Nittin Henry, C. Nirmal, Anu Pullangodan, KAjay Raj, VJ Arun
Background and Objectives: An ideal model for the foundation of a safe blood supply is a committed group of healthy, altruistic voluntary blood donors (VBDs) recruited by a well-organized, dynamic VBD organization (VBDO). We address the data deficiency on VBDOs in strengthening the voluntary blood donation program. The aims of the study are to assess the part played by VBDO in strengthening VBDs, regular repeat blood donor (RRBD), and regular repeat VBD (RRVBD), classifying the VBDOs on their functional realm, and analyzing the variables affecting blood donations based on their association with VBDOs. Methods: This was a cross-sectional observational study from September 2019 to December 2019. All donors provided a questionnaire in “Google Forms” with a consent form through social media. Modified Kuppuswamy score 2019 was used to classify donors based on occupation, education, and socioeconomic classification (SEC). Pearson's Chi-square test was used for statistical analysis. Results: Eight hundred and thirty-four responses were obtained from 960 donors. 78.7% responses belonged to VBDs, 62.6% belonged to donors not associated with VBDOs and there was no statistically sifnificant difference between VBDs and replacement donors based on their association with VBDOs. 46.9% and 55.6% of VBDO donors are RRBD and vice versa, respectively, showing statistical significance. Majority of RRVBDs, i.e., 97 (52.2%), belong to VBDO showing statistical significance. Site of donation and gender showed statistical significance unlike age, education, occupation, and SEC. 61.25% of VBDO donors were associated with nongovernmental organizations. Conclusions: VBDOs contribute more toward the regularity of donation rather than donating blood voluntarily and retaining blood donors.
{"title":"Contributions of voluntary blood donor organizations to voluntary blood donation","authors":"Nittin Henry, C. Nirmal, Anu Pullangodan, KAjay Raj, VJ Arun","doi":"10.4103/gjtm.gjtm_90_22","DOIUrl":"https://doi.org/10.4103/gjtm.gjtm_90_22","url":null,"abstract":"Background and Objectives: An ideal model for the foundation of a safe blood supply is a committed group of healthy, altruistic voluntary blood donors (VBDs) recruited by a well-organized, dynamic VBD organization (VBDO). We address the data deficiency on VBDOs in strengthening the voluntary blood donation program. The aims of the study are to assess the part played by VBDO in strengthening VBDs, regular repeat blood donor (RRBD), and regular repeat VBD (RRVBD), classifying the VBDOs on their functional realm, and analyzing the variables affecting blood donations based on their association with VBDOs. Methods: This was a cross-sectional observational study from September 2019 to December 2019. All donors provided a questionnaire in “Google Forms” with a consent form through social media. Modified Kuppuswamy score 2019 was used to classify donors based on occupation, education, and socioeconomic classification (SEC). Pearson's Chi-square test was used for statistical analysis. Results: Eight hundred and thirty-four responses were obtained from 960 donors. 78.7% responses belonged to VBDs, 62.6% belonged to donors not associated with VBDOs and there was no statistically sifnificant difference between VBDs and replacement donors based on their association with VBDOs. 46.9% and 55.6% of VBDO donors are RRBD and vice versa, respectively, showing statistical significance. Majority of RRVBDs, i.e., 97 (52.2%), belong to VBDO showing statistical significance. Site of donation and gender showed statistical significance unlike age, education, occupation, and SEC. 61.25% of VBDO donors were associated with nongovernmental organizations. Conclusions: VBDOs contribute more toward the regularity of donation rather than donating blood voluntarily and retaining blood donors.","PeriodicalId":52961,"journal":{"name":"Global Journal of Transfusion Medicine","volume":"2022 1","pages":"125 - 128"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139364693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Akshaya Tomar, N. Kushwaha, B. Asthana, Sudeep Kumar, Sanjeevan Sharma
Background and Objectives: Transfusion of stored, packed red blood cells (PRBCs) is a common therapeutic intervention; however, development of hemolysis during storage might contributes to some negative consequences due to the release of free hemoglobin (fHb), a potent nitric oxide scavenger, which may impair vasodilation and microcirculatory perfusion after transfusion. We undertook this study to find out the change in fHb levels in recipients, whether this affects microvascular oxygenation posttransfusion. Methods: Eighty stable transfusion recipients were selected for this prospective observational study and were divided into three groups as per the age of blood transfused (<7 days, 7–14 days, and >14 days). Blood samples were collected to analyze the plasma levels of fHb in the bag. The patient's circulating plasma Hb (FHb) and pO2 by venous blood gas analysis were studied before and after 1 h of transfusion. Data were analyzed through paired t-test, ANOVA, and Pearson's correlation coefficient using the SPSS version 23. Results: Overall, there was a significant difference between the three groups in terms of change in plasma fHb (g/dL) from pretransfusion to the 1 h posttransfusion time points (P < 0.05). Significant increase in pO2 Levels was noticed from the pretransfusion to 1 h posttransfusion time points in bags <7 days old (t = −4.6, P < 0.001). Furthermore, a strong negative correlation was obtained between FHb and pO2 using Pearson's correlation coefficient (r = −0.738; P < 0.001). Conclusion: This study concludes that red blood cell transfusion can significantly increase posttransfusion plasma Hb levels depending upon the age of PRBC units and has an implication on microvascular oxygenation. However, the effect on the clinical outcome of the patient was not studied, and it would be worthwhile to investigate whether the age of the blood transfused affects the patient morbidity or mortality.
{"title":"Blood transfusion-related change in circulating plasma-free hemoglobin levels and its impact on microvascular oxygenation: A prospective, observational study","authors":"Akshaya Tomar, N. Kushwaha, B. Asthana, Sudeep Kumar, Sanjeevan Sharma","doi":"10.4103/gjtm.gjtm_89_22","DOIUrl":"https://doi.org/10.4103/gjtm.gjtm_89_22","url":null,"abstract":"Background and Objectives: Transfusion of stored, packed red blood cells (PRBCs) is a common therapeutic intervention; however, development of hemolysis during storage might contributes to some negative consequences due to the release of free hemoglobin (fHb), a potent nitric oxide scavenger, which may impair vasodilation and microcirculatory perfusion after transfusion. We undertook this study to find out the change in fHb levels in recipients, whether this affects microvascular oxygenation posttransfusion. Methods: Eighty stable transfusion recipients were selected for this prospective observational study and were divided into three groups as per the age of blood transfused (<7 days, 7–14 days, and >14 days). Blood samples were collected to analyze the plasma levels of fHb in the bag. The patient's circulating plasma Hb (FHb) and pO2 by venous blood gas analysis were studied before and after 1 h of transfusion. Data were analyzed through paired t-test, ANOVA, and Pearson's correlation coefficient using the SPSS version 23. Results: Overall, there was a significant difference between the three groups in terms of change in plasma fHb (g/dL) from pretransfusion to the 1 h posttransfusion time points (P < 0.05). Significant increase in pO2 Levels was noticed from the pretransfusion to 1 h posttransfusion time points in bags <7 days old (t = −4.6, P < 0.001). Furthermore, a strong negative correlation was obtained between FHb and pO2 using Pearson's correlation coefficient (r = −0.738; P < 0.001). Conclusion: This study concludes that red blood cell transfusion can significantly increase posttransfusion plasma Hb levels depending upon the age of PRBC units and has an implication on microvascular oxygenation. However, the effect on the clinical outcome of the patient was not studied, and it would be worthwhile to investigate whether the age of the blood transfused affects the patient morbidity or mortality.","PeriodicalId":52961,"journal":{"name":"Global Journal of Transfusion Medicine","volume":"435 1","pages":"139 - 145"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139366245","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
H. Qanoon, R. Makhdoomi, Zaffar Shah, Rafiqa Eachkoti, Reshma Roshan
Background and Objectives: We aimed to analyze the impact of prestorage Inline leukodepletion and storage time on interleukin 8 (IL-8) levels in stored buffy coat-depleted packed red blood cell (PRBC) units in the Kashmiri population setting. Methods: A total of 50 donors of Kashmiri origin from North India equally and randomly distributed between Leukodepleted (LD) and non-LD (NLD) arms were recruited in this study. Leukodepletion of PRBCs units was performed using 3rd Generation integrated LD filters and the residual white blood cell (WBC) count was enumerated by FACS using fluorochrome-tagged CD45+ antibodies and IL-8 levels measured by ELISA. Results: In contrast to NLD arm, leukodepletion in the LD arm significantly reduced total leukocyte count (TLC) from pre-LD TLC of 2.25 ± 0.47 × 109/PRBC unit to post LD cell count of 2.40 ± 0.65 × 106/PRBC unit, P = 0.001, i.e., 3 log reduction, P = 0.0001. Contrary to the LD arm, a significant difference in IL-8 levels in NLD arm was observed with 27.15 ± 30.32 pg/mL on day 0, 45.15 ± 36.15 pg/mL on day 14, and on day 28, 37.98 ± 33.05 pg/mL. Furthermore, significant variance (LD vs. NLD) in IL-8 levels was observed at day 0, 14th, and 28th day of storage, with maximum variance observed on day 14th Fstat = 21.46, P = 0.00, depicting prestorage LD have a significant role in suppressing the IL-8 levels in LD stored PRBC units while as in NLD PRBC units with time IL-8 accumulated as its cell source (WBCs) was intact. Conclusion: Inline prestorage leukodepletion by 3rd generation LD filters was uniformly effective in reducing the residual WBC count to desired levels of <5 × 106/unit of PRBC. The significant decrease in TLC and resultant far less accumulation of cytokine (IL-8) in prestorage LD PRBC units of Kashmiri origin, as observed in this study, would be translated into clinical benefits associated with transfusion of LD-PRBC units.
{"title":"Prestorage inline leukodepletion of buffy coat-depleted packed red blood cells: Comparative analysis of white blood cell count and interleukin-8 between leukodepleted and nonleukodepleted packed red blood cells","authors":"H. Qanoon, R. Makhdoomi, Zaffar Shah, Rafiqa Eachkoti, Reshma Roshan","doi":"10.4103/gjtm.gjtm_9_23","DOIUrl":"https://doi.org/10.4103/gjtm.gjtm_9_23","url":null,"abstract":"Background and Objectives: We aimed to analyze the impact of prestorage Inline leukodepletion and storage time on interleukin 8 (IL-8) levels in stored buffy coat-depleted packed red blood cell (PRBC) units in the Kashmiri population setting. Methods: A total of 50 donors of Kashmiri origin from North India equally and randomly distributed between Leukodepleted (LD) and non-LD (NLD) arms were recruited in this study. Leukodepletion of PRBCs units was performed using 3rd Generation integrated LD filters and the residual white blood cell (WBC) count was enumerated by FACS using fluorochrome-tagged CD45+ antibodies and IL-8 levels measured by ELISA. Results: In contrast to NLD arm, leukodepletion in the LD arm significantly reduced total leukocyte count (TLC) from pre-LD TLC of 2.25 ± 0.47 × 109/PRBC unit to post LD cell count of 2.40 ± 0.65 × 106/PRBC unit, P = 0.001, i.e., 3 log reduction, P = 0.0001. Contrary to the LD arm, a significant difference in IL-8 levels in NLD arm was observed with 27.15 ± 30.32 pg/mL on day 0, 45.15 ± 36.15 pg/mL on day 14, and on day 28, 37.98 ± 33.05 pg/mL. Furthermore, significant variance (LD vs. NLD) in IL-8 levels was observed at day 0, 14th, and 28th day of storage, with maximum variance observed on day 14th Fstat = 21.46, P = 0.00, depicting prestorage LD have a significant role in suppressing the IL-8 levels in LD stored PRBC units while as in NLD PRBC units with time IL-8 accumulated as its cell source (WBCs) was intact. Conclusion: Inline prestorage leukodepletion by 3rd generation LD filters was uniformly effective in reducing the residual WBC count to desired levels of <5 × 106/unit of PRBC. The significant decrease in TLC and resultant far less accumulation of cytokine (IL-8) in prestorage LD PRBC units of Kashmiri origin, as observed in this study, would be translated into clinical benefits associated with transfusion of LD-PRBC units.","PeriodicalId":52961,"journal":{"name":"Global Journal of Transfusion Medicine","volume":"59 1","pages":"118 - 124"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139365832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Amit Biswas, Anurag Gairola, AjayKumar Baranwal, Rajat Jagani, Amit Pawar, U. Dimri
Daratumumab (DARA) is an anti-CD38 monoclonal antibody which has promising results in relapsed and refractory multiple myeloma (RRMM). DARA interferes with blood compatibility testing by causing incompatible results while crossmatching by antihuman globulin phase and presenting as a panagglutination picture in the indirect antiglobulin test. Immunohematology workup must be done to rule out allo- or autoantibody and to issue compatible unit to the patient as transfusion support is vital for all these patients and must not be delayed. Here, we present a case report of one such patient who was undergoing treatment with DARA for RRMM and had incompatibility found during crossmatching. Out of the available methods to resolve this problem, we utilized the treatment of red cells with 2-mercaptoethanol at our blood center which was effective, time saving, feasible, and less resource demanding. During the progressive course of disease, our patient required transfusion on a regular basis, and we were able to provide compatible units on each instance utilizing the same technique.
Daratumumab（DARA）是一种抗CD38单克隆抗体，在复发性和难治性多发性骨髓瘤（RRMM）中疗效显著。达拉单抗会干扰血液相容性检测，在抗人球蛋白相交叉配血时导致不相容结果，在间接抗球蛋白检测中表现为泛凝集现象。必须进行免疫血液学检查以排除同种异体或自身抗体，并为患者提供相容单位，因为输血支持对所有这些患者都至关重要，绝不能延误。在此，我们报告了一例此类患者的病例，该患者正在接受 DARA 治疗 RRMM，但在交叉配血时发现了不相容的情况。在解决这一问题的现有方法中，我们血液中心采用了用2-巯基乙醇处理红细胞的方法，这种方法有效、省时、可行，对资源的需求也较少。在疾病进展过程中，我们的病人需要定期输血，而我们每次都能利用同样的技术提供相容的单位。
{"title":"Daratumumab: A drug with transfusion dilemma","authors":"Amit Biswas, Anurag Gairola, AjayKumar Baranwal, Rajat Jagani, Amit Pawar, U. Dimri","doi":"10.4103/gjtm.gjtm_36_23","DOIUrl":"https://doi.org/10.4103/gjtm.gjtm_36_23","url":null,"abstract":"Daratumumab (DARA) is an anti-CD38 monoclonal antibody which has promising results in relapsed and refractory multiple myeloma (RRMM). DARA interferes with blood compatibility testing by causing incompatible results while crossmatching by antihuman globulin phase and presenting as a panagglutination picture in the indirect antiglobulin test. Immunohematology workup must be done to rule out allo- or autoantibody and to issue compatible unit to the patient as transfusion support is vital for all these patients and must not be delayed. Here, we present a case report of one such patient who was undergoing treatment with DARA for RRMM and had incompatibility found during crossmatching. Out of the available methods to resolve this problem, we utilized the treatment of red cells with 2-mercaptoethanol at our blood center which was effective, time saving, feasible, and less resource demanding. During the progressive course of disease, our patient required transfusion on a regular basis, and we were able to provide compatible units on each instance utilizing the same technique.","PeriodicalId":52961,"journal":{"name":"Global Journal of Transfusion Medicine","volume":"58 1","pages":"222 - 226"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139365389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Valathuparambil Fathima, M. Murugesan, Radhakrishna Anju
Background and Objectives: Acute hemolytic transfusion reactions (HTRs) one of the serious adverse events manifesting within 24 h of blood transfusion. To review the adverse transfusion reactions in our cancer center over a 1-year period, especially HTR and its causation to find the ways of mitigating the same. Methods: This was a retrospective analysis of HTR in tertiary care cancer center from South India. Patients who developed HTR in 2022 were included for discussion. Results: A total of six HTRs observed in five patients during 1 year. Case 1 was an acute presentation of HTR due to Anti Jka antibody. Case 2 was a nonimmune HTR associated with leukodepleted irradiated packed red blood cells transfusion. Case 3 was an incidental finding of passive hemolysis due to ABO incompatible platelet transfusion in patient clinically manifesting febrile and transfusion-associated dyspnea. Case 4 presented as an HTR with inconclusive evidence suggestive of HTR, with an impression of hemolysis as a part of the underlying disease. Conclusion: While the incidence of HTR due to ABO-incompatible transfusion reactions has been minimized, the other potential causes for acute HTR are still a concern. An effective hemovigiliance and strict adherence to standards in blood component practice may help to mitigate any form of transfusion reaction.
{"title":"Spectrum of hemolytic transfusion reactions from tertiary cancer center over a 1-year period","authors":"Valathuparambil Fathima, M. Murugesan, Radhakrishna Anju","doi":"10.4103/gjtm.gjtm_21_23","DOIUrl":"https://doi.org/10.4103/gjtm.gjtm_21_23","url":null,"abstract":"Background and Objectives: Acute hemolytic transfusion reactions (HTRs) one of the serious adverse events manifesting within 24 h of blood transfusion. To review the adverse transfusion reactions in our cancer center over a 1-year period, especially HTR and its causation to find the ways of mitigating the same. Methods: This was a retrospective analysis of HTR in tertiary care cancer center from South India. Patients who developed HTR in 2022 were included for discussion. Results: A total of six HTRs observed in five patients during 1 year. Case 1 was an acute presentation of HTR due to Anti Jka antibody. Case 2 was a nonimmune HTR associated with leukodepleted irradiated packed red blood cells transfusion. Case 3 was an incidental finding of passive hemolysis due to ABO incompatible platelet transfusion in patient clinically manifesting febrile and transfusion-associated dyspnea. Case 4 presented as an HTR with inconclusive evidence suggestive of HTR, with an impression of hemolysis as a part of the underlying disease. Conclusion: While the incidence of HTR due to ABO-incompatible transfusion reactions has been minimized, the other potential causes for acute HTR are still a concern. An effective hemovigiliance and strict adherence to standards in blood component practice may help to mitigate any form of transfusion reaction.","PeriodicalId":52961,"journal":{"name":"Global Journal of Transfusion Medicine","volume":"6 1","pages":"197 - 201"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139365562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background and Objectives: Periodical internal audits evaluate the process flow of transfusion which arrests the spectrum of adverse events .The objective of the study was to provide evidence that blood is being ordered, handled, and administered according to transfusion guidelines and to highlight the deviations with the secondary objective of improving knowledge and practices in nursing officers. Methods: Nursing officers were audited on 50 patients each in P1 and P2 phase. Training of 243 nursing staff was done after P1 phase. Training comprised education and interventions over 45 days – 18 didactic lectures and 36 bedside classes. Nurses were audited both before and after the completion of the training. Results: One hundred and forty-five nurses had knowledge and practice score in between 11 and 15 in P1 which improved to 243 (100%) in P2. Transfusion order for one patient was not written in P1, whereas 100% compliance was seen in P2. Noncompliance in taking consent for transfusion improved from 5 to 1 in P2. Blood request error and sample labeling error reduced from 8% to 0% and 4% to 0%, respectively, in P2. Sample labeling was inappropriate in 2 patients in P1 which improved to nil in P2. Checking of vital signs check and intravenous cannula patency improved from 96% to 98%. Crosscheck of packed red blood cell nursing officers before transfusion reduced from 8% to 0% and from 30% to 2% among medical officer (P < 0.05). Delay in the initiation of transfusion, reduced from 7 to 2 patients. Conclusion: Timely audit of transfusion practices reduces mistakes and errors hence improved patient care.
{"title":"Prospective audit of blood transfusion practices among nurses and role of education and intervention at a tertiary care hospital","authors":"Nippun Prinja, Sarabjeet Kaur, Jyothi Matthews, Priyanka Nagrath, Lokesh Pal, Girja Sharma, Archana Bajaj","doi":"10.4103/gjtm.gjtm_35_23","DOIUrl":"https://doi.org/10.4103/gjtm.gjtm_35_23","url":null,"abstract":"Background and Objectives: Periodical internal audits evaluate the process flow of transfusion which arrests the spectrum of adverse events .The objective of the study was to provide evidence that blood is being ordered, handled, and administered according to transfusion guidelines and to highlight the deviations with the secondary objective of improving knowledge and practices in nursing officers. Methods: Nursing officers were audited on 50 patients each in P1 and P2 phase. Training of 243 nursing staff was done after P1 phase. Training comprised education and interventions over 45 days – 18 didactic lectures and 36 bedside classes. Nurses were audited both before and after the completion of the training. Results: One hundred and forty-five nurses had knowledge and practice score in between 11 and 15 in P1 which improved to 243 (100%) in P2. Transfusion order for one patient was not written in P1, whereas 100% compliance was seen in P2. Noncompliance in taking consent for transfusion improved from 5 to 1 in P2. Blood request error and sample labeling error reduced from 8% to 0% and 4% to 0%, respectively, in P2. Sample labeling was inappropriate in 2 patients in P1 which improved to nil in P2. Checking of vital signs check and intravenous cannula patency improved from 96% to 98%. Crosscheck of packed red blood cell nursing officers before transfusion reduced from 8% to 0% and from 30% to 2% among medical officer (P < 0.05). Delay in the initiation of transfusion, reduced from 7 to 2 patients. Conclusion: Timely audit of transfusion practices reduces mistakes and errors hence improved patient care.","PeriodicalId":52961,"journal":{"name":"Global Journal of Transfusion Medicine","volume":"39 1","pages":"163 - 168"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139365969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background and Objectives: The anti-A and anti-B are naturally occurring antibodies in the human body but alloantibodies may be formed in individuals who lacks that corresponding red cell antigen after any sensitising event like blood transfusion or pregnancy. The aim of this study was to find the incidence of evanescenct RBC alloantibodies that may not be detectable at the time of pre-transfusion screening. Methods: This was a retrospective observational study from January 2017 to May 2019 in a tertiary care centre from North India. The data on antibody screening and identification retrieved from the departmental records. The patients were screened for red blood cell antibody and those with a positive screening test were further investigated for antibody identification. Antibody screening was performed by solid phase method using Immucor Capture-R Ready Screen (4 cell). Confirmed positive samples were investigated with advance methods of Antibody ID using Reagent panel Red Blood Cells Capture-R Ready ID (16 Cell) in Automated Analyzer Iris or Neo (Immucor Inc. Nocross, GA, USA). As and when required other advance techniques of adsorption and elution, etc were also performed too. Results: The total number of patient screened during this period were 8071. Amongst them 312 were positive for antibody screening (3.8%), of those 216 (62.9%) cases had alloantibodies and 96 (30.7%) cases had autoantibodies. Among the 216 cases of alloantibody, 147 (68.1%) cases had single alloantibody and 69 (31.9%) cases had multiple alloantibodies. Amongst the patients having single alloantibody, the prevalence was highest for Anti-D 54 (36.7%), followed by Anti-E 27 (18.3%), Anti-C 8 (5.4%), Anti-c 7 (4.7%), Anti-K 9 (6.1%), Anti-Fyb 11 (7.4%), Anti-M 18 (12.2%), Anti-N 4 (2.7%), Anti-Fyb 3 (2%), Anti-Lea 3 (2%), Anti-Cw 2 (1.3%) and Anti-Mia 1 (0.6%). Of the 96 patients with autoantibody 72 had warm autoantibody, 10 had cold autoantibody and there were 8 cases of mixed warm and cold autoantibodies. There were 6 patients with warm autoantibody with underlying alloantibody. Conclusion: In conclusion, the high prevalence of Anti-Rh (Anti-D, E), Anti-M, Anti-Fyb antibodies in patient requiring transfusion reiterates the importance of stringent antibody screening and identification as an essential step in preventing delayed hemolytic transfusion reaction.
{"title":"The incidence of evanescent antibodies to red blood cell antigens in a tertiary care hospital in Northern India","authors":"Sourav Chowdhury, M. Chowdhry","doi":"10.4103/gjtm.gjtm_56_23","DOIUrl":"https://doi.org/10.4103/gjtm.gjtm_56_23","url":null,"abstract":"Background and Objectives: The anti-A and anti-B are naturally occurring antibodies in the human body but alloantibodies may be formed in individuals who lacks that corresponding red cell antigen after any sensitising event like blood transfusion or pregnancy. The aim of this study was to find the incidence of evanescenct RBC alloantibodies that may not be detectable at the time of pre-transfusion screening. Methods: This was a retrospective observational study from January 2017 to May 2019 in a tertiary care centre from North India. The data on antibody screening and identification retrieved from the departmental records. The patients were screened for red blood cell antibody and those with a positive screening test were further investigated for antibody identification. Antibody screening was performed by solid phase method using Immucor Capture-R Ready Screen (4 cell). Confirmed positive samples were investigated with advance methods of Antibody ID using Reagent panel Red Blood Cells Capture-R Ready ID (16 Cell) in Automated Analyzer Iris or Neo (Immucor Inc. Nocross, GA, USA). As and when required other advance techniques of adsorption and elution, etc were also performed too. Results: The total number of patient screened during this period were 8071. Amongst them 312 were positive for antibody screening (3.8%), of those 216 (62.9%) cases had alloantibodies and 96 (30.7%) cases had autoantibodies. Among the 216 cases of alloantibody, 147 (68.1%) cases had single alloantibody and 69 (31.9%) cases had multiple alloantibodies. Amongst the patients having single alloantibody, the prevalence was highest for Anti-D 54 (36.7%), followed by Anti-E 27 (18.3%), Anti-C 8 (5.4%), Anti-c 7 (4.7%), Anti-K 9 (6.1%), Anti-Fyb 11 (7.4%), Anti-M 18 (12.2%), Anti-N 4 (2.7%), Anti-Fyb 3 (2%), Anti-Lea 3 (2%), Anti-Cw 2 (1.3%) and Anti-Mia 1 (0.6%). Of the 96 patients with autoantibody 72 had warm autoantibody, 10 had cold autoantibody and there were 8 cases of mixed warm and cold autoantibodies. There were 6 patients with warm autoantibody with underlying alloantibody. Conclusion: In conclusion, the high prevalence of Anti-Rh (Anti-D, E), Anti-M, Anti-Fyb antibodies in patient requiring transfusion reiterates the importance of stringent antibody screening and identification as an essential step in preventing delayed hemolytic transfusion reaction.","PeriodicalId":52961,"journal":{"name":"Global Journal of Transfusion Medicine","volume":"71 1","pages":"152 - 155"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139366210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Mangwana, Gaurav Dixit, Christina Celluzzi, Wanxing Cui, Asawari Bapat
Background: Neutrophil granulocytes are essential components of innate immune response. An absolute number of neutrophils are a fundamental indicator of host defense. With increasing severity of neutropenia, either due to the disease or as a result of chemotherapy for hematologic malignancies, there is an exponential increase in the risk of severe infection. In such conditions, granulocyte transfusion is considered a potential therapeutic option due to its phagocytic properties. The study was undertaken to analyze data of granulocyte collections and transfusions in resource-constrained Settings. Methods: In this observational prospective study, granulocytes were harvested by combined administration of granulocyte colony-stimulating factors and dexamethasone mobilization and transfused to severely neutropenic patients. Data on granulocyte collections and transfusion, various determinants of donor, and procedural characteristics and patient outcomes, with respect to 30-day mortality, were analyzed. Results: After granulocyte transfusion, patients' posttransfusion white blood cell and neutrophils increased significantly. Higher platelet counts in the harvested products resulted into significant increment of patients' platelet count and markedly reduced demands of platelet transfusions, reducing chances of alloimmunization. Eighty-five percent of patients could be saved, showed improvements in their clinical conditions, and were discharged from hospital in stable condition. Conclusion: Granulocyte transfusions are an important therapeutic modality in neutropenic patients with resistant infections, until spontaneous recovery of neutrophil count occurs in patients. Cost Reduction of some of the resources should be considered for LMIC as lower price will encourage more facilities willing to offer similar procedures to aid patients. Training workforce for new and novel processes is need of hour and will add value by equipping LMIC facilities in serving the patients. Granulocyte transfusions are life-saving tool and found to be safe and well tolerated by recipients. They can play a vital role in improving outcomes and saving patients in resource-constraint countries, where there is increasing emergence of multidrug-resistant bacterial infections.
{"title":"Experience of granulocyte collections and transfusions in resource-constrained settings","authors":"S. Mangwana, Gaurav Dixit, Christina Celluzzi, Wanxing Cui, Asawari Bapat","doi":"10.4103/gjtm.gjtm_33_23","DOIUrl":"https://doi.org/10.4103/gjtm.gjtm_33_23","url":null,"abstract":"Background: Neutrophil granulocytes are essential components of innate immune response. An absolute number of neutrophils are a fundamental indicator of host defense. With increasing severity of neutropenia, either due to the disease or as a result of chemotherapy for hematologic malignancies, there is an exponential increase in the risk of severe infection. In such conditions, granulocyte transfusion is considered a potential therapeutic option due to its phagocytic properties. The study was undertaken to analyze data of granulocyte collections and transfusions in resource-constrained Settings. Methods: In this observational prospective study, granulocytes were harvested by combined administration of granulocyte colony-stimulating factors and dexamethasone mobilization and transfused to severely neutropenic patients. Data on granulocyte collections and transfusion, various determinants of donor, and procedural characteristics and patient outcomes, with respect to 30-day mortality, were analyzed. Results: After granulocyte transfusion, patients' posttransfusion white blood cell and neutrophils increased significantly. Higher platelet counts in the harvested products resulted into significant increment of patients' platelet count and markedly reduced demands of platelet transfusions, reducing chances of alloimmunization. Eighty-five percent of patients could be saved, showed improvements in their clinical conditions, and were discharged from hospital in stable condition. Conclusion: Granulocyte transfusions are an important therapeutic modality in neutropenic patients with resistant infections, until spontaneous recovery of neutrophil count occurs in patients. Cost Reduction of some of the resources should be considered for LMIC as lower price will encourage more facilities willing to offer similar procedures to aid patients. Training workforce for new and novel processes is need of hour and will add value by equipping LMIC facilities in serving the patients. Granulocyte transfusions are life-saving tool and found to be safe and well tolerated by recipients. They can play a vital role in improving outcomes and saving patients in resource-constraint countries, where there is increasing emergence of multidrug-resistant bacterial infections.","PeriodicalId":52961,"journal":{"name":"Global Journal of Transfusion Medicine","volume":"19 1","pages":"215 - 221"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139364545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hypotensive transfusion reaction is a distinct category of adverse sequelae of transfusion characterized by an early and abrupt onset of hypotension, typically resolving promptly upon discontinuation of the transfusion. The primary mechanism behind this reaction seems to be the accumulation of bradykinin in the transfused blood product during processing. The authors wish to highlight a case of isolated hypotensive reaction following administration of leukoreduced platelets in an Indian male patient, which required vasopressors. Awareness of the risk factors and clinical presentation for this type of reaction are vital for proper patient care and the prevention of future incidents.
{"title":"Hypotensive transfusion reaction due to leukoreduced platelets","authors":"Ramasubramaniam Natarajan, Rajasekar Arumugam","doi":"10.4103/gjtm.gjtm_42_23","DOIUrl":"https://doi.org/10.4103/gjtm.gjtm_42_23","url":null,"abstract":"Hypotensive transfusion reaction is a distinct category of adverse sequelae of transfusion characterized by an early and abrupt onset of hypotension, typically resolving promptly upon discontinuation of the transfusion. The primary mechanism behind this reaction seems to be the accumulation of bradykinin in the transfused blood product during processing. The authors wish to highlight a case of isolated hypotensive reaction following administration of leukoreduced platelets in an Indian male patient, which required vasopressors. Awareness of the risk factors and clinical presentation for this type of reaction are vital for proper patient care and the prevention of future incidents.","PeriodicalId":52961,"journal":{"name":"Global Journal of Transfusion Medicine","volume":"281 1","pages":"205 - 207"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139365947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Fereshteh Moshfegh, Negar Farahbakhsh, M. Bahraini, Jalil Kardan-Yamchi, A. Fazeli, E. Boluki
Background and Objectives: The procedure of blood ordering is a major issue in hospitals. Hence, maximum surgical blood ordering schedule is recommended to manage the blood application process properly. The aim of this study was to evaluate the demand and rate of blood consumption in different wards of a pediatric hospital. Methods: This is a cross-sectional on patients ≤18 years old who underwent major surgical procedures from 2015 to 2019. Data included type of department, number of total blood bags requested as well as cross-matched and transfused units. Furthermore, indices such as cross-matched to transfusion (Cross-matched to Transfused (C/T) ratio) in various hospital departments and months were calculated. Results: This study revealed that the utilization rate was 77.29% of blood units among a total of 97356 cases done. The emergency department consumed only 28.08% of its requests. C/T ratio for all departments of the hospital was 1.34. The most and lowest numbers of requests were for surgery 2 department and newborn intensive care unit, respectively. Furthermore, we have observed the lowest rate of C/T ratio in December. Conclusions: Our data showed that in the majority of elective pediatric surgical procedures, a large number of blood units tested for antibody screening were consumed, reducing the consumption of cord blood bags as well as the financial burden for the hospital and the patients. Furthermore, our findings revealed that based on the calculated C/T ratio, the hospital used the correct procedure for blood requests in period of 1 year. In addition, the time for preparation of blood was decreased dramatically.
{"title":"Monitoring blood transfusion policies and implementation of maximum surgical blood ordering schedule","authors":"Fereshteh Moshfegh, Negar Farahbakhsh, M. Bahraini, Jalil Kardan-Yamchi, A. Fazeli, E. Boluki","doi":"10.4103/gjtm.gjtm_58_23","DOIUrl":"https://doi.org/10.4103/gjtm.gjtm_58_23","url":null,"abstract":"Background and Objectives: The procedure of blood ordering is a major issue in hospitals. Hence, maximum surgical blood ordering schedule is recommended to manage the blood application process properly. The aim of this study was to evaluate the demand and rate of blood consumption in different wards of a pediatric hospital. Methods: This is a cross-sectional on patients ≤18 years old who underwent major surgical procedures from 2015 to 2019. Data included type of department, number of total blood bags requested as well as cross-matched and transfused units. Furthermore, indices such as cross-matched to transfusion (Cross-matched to Transfused (C/T) ratio) in various hospital departments and months were calculated. Results: This study revealed that the utilization rate was 77.29% of blood units among a total of 97356 cases done. The emergency department consumed only 28.08% of its requests. C/T ratio for all departments of the hospital was 1.34. The most and lowest numbers of requests were for surgery 2 department and newborn intensive care unit, respectively. Furthermore, we have observed the lowest rate of C/T ratio in December. Conclusions: Our data showed that in the majority of elective pediatric surgical procedures, a large number of blood units tested for antibody screening were consumed, reducing the consumption of cord blood bags as well as the financial burden for the hospital and the patients. Furthermore, our findings revealed that based on the calculated C/T ratio, the hospital used the correct procedure for blood requests in period of 1 year. In addition, the time for preparation of blood was decreased dramatically.","PeriodicalId":52961,"journal":{"name":"Global Journal of Transfusion Medicine","volume":"41 1","pages":"146 - 151"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139364770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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