Vox Sanguinis最新文献

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: 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.

Background and objectives: Plasma components are visually inspected, and non-transparent, turbid units are rejected for transfusion and fractionation. Additionally, in case a plasma component is deemed lipaemic, there is conflicting data on the accompanying red cell concentrate (RCC) in vitro quality. As visual inspection of plasma turbidity is a subjective method, we aimed to devise an objective measurement using a quick, non-invasive, table-top spectrophotometry-based method. Using this method, the correlation between spectrophotometric data and its predictive value on haemolysis of the accompanying RCC during storage was assessed.

Materials and methods: A total of 365 plasma units were visually inspected for turbidity and analysed for light reflection parameters (L*, a* and b*) and triglyceride (TG) levels. Leukoreduced RCCs in saline-adenine-glucose-mannitol (SAGM), prepared from the accompanying lipaemic whole blood, were stored for up to 6 weeks and analysed for quality parameters.

Results: The light reflection L* value was the most discriminating between clear and turbid/lipaemic plasma. Also, a correlation was found between TG levels and L* values (R² = 0.703). Plasma with TG ≥ 2.5 mmol/L showed an L* value >50 with >90% specificity and sensitivity. RCC from donations with a plasma L* value ≥68 showed significantly higher haemolysis levels (p < 0.05) during storage.

Conclusion: The non-invasive photometric analysis of plasma turbidity correlated both with visual inspection and plasma TG levels. Measurement of L* values of plasma may be helpful in identifying donations with high TG levels and higher risk for increased haemolysis during RCC storage.

Background and objectives: Honduras became the first lower middle-income country (LMIC) to adopt amotosalen/UVA pathogen-reduced (PR) platelet concentrates (PCs) as a national platelet safety measure in 2018. The Honduran Red Cross (HRC) produces ~70% of the national platelet supply using the platelet-rich plasma (PRP) method. Between 2015 and 2018, PCs were screened with bacterial culture and issued as individual, non-pooled PRP units with weight-based dosing and 5-day shelf-life. PR PCs were produced in six-PRP pools with a standardized dose (≥3.0 × 10¹¹), no bacterial screening and 7-day shelf-life. Gamma irradiation and leukoreduction were not used.

Materials and methods: PC production and distribution data were retrospectively analysed in two periods. Period 1 (P1) included 3 years of PRP PCs and a transition year (2015-18). Period 2 (P2) included 5 years of PR PCs (2019-23). PC doses were standardized to an equivalent adult dose for both periods. Descriptive statistics were calculated.

Results: HRC produced 10% more PC doses per year on average in P2 compared to P1. Mean annual waste at HRC declined from 23.9% in P1 to 1.1% in P2. Two urban regions consumed 96% of PC doses in P1 and 88.3% in P2. PC distributions increased in 14/18 regions.

Conclusion: Standardized dosage, PR and 7-day shelf-life increased PC availability, reduced waste, eliminated bacterial screening and avoided additional costs for arboviral testing, leukoreduction and irradiation. Access to PC transfusion remains limited in Honduras; however, the conversion to pooled PR PCs illustrates the potential to sustainably expand PC distribution in an LMIC.

Background and objectives: Several studies have suggested that blood donors have lower risk of gastrointestinal and breast cancers, whereas some have indicated an increased risk of haematological cancers. We examined these associations by appropriately adjusting the 'healthy donor effect' (HDE).

Materials and methods: We examined the risk of gastrointestinal/colorectal, breast and haematological cancers in regular high-frequency whole blood (WB) donors using the Sax Institute's 45 and Up Study data linked with blood donation and other health-related data. We calculated 5-year cancer risks, risk differences and risk ratios. To mitigate HDE, we used 5-year qualification period to select the exposure groups, and applied statistical adjustments using inverse probability weighting, along with other advanced doubly robust g-methods.

Results: We identified 2867 (42.4%) as regular high-frequency and 3888 (57.6%) as low-frequency donors. The inverse probability weighted 5-year risk difference between high and low-frequency donors for gastrointestinal/colorectal cancer was 0.2% (95% CI, -0.1% to 0.5%) with a risk ratio of 1.25 (0.83-1.68). For breast cancer, the risk difference was -0.2% (-0.9% to 0.4%), with a risk ratio of 0.87 (0.48-1.26). Regarding haematological cancers, the risk difference was 0.0% (-0.3% to 0.5%) with a risk ratio of 0.97 (0.55-1.40). Our doubly robust estimators targeted minimum loss-based estimator (TMLE) and sequentially doubly robust (SDR) estimator, yielded similar results, but none of the findings were statistically significant.

Conclusion: After applying methods to mitigate the HDE, we did not find any statistically significant differences in the risk of gastrointestinal/colorectal, breast and haematological cancers between regular high-frequency and low-frequency WB donors.