Transfusion and Apheresis Science最新文献

Measurement uncertainty (MU) is increasingly recognized as a critical analytical parameter within ISO and European regulatory frameworks. In transfusion laboratories, where hemoglobin testing determines donor eligibility and informs transfusion decisions, MU directly impacts patient and donor safety. This study applies ISO/TS 20914:2019 to estimate MU in hemoglobin testing using the cyanmethemoglobin method in EDTA-K3 venous blood. A parametric simulation model informed by EFLM biological variation data was used to evaluate three scenarios: (1) within-laboratory imprecision, (2) addition of calibrator uncertainty, and (3) incorporation of significant bias uncertainty. All scenarios met desirable (2.7 %) and minimum (4.1 %) performance targets for allowable uncertainty. These findings reinforce the integration of MU estimation as a European and ISO-endorsed best practice in transfusion laboratory medicine. This approach supports traceable, risk-informed decision-making, aligning transfusion services with ISO 15189:2022 requirements.

Apheresis, the selective removal or collection of blood components, has become an essential pillar of modern transfusion medicine, serving both donor and therapeutic purposes. While high-income countries have achieved wide adoption of automated apheresis for component collection and disease management, its use in Africa, including Ethiopia, remains limited. In Ethiopia, apheresis services are confined to a few facilities within the Ethiopian Blood and Tissue Bank Service (EBTBS) and select private institutions. Key challenges include inadequate infrastructure, unreliable supply chains, a shortage of trained personnel, the absence of national standards, and inadequate reimbursement mechanisms. Equipment maintenance difficulties, inconsistent power supply, and low clinical awareness further restrict utilization. Despite these constraints, significant opportunities are emerging. Ongoing national policy and institutional reforms, expanding healthcare investments, and integration with organ transplantation and regenerative medicine programs provide a strong foundation for scaling up services. Regional and international partnerships with organizations such as the World Health Organization, African Society of Blood Transfusion, and International Society of Blood Transfusion, along with advancements in digital health and research, can enhance capacity, traceability, and quality. Expanding apheresis capacity in Ethiopia presents a strategic opportunity to strengthen transfusion medicine, improve clinical outcomes, and build a resilient and sustainable blood system aligned with global standards.

The transfusion of ABO compatible but not ABO identical red blood cells and plasma and the transfusion of platelets and cryoprecipitate without concern for ABO in any manner, are practices that have been accepted as safe for patients. While these practices make managing blood component inventories easier by reducing component outdating, they do lead to the development of immune complexes, donor antibody induced hemolysis, and potentially endothelial cell and platelet injury. A growing body of evidence has shown that these practices are associated, likely causally, with negative consequences for patients including increased mortality. The adoption of a policy of providing only ABO identical blood components when practical, and avoiding infusion of ABO incompatible antibody, cellular and soluble antigen should thus become the optimal standard of care for patients.

Maintaining an adequate platelet supply in the United States (US) has become increasingly challenging due to stringent regulatory requirements, diminishing donor availability, and expanding clinical demand. Current US regulations require a minimum apheresis platelet yield of 3.0 × 10 ¹ ¹ per unit, a standard substantially higher than those used internationally. Implementation of bacterial risk mitigation strategies has further increased the proportion of plateletpheresis collections falling below this threshold, resulting in low-yield platelet units becoming a structurally important component of the national inventory. Analysis of US platelet utilization from 2022 to 2024 demonstrates that despite persistent supply pressures, the proportion of low-yield units remained relatively stable, while dividing of platelet units declined. Evidence from clinical studies indicates that low-yield platelets provide hemostatic efficacy comparable to standard-yield components in thrombocytopenic patients with marrow failure. However, single-center observations suggest an increase in overall platelet utilization when lower-yield units represent a larger proportion of available inventory, highlighting the influence of transfusion practices on product demand. Given ongoing supply constraints, the established availability of low-yield components, and international experience demonstrating safe use at lower minimum thresholds, reconsideration of the current US minimum plateletpheresis yield requirement is warranted. Harmonizing regulatory standards with global practice has the potential to enhance platelet availability, reduce donor burden, and strengthen national supply resilience without compromising patient safety. Further studies are needed to assess outcomes across diverse patient populations.

Background: Data on apheresis services in Africa are limited, despite increasing clinical demand and persistently low blood donation rates across the continent. This study assessed the current availability, use, and challenges of donor and clinical apheresis services in African countries.

Methods: A structured electronic survey was distributed in 2025 to transfusion services and relevant stakeholders in all 54 African countries. Contacts were identified through online searches and professional networks. Responses were analyzed to determine the status of apheresis practices.

Results: Contacts were obtained for 38 countries, and 12 responded (32 %). Donor platelet and plasma apheresis were performed in 67 % and 50 % of responding countries, with all others planning implementation. Reported challenges included limited trained staff, equipment breakdowns, consumable shortages, donor recruitment difficulties, and financial constraints. Clinical apheresis services were available in 50 % of responding countries, while CD34⁺ cell collection was reported only in Senegal and South Africa. Key barriers included high costs, inadequate infrastructure, shortages of consumables, and limited clinician awareness.

Conclusions: Apheresis services are emerging across Africa but remain constrained by financial, technical, and personnel limitations. Investments in infrastructure, training, and service sustainability are essential to expand access to both donor and clinical apheresis.

Introduction: The history of transfusion medicine is vast and diverse. From its humble beginnings with animal-to-animal transfusions, followed by animal-to-human transfusions, and the first human-to-human transfusions, through the discovery of blood groups to today's highly developed quality systems, it has proven to be an important and independent field of medicine that supports other medical specialties such as surgery, transplantation, and trauma. Each period of this fascinating history is significant, with experts who worked to improve and find new ways to ensure the safe supply of blood to patients.Transfusion medicine continues to evolve, aiming to achieve the highest quality standards and foster new developments and discoveries. Its primary goal is to maintain a safe, uncontaminated supply of blood, blood components, and blood products through a sufficient number of healthy blood donors. The purpose of this article is to present the most important highlights in transfusion medicine.

Methods: This study is based on a review of literature and historical documents from the 15th to the 21st century.

Conclusion: The history of transfusion medicine is fascinating and essential for understanding the background of this noble and important field of medicine.