P. Sriraman, S. Noushad, A. Basavarajegowda, D. Sahoo, Rajendra Gurunath Kulkarni, SunilJai Karnesh
Peripheral blood hematopoietic progenitor cell harvest by apheresis in pediatric patients, a double-edged sword, has advantages and disadvantages over conventional bone marrow transplantation. The effect of granulocyte colony-stimulating factor (G-CSF) mobilization on hemostasis in literature is very scarce. A 3-year-old female child with metastatic neuroblastoma planned for autologous transplant. Following G-CSF mobilization (75 mg; 4 days), the procedure was performed with all default parameters in Spectra Optia with an acid citrate dextrose (ACD) flow rate 1:12, assuming 3-total blood volume (TBV) to be processed with 150 ml of expected collection with target yield of 6 × 106 CD34 cells/kg. Despite normal coagulation laboratory parameters, it was abandoned for reasons such as low-flow alarms and thrombi in the kit tubings. In the subsequent procedures, the ACD to whole blood ratio was decreased to 1:16, and used bolus of heparin was followed by continuous heparin infusion throughout the procedure. Despite using heparin anticoagulation, a long thrombus was aspirated at needleless port. The procedure was completed with continuous low-flow alarms. A cumulative dose of 5.67 × 106 CD34 cells/kg was achieved over four procedures, but the cause of hypercoagulability was unknown. All the coagulation parameters were within normal limits before and after the procedure. The exact cause for hypercoagulability remains elusive. There are no studies or case reports in the pediatric population on hypercoagulability following apheresis procedure after G-CSF mobilization, but evidence is available for adults, with lack of explanation. It can also be due to low draw flow from the patient side or embolization of thrombi developed in the anticoagulant unprimed site in the kit tubings. More extensive studies are required to explain the mechanism of hypercoagulability during apheresis procedures in the pediatric population.
{"title":"Hypercoagulability in pediatric autologous hematopoietic progenitor cell collection – Is it the time to reconsider screening? – A case report","authors":"P. Sriraman, S. Noushad, A. Basavarajegowda, D. Sahoo, Rajendra Gurunath Kulkarni, SunilJai Karnesh","doi":"10.4103/gjtm.gjtm_34_23","DOIUrl":"https://doi.org/10.4103/gjtm.gjtm_34_23","url":null,"abstract":"Peripheral blood hematopoietic progenitor cell harvest by apheresis in pediatric patients, a double-edged sword, has advantages and disadvantages over conventional bone marrow transplantation. The effect of granulocyte colony-stimulating factor (G-CSF) mobilization on hemostasis in literature is very scarce. A 3-year-old female child with metastatic neuroblastoma planned for autologous transplant. Following G-CSF mobilization (75 mg; 4 days), the procedure was performed with all default parameters in Spectra Optia with an acid citrate dextrose (ACD) flow rate 1:12, assuming 3-total blood volume (TBV) to be processed with 150 ml of expected collection with target yield of 6 × 106 CD34 cells/kg. Despite normal coagulation laboratory parameters, it was abandoned for reasons such as low-flow alarms and thrombi in the kit tubings. In the subsequent procedures, the ACD to whole blood ratio was decreased to 1:16, and used bolus of heparin was followed by continuous heparin infusion throughout the procedure. Despite using heparin anticoagulation, a long thrombus was aspirated at needleless port. The procedure was completed with continuous low-flow alarms. A cumulative dose of 5.67 × 106 CD34 cells/kg was achieved over four procedures, but the cause of hypercoagulability was unknown. All the coagulation parameters were within normal limits before and after the procedure. The exact cause for hypercoagulability remains elusive. There are no studies or case reports in the pediatric population on hypercoagulability following apheresis procedure after G-CSF mobilization, but evidence is available for adults, with lack of explanation. It can also be due to low draw flow from the patient side or embolization of thrombi developed in the anticoagulant unprimed site in the kit tubings. More extensive studies are required to explain the mechanism of hypercoagulability during apheresis procedures in the pediatric population.","PeriodicalId":52961,"journal":{"name":"Global Journal of Transfusion Medicine","volume":"27 1","pages":"208 - 211"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139364828","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}
Shubham Gupta, A. Tiwari, Naveen Agnihotri, Ajju Agnihotri, G. Aggarwal
Background and Objectives: Blood transfusions are frequently prescribed for acute and chronic conditions. When transfused judiciously, blood can save life and improve the health of the patient(s). However, transfusion of blood and blood components is never risk-free. Despite this, transfusion consent may not be obtained satisfactorily. We assessed the knowledge of patients about their blood transfusion and consenting process and the impact of structured information on their knowledge. Methods: A cross-sectional qualitative study design was employed. The study included all consenting adult patients who were intended recipients of red blood cell transfusion. Patient information sheet (PIS) along with pre- and postquestionnaire was administered to study patients. Results: Our study examined patients “knowledge and their attitude” about blood transfusion and recalling of their decision on consenting to transfusion. For the reason of being transfused, 58.5% were not aware, while 73% were unaware about the benefits of blood transfusion. Similarly, 85.5% were unaware about the risk of blood transfusion. There was a lack of knowledge about the “alternative option” of blood transfusion. Our findings also suggest that a standardized informed consent process was not being carried out. Conclusion: There is a need for strengthening IEC in the blood transfusion process. The present study has highlighted the role of printed/written information (PIS) in the native language and in imparting knowledge in the context of blood transfusion.
{"title":"Assessment of patient's knowledge about blood transfusion and impact of structured information on this knowledge: Single-center report from India","authors":"Shubham Gupta, A. Tiwari, Naveen Agnihotri, Ajju Agnihotri, G. Aggarwal","doi":"10.4103/gjtm.gjtm_45_23","DOIUrl":"https://doi.org/10.4103/gjtm.gjtm_45_23","url":null,"abstract":"Background and Objectives: Blood transfusions are frequently prescribed for acute and chronic conditions. When transfused judiciously, blood can save life and improve the health of the patient(s). However, transfusion of blood and blood components is never risk-free. Despite this, transfusion consent may not be obtained satisfactorily. We assessed the knowledge of patients about their blood transfusion and consenting process and the impact of structured information on their knowledge. Methods: A cross-sectional qualitative study design was employed. The study included all consenting adult patients who were intended recipients of red blood cell transfusion. Patient information sheet (PIS) along with pre- and postquestionnaire was administered to study patients. Results: Our study examined patients “knowledge and their attitude” about blood transfusion and recalling of their decision on consenting to transfusion. For the reason of being transfused, 58.5% were not aware, while 73% were unaware about the benefits of blood transfusion. Similarly, 85.5% were unaware about the risk of blood transfusion. There was a lack of knowledge about the “alternative option” of blood transfusion. Our findings also suggest that a standardized informed consent process was not being carried out. Conclusion: There is a need for strengthening IEC in the blood transfusion process. The present study has highlighted the role of printed/written information (PIS) in the native language and in imparting knowledge in the context of blood transfusion.","PeriodicalId":52961,"journal":{"name":"Global Journal of Transfusion Medicine","volume":"3 1","pages":"113 - 117"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139365347","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}
Mixed autoimmune hemolytic anemia (AIHA) represents <5% of pediatric AIHA cases. Spontaneous agglutination is known in patients with cold agglutinins reacting at room temperature. They often interfere with serological tests; generally, they can be dispersed by simple warming techniques. Rarely, in severe cases, as seen in the index case, dithiothreitol treatment of the red cells is needed to eliminate autoagglutination.
{"title":"Utility of dithiothreitol in a case of spontaneous autoagglutination due to mixed autoimmune hemolytic anemia in a child – A rare scenario","authors":"Rajeswari Subramaniyan","doi":"10.4103/gjtm.gjtm_64_23","DOIUrl":"https://doi.org/10.4103/gjtm.gjtm_64_23","url":null,"abstract":"Mixed autoimmune hemolytic anemia (AIHA) represents <5% of pediatric AIHA cases. Spontaneous agglutination is known in patients with cold agglutinins reacting at room temperature. They often interfere with serological tests; generally, they can be dispersed by simple warming techniques. Rarely, in severe cases, as seen in the index case, dithiothreitol treatment of the red cells is needed to eliminate autoagglutination.","PeriodicalId":52961,"journal":{"name":"Global Journal of Transfusion Medicine","volume":"2 1","pages":"212 - 214"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139365596","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 virtuous act of blood donations should be encouraged and promoted by all means while safeguarding the well-being of the donor. If regular blood donations lead to iron store depletion in any individual, it may be identified and preventive measures should be taken. The current practice of hemoglobin (Hb) testing alone before donation may not detect the depletion of iron stores. Yet, a policy to introduce tests for iron stores and iron supplementation in regular donors requires extensive research in this area because of the cost and feasibility concerns. The objectives were to study the prevalence of subclinical anemia among voluntary blood donors using serum ferritin levels attending the blood transfusion center and to compare the average Hb and serum ferritin levels of donors across different age groups, gender, and donation frequencies. Methods: A cross-sectional study was done on 300 consecutively enrolled voluntary whole-blood donors (December 2018–November 2019) who fulfilled eligibility criteria. Donors were further divided into four groups, depending on their number of donations. Their samples were tested for Hb and serum ferritin to check for reduced body iron stores. The data obtained were analyzed using SPSS version 23. Results: A total of 300 regular voluntary donors were included in the study. 57.7% of donors were in the age group of 20–29 years, of which 83.33% were males. The total prevalence of subclinical anemia was 16%, in whom 54.2% were males and 45.8% were females. Out of the total female donors in our study (50), 44% suffered from subclinical anemia. Out of the total male donors in the study (250), 10.4% suffered from subclinical anemia. There was a significant association between frequency of donation and subclinical anemia (odds ratio [OR] =6.36, P < 0.001). There was a significant association between subclinical anemia across gender (high for females; OR = 6.76, P < 0.001). There was a significant correlation between the frequency of donation and serum ferritin (Spearman correlation coefficient: −0.299), but there was no correlation observed between the frequency of donation and Hb levels. Conclusion: The study demonstrates the depletion of iron store with increasing donation frequency. This calls for continual supervision of body iron stores rather than Hb alone to ensure the continuous supply of healthy blood donors.
{"title":"Necessity of implementing ferritin testing for regular blood donors – A cross-sectional analysis of serum ferritin levels in individuals donating blood at various frequencies in a year at a regional blood transfusion center","authors":"P. Shaiji, Yameena Hameed, D. Meena","doi":"10.4103/gjtm.gjtm_43_23","DOIUrl":"https://doi.org/10.4103/gjtm.gjtm_43_23","url":null,"abstract":"Background and Objectives: The virtuous act of blood donations should be encouraged and promoted by all means while safeguarding the well-being of the donor. If regular blood donations lead to iron store depletion in any individual, it may be identified and preventive measures should be taken. The current practice of hemoglobin (Hb) testing alone before donation may not detect the depletion of iron stores. Yet, a policy to introduce tests for iron stores and iron supplementation in regular donors requires extensive research in this area because of the cost and feasibility concerns. The objectives were to study the prevalence of subclinical anemia among voluntary blood donors using serum ferritin levels attending the blood transfusion center and to compare the average Hb and serum ferritin levels of donors across different age groups, gender, and donation frequencies. Methods: A cross-sectional study was done on 300 consecutively enrolled voluntary whole-blood donors (December 2018–November 2019) who fulfilled eligibility criteria. Donors were further divided into four groups, depending on their number of donations. Their samples were tested for Hb and serum ferritin to check for reduced body iron stores. The data obtained were analyzed using SPSS version 23. Results: A total of 300 regular voluntary donors were included in the study. 57.7% of donors were in the age group of 20–29 years, of which 83.33% were males. The total prevalence of subclinical anemia was 16%, in whom 54.2% were males and 45.8% were females. Out of the total female donors in our study (50), 44% suffered from subclinical anemia. Out of the total male donors in the study (250), 10.4% suffered from subclinical anemia. There was a significant association between frequency of donation and subclinical anemia (odds ratio [OR] =6.36, P < 0.001). There was a significant association between subclinical anemia across gender (high for females; OR = 6.76, P < 0.001). There was a significant correlation between the frequency of donation and serum ferritin (Spearman correlation coefficient: −0.299), but there was no correlation observed between the frequency of donation and Hb levels. Conclusion: The study demonstrates the depletion of iron store with increasing donation frequency. This calls for continual supervision of body iron stores rather than Hb alone to ensure the continuous supply of healthy blood donors.","PeriodicalId":52961,"journal":{"name":"Global Journal of Transfusion Medicine","volume":"155 1","pages":"156 - 162"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139364459","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}
R. Seir, Lana Nazzal, Dorgam Yasin, Lina Manasrah, Osama Najjar
Blood transfusion is a vital component of the health-care system, especially considering the ongoing violent Palestinian-Israeli conflict that increases the need to maintain sufficient availability of safe blood for medical emergencies. We assessed the elements of blood transfusion services (BTS) against the guidelines of the World Health Organization guidelines to identify the achievements and gaps of the Palestinian BTS. Before the provision of the Palestinian Authority in 1994, BTS was provided by one blood bank and lacked any legislative or regulatory framework. Currently, BTS is overseen by the Palestinian Ministry of Health (MoH). There are 32 functional blood banks in the West Bank. Fourteen functional blood banks are overseen by MoH including the Central Blood Bank, which takes the role of a reference blood bank and 13 hospital-based blood banks. BTS in Palestine still lacks some of the major components required for a good national effective and safe BTS such as legislative and regulatory frameworks that are integrated within the national health system, defined standards and national guidelines on the clinical use of blood components, a national comprehensive quality assurance program for BTS, and a hemovigilance system to capture data on adverse events. In addition, there are no national blood donor programs or educational programs for staff in place.
{"title":"An overview of blood transfusion services in Palestine","authors":"R. Seir, Lana Nazzal, Dorgam Yasin, Lina Manasrah, Osama Najjar","doi":"10.4103/gjtm.gjtm_30_23","DOIUrl":"https://doi.org/10.4103/gjtm.gjtm_30_23","url":null,"abstract":"Blood transfusion is a vital component of the health-care system, especially considering the ongoing violent Palestinian-Israeli conflict that increases the need to maintain sufficient availability of safe blood for medical emergencies. We assessed the elements of blood transfusion services (BTS) against the guidelines of the World Health Organization guidelines to identify the achievements and gaps of the Palestinian BTS. Before the provision of the Palestinian Authority in 1994, BTS was provided by one blood bank and lacked any legislative or regulatory framework. Currently, BTS is overseen by the Palestinian Ministry of Health (MoH). There are 32 functional blood banks in the West Bank. Fourteen functional blood banks are overseen by MoH including the Central Blood Bank, which takes the role of a reference blood bank and 13 hospital-based blood banks. BTS in Palestine still lacks some of the major components required for a good national effective and safe BTS such as legislative and regulatory frameworks that are integrated within the national health system, defined standards and national guidelines on the clinical use of blood components, a national comprehensive quality assurance program for BTS, and a hemovigilance system to capture data on adverse events. In addition, there are no national blood donor programs or educational programs for staff in place.","PeriodicalId":52961,"journal":{"name":"Global Journal of Transfusion Medicine","volume":"13 1","pages":"227 - 230"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139364899","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}
T. Yangdon, Mahrukh Getshen, S. Dorji, Lobzang Tashi
Background and Objectives: Even though Blood Transfusion Service is considered as life-saving intervention, it is associated with the occurrence of uneventful reactions from the transfusion of blood and blood units. Bhutan Blood Bank is fragmented with different levels of services provided which leads to varied levels of adverse blood transfusion reaction reported. Study on the hemovigilance system at tertiary care hospital is conducted so as to study the frequency and types of reactions over a period of three years from 1st January 2019 to 31st December 2021. Methods: All ATRs occurring within a period of 3 years were studied according to the Blood Bank standard operating procedure. Adverse transfusion events related to blood and blood units were analyzed and classified on the basis of their clinical features and laboratory tests. Descriptive statistics were used to represent the adverse transfusion reactions. Results: During this period, a total of 19,961 blood and blood components were issued and 120 adverse transfusion events were reported. Most reaction reported were febrile non-hemolytic transfusion reaction, FNHTR (59.2%) followed by allergic reaction (22.5%) occurring predominantly in females (93%). Packed red cells were the common component causing adverse events (83 %) with most observable in Group A (42.5%) blood units. Conclusion: Febrile and allergic reactions are the most common type of reaction reported. Although such reaction type is least harmful but fatal reaction can occur and preventive measures must be taken to avoid such reactions. This preliminary study indicates the importance of having continuous monitoring and quality assessment scheme in addressing the issues of adverse transfusion reaction. Furthermore, establishing a hospital transfusion committee is vital for delivery of safe and efficient blood transfusion services.
{"title":"Adverse blood transfusion reaction reporting at a tertiary care hospital, Bhutan","authors":"T. Yangdon, Mahrukh Getshen, S. Dorji, Lobzang Tashi","doi":"10.4103/gjtm.gjtm_54_23","DOIUrl":"https://doi.org/10.4103/gjtm.gjtm_54_23","url":null,"abstract":"Background and Objectives: Even though Blood Transfusion Service is considered as life-saving intervention, it is associated with the occurrence of uneventful reactions from the transfusion of blood and blood units. Bhutan Blood Bank is fragmented with different levels of services provided which leads to varied levels of adverse blood transfusion reaction reported. Study on the hemovigilance system at tertiary care hospital is conducted so as to study the frequency and types of reactions over a period of three years from 1st January 2019 to 31st December 2021. Methods: All ATRs occurring within a period of 3 years were studied according to the Blood Bank standard operating procedure. Adverse transfusion events related to blood and blood units were analyzed and classified on the basis of their clinical features and laboratory tests. Descriptive statistics were used to represent the adverse transfusion reactions. Results: During this period, a total of 19,961 blood and blood components were issued and 120 adverse transfusion events were reported. Most reaction reported were febrile non-hemolytic transfusion reaction, FNHTR (59.2%) followed by allergic reaction (22.5%) occurring predominantly in females (93%). Packed red cells were the common component causing adverse events (83 %) with most observable in Group A (42.5%) blood units. Conclusion: Febrile and allergic reactions are the most common type of reaction reported. Although such reaction type is least harmful but fatal reaction can occur and preventive measures must be taken to avoid such reactions. This preliminary study indicates the importance of having continuous monitoring and quality assessment scheme in addressing the issues of adverse transfusion reaction. Furthermore, establishing a hospital transfusion committee is vital for delivery of safe and efficient blood transfusion services.","PeriodicalId":52961,"journal":{"name":"Global Journal of Transfusion Medicine","volume":"143 1","pages":"129 - 132"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139364904","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}
Shivanand Kumatagi, R. Amod, Sajith Sukumaran, Debasish Gupta
A 52-year-old man presented with behavioral and cognitive symptoms and involuntary movements. Serum CASPR-2 antibodies were strongly positive, and the nerve conduction study showed hyperexcitability. Thus, it was diagnosed as a case of Morvan's syndrome, detected after 3 months. The failed therapy with steroids led to the initiation of the therapeutic plasma exchange (TPE). Five cycles of TPE were completed to improve dramatically the cognitive and behavioral issues as well as the involuntary movements. He was initiated on rituximab for long-term maintenance therapy. In conclusion, TPE can be initiated even after 3 months of onset to achieve significant recovery. Although it is challenging, it is still a tolerated procedure with good outcomes.
{"title":"Successful management of steroid-refractory Morvan's syndrome 3 months after onset with therapeutic plasma exchange","authors":"Shivanand Kumatagi, R. Amod, Sajith Sukumaran, Debasish Gupta","doi":"10.4103/gjtm.gjtm_51_23","DOIUrl":"https://doi.org/10.4103/gjtm.gjtm_51_23","url":null,"abstract":"A 52-year-old man presented with behavioral and cognitive symptoms and involuntary movements. Serum CASPR-2 antibodies were strongly positive, and the nerve conduction study showed hyperexcitability. Thus, it was diagnosed as a case of Morvan's syndrome, detected after 3 months. The failed therapy with steroids led to the initiation of the therapeutic plasma exchange (TPE). Five cycles of TPE were completed to improve dramatically the cognitive and behavioral issues as well as the involuntary movements. He was initiated on rituximab for long-term maintenance therapy. In conclusion, TPE can be initiated even after 3 months of onset to achieve significant recovery. Although it is challenging, it is still a tolerated procedure with good outcomes.","PeriodicalId":52961,"journal":{"name":"Global Journal of Transfusion Medicine","volume":"40 1","pages":"202 - 204"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139364993","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 transfusion of fresh frozen plasma (FFP) is an essential modality of treatment but carries a residual risk of transfusion-transmitted infections and other adverse events. Continuous education and promotion of evidence-based practice are essential among clinicians to follow good clinical practices with respect to transfusion. This study aims to assess the impact of transfusion audit and educational interventions on the appropriateness of FFP transfusions with respect to indications, by comparing the proportion of appropriate FFP requests before and after the intervention. The study was an interventional study done on all medical professionals who requested FFP for various reasons from the department of transfusion medicine, for 1 year from April 01, 2011, to March 31, 2012. Methods: The study was done in three phases, preintervention audit; intervention including continuous education, one-to-one interactions, and hospital transfusion committee-mediated regulations; and postintervention audit. Statistical analysis was done by SPSS version 16. A paired t-test was used to compare quantitative variables which were continuous. Chi-square test was used for associations in categorical data. Results: A total of 3281 units of FFP were transfused in the preintervention period, and 2480 units in the postintervention period. Out of a total of 823 appropriate indications 75.6% indications were definitely indicated in the preintervention period. This increased to 81.8% of total 1290 requests after the intervention. The increase in definite indications was found to be statistically significant. Conclusion: Transfusion audits and educational interventions can create an impact on the appropriateness of FFP Transfusions especially if targeted to particular specialties and continued to follow-up.
{"title":"Transfusion audit and targeted education as tools to improve clinical practice of fresh frozen plasma transfusions: An interventional study","authors":"Nisha Navin, S. Shahulhameed, Meena Dharmadas","doi":"10.4103/gjtm.gjtm_32_23","DOIUrl":"https://doi.org/10.4103/gjtm.gjtm_32_23","url":null,"abstract":"Background and Objectives: The transfusion of fresh frozen plasma (FFP) is an essential modality of treatment but carries a residual risk of transfusion-transmitted infections and other adverse events. Continuous education and promotion of evidence-based practice are essential among clinicians to follow good clinical practices with respect to transfusion. This study aims to assess the impact of transfusion audit and educational interventions on the appropriateness of FFP transfusions with respect to indications, by comparing the proportion of appropriate FFP requests before and after the intervention. The study was an interventional study done on all medical professionals who requested FFP for various reasons from the department of transfusion medicine, for 1 year from April 01, 2011, to March 31, 2012. Methods: The study was done in three phases, preintervention audit; intervention including continuous education, one-to-one interactions, and hospital transfusion committee-mediated regulations; and postintervention audit. Statistical analysis was done by SPSS version 16. A paired t-test was used to compare quantitative variables which were continuous. Chi-square test was used for associations in categorical data. Results: A total of 3281 units of FFP were transfused in the preintervention period, and 2480 units in the postintervention period. Out of a total of 823 appropriate indications 75.6% indications were definitely indicated in the preintervention period. This increased to 81.8% of total 1290 requests after the intervention. The increase in definite indications was found to be statistically significant. Conclusion: Transfusion audits and educational interventions can create an impact on the appropriateness of FFP Transfusions especially if targeted to particular specialties and continued to follow-up.","PeriodicalId":52961,"journal":{"name":"Global Journal of Transfusion Medicine","volume":"16 1","pages":"169 - 175"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139365057","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}
P. Pandey, D. Setya, S. Ranjan, Supriya Kumari, Dharmender Kumar
Background and Objectives: Correlation has been shown between hepatitis B surface antigen (HBsAg) and hepatitis B virus (HBV) levels in different patient categories. However, this has not been studied for donors. The aim of this study was to study the relationship between HBV DNA levels and E ratio obtained for HBsAg testing by chemiluminescence immunoassay (CLIA) performed on donor samples. Methods: A prospective, observational study was conducted in the department of transfusion medicine at a large tertiary health-care setup in North India from 2017 to 2021. Serological testing for HBV included HBsAg testing by CLIA. All reactive samples were tested in duplicate by electro CLIA (eCLIA). All samples found to be reactive in all three tests were then tested by a rapid diagnostic test and quantitative polymerase chain reaction. Results: During the study duration, 251 donors were found to be reactive for HBsAg by CLIA and eCLIA in screening. Of these 251, HBV DNA could not be detected in 85 (33.86%) samples, whereas in rest 166 (66.14%) samples, HBV DNA was detected. Mean E ratio for CLIA for all 251 samples was 5177.45, whereas mean viral copies detected were 19645858.66. The correlation for all 251 samples was found to be weak negative. The correlation for sero-reactive samples with the presence of HBV DNA was also found to be weak negative. Conclusion: In conclusion, we found significant but weak correlation between HBsAg results obtained by CLIA and HBV DNA levels for blood donors. The measurement of HBV DNA level is necessary for all apparently healthy donors coming for blood donation and testing reactive for HBsAg in screening assays.
背景和目的：不同类别患者的乙型肝炎表面抗原（HBsAg）和乙型肝炎病毒（HBV）水平之间存在相关性。但尚未对捐献者进行过研究。本研究旨在研究捐献者样本中通过化学发光免疫分析法（CLIA）进行 HBsAg 检测时获得的 HBV DNA 水平与 E 比值之间的关系。研究方法2017 年至 2021 年，在印度北部一家大型三级医疗机构的输血医学科开展了一项前瞻性观察研究。HBV 血清学检测包括通过 CLIA 进行的 HBsAg 检测。所有反应性样本均通过电子 CLIA（eCLIA）进行重复检测。然后通过快速诊断检测和定量聚合酶链反应对所有在三种检测中均发现有反应的样本进行检测。结果：在研究期间，通过 CLIA 和 eCLIA 筛查，发现 251 名献血者的 HBsAg 呈阳性反应。在这 251 份样本中，有 85 份样本（33.86%）检测不到 HBV DNA，其余 166 份样本（66.14%）检测到 HBV DNA。在所有 251 个样本中，CLIA 的平均 E 比值为 5177.45，而检测到的平均病毒拷贝数为 19645858.66。所有 251 份样本的相关性均为弱负相关。血清反应样本与 HBV DNA 存在的相关性也呈弱阴性。结论总之，我们发现献血者通过 CLIA 获得的 HBsAg 结果与 HBV DNA 水平之间存在明显但微弱的相关性。所有表面健康的献血者在献血前都有必要测量 HBV DNA 水平，并在筛查试验中检测 HBsAg 反应性。
{"title":"Correlation between hepatitis B viral load and hepatitis B surface antigen levels in asymptomatic seropositive blood donors","authors":"P. Pandey, D. Setya, S. Ranjan, Supriya Kumari, Dharmender Kumar","doi":"10.4103/gjtm.gjtm_12_23","DOIUrl":"https://doi.org/10.4103/gjtm.gjtm_12_23","url":null,"abstract":"Background and Objectives: Correlation has been shown between hepatitis B surface antigen (HBsAg) and hepatitis B virus (HBV) levels in different patient categories. However, this has not been studied for donors. The aim of this study was to study the relationship between HBV DNA levels and E ratio obtained for HBsAg testing by chemiluminescence immunoassay (CLIA) performed on donor samples. Methods: A prospective, observational study was conducted in the department of transfusion medicine at a large tertiary health-care setup in North India from 2017 to 2021. Serological testing for HBV included HBsAg testing by CLIA. All reactive samples were tested in duplicate by electro CLIA (eCLIA). All samples found to be reactive in all three tests were then tested by a rapid diagnostic test and quantitative polymerase chain reaction. Results: During the study duration, 251 donors were found to be reactive for HBsAg by CLIA and eCLIA in screening. Of these 251, HBV DNA could not be detected in 85 (33.86%) samples, whereas in rest 166 (66.14%) samples, HBV DNA was detected. Mean E ratio for CLIA for all 251 samples was 5177.45, whereas mean viral copies detected were 19645858.66. The correlation for all 251 samples was found to be weak negative. The correlation for sero-reactive samples with the presence of HBV DNA was also found to be weak negative. Conclusion: In conclusion, we found significant but weak correlation between HBsAg results obtained by CLIA and HBV DNA levels for blood donors. The measurement of HBV DNA level is necessary for all apparently healthy donors coming for blood donation and testing reactive for HBsAg in screening assays.","PeriodicalId":52961,"journal":{"name":"Global Journal of Transfusion Medicine","volume":"12 1","pages":"186 - 189"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139365072","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}
Rongna Ma, Yuning Liu, Hong Liu, Zhong Xu, Xiaofei Wu, Yao Jia, Yuwen Huang, Qin Mo, Xun Wang
Background and Objectives: While there exists a significant wastage of platelets on one side (volatile demands and short lifetime), there is also a shortage for use on the other (lack of donors and emergency transfusions). A new centralized management system was established to tackle this dilemma. Methods: To assess the function of this system, data were collected from the Fengxian Blood Bank (FBB) Collection and Supply Information System during 2016 and 2018, then analyzed by IBM SPSS Statistics version 20. Results: Since implementing the centralized management system, a total of 1340 units of apheresis platelets were distributed by FBB. However, the number of units collected was 2737, twice as much as what had been distributed. With the aid of the system, the excess of 1644 units of apheresis platelets were transferred to the Shanghai Blood Center (SBC) inventory at their disposal. On the other hand, 247 units (included in 1340 distributed units) were compensated by SBC during the platelet shortage. In addition, the hospital demand meeting rate shows a significant increase from 82.61% to 99.78%, especially for type AB which increases from 62% to 100%. Conclusions: In conclusion, the centralized management system vastly improved the efficiency of platelet collection and distribution by the regional supply and demand. Such success would be a superb example of blood banks facing similar problems.
{"title":"Pilot study of centralized management system in Shanghai: A promising solution to platelet collection and supply imbalance in small blood banks","authors":"Rongna Ma, Yuning Liu, Hong Liu, Zhong Xu, Xiaofei Wu, Yao Jia, Yuwen Huang, Qin Mo, Xun Wang","doi":"10.4103/gjtm.gjtm_31_23","DOIUrl":"https://doi.org/10.4103/gjtm.gjtm_31_23","url":null,"abstract":"Background and Objectives: While there exists a significant wastage of platelets on one side (volatile demands and short lifetime), there is also a shortage for use on the other (lack of donors and emergency transfusions). A new centralized management system was established to tackle this dilemma. Methods: To assess the function of this system, data were collected from the Fengxian Blood Bank (FBB) Collection and Supply Information System during 2016 and 2018, then analyzed by IBM SPSS Statistics version 20. Results: Since implementing the centralized management system, a total of 1340 units of apheresis platelets were distributed by FBB. However, the number of units collected was 2737, twice as much as what had been distributed. With the aid of the system, the excess of 1644 units of apheresis platelets were transferred to the Shanghai Blood Center (SBC) inventory at their disposal. On the other hand, 247 units (included in 1340 distributed units) were compensated by SBC during the platelet shortage. In addition, the hospital demand meeting rate shows a significant increase from 82.61% to 99.78%, especially for type AB which increases from 62% to 100%. Conclusions: In conclusion, the centralized management system vastly improved the efficiency of platelet collection and distribution by the regional supply and demand. Such success would be a superb example of blood banks facing similar problems.","PeriodicalId":52961,"journal":{"name":"Global Journal of Transfusion Medicine","volume":"397 1","pages":"133 - 138"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139365323","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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