Vox Sanguinis最新文献

Background and objectives: Platelet transfusions carry an important risk of infection transmission. The Mirasol Pathogen Reduction Technology system for platelets uses riboflavin and UV light to introduce irreparable lesions into nucleic acids, thereby inhibiting pathogen replication and inactivating white blood cells. The objective of this study is to evaluate the safety of pathogen-reduced platelet transfusions (PRPTs) in critically ill infants in a neonatal intensive care unit (NICU) in the Caribbean.

Materials and methods: We conducted a descriptive retrospective study of the use of Mirasol PRPTs in patients admitted to the NICU of the general hospital in Curaçao from February 2016 to April 2023.

Results: A total of 208 PRPTs were administered to 46 patients (median [range] transfusions per patient: 3 [1-24]). Three patients were born term, and 43 were born preterm (median [range] gestational age: 27 4/7 weeks [24 6/7-36 6/7]). PRPTs were well-tolerated and no complications occurred, especially no signs of haemolysis nor any signs of new infection within 24 h after transfusion. Twenty-one of 46 patients (46%) died during their admittance. None of the deaths were deemed related to PRPT.

Conclusion: Mirasol PRPT appears to be safe for use in critically ill neonates, including extremely preterm neonates.

Background and objectives: The World Health Organization (WHO) African Region accounts for 94% of malaria cases globally, with variability recognized within endemic regions. To determine the detection rate of Plasmodium RNA in blood donors resident in malaria-endemic areas, samples from three African countries were tested using a Plasmodium nucleic acid test.

Materials and methods: Whole blood (WB) samples collected from routine donors in Cameroon, Madagascar and Mali were shipped frozen to the United States. Samples were tested individually from WB lysates with the Procleix Plasmodium assay (transcription-mediated amplification [TMA]). Reactive samples were considered either repeat reactive or initial reactive only, depending on TMA-retest results. When available, matching plasma samples were tested for Plasmodium antibodies by enzyme immunoassay (EIA).

Results: Plasmodium repeat reactivity ranged from 41% (91/223 tested) in Cameroon to 12% (26/216) in Mali and 1% (3/249) in Madagascar. Initially reactive samples, where reactivity did not repeat, were identified from Cameroon (5/223; 2%) and Mali (2/216; 1%). The matched-plasma subgroup had EIA reactivity ranging from 86% (113/131 tested) in Cameroon to 59% (10/17) in Mali and 27% (68/248) in Madagascar.

Conclusion: Plasmodium ribosomal RNA (rRNA) detection and antibody rates varied greatly in the three countries studied. Detection of Plasmodium rRNA can provide an additional tool to address malaria risk in blood donors.

Background and objectives: Sickle cell trait (SCT) persons are significant donors, and discarding these blood units reduces their supplies, mainly in the third-world countries. This work focused on 12 metabolites associated with the red blood cell (RBC) storage lesion and 23 amino acids in the supernatants of packed RBC units from SCT and reference (non-SCT) donors stored in the same conditions.

Materials and methods: All samples of RBC concentrates were collected and separated from the storage of Colsan (Beneficient Association of Blood Collection), where they were routinely processed and separated as packed RBC units and stored in the refrigerator (2°-6°C). The supernatant samples of each packed RBC bag were separated by centrifugation at days 1, 7, 14, 21, 28 and 35 of storage and kept at -80°C till the metabolite analysis together.

Results: The quantitation of metabolites and amino acids examined in the supernatant of SCT and reference donors showed no statistical differences along the cold storage. Lactic acid and malic acid releases occur in three phases during RBC storage. Basic and acid amino acids and corresponding amides have low and stable values during the first 14 days of storage, followed by a steep increase.

Conclusion: Our metabolomic results give elements that seem not to contraindicate the transfusion of RBC with SCT, besides its more structural fragility.

Background and objectives: Granulocyte transfusion supports patients with severe neutropenia. Maintaining a pool of eligible donors and optimizing donation frequency are essential for ensuring an adequate supply while safeguarding donor well-being. This study investigates the impact of donation frequency on erythrogram parameters, focusing on sex-specific differences.

Study design and methods: We conducted a retrospective analysis of 343 successive granulocyte collections from 65 apheresis donors over 11 years (2012-2023). Donors were categorized by sex, and erythrogram parameters were analysed in relation to donation frequency and intervals.

Results: Frequent donations within a short inter-donation interval (≥3 in 14 days) affected subsequent pre-donation haemoglobin levels. Each additional donation within 14 days led to a decrease of 0.81 g/dL in haemoglobin (p = 0.017). A significant interaction between sex and donations within 14 days (β = 0.76, p = 0.018) indicated that frequent donations had a more pronounced negative effect on haemoglobin levels in female donors. The proportion of donations meeting the pre-donation haemoglobin eligibility criteria declined with each successive donation within 14 days (100% at first, 85.8% at second, 25% at third). Female donors showed a significant haemoglobin reduction over three donations within 14 days (13.4-11.6 g/dL, p = 0.005) compared to males (14.4 -14 g/dL, p = 0.95).

Conclusion: Short inter-donation intervals have a more pronounced negative effect on pre-donation haemoglobin levels in female donors, underscoring the need for individualized donation guidelines to ensure donor safety.

Background and objectives: Cold-stored whole blood (CS-WB) in paediatric cardiac surgery is making a resurgence, given its identified benefits compared to conventional blood component therapy (CT).

Study design and methods: A single-centre retrospective study was conducted from January 2018 to October 2018 by including children <18 years of age undergoing cardiac surgery requiring cardiopulmonary bypass. ABO-compatible CS-WB from non-directed random donors was leukoreduced with platelet-sparing filters and compared with CT.

Results: Fifty-seven patients (30, 53% CS-WB; 27, 47% CT) were studied. Patient demographics were similar, although CT patients were cooled to a lower intra-operative temperature. Blood product requirements 24 h post operation were less in the CS-WB group (11.1 vs. 26.7 mL/kg, p = 0.048). Twelve (40%) patients in the CS-WB cohort had more than one donor exposure versus 25 (93%) in the CT group (p < 0.001). CT patients compared to CS-WB patients had a greater decrease in pre-operative versus 48-h post-operative haemoglobin, platelets and prothrombin time. Patients who received CT compared to CS-WB had a trend towards higher median (interquartile range [IQR]) chest-tube output (mL/kg/h) in the first 4 h post cardiac intensive care unit (ICU) admission (2.1 [0.8, 3] vs. 1.6 [0.8, 2.2], p = 0.197). There was no difference in antifibrinolytic use, length of stay, sepsis, acute kidney injury or wound infection. Survival to discharge was similar.

Conclusion: CS-WB in paediatric cardiac surgery may reduce donor exposure and improve haemostatic balance. Future multi-centre prospective studies are needed to validate these findings and identify patients who would benefit from CS-WB in paediatric cardiac surgery.

Background and objectives: Malaria risk deferral policies are important for mitigating the risk of transfusion-transmitted malaria and apply to all transfusable components, including plasma. While donors of plasma components are deferred for malaria risk in the United States, the viability of intraerythrocytic Plasmodium falciparum parasites present in human plasma components stored under different temperatures and durations has not been previously reported.

Materials and methods: We spiked human plasma with a low level of ring-stage P. falciparum-infected red blood cells and then determined their viability in cultures after storage at room temperature (22°C), refrigeration (4°C) and frozen conditions at -20 and -80°C.

Results: P. falciparum parasites spiked in human plasma remained viable after storage at 22°C for a maximum of 7 days. When stored at 4°C, parasites were viable after 1 and 3 days of storage and only for 1 day after storage at -20°C. Storage at -80°C had a cryopreserving effect and parasites remained viable for up to 176 days, the longest period tested.

Conclusion: P. falciparum parasites can survive for short durations in human plasma when stored at room temperature, or in refrigerated or frozen conditions at -20°C. However, when stored at -80°C, viable parasites were detected for up to 176 days, the maximum duration for which viability was assessed. In summary, Plasmodium parasites can survive in human plasma under different storage conditions and pose a risk of transfusion-transmitted infection.

Background and objectives: Restless legs syndrome (RLS), with adverse health outcomes, has been linked to blood donation, but evidence published thus far has not been rigorously analysed. This systematic review aggregates existing evidence on RLS among blood donors and identifies associated factors worthy of further investigation.

Materials and methods: MEDLINE and EMBASE were searched for articles published through 16 December 2023. Eleven studies from eight countries were selected from 142 publications. The pooled prevalence of RLS was calculated using a random-effects model, with heterogeneity assessed by the Cochran Q and I² statistics. Meta-regression and sensitivity analyses explored sources of heterogeneity and the robustness of findings.

Results: Eleven studies, involving 20,255 blood donors, were included. The pooled prevalence of RLS among blood donors was 10.30% (95% confidence interval [CI]: 5.54%-16.30%), which was significantly higher than in the general adult population (3.0%, 95% CI: 1.4%-3.8%). Meta-regression identified the year of study and geographical region as significant sources of heterogeneity. From the five studies that used logistic regression analyses, female sex and older age stand out as associated factors. No publication bias was detected, and sensitivity analysis confirmed the robustness of results.

Conclusion: Our findings suggest a high burden of RLS among blood donors, underscoring the need for further research with standardized criteria, appropriate design and analytical methodologies to better understand the impact of RLS on individual donors and the global blood supply.