Asian Journal of Transfusion Science最新文献

Background: Cold agglutinin disease (CAD) is relatively rare and has primarily been reported as retrospective case series.

Aim: We reviewed our experience with CAD to shed light on this disease.

Study settings and design: This was a retrospective review of all patients with CAD managed at our institution between 2007 and 2018.

Materials and methods: The study was approved by our institutional review board. We extracted patients' demographic, clinical, and laboratory data, blood transfusions, and outcomes from their electronic medical records.

Statistical analysis used: Statistical analysis was performed using SPSS version 17. The method of Kaplan-Meier was used to plot survival curves.

Results: Forty-eight patients fulfilled the inclusion criteria for CAD. The median age of patients was 73.1 (range, 43-99) years; 36 (75%) were female. The majority (n = 38; 79.2%) of patients were Caucasians. Most patients (n = 25, 52.1%) presented with symptomatic anemia. Eight patients were asymptomatic. The median hemoglobin level was 8.6 g/dL (range, 3-12 g/dL); 7 (14.6%) patients had concurrent thrombocytopenia. Lactate dehydrogenase was elevated in 40/47 (85.1%) patients and haptoglobin was below normal in 35/46 (76.1%) patients. Coagulopathy was observed in 19 (52.8%) of 36 patients. Sixteen (33.3%) patients required blood transfusion during admission at the time of diagnosis with a median number of 3.5 red blood cell units. Twenty-five (52.1%) patients were alive after a median follow-up of 50.1 months. The 5-year and 10-year survival was estimated at 58.2% and 30.8%, respectively.

Conclusion: CAD poses considerable burden on patients and health-care systems. Patients vary widely in their disease severity and course.

There are many challenges to obtain antigen-negative, crossmatch compatible blood for a patient with multiple alloantibodies. We present a case report of a 31-year-old female patient with a recurrent pontine cavernoma who was to undergo a neurosurgical procedure. We identified alloantibodies anti-Fy^a and anti-c in her blood sample. To meet her intraoperative blood requirement, we attempted with autologous blood transfusion using both predeposit autologous donation and acute normovolemic hemodilution. Autologous blood alone was sufficient despite anticipating surgical blood loss and a postoperative surgical site infection.

Introduction: HIV fourth-generation assay, designed for the detection of HIV p24 antigen along with anti-HIV antibodies of both immunoglobulin M and immunoglobulin G type against HIV 1 and HIV 2 viral antigens, have helped in the early detection of HIV infection and supports in minimizing the transmission risk in the acute phase of infection. The objective of this study was to evaluate the analytical and clinical performance of HIV fourth-generation assay based on enhanced chemiluminescence technology.

Materials and methods: The analytical performance of the assay was evaluated in terms of accuracy, precision, limit of detection, type of sample (serum vs. plasma), cross-reactivity (with other transfusion transmissible infections markers), and interference (with endogenous substances). Proficiency control material included kit-controls, archived known positive donor samples, third-party controls, and World Health Organization (WHO)/National Institute for Biological Standards and Controls (NIBSC, MHRA, UK) controls. The clinical performance was evaluated using routine donor and patient samples received during the study period.

Results: HIV fourth-generation assay showed reliable and reproducible results measured in terms of coefficient of variation % with kit-controls, archived known positive donor samples, third-party controls, and WHO international standards for anti-HIV 1 and 2 antibodies, HIV1 p24 antigens and HIV2 p26 antigen controls. The analytical sensitivity of the HIV fourth-generation assay was found to be 0.1 IU/mL of HIV1 p24 antigen control and there was no cross-reactivity or interference observed. In the clinical performance of the assay, HIV fourth-generation assay showed reliable performance in both donor and patient samples.

Conclusion: HIV fourth-generation assay meets the requirements for its use as a screening assay for HIV infection based on the analytical and clinical performance of the assay.

Background: Multiple reports are available from different parts of the globe indicating the incidences of alloimmunization and blood transfusion-related reactions, which emphasizes the need for phenotyping and providing antigen-matched safe blood.

Aims and objectives: This study aims to determine the frequency of Rh and Kell antigens and phenotype for both donors and patients to propose the importance of providing Rh Kell phenotype cross-matched packed red blood cell (RBC) units to minimize the alloimmunization and transfusion reactions.

Materials and methods: Ten thousand blood donors and four thousand patients were investigated between October 2017 and July 2019. Each donor unit was tested for blood grouping, antibody screening, and Rh Kell antigen Phenotyping, and the blood unit was issued after the patient's blood grouping, antibody screening by 3 cell panels, and Rh Kell antigen phenotyping followed by cross-matching with an Rh Kell-matched phenotype RBC unit.

Results: Nine thousand four hundred and fifty-two donors were D positive (94.5%) while 548 tested D negative (5.5%). Overall Rh and K antigens frequencies in donors were: "e" (98%) >"D" (94.5%) >"C" (86.6%) > "c" (57.5%) >"E" (18.8%) >K (0.98%). Among patients, 3762 tested D positive (94.05%), and 238 tested D negative (5.95%). Overall Rh and K antigens frequencies in patients were: "e" (98.5%) >"D" (94.05%) >"C" (90.2%) >"c" (51%) >"E" (18.2%) >K (1.8%).

Conclusion: Our study has given us more clarity on the prevalence of major Rh and K antigens in our donor as well as patient populations, highlighting the similarities as well as differences. This variance holds a great significance, since such donor units when transfused into patients may lead to alloimmunization and adverse transfusion reactions. Hence, the determination of Rh and Kell phenotypes and providing phenotype-matched blood will help prevent such events.