Blood Transfusion最新文献

Background: Adherence to optimal practices in the preparation and issuance of pediatric blood components can significantly influence patient care outcomes. This study aims to examine the blood banking procedures across prominent Italian children's hospitals, with the goal of identifying both consistent and potentially divergent standards within this field.

Materials and methods: A survey was conducted among the blood banks affiliated with the Italian Association of Pediatric Hospitals. Modeled after the AABB Neonatal and Pediatric Blood Bank Practices Survey, the questionnaire comprised 25 questions covering hospital characteristics, definitions of the neonatal period, pre-transfusion tests, blood component availability, and irradiation protocols.

Results: Fourteen out of the sixteen invited blood banks participated in the survey. The findings revealed a wide range of practices among the surveyed hospitals. Major differences were noted in the neonatal period definition, pre-transfusion compatibility procedures, and platelet transfusion protocols. All hospitals provided leukodepleted packed red blood cells (pRBCs), with differences in availability of autologous blood and reconstituted whole blood. Irradiated blood components were universally accessible, with differences in post-irradiation acceptable storage time. Additionally, differences in dosages for packed red blood cells (pRBCs) and platelet concentrates (PCs) were observed across hospitals.

Conclusions: Standardized guidelines for pediatric transfusion practices within Italian blood banks are of paramount importance. The observed variability underscores the necessity for sharing best practices among centers supplying blood components to pediatric patients.

Background: Current national and international guidelines (Italian Bone Marrow Donor Registry [IBMDR], World Marrow Donor Association [WMDA] standards) provide an indication for preoperative autologous blood donation (PAD) only in adult family and volunteer non-family donors in anticipation of bone marrow (BM) hematopoietic stem cell (HSC) donation to avoid the use of homologous transfusions. In addition, there is no clear guidance from the relevant scientific societies regarding pediatric and adolescent donors.

Material and methods: To assess the actual use of PAD in pediatric (up to 14 years) and adolescent (aged 15-18 years) family donors in relation to BM HSC donation in the five years 2017-2021, a specific online questionnaire was administered to blood establishments and clinical units of pediatric transplantation programs responsible for BM HSC collection.

Results: Adherence to the project was 100% (18/18 centers). During the five-year period considered, 273 BM HSC donors (205 pediatric and 68 adolescent) were registered. Forty percent of the non-trait carrier donors who underwent PAD received iron therapy in preparation for BM HSC donation; only 4.8% of the pediatric and none of the adolescents had hemoglobin values below the age limit at donation. Finally, 66.4% of pediatric donors and 15.4% of non-trait carrier adolescent donors who did not undergo PAD received homologous transfusions during BM harvest.

Discussion: The present study highlights the highly heterogeneous criteria for the use of PAD (including calculating of the volume of whole blood collected) and the lack of a specific policy in preparation for BM HSC donation, either from non-trait carrier donors or those with sickle cell or thalassemia trait, both pediatric and adolescent.