Vox Sanguinis最新文献

Background and objectives: Artificial intelligence (AI) has been gaining increasing interest in healthcare. During the 2024 International Society of Blood Transfusion (ISBT) Congress, the Clinical Transfusion Working Party (CTWP) conducted a session to explore the exciting intersection of AI in transfusion medicine (TM) practice, education and research. We report here the potential applications and the session outcome.

Materials and methods: A pre-workshop survey explored the participants' demographics and areas of use of AI and whether they have had any AI-specific training or education. The workshop included presentations on the regulatory aspects of AI use and its application in TM practice, education and research. These were followed by round-table discussions to explore participants' experience and concerns.

Results: The workshop had 72 attendees, with 38% falling in the 36-45-year age group. A total of 70% indicated the use of AI, but only 12% reported having specific training or education. Participants expressed interest in different potential applications but also shared concerns on over-reliance, potential loss of skills, the accuracy of provided information and content plagiarism.

Conclusion: The findings of the workshop highlight the need for training, educational resources, standards and regulatory frameworks to guide the use of AI tools in the field of TM.

Background and objectives: Great variations may be observed in the haemoglobin (Hb) content of packed red blood cell (PRBC) units prepared by different methods. This study aimed to assess the Hb increment in thalassaemia major patients transfused with leucoreduced PRBCs (LPRBCs) prepared by two different methods: (i) standard leucoreduced PRBCs (SLPRBCs) and (ii) leucoreduced PRBCs prepared by a new method where leucoreduction of whole blood is done first (NLPRBCs).

Materials and methods: This prospective, randomized, controlled trial included 80 adult thalassaemia major patients who were randomized into two groups of 40 each. Group I patients received SLPRBC and those of Group II received NLPRBC transfusions for 3 months.

Results: SLPRBCs had a mean (±SD) volume of 275.50 ± 17.07 mL, while it was 316.46 ± 1.42 mL for NLPRBCs (p < 0.001). The mean Hb content of SLPRBCs was 50.60 ± 5.12 g, while that of NLPRBCs was 56.98 ± 5.92 g (p < 0.001). The mean Hb increment in Group I patients was 2.11 ± 0.89 g/dL, while that of Group II patients was 2.48 ± 0.88 g/dL (p < 0.001). The mean transfusion interval for Group I patients was 20.30 ± 3.75 days, while it was 21.34 ± 5.13 days for Group II patients (p < 0.045). A significant positive correlation was observed between the Hb dose transfused and the Hb increment with both SLPRBC (ρ = 0.4, p < 0.001) and NLPRBC (ρ = 0.19, p = 0.011) transfusions.

Conclusion: NLPRBCs had significantly higher Hb content than the SLPRBCs, leading to a better Hb increment post transfusion, which may potentially prolong the transfusion interval in thalassaemia major patients.

Background and objectives: Despite screening procedures, a few blood donors confirm positive for transfusion-transmissible infections and are deferred. Effective notification of laboratory results is essential to ensure that donors are advised of confirmed results and to seek medical care. Here we report results from post-notification interviews of Canadian Blood Services donors.

Materials and methods: Over 17 years, 2006-2022, all donors with confirmed positive results for hepatitis B virus (HBV), hepatitis C virus (HCV), human T-cell lymphotropic virus (HTLV) and syphilis were notified by registered mail of their result and advised to see a physician. In a separate communication, all donors were later invited to participate in a scripted interview asking whether they tested positive for an infection; if yes, which one, what their reaction was, whether they consulted a physician and whether public health contacted them. Frequencies of responses were calculated.

Results: Of 2654 donors with confirmed positive test results, 876 (33%) participated; 90% said they were informed of a positive test result. Of these, about a quarter did not know for which infection they were positive. Most were surprised, and some were sad or disappointed. Most saw a physician after notification (77%). About two-thirds with HBV or HCV said they were contacted by public health, slightly fewer (58%) with syphilis, 27% of those with HTLV.

Conclusion: Most donors recalled being notified and were aware of their positive test, but details of the infection were sometimes not understood or recalled, and not all donors consulted a physician about the infection.

Background and objectives: Professionals who work or study in transfusion medicine under 40 years of age are considered young professionals (YPs) by the International Society of Blood Transfusion (ISBT). While the ISBT provides opportunities for YPs, their needs have to be assessed to customize initiatives in a way that could potentially improve their engagement. This survey aimed to assess the needs of YPs in transfusion medicine and understand their perspectives on future ISBT initiatives.

Materials and methods: Between January and February 2023, a 28-question online survey was accessible through a generalized link across the ISBT network. Skip-logic responses from 352 YPs, including 151 ISBT members and 201 non-members, were analysed. Each question varied in the number of responders and, consequently, the number of responses.

Results: Firstly, the most important needs of YPs from the survey were educational opportunities and training programmes, with 70% of respondents indicating for educational content in specific fields of transfusion. Secondly, Transfusion Today published by the ISBT (46.9%) ranked the highest in engagement, while ISBT Academy and Academy funding ranked the lowest (12.8%). ISBT members reported attending ISBT activities or using ISBT resources more often than non-members, although this was not statistically significant. The primary barrier preventing both non-members and ISBT members from engaging in ISBT activities was a lack of awareness.

Conclusion: Raising awareness on a regular basis, a customized communication style (e.g., by a representative or different languages) and activities for non-members may be key to improving YP engagement and expanding the ISBT network.

Background and objectives: Although transfusion reactions occur in less than 2% of recipients, they are currently one of the most serious concerns in blood transfusion. Damage-associated molecular patterns (DAMPs) are released from injured, stressed or dead cells, leading to inflammation and immune system activation. One of the recognized DAMPs is mitochondrial DNA (mtDNA). It is found in various blood products, including fresh frozen plasma (FFP), red blood cell units (RBCUs) and platelet concentrates (PCs), and can induce adverse reactions in recipients by stimulating the innate immune system and inflammatory cellular pathways. The aim of this study was to investigate the factors influencing the release of mtDNA in various blood products and its subsequent impact on transfusion reactions.

Materials and methods: In this study, mtDNA, mitochondrial DNA, mtDNA DAMPs, extracellular mtDNA, blood products, blood components and transfusion reactions between 2009 and 2023 were searched in Google Scholar, PubMed and Scopus databases.

Results: This study has demonstrated the presence of mtDNA in the extracellular milieu of various blood products, including PCs, FFP and RBCUs. Understanding the determinants of mtDNA release and its implications for transfusion safety is critical. Strategies aimed at reducing mtDNA release, such as optimizing preparation techniques and donor selection criteria, hold promise for reducing transfusion-related complications.

Conclusion: By addressing these factors, healthcare providers can enhance the safety and efficacy of blood transfusion practices, ultimately improving patient outcomes.

Background and objectives: Identifying RhCE variants is essential to prevent alloimmunization and manage complex cases. Unfortunately, these variants are often only detected after antibody formation, as they may go unnoticed in serological tests. This study aimed to assess monoclonal antisera using various methodologies to define the reactivity patterns of some variants by variable expression of RhCE antigens.

Materials and methods: Samples were chosen based on atypical reactivity on routine RhCE typing of donors, screening of Afro-descendant donors using tube testing and patient samples with antibodies against their own antigens. All 53 samples were tested using tube, gel and microplate tests with five antisera. Antigen expression was assessed by flow cytometry, and RhCE variants were molecularly classified.

Results: Tube test screening of African descent donors proved more effective in identifying a broad range of weak or partial antigens, particularly when using anti-e composed of MS-21, MS-16, MS63 clones and anti-c from the MS8011531019 clone. Automated instrument phenotyping successfully identified samples with RHCE*ceJAL allele, while most other variants were detected as positive (4+), similar to gel test, which intensified most reactions. When comparing methods and antisera for detecting variant e antigens, tube test identified a higher percentage of weak samples (63%-77%) compared with microplate (35%) and gel tests (14%).

Conclusion: The results highlight the critical role of tube test in serological routines and the need to select clones capable of identifying RhCE variants. Detecting reduced RhCE antigen expression during routine serological testing can guide further molecular investigations and help prevent Rh alloimmunization.

Background and objectives: To determine whether intra-individual differences in pre-donation blood test results were associated with vasovagal reactions (VVRs).

Materials and methods: The study included donors who voluntarily donated 400 mL of whole blood at least twice during a 5-year blood collection period of the Japanese Red Cross, including both donations with and without a VVR. A conditional logistic regression analysis by age group and sex was conducted, using each donor as a stratum, together with an analysis of deviance to test the significance of including an interaction term between age group and blood data in the regression model.

Results: A total of 1873 donors were included in the analysis. Haemoglobin, haematocrit, total protein and albumin values prior to donation were higher when a VVR was observed than when it was not for each age group and sex. The regression analysis showed significant positive associations between each of these blood parameters and VVR in all combinations of age groups and sex. A particularly strong positive association between haemoglobin and VVRs is seen in women aged ≥50 years (odds ratio, OR [95% confidence interval, CI]: 1.844 [1.457, 2.333]).

Conclusion: Haemoglobin, haematocrit, total protein and albumin levels within individual donors were significantly higher at donation with a VVR. This was most notable in women aged ≥50 years. Comparing the pre-donation haemoglobin value with past values in the same donor at the donation site would help raise awareness of the risk of VVRs.

Background and objectives: Reproductive-aged women are at an increased risk of developing iron deficiency (ID). We aimed to develop a non-invasive screening tool to identify ID in women and assess the acceptability of screening.

Study design and methods: We screened women (age 18-49 years) in the community of Western Australia.

Primary outcome: acceptability of screening, assessed by the feasibility of recruiting the required sample size (n = 323).

Secondary outcomes: Hand grip strength, finger prick haemoglobin concentration (Hb), prevalence of heavy menstrual bleeding (HMB), diet, pregnancy history, blood donation, symptoms of ID and history of ID or anaemia (Hb < 120 g/L). Those with Hb <130 g/L and no history of iron therapy in the past 2 years were given referrals for venous full blood count and ferritin sampling.

Results: Across 5 days, we recruited 640 eligible women. Of which, 178 (28%) had HMB and 79 (12%) were anaemic. Mean age was 33.5 ± 9.2 years, and mean Hb was 132.4 ± 11.9 g/L. In the past 2 years: 335 (52%) were diagnosed with ID or anaemia; 322 (50%) had taken oral iron; and 210 (33%) had an intravenous iron infusion. Vegetarian diets were followed by 89 (14%); 40 (6%) were regular blood donors; 290 (45%) had a previous pregnancy. HMB increased the risk of symptoms of ID and having prior ID/anaemia diagnosis (67% vs. 47%) or treatment (p < 0.022). Hand grip strength showed a positive relationship with both Hb (adjusted R² = 0.012, p = 0.004) and ferritin (adjusted R² = 0.135, p = 0.005).

Conclusion: ID screening was well accepted by women in the community, with high recruitment rates over a short period. Future screening tool development may consider incorporating hand grip strength and HMB assessment.