Asian Journal of Transfusion Science最新文献

Introduction: Anemia is one of the leading causes of deferral from blood donation. Classically, an individual's iron status is assessed with respect to serum ferritin (S. ferritin) levels. S. ferritin levels vary with phases of the menstrual cycle and may not reflect the actual iron stores. Currently, there are certain studies that explain the role of Vitamin D in erythropoiesis. The present study was conducted to assess the emerging association of Vitamin D with hemoglobin (Hb) levels among the female blood donor population.

Materials and methods: A hospital-based cross-sectional study was conducted on 111 female blood donors over 1 year. The association of Hb levels with Vitamin D and S. ferritin levels, dietary factors, frequency of blood donations, and the number of pregnancies was analyzed.

Results: The prevalence of Vitamin D deficiency was 80.18% (n = 89) in this study. Among donors with low Hb levels, 24.32% (n = 27) had low ferritin and 51.34% (n = 57) had low Vitamin D levels. 18.01% (n = 20) of the donors had low Hb levels with coexistent low ferritin and low Vitamin D levels.

Conclusion: It is imperative to replenish the iron stores of blood donors who face deferral from blood donation due to low Hb levels. This is a preliminary study from India which looks into the Hb levels of female donors with regard to their Vitamin D status. Those females who were found to be deficient in Hb and Vitamin D levels were referred to treating clinicians for supplementation and dietary modifications. The major goal of this study was to bring those women who got deferred due to low Hb levels back to the voluntary blood donor pool once they replenished their iron stores.

Background and objectives: Collection and providing standard blood samples for examination is critical for all medical laboratories. Currently, for all blood samples taken from the elderly and young people, the same preparation protocol is applied. We hypothesized that the blood taken from older individuals is more vulnerable to preparation conditions compared with the younger ones. This study aimed to assess the effect of storage duration and temperature on biochemical analytes in serum samples taken from old and young participants.

Materials and methods: Blood samples from 30 healthy participants including 15 young people (eight males and seven females, 20-35 years old) and 15 elderly people (eight males and seven females, 60-75 years old) were collected. For each participant, serum sample tubes stored at different time intervals (2 and 24 h) and temperatures (4°C, 25°C, and - 20°C). The biochemical analytes were examined by an automated analyzer. Total antioxidant capacity was assayed by a commercial kit. Nitric oxide metabolites were measured by Griess reagent.

Results and conclusion: Intragroup analysis in young and older participants showed that lactate dehydrogenase levels were significant in 2 h incubation time at 20-24°C and in 24-h incubation times at 20-24°C and 4°C compared with the baseline time (T0) (P < 0.05). Intergroup analysis showed that glucose and urea levels were higher among the older participants than the youth group at baseline and 24 h times (P < 0.05). Furthermore, the magnesium and nitric oxide levels were higher in the youth group than the elderly ones at baseline and 24 h times (P < 0.05).

Background: Donor notification and counseling have been mandated by the Indian action plan for blood safety to facilitate the early diagnosis and subsequent management of sero-reactive blood donors as well as to prevent the spread of infection through subsequent blood donations. This retrospective and questionnaire-based study was conducted with the aim of understanding the level of knowledge, difference in attitudes, and pattern of responses of sero-reactive blood donors which could aid in designing of clear and unambiguous donor educational program as well as enhance the effectiveness of donor selection procedures. Furthermore, the rates of donors' response to notification and compliance to clinical referral were assessed to find the areas which require improvement.

Methods: Blood donors sero-reactive for viral markers were notified and subjected to postdonation counselling and were asked questions to assess their knowledge, attitude, and response. Retrospective analysis of data of 5 years was done. Donors were followed up by enquiring their status 6 months' postreferral.

Results: Of the 1991 repeat reactive blood donors, 1256 (63.08%) responded for counseling and referral. Long distance and busy schedule were the most common reasons for nonresponse. Lack of privacy and lack of understanding were the main reason for nondisclosure of pertinent information by blood donors. On follow-up, 634 (50.48%) of those counseled actually visited the prescribed referral center.

Conclusion: Donor counseling should be done by a trained counselor ensuring an understanding of the importance of transfusion-transmitted infection transmission. Donors should be informed about high-risk behavior and self-exclusion should be facilitated.

Therapeutic plasma exchange (TPE) has been associated to improve survival in critically ill patients with liver failure who are not anticipated to survive until liver transplantation. In pregnant patients with acute liver failure (ALF), standard volume TPE can be done, foreseeing complications such as fetal distress, hypofibrinogenemia, hypercalcemia, and adverse transfusion reactions. TPE has been demonstrated to lower inflammatory cytokine levels, modify adaptive immunity with the potential to minimize infection susceptibility, and lower albumin and water-bound toxin levels in liver failure. In this article, the multidisciplinary approach, efficacy, and technical considerations were elaborated in the management of a young pregnant female diagnosed with ALF by TPE.

Introduction: Therapeutic plasma exchange (TPE) is a procedure used to treat various neurological and non-neurological disorders by removing and replacing a patient's plasma to eliminate disease-causing substances. Here, we present our experience using TPE to treat various diseases with an apheresis machine.

Aim: To evaluate the safety and efficacy of TPE as a treatment modality in various patients with neurological and non-neurological diseases admitted in tertiary care center in western India.

Methodology: A retrospective analysis of 152 TPE procedures was conducted over 3 years (April 2021-April 2024) in a Western Indian tertiary care hospital. The study involved 39 patients aged 7-72 years. Clinical improvement was assessed through relevant investigations before, during, and after TPE procedures.

Results: Thirty-nine patients were studied, with Guillain-Barre Syndrome (GBS) being the most common indication for TPE, followed by acute liver failure (ALF) and myasthenia gravis (MG). Clinical improvement was seen in 76.19% (16/21) of GBS patients, 12.5 (1/8) of ALF, and 100% (5/5) of MG patients. 13/18 (72.22%) patients in the neurological category showed complete recovery even after replacement of 0.5-0.9 plasma volume (n = 18). The adverse reaction rate for TPE was 5.92% (9 events in 152 cycles), most common being allergic reactions and paresthesia.

Conclusion: TPE is safe and efficient treatment modality for the treatment of neurological and non-neurological diseases. Our experience highlights TPE's safety and efficacy. One group in the neurological category showed improvement even with low-volume exchanges (0.5-0.9 PV). Further research is required to enhance the understanding and use of TPE in patient care.

Thrombotic microangiopathies (TMAs) are a group of disorders characterized by microangiopathic hemolytic anemia and thrombocytopenia, leading to ischemic tissue injury. We, hereby, describe an interesting case of TMA secondary to dengue along with dengue encephalitis. Dengue-related TMA is rarely described. Treatment was initiated with standard-volume (1.5 plasma volume) therapeutic plasma exchange (TPE) by centrifugation method on a multifunctional cell separator (Spectra Optia, Terumo BCT, USA) within a few hours of admission based on high PLASMIC score, which led to improvement in hemolytic parameters and kidney injury. This case highlights the role of early diagnosis and early initiation of TPE is key in the management of dengue-related TMAs.

Background: Over decades, increased demand of platelet transfusions for patients with various conditions led to accelerated use of technologically advanced plateletpheresis.

Aims: Study the demographics of plateletpheresis donor and plateletpheresis session profile.

Setting and design: Prospective, cross-sectional, open label study.

Materials and methods: Plateletpheresis performed on Trima Accel (TA) and mechanical circulatory support (MCS) + during 2017-2018 on donors selected according to the guidelines.

Statistical analysis: SPSS (version 17) for windows statistical package.

Results: Two thousand eighty hundred and thirty-six plateletpheresis procedures were done, out of which 666 (23.48%) were done on TA while 2170 (76.51%) were done on MCS +. Maximum donors, 1437 (55.66%) were in the 21-30 years category; Mean age was 30.75 years ± 8.44 standard deviation (SD); range18-65 years. Maximum donors 1185 (41.78%) were in the 61-70 kg category with mean weight - 74.33 kg ± 9.80 SD and mean height - 170.46 cm ± 4.99 SD only 4 (0.15%) donors were females. Two thousand six (70.73%) donors were voluntary, with 1620 (57.12%) repeat donors. Mean platelet count was 272.98 ± 56.59 × 10⁹/L with maximum donors having platelet count between 200 and 300 × 10⁹/L and ranged from 157 to 508 × 10⁹/L. Mean hemoglobin of donors - 14.87 g % ± 3.16 SD; total serum protein - 6.31 g/dl ± 4.8 SD. Mean platelet yield was 3.50 × 10¹¹ ± 0.71 SD; ranged from 2.9 to 7 × 10¹¹. Plateletpheresis session profile of reactors and nonreactors showed that acid citrate dextrose used in reactors was more - 353.44 ml as compared to nonreactors - 311.72 ml. Reactors showed more volume of whole blood processed - 2899.43 ml as compared to nonreactors - 2601.63 ml. Time taken for completing the session was more in reactors - 82.40 mins as compared to nonreactors - 70.80 min. Platelet yield was 3.79 × 10¹¹ and 3.49 × 10¹¹ and plasma volume was 275.6 ml and 261.2 ml in reactors and nonreactors respectively.

Conclusion: Demographics of plateletpheresis donors and session profile are vital for their safety.

Introduction: Restless legs syndrome (RLS) is characterized by an urge to move the legs or arms, associated with uncomfortable sensations. Frequent blood donation is one of the known risk factors for RLS. Earlier studies have shown that the prevalence of RLS varies between 4% and 18% among blood donors. The present study was done to assess the prevalence of RLS among repeat blood donors and to find out its correlates in Indian population.

Materials and methods: This study was done for a period of 1 year from April 2019 to March 2020. Two hundred donors who fulfilled the definition of "regular donor" by National AIDS Control Organization were enrolled by convenient sampling. Responses to the Hindi version of CHRLS questionnaire for RLS were noted, and history of number of previous blood donations was taken. Estimation of red cell indices and serum ferritin levels was also done.

Results: Two hundred donors were selected for analysis. Out of which, 198 donors were males (99%). RLS was reported in only four donors (2%) and all of them were males. This was comparable to population prevalence of RLS reported in this region.

Conclusion: The prevalence of RLS among repeat blood donors in Indian population was comparable to the general population. Our findings could be reassuring for the frequent donors. Inclusion of basic questions on symptoms of RLS in the donor screening questionnaire can be useful in detecting impending iron deficiency, though its impact on a big scale is doubtful.

Limitation of standard coagulation tests in early detection of coagulopathy leads to empirical decision-making for the management of the coagulopathy, which in many cases is accompanied by improper transfusion. Some studies have investigated the role of rotational thromboelastometry (ROTEM) in reducing the need for blood products in different clinical conditions, which have been associated with different results. Whether ROTEM as a point of care test reduces the need for transfusion in all clinical settings is still a question. A brief introduction of methodology of ROTEM and its role in patient blood management (PBM) approach is explored in this review. Search was performed to find literature describing ROTEM applied for decrease in transfusion requirements. Specific search terms were "Thromboelastometry," "ROTEM," "Cardiac surgical procedures," "Trauma," "wounds and injuries" "Liver transplantation," "obstetric" "Transfusion," and "PBM." we reached to 75 publications for this review after application of our search strategy. The number of publications in the field of obstetric was insufficient for review and conclusion. The available evidence supports the helpfulness of ROTEM test in reducing the need for blood transfusions in surgery or trauma. However, it is need to further investigation to evaluate the benefit and efficacy of ROTEM in other medical conditions such as obstetric hemorrhage.