Asian Journal of Transfusion Science最新文献

Background: The direct antiglobulin test (DAT) detects red blood cell (RBC) sensitivity to complement or IgG in vivo. The clinical disorders of hemolytic disease of the newborn, hemolytic transfusion reaction, and autoimmune and drug-induced hemolytic anemia are some examples of those that can cause in vivo coating of RBCs with antibodies or complement autoimmune hemolytic anemia (AIHA). Rarely, DAT is positive in nonimmune-mediated hemolytic anemias as well. Standard donor screening techniques do not require the DAT to be performed.

Aims and objectives: The aim of the study was to assess the prevalence of DAT positive in healthy blood donors at a tertiary blood center in North India.

Materials and methods: This 2-year prospective observational study included whole blood donors from January 2020 to December 2022. A total of 152,564 healthy blood donors including 150,246 (98.5%) males and 2318 (1.5%) females were donated at the department of transfusion medicine.

Results: Of a total of 152,564 donors, 150,246 (98.5%) were male, and 2,318 (1.5%) were female. Among the male donors, 11 (0.007%) had a history of blood transfusion and 16 (0.011%) tested DAT positive. Among the female donors, 15 (0.647%) had a history of blood transfusion and none of them tested DAT positive.

Conclusion: We observed low levels of DAT positivity in healthy blood donors. Such donors should be regularly monitored to check for any long-term development of malignancies or clinical or laboratory indications of hemolysis. DAT-positive blood units do not supply the recipient at risk, which may cause negative consequences.

Background: Thalassemia is one of the most common congenital hemoglobinopathies globally. Regular red blood cell (RBC) transfusion is of paramount importance in the treatment of thalassemia patients. However, this practice increases the risk of alloimmunization. This study was performed to determine the prevalence of RBC antibodies among multiple-transfused thalassemic patients in southern Khorasan, the eastern side of Iran.

Methods: For the purpose of screening unexpected antibodies, blood samples of 68 β-thalassemia major patients were investigated. After determining positive cases through screening phase, the process of antibody identification was carried out using reagent cells.

Results: The overall rate of alloimmunization was 2.9%, and the most frequent clinically important alloantibodies were anti-Kell and anti-Rh systems. Anti-K was detected in one of the patients. Furthermore, the simultaneous occurrence of anti-E and anti-C was seen in another study subject.

Conclusion: A number of factors might have contributed to the low alloimmunization rate detected in this study, including the homogeneity of the population in South Khorasan, well-matched donors for those patients, first transfusion at an early age, and the use of leukodepleted blood.

Hemolytic disease of foetus and newborn (HDFN) is a disease characterized by the destruction of fetal red cells by the maternal antibodies which occurs due to allo immunization in the mother by feto-maternal blood group incompatibility. The antibodies most frequently implicated in HDFN may vary depending on the demographic location under consideration. In areas where RhIg administration is available, ABO antibodies are more commonly implicated. Following ABO antibodies, anti-RhD antibodies which are of IgG type are more commonly implicated in causing HDFN. HDFN caused by other Rh system antibodies namely anti-C, anti-c, anti-E, anti- e, MNS, KEL, FY, JK, and DI systems is less frequent. We have reported one such rare case of Hemolytic disease of fetus and newborn due to Anti--S. During the routine antenatal screening for irregular antibodies, using antibody identification cell panel BIO-RAD (ID Diapanel 11x4) which belongs to lot number (06171.47.x - 06271.47.x), anti-S was identified in the mother serum. The baby was non-hydropic at birth with an increase in bilirubin which required high-intensity phototherapy.

Background: Transfusion support is vital for the management of patients with hepatobiliary disease. Repeated blood transfusions increase the risk of alloimmunization, i.e., the development of alloantibodies, which might lead to difficulties in blood crossmatching.

Aims: This study aims to: (1) determine the incidence of red blood cell (RBC) alloimmunization and (2) evaluate the associations between antibody development and demographic factors among hepatobiliary patients.

Method: ABO blood grouping, antibody screening, antibody identification and crossmatch were done on all patients samples included in the study.

Settings and design: A cross-sectional study was conducted from February 2021 to September 2021, with a total of 132 samples from hepatobiliary patients. The relationships between RBC alloimmunization in transfused hepatobiliary patients and demographic factors (gender, age, and history of transfusion) were assessed by binary logistic regression.

Results: Overall, 67.4% of the patients developed alloimmunization. The majority had a single alloantibody (75.2%) and the most frequently identified antibody specificities were anti-E (37.6%), anti-c (12.8%), anti-Mia (14.4%), and anti-Kidd (11.2%). The predominant antibodies were those against the Rh system (58.4%). Female patients recorded the highest incidence of alloimmunization (69.8%). Female patients also demonstrated a higher tendency to produce both anti-E + anti-c than male patients.

Conclusion: The prevalence of RBC alloimmunization is high among hepatobiliary patients and it may cause complications requiring multiple transfusions. The number of transfused packed cells has been clearly shown to be proportionally significant with the risk for alloimmunization in hepatobiliary patients. Hence, this study highlights the importance of immunohematology tests before blood transfusion.

Noise in the immunohematological investigations can be described as a false reactivity of red blood cells (RBCs) in serologic testing that is not related to the interaction of RBC antigens and antibodies that the test system is intended to detect. These false-positive reactions can cause confusion during the cross-matching and RBC antibody screening and may result in delays in patient transfusion. Although these antibodies are predominantly clinically insignificant, proper laboratory work-up is indicated to avoid misidentification of a clinically significant antibody as a noise. In this report, we describe the three rare cases where the reactivity was found against the ingredients of the column matrix (glass beads). It is imperative that such reactivity is recognized and resolved during the investigation of blood group discrepancies, positive RBC antibody screens and in cases of positive cross-matches.

Vasovagal syncope (VVS) in donors is a transient loss of consciousness due to short-term global cerebral hypoperfusion, which has a rapid onset and has complete spontaneous recovery. VVS may be triggered by pain, fear, anxiety, or emotional upset and loss of blood perse. It is an exaggeration of an adaptive response meant to assist in reducing the amount of bleeding/loss of blood. The four major components necessary for rapid cardiovascular adjustments to supine or upright posture, otherwise called orthostasis, are the autonomic nervous system, adequate blood volume, and intact skeletal and respiratory muscle pumps. The taxing of these autoregulatory mechanisms and their inability to compensate sufficiently results in VVS. VVR episodes can be described in 3 phases; Presyncope, Syncope, and Postsyncope. The actual syncope generally lasts for <15 s, comprising staring, muscle jerks, eye deviation/rolling, sometimes incontinence, loss of consciousness, gasping, snoring, apnea, inability to move/react, etc., The postsyncopal phase is the longest, which is generally manifested as fatigue.

Early detection of any disease is always a life-saving methodology for human beings likewise the detection of p24 antigen is always better than the detection of HIV antibodies. In the current era, p24 antigen is added additionally in HIV antibodies detection assays and called HIV fourth-generation immunodiagnostic kit. The different HIV fourth-generation kit having different capacities to pick up the low concentration of analyte as well as represent the detection values in different units. A total of 30 assays were used in this study and it was found that the detection concentration assigned by the manufacturers in the case of imported kits was 0.48 IU/mL to 2 IU/mL. However, the detection range of the indigenous kits was 25 pg/mL to 1000 IU/mL. This study gives an idea/knowledge for the startups concerned with high hope and broad scope for make in India concept in the IVDs market.

Background and objectives: Objective of the study is to explore the possibility of utilization of seven part fully automated hematology analyzer for enumeration of residual leukocytes (residual white blood cells [rWBCs]) in leukoreduced packed red cells (LR-PRCs) prepared from whole blood at a blood center as an alternate to the gold standard method, flow cytometry. In this study, we evaluate the performance characteristic of hematology analyzer against flow cytometry for the estimation of rWBCs in 39 LR-PRC units.

Materials and methods: PRCs prepared from whole blood donations by 39 donors were leukoreduced and their volumes were noted. The samples from these LR-PRCs were processed on HORIBA Yumizen H2500 hematology analyzer and Backman Coulter DxFlex (B5R3V5) Flow Cytometer and compared.

Results: A total of 39 LR-PRCs were analyzed. The average volume of these LR-PRC units was 252 mL ranging from 227 to 285 mL/bag. The average rWBC count for all LR-PRC units as per flowcytometry method was 3.1 × 10⁶/bag. There were 5 LR-PRC units with rWBC count more than 5 × 10⁶/bag which did not fulfill the minimum quality control criteria of LR-PRCs as per the Indian standards (DGHS).

Conclusion: The new generation fully automated hematology analyzers could be simple, reliable, economical, and practically best method for assessing the efficacy of leukoreduction in LR-PRCs. They can be adopted by resource-constrained blood centers as an alternative to flow cytometry for this purpose. It can be practically applied to check the quality of leukoreduction in all blood component samples before release from blood center for transfusion to the patients.

Background: Hemovigilance has become one of the important quality check systems of blood transfusion process, but under/non-reporting of transfusion-associated adverse reactions despite the presence of reporting systems emphasize the need to understand the challenges being faced in active reporting of adverse transfusion reactions.

Aim: To identify and document the possible factors leading to under-reporting and impacting the quality of blood transfusion reactions being submitted under Haemovigilance Programme of India (HvPI).

Settings and design: This was a cross-sectional, observational type study, carried out in six blood banks, two each of government, private, and stand-alone sectors in Delhi National Capital Region enrolled under HvPI.

Materials and methods: The study was carried out for a period of 6 months with a-month residence in each blood bank. During this period, data related to adverse transfusion reactions and their reporting were collected using a designed data collecting form and a validated questionnaire from all the six blood banks.

Statistical analysis used: MS Excel Ver. 2007 was used for compilation and descriptive analysis of collected data, and SPSS Ver. 25.0 was used for determining the Cronbach's alpha for the questionnaire which was statistically significant (α > 0.7).

Results: In a period of 6 months, a total of 5136 blood products were issued from these blood banks along with 5136 reaction reporting forms, but only 515 transfusion reaction report forms were returned to these blood banks. It was found that each blood bank faces some challenges with respect to identifying and reporting adverse transfusion reactions.

Conclusion: Addressing the gaps identified during this study will result in robust hemovigilance system in our country and having reliability of data being reported under HvPI.