Asian Journal of Transfusion Science最新文献

Donath-Landsteiner (DL) antibodies are immunoglobulins formed in response to a viral, bacterial, or spirochete infection and are capable of inducing paroxysmal cold hemoglobinuria (PCH), an autoimmune hemolytic anemia. In the past, PCH was most commonly associated with syphilitic infections; however, now, it is more frequently seen in children secondary to upper respiratory infections and DL test is the diagnostic test. We report a case of a 4-year-old male presented with a sudden drop in hemoglobin and hematuria with a 2-week history of fever and upper respiratory tract infection who was subsequently diagnosed as PCH with the help of DL Test.

Background: Knowing donor concerns, misconceptions, and attitudes toward blood donation helps us to formulate appropriate donor motivation strategies. Knowledge, attitude, and practice studies are commonly used to investigate various aspects of human behavior, like assessing what people know about blood donation, how they feel about it, and what they actually practice based on their knowledge and attitude.

Aim: The aim of our study was to evaluate various factors such as reasons for donating/not donating blood, sources of knowledge, motivating/demotivating factors, and the impact of peer structure on potential donors.

Settings and design: The study was done at the blood center of a tertiary care health setup. It was a cross-sectional observational study.

Materials and methods: The study was conducted with 500 participants through an organized, self-directed questionnaire which was shared through printed sheets and in Google Sheets format.

Statistical analysis used: The data were tabulated into an Excel sheet and analyzed through SPSS software. Chi-square test and general linear models were used to assess the association between various aspects of the participants.

Results and conclusion: Out of 500 participants, 80.4% were males with a mean age of 31.3 ± 7.9 years. 98.8% of participants were aware of their blood groups, 'O' being the most common one. 91.4% were unaware of the minimum weight requirement for blood donation. 7.2% were not ready to donate to strangers in need of blood and 25.8% believed they should be given remuneration for their donation. 99.4% had a positive attitude toward donation, but 1.4% were not ready to donate in the future. 16.8% had a fear of getting infected while donating blood and 15.6% were unsure about it. All these findings point out that proper knowledge and communication about the whole blood donation process will certainly help to maintain a prosperous voluntary blood donor program.

Background: The Blood Donor Health is an important component in blood transfusion services. The retention of blood donors is important, if not less than the recruitment of new blood donors. Despite the recognized importance of donor health, several challenges impede the retention of donors. These include the donor experience in the form of adverse reactions ranging from mild to severe which can be immediate or delayed. Such experiences can deter blood donors from returning to donor pool. Our study focuses on the incidence, types, and impacts of delayed adverse reactions (DARs) among whole blood donors in an Indian context, aiming to enhance donor retention through improved safety and experience.

Materials and methods: A prospective observational study was conducted at a premier tertiary care and research institute in Central India. The study included 1615 whole blood donors over 6-month period and used telephonic interviews on day 7 for postdonation follow-up. Statistical analysis was performed using Epi Info software, focusing on donor demographics, incidence, and types of DARs, and their association with various factors.

Results: The study found a 6.31% incidence of DARs, the most common being generalized weakness, followed by bruising and painful arms. A higher body mass index (BMI) significantly associated with an increased incidence of DARs. Notably, 75.5% of donors who experienced DARs expressed reluctance toward future blood donations, compared to 2.8% of those without DARs, highlighting the impact of DARs on donor retention.

Conclusion: This study underscores the importance of monitoring and managing DARs to enhance donor safety and experience, thereby improving retention rates. It suggests the need for systematic follow-up protocols, focused strategies for high-risk groups, enhanced support for female donors, standardization in definitions, and robust donor education programs. The findings contribute to the knowledge base on DARs in blood donation, ensuring a reliable blood supply crucial for healthcare.

Sickle cell disease is a group of disorders caused by a mutation in the beta chain of hemoglobin (Hb) leading to a vicious cycle of HbS polymerization, increased adhesion-mediated vaso-occlusion and hemolysis-mediated endothelial dysfunction. Herein, we describe a multimodality approach undertaken in a 10-year-old girl child with sickle cell anemia with preformed donor specific antibody (DSA). The initial autologous stem cell rescue collection had to be aborted due to excessive clotting in the stem cell collection set due to elevated Hb S levels. Red cell exchange was performed in view of this and the subsequent autologous harvest was successful. Five cycles of therapeutic plasma exchanges were done before allogeneic stem cell transplantation to reduce the mean fluorescent intensity value of DSA. The child tolerated the procedures well without any adverse events.

The role and safety of therapeutic plasma exchange (TPE) in COVID-19-induced severe acute respiratory distress remains unclear, especially in the wake that a specific and effective treatment modality has not been discovered for the treatment of COVID-19. Here, we report a case where a patient presenting with severe COVID-19 acute respiratory distress syndromes (ARDS) complicated by myasthenia gravis showed significant improvement after the third session of TPE and was subsequently weaned off from the ventilator and shifted to the ward from intensive care unit. TPE can be considered an efficient and safe treatment modality in severe COVID-19 ARDS.

Background: ABO and RhD grouping are the most important pretransfusion tests. Discrepancies in blood grouping are one of the major causes of transfusion reactions. Although ABO and RhD blood group discrepancies are not a very frequent phenomenon, an overall prevalence in the healthy populations was not known in the south-eastern part of West Bengal, India.

Aims: To analyze the overall prevalence of ABO-Rh (D) blood group discrepancies in healthy blood donor populations, serological methods to resolve them and to supply blood in emergency circumstances to such persons.

Materials and methods: In this study, a total of 8000 voluntary blood donors were chosen by the simple random sampling from South-Eastern part of West Bengal and blood grouping was done by the conventional tube technique method. Discrepancies were found among 24 blood donors with overall incidence of 0.3%. Resolution of group discrepancies done by extended incubation, weak D testing, subgroup detection with specific antisera, adsorption elution technique, secretor status by inhibition technique, etc., Direct immunoglobulin test (DAT) was done on all the samples by the polyspecific gel card method.

Results: Most of the discrepancies were due to weak or missing serum reactivity, (11 samples, incidence 0.13%), extra serum or red cell activity found in 6 samples (incidence 0.07%), subgroups causing weak red cell activity found in 4 samples (incidence 0.05%), and weak D antigen found in three samples (incidence 0.03%). One sample was DAT positive with no grouping anomaly.

Conclusion: Here, in this study, blood group discrepancies were resolved using simple serological techniques. This study may help to resolute group discrepancies in day to day transfusion practices where modern facilities are not available.

Context: On exposure to SARS-CoV-2 in participants anti-SARS-CoV-2 antibodies are expected to appear as a humoral response. Furthermore, various factors affect their expression.

Aims: The aim of this study is to investigate the humoral response of COVID-19-recovered participants and correlation with duration of disease, duration of COVID positive to date of test, occupation, blood group, age group, weight, gender, and symptoms of anti-SARS-CoV-2 antibodies.

Settings and design: This prospective observational study was conducted at the Department of Transfusion Medicine, at a tertiary care center in North India.

Methods: Seventy-two participants were tested for anti-SARS-CoV-2 antibodies on chemiluminescent microparticle immunoassay postgetting COVID negative.

Statistical analysis: The data were analyzed using Kruskal-Wallis and Mann-Whitney test. To correlate variables such as duration of disease, duration of COVID positive to date of test of immunoglobulin G (IgG), occupation, blood group, weight, gender, symptoms, and age group Chi-square test were used.

Results: The correlation of anti-SARS-CoV-2 antibodies with a duration of disease (P > 0.05), duration of COVID positive to date of test of IgG (P > 0.05), occupation (P > 0.05), blood group (P > 0.05), weight (P > 0.05), gender (P > 0.05), and symptoms (P > 0.05) is insignificant and whereas significant correlation with age group (P < 0.05) seen.

Conclusions: A significant correlation was seen in anti-SARS-COV-2 antibodies and age group. Higher antibody levels were seen in participants of the upper extreme age group (50-60 years).

Context: Coronavirus (severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2]) in the latest coronavirus disease (COVID-19) pandemic has been shown to cause a rise of ferritin levels through a possible viremia. Hemoglobin in the erythrocyte (red blood cell [RBC]) is a potential source of ferritin and we hypothesized that erythrocyte might be infected by this virus. Any infected RBC in asymptomatic blood donors might become a huge threat to the blood.

Aim: The aim of the study is to identify the presence of SARS-CoV-2 ribonucleic Acid (RNA) in RBC of patients suffering from COVID-19 disease.

Setting and design: A prospective study was performed to identify the presence of SARS-CoV-2 RNA in erythrocytes of patients with COVID-19.

Subjects and methods: Ten samples were collected from patients with COVID-19 at different times during their admission. After sampling, these were processed and stored like Packed red blood cells (PRBCs). These units were further processed by washing or leukoreduction with further sampling. All these samples were tested for the detection of SARS-CoV-2 RNA by real-time-polymerase chain reaction.

Statistical analysis: Descriptive statistics with Microsoft Excel were performed.

Results: The study could not identify the SARS-CoV-2 virus in the erythrocytes or plasma of infected patients.

Conclusion: SARS-CoV-2 virus may not be a transfusion transmissible infection, however, this needs to be confirmed with a larger study. It is recommended to have a lookout hemovigilance policy given newer variants of SARS-CoV-2 and for possible new viruses that may emerge in the future.

Background and objectives: Adherence to the massive hemorrhage protocol (MHP) is essential for its successful implementation. An indigenous low-volume MHP was designed in accordance with the institutional needs. Adherence to various components of the designed MHP components was assessed.

Materials and methods: Retrospective analysis of all MHP activations for 1-year duration was performed. Patient demographics, injury details, and baseline vitals were collected along with details of transfusion. Adherence to critical steps such as activation criteria, timing of delivery of the blood components, pack size and ratios of blood components, and endpoints were assessed, followed by calculation of adherence scores.

Results: MHP was activated in 1.1% of patients presenting to the emergency. Massive transfusions were required for 76%. Adherence scores of ≥50% were achieved in 77% of MHP activations. Timely issue of the first transfusion pack was achieved in all cases, whereas the demand for the red blood cell (RBC) components exceeded the predefined number of units, thus affecting the desired ratio of blood components. Hemorrhagic deaths within 24 h were observed in 13 patients and were not affected by the overall adherence scores.

Conclusion: Adherence to prepared MHP was moderate for most patients. Adherence can be improved significantly by increasing the number of compatible blood components after the first transfusion pack in case of limited inventory. In addition, reducing the delivery time for the subsequent transfusion packs, incorporation of hemostatic adjuncts, and point-of-care tests in the MHP should be considered on a priority basis.

Background: Hepatitis C virus (HCV) is a major issue in the field of blood transfusion safety and blood components. Serological tests are used to detect anti-HCV antibodies in blood donors. This study was performed to evaluate the status of anti-HCV antibodies in blood donors and serological assays.

Subjects and methods: Data related to the results of screening and confirmation tests of 427,203 blood donors were examined over a 6-year period.

Results: The results showed the highest frequency of positive ELISA results 329 (% 0.39) among first-time blood donors. Out of 901 samples with reactive/positive ELISA result, 104 (11.5%) samples had positive or IND confirmation test results which were belong to donors with a history of healthy blood donation. Antibodies against the NS3 (23%) and core (16.9%) antigens had the highest frequency among blood donors with positive/Reactive ELISA, respectively. The core antigen was the highest immunoreactive protein. A median correlation was found between OD in the ELISA test and the antibody profile in the RIBA test (r = 0.62, P = 0.0001).

Conclusion: The seroconversion in healthy blood donors is worrying in relation to the status of the disease in the community and its high incidence. Using Core and NS3 antigens assay can be helpful in screening and diagnosis or antigen detection might be the first next step following a Positive/Reactive antibody test. The use of serological algorithm in blood transfusion centers is questionable and our research has challenged the theory that blood donors with a history of blood donation are healthier in transmitting viral infections.