Vox Sanguinis最新文献

Background and objectives: The International Society of Blood Transfusion (ISBT) Quality Management Working Party (QM-WP) initiated a project to harmonize the definitions commonly used in quality management within blood establishments (BEs) around the world. A working group was established with the aim of providing simple, unambiguous definitions that can be applied in a standardized way.

Materials and methods: Common references available internationally were consulted in drafting a list of definitions relating to quality management. The criteria for selecting the most appropriate definition included clarity, simplicity, comprehensiveness and optimal applicability.

Results: The resulting list of definitions was published on the ISBT website in July 2023, with reference sources quoted for each definition. Individual references can be accessed via links appearing at the end of the document.

Conclusion: BEs are encouraged to utilize the document when developing internal quality system documents. The list is not prescriptive but is meant to serve as a recommendation. It is understood, however, that establishments in some countries are obliged to follow national legislation and terminology. It is the intention of the ISBT QM-WP to periodically review the list of definitions, performing updates when required.

To comply with regulatory guidelines, blood products undergo laboratory testing to assess red blood cell (RBC) quality during manufacturing, storage and delivery. Measurements of metabolites such as 2,3-diphosphoglycerate (2,3-DPG) have been relied upon as proxies for in vivo function, although their predictive value for clinical efficacy is not well substantiated. Following the discontinuation of the only validated commercial assay for 2,3-DPG, we reviewed existing literature and performed a retrospective analysis of datasets from two blood centres in North America to evaluate adenosine-5'-triphosphate (ATP) and p50 as alternatives. The literature did not provide sufficient evidence to support adopting p50 in place of 2,3-DPG. Although the assays are complementary, we found several exceptions in which biological and technical factors reduced the strength of correlation between 2,3-DPG and p50. ATP, another marker of RBC quality, was not well correlated either with 2,3-DPG or p50 in quality monitoring datasets or with in vivo circulation kinetics in healthy adults. Our assessment underscores the need for a replacement assay for 2,3-DPG for comprehensive characterization of novel red cell products and storage conditions.

Background and objectives: This study explores the perceptions of deferred blood donors in the Netherlands regarding the information provided upon receiving false-positive screening (FPS) deferral letters for infectious diseases. To ensure blood supply safety, rigorous screening for infectious agents is implemented by blood establishments. However, FPS results can create challenges after donor notification, leading to psychological distress.

Materials and methods: The study purposively selected whole-blood donors who had received deferral letters due to two FPS results between April and October 2023. Semi-structured interviews, guided by the Health Belief Model (HBM), examined health behaviours through seven constructs. Additionally, a survey of European Blood Alliance (EBA) members was conducted to gather insights on FPS management practices. Interview transcripts were coded and modelled to illustrate relationships between the themes.

Results: Ten in-depth interviews were held, revealing varied responses: some donors felt reassured by safety protocols, while the majority experienced psychological distress. Key themes included emotional reactions, contact methods, follow-up communication, engagement with Sanquin Blood Supply and altruistic motivations. The EBA survey shows varied FPS notification practices, rejection protocols, limited donor reaction studies and diverse support measures.

Conclusion: Improving communication clarity, providing follow-up procedures and adopting best practices from EBA members can enhance donor experience. These efforts are essential for refining the deferral process and improving donor perceptions, ultimately benefiting the donor and the blood supply system.

Background and objectives: The healthy donor effect (HDE) is a bias evident when comparing the effect of blood donation on health, often leading to conclusions such as 'donors with a high frequency of donation have better health outcomes than non-donors or donors with a lower frequency of donation'. To overcome this bias, we used a target trial emulation method while examining the relationship between blood donation and mortality among blood donors in Australia.

Materials and methods: We emulated 60 target trials from July 2006 to June 2011 using the Sax Institute's 45 and Up Study data, which was linked with other electronic health databases, including blood donation data in New South Wales, Australia. We conducted observational analogues of intention-to-treat (ITT) analyses comparing donors with non-donors, adjusting for variables that impact mortality. Hazard ratios (HRs) were approximated by the pooled logistic regression model.

Results: The 60 trials generated 263,300 person-trials with 121,967 unique participants included in the analysis. The unadjusted ITT mortality HR (95% confidence interval [CI]) between donors and non-donors was 0.57 (95% CI: 0.42-0.77). The HR was 0.70 (95% CI: 0.52-0.95) and 1.0 (95% CI: 0.73-1.35) after adjusting for age and sex, and then all the baseline covariates, respectively.

Conclusion: Blood donation did not significantly affect mortality during the follow-up when appropriate methods to mitigate the HDE were used, although blood donors were observed to have a lower crude mortality rate than non-donors.

Background and objectives: Platelet transfusions are essential for mitigating the bleeding risk of neonatal patients with thrombocytopenia. As neonatal patients have a small blood volume, adult therapeutic dose platelet units are split into reduced-volume storage containers to maximize the use of the donated product and reduce donor exposure. The shelf-life of platelets stored in reduced-volume containers, however, is limited to 5 days. Agitation in platelet concentrate (PC) storage is thought to promote gaseous exchange by maintaining a gradient of O₂ across the bag film; however, recent studies have shown that agitation-induced shear promotes the progressive decline of platelet quality over storage.

Materials and methods: Electron paramagnetic resonance oximetry and Fickian diffusion modelling of O₂ were used to investigate the differences in O₂ availability, by assessing the O₂ concentration, oxygen consumption rate (OCR), influx of O₂, total PC OCR and O₂ distribution in PCs stored under routine conditions in neonatal (Macopharma, VQE605B) versus adult (Haemonetics, ATSBC1ESE) PC storage containers. The influence of agitation on neonatal PC storage was evaluated.

Results: Results indicate neonatal PCs experience significantly higher O₂ availability compared to adult PCs and can withstand greater insult to their ambient O₂ concentration. Adjusting the agitation frequency of neonatal PCs stored from 20 to 400 rpm had no detrimental effect on O₂ availability, compared to storage at 60 rpm.

Conclusion: Neonatal PCs can maintain higher O₂ availability and tolerate reduced agitation without compromising oxygenation; therefore, reduced agitation strategies may be a feasible option to minimize shear during storage without compromising O₂ availability.

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.