, we report 6 years of service.

Materials and methods: Cell-free fetal DNA (cffDNA) was extracted from 1000-μL plasma from pregnant RhD negative women at gestation age (GA) > 11 weeks. Samples were tested in triplicate for RHD by quantitative PCR using a multiplex assay of RHD exons 7 and 10.

Results: Of the 20,099 samples tested, 58.2% were predicted RhD positive and 36.9% were predicted RhD negative. Discrepancies were seen in 52 cases: 7 (0.03%) were predicted RhD negative but cord RhD positive and 45 (0.2%) were predicted RhD positive but cord RhD negative.

Conclusion: This test has ensured that over 7400 women have avoided unnecessary anti-D prophylaxis. There were few discrepant results, with false negatives posing a greater clinical risk due to withheld anti-D, increasing immunization risk. Three were linked to pre-analytical errors prompting procedural changes. Due to the success of fetal RHD screening, cord blood testing has been discontinued in some countries; a practice which could be reviewed in Ireland.

Background and objectives: The safety of varying plasma donation frequencies remains unclear. This non-inferiority randomized controlled trial investigated the effect of plasma donation frequency on total serum protein (TSP), immunoglobulin G (IgG) concentrations, additional biomarkers, adverse events (AEs) and psychological distress.

Materials and methods: In this trial, 120 male donors were randomized into three groups: high-frequency plasma donors (HFPDs, three times every 2 weeks), regular-frequency plasma donors (RFPDs, once every 2 weeks) and a control group (whole blood donation every 3 months). Blood samples were collected biweekly from baseline until the last donation in Week 16 and 4 weeks after the last donation.

Results: HFPDs completed median (range) 21.5 (1-24), RFPDs 8 (1-8) and controls 2 (1-2) donations. HFPDs had lower concentrations of TSP and IgG compared to controls, with a mean difference (95% confidence interval [CI]) of -5.5 g/L (-7.4, -3.6) and -2.8 g/L (-3.8, -1.8), respectively. Within-group analysis revealed significant reductions, which increased with the frequency of donations, in TSP, IgG, IgG subclasses, immunoglobulin M (IgM), immunoglobulin A (IgA), ferritin and haemoglobin. Many of the biomarkers required more than 4 weeks to return to baseline levels. Only mild AEs were reported, and plasma donation frequency had no effect on psychological distress.

Conclusion: High- and regular-frequency plasmapheresis substantially reduces concentrations of TSP, IgG and other biomarkers, with greater reductions at higher donation frequencies. Further research is needed to assess the long-term health implications of frequent plasma donation.

Background and objectives: Hepatitis delta virus (HDV) superinfection with hepatitis B virus (HBV) infection can cause a severe form of viral hepatitis. A nation-wide general population study in Cameroon in 2018 showed a high seroprevalence of 46.7% (901/1928) of HDV among hepatitis B surface antigen (HBsAg) carriers. However, there is a lack of published data on the seroprevalence of HDV among the HBV-positive blood donor population in Cameroon. The aim of this study was to determine the seroprevalence of HDV among blood donors positive for HBV at the Yaounde Central Hospital.

Materials and methods: First-time blood donors were screened for HBsAg between June and November 2022 using a rapid test (DIASPOT), followed by an enzyme-linked immunosorbent assay (ELISA) (Fortress diagnostics) if the rapid test was negative. HBsAg-positive samples were further screened for anti-HDV by ELISA (HDVAb, DIAPRO, DAB.CE).

Results: Of the 195 blood donors who tested positive for HBsAg, 91 (46.7%) were positive by the rapid test, whereas 104 (53.3%) were negative by the rapid test but positive by ELISA. Anti-HDV was detected in 39 (20%) of samples. Anti-HDV reactivity was associated with the HBsAg screening method (p < 0.05).

Conclusion: The burden of HDV/HBV infection among asymptomatic blood donors in the Yaounde region of Cameroon is of concern.

Background and objectives: Obtaining consent for blood transfusion is a critical component of patient safety and promotes active patient engagement. This study aimed to assess how this practice is currently implemented in Brazil.

Materials and methods: A cross-sectional study was conducted from September 2024 to January 2025. Healthcare professionals involved in transfusion procedures across Brazil were invited to complete an electronic questionnaire based on international recommendations. Data were analysed using descriptive statistics.

Results: Of 109 responses, 9 were excluded due to duplication. In the final sample, 63% were professionals affiliated with teaching hospitals and 61% worked in services performing over 200 transfusions per month. Overall, 21% reported not using a consent form prior to transfusion. Among the remaining respondents, 15% stated that consent could be obtained at admission, regardless of transfusion indication. The validity period of consent and procedures for legally incapacitated patients varied widely. Additionally, 33% of forms did not mention benefits, 82% of them did not include a description of the transfusion process, only 20% addressed alternatives to transfusion, and 33% included an option for revocation.

Conclusion: The transfusion consent process in Brazil requires significant improvement. Strengthening this practice is essential to uphold patient autonomy and enhance engagement of patients and families in healthcare decisions.

Background and objectives: Many family investigations of the HLA region are performed in order to identify HLA identical related stem cell donors. In rare cases, deviations from the expected inheritance can be observed. Such a case is shown in this presentation.

Materials and methods: Alleles of the HLA complex have been defined in the members of an Austrian family with atypical segregation of HLA alleles by using the following methods: HLA DNA typing by low-, medium- and high-resolution techniques; genotyping of short tandem repeat (STR) markers in the HLA region; and array-based genome-wide single-nucleotide polymorphism (SNP) analyses.

Results: A duplication of the HLA region encompassing HLA-B, HLA-C and the STR loci D6S2678 and STR-MICA is detected.

Conclusion: A duplication in the HLA-B/-C region of the HLA system is observed, which results from an unequal crossing-over encompassing a chromosomal region of around 377 kb.

Background and objectives: India, home to the largest population of patients with thalassaemia major (TM), has made notable progress in the care through the National Health Mission, National Rare Disease Registry and Thalassaemia Bal Sewa Yojana. This study aimed to assess the infrastructure, support systems and human resources across thalassaemia treatment centres in India to map current service availability and guide policy enhancements for its prevention and comprehensive management.

Materials and methods: A nationwide survey was conducted between January 2023 and March 2024 among centres managing TM. The survey was disseminated through professional groups, civil societies and non-governmental organizations.

Results: Sixty-eight centres participated (government 26, private 28, charitable 14). About 85% of patients were from low-income families, highlighting the dependence on government support. Transfusion services with leukodepleted red cells were available in 97% of centres, with most maintaining adequate pre-transfusion haemoglobin. Chelation service was accessible in the majority of centres, and 87% provided prenatal diagnostics. Bone marrow transplantation was offered in 60 centres and comprehensive care services in 58 centres. Despite free transfusions and chelation, monthly out-of-pocket costs ranged from Indian rupees (INR) ₹500 to ₹16,000 (US$ 5.92-189.49).

Conclusion: Government initiatives have expanded thalassaemia services and reduced financial barriers. Continued efforts to strengthen the national registry and unify policy frameworks will help ensure equitable access across all regions.

Disaster preparedness on a national scale for the provision of blood products during an emergency requires a multifaceted approach. In Israel, the national blood collector, Magen David Adom (MDA), is responsible for collecting, testing and distributing blood products to hospitals and the Israeli Defense Force (IDF). Through close collaboration between MDA and the IDF, blood products have been a mainstay in the prehospital resuscitation of injured soldiers and civilians for several years. Injured soldiers and civilians are taken to the same hospitals; there is not a differentiation between military and civilian hospitals in Israel, which poses its own challenges when stocking blood during peace times and when scaling up operations during times of emergency. This review will examine the approaches to collecting, distributing and administering blood during disasters in Israel from these three perspectives-the national blood supplier, the IDF and a trauma hospital-and highlight some of the unique challenges faced during these circumstances.