Transfusion Clinique et Biologique最新文献

{"title":"Red cell alloimmunization in resource-constrained settings: A critical review of immunobiological drivers and structural determinants","authors":"Lina Sofia Castillo,&nbsp;Marcela Quintero Santacruz","doi":"10.1016/j.tracli.2026.03.002","DOIUrl":"10.1016/j.tracli.2026.03.002","url":null,"abstract":"<div><div>Red blood cell (RBC) alloimmunization continues to challenge the foundational promise of transfusion therapy: to provide safe and universally effective support. Although most transfused individuals remain tolerant, a vulnerable minority develop alloantibodies that complicate care and increase the risk of delayed hemolytic transfusion reactions (DHTRs). While high-income nations increasingly mitigate this risk through molecular genotyping, low- and middle-income countries (LMICs) face a distinct landscape defined by antigenic mismatch and resource scarcity. This critical review evaluates alloimmunization not merely as a technical failure, but as a phenomenon driven by the collision of immunobiological susceptibility and structural health determinants. A structured literature review informed by PRISMA reporting recommendations was conducted to synthesize immunobiological and health-systems evidence across diverse epidemiological settings. We synthesize evidence on immune responsiveness alongside the economic realities of LMICs, where competing health priorities often necessitate trade-offs in laboratory capacity. By critically examining compatibility strategies through the lenses of feasibility and cost-effectiveness, we propose a risk-adapted, tiered framework for antigen matching. This approach challenges one-size-fits-all paradigms, suggesting that transfusion safety can be optimized by aligning biological risk with available resources rather than relying solely on inaccessible technologies.</div></div>","PeriodicalId":23262,"journal":{"name":"Transfusion Clinique et Biologique","volume":"33 2","pages":"Pages 123-127"},"PeriodicalIF":1.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147464699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Respect for patient autonomy in refusing blood transfusion: recent developments in French case law","authors":"Jean-Baptiste Thibert","doi":"10.1016/j.tracli.2026.02.003","DOIUrl":"10.1016/j.tracli.2026.02.003","url":null,"abstract":"","PeriodicalId":23262,"journal":{"name":"Transfusion Clinique et Biologique","volume":"33 2","pages":"Pages 131-134"},"PeriodicalIF":1.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146184065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Platelet antibody screening for post-transfusion refractoriness: Encouraging data undermined by methodological limitations and lack of implementation science","authors":"Aryabhatta Sadhu ,&nbsp;Aishee Pal Sadhu","doi":"10.1016/j.tracli.2026.03.003","DOIUrl":"10.1016/j.tracli.2026.03.003","url":null,"abstract":"","PeriodicalId":23262,"journal":{"name":"Transfusion Clinique et Biologique","volume":"33 2","pages":"Pages 144-145"},"PeriodicalIF":1.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147597220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comprehensive Evaluation of Pooled Red Blood Cell Saline Suspensions Used in Routine Blood Typing: A Resource Optimisation Laboratory-Based Study","authors":"Manish Raturi ,&nbsp;Dushyant S. Gaur,&nbsp;Purshotam Paudel,&nbsp;Yashaswi Dhiman,&nbsp;Brajesh Upreti","doi":"10.1016/j.tracli.2026.01.004","DOIUrl":"10.1016/j.tracli.2026.01.004","url":null,"abstract":"","PeriodicalId":23262,"journal":{"name":"Transfusion Clinique et Biologique","volume":"33 2","pages":"Pages 128-130"},"PeriodicalIF":1.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145992245","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Je suis le globule rouge, le chevalier des organes1","authors":"Claude Tayou Tagny","doi":"10.1016/j.tracli.2026.01.003","DOIUrl":"10.1016/j.tracli.2026.01.003","url":null,"abstract":"","PeriodicalId":23262,"journal":{"name":"Transfusion Clinique et Biologique","volume":"33 2","pages":"Page 135"},"PeriodicalIF":1.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145919456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Very restrictive versus standard RBC transfusion strategy in anemic critically ill patients (VeRTEx): protocol for a pilot randomized controlled trial","authors":"Laurens A. Oomen ,&nbsp;Caroline M. Schaap ,&nbsp;Bart J. Biemond ,&nbsp;Tessa A. van der Meer ,&nbsp;Jimmy Schenk ,&nbsp;Alexander P.J. Vlaar ,&nbsp;Robert B. Klanderman ,&nbsp;Marcella C.A. Müller","doi":"10.1016/j.tracli.2026.02.001","DOIUrl":"10.1016/j.tracli.2026.02.001","url":null,"abstract":"<div><h3>Background</h3><div>Red blood cell (RBC) transfusions can be a life-saving intervention, particularly in critically ill patients. However, over the past two decades, their potential for harm has become increasingly evident, leading to the adoption of restrictive transfusion strategies. Current guidelines recommend a transfusion threshold of 7.0 g/dL hemoglobin (Hb) in critically ill patients. However evidence for this exact limit is lacking and there is increasing evidence that Hb-levels under 7 g/dL do not inherently lead to increased mortality or morbidity. This study aims to explore the feasibility of a more restrictive RBC transfusion threshold of 5.0 g/dL compared to the current threshold of 7.0 g/dL in the majority of critically ill patients.</div></div><div><h3>Methods</h3><div>The study will be a prospective randomized controlled pilot trial conducted in critically ill patients (18 years or older). Participants will be randomized to be treated according to a 5.0 g/dL or a 7.0 g/dL RBC transfusion threshold. Transfusions will be administered 1 RBC unit at a time when the assigned threshold is reached. The primary endpoint is the feasibility of the intervention, expressed as protocol compliance, defined as the percentage of RBC transfusions initiated below the assigned threshold. Secondary outcomes include the SOFA score, protocol violations, incidence of major bleeding, early signs of organ hypoperfusion or organ ischemia, use of life support, acute kidney injury, 30-day mortality, ICU and hospital stay duration, readmission rates, and cost-effectiveness.</div></div><div><h3>Discussion</h3><div>This pilot study aims to determine whether employing a more restrictive transfusion threshold of 5.0 g/dL is feasible when compared to the current 7.0 g/dL threshold in critically ill patients. This study could pave the way for a future large-scale trial that may lead to more stringent transfusion policies, potentially improving patient outcomes, reducing transfusion-related risks in critically ill populations and limit the dependence on donor red blood cells.</div><div><strong><br>Trial Registration:</strong> This trial was registered at highly restrictive vs normal red blood cell transfusion strategy in anemic critically ill patients – A feasibility trial | Research with human participants (identifier: NL-OMON57318) at 12th of February 2025.</div></div>","PeriodicalId":23262,"journal":{"name":"Transfusion Clinique et Biologique","volume":"33 2","pages":"Pages 89-96"},"PeriodicalIF":1.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146133814","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of the platelet storage time on transfusion-related adverse reactions: A French hemovigilance study","authors":"Juliana Pires Marafon ,&nbsp;Sophie Reuter ,&nbsp;Hervé Isola ,&nbsp;Sophie Somme ,&nbsp;Blandine Maître","doi":"10.1016/j.tracli.2026.01.006","DOIUrl":"10.1016/j.tracli.2026.01.006","url":null,"abstract":"<div><h3>Background</h3><div>The legal shelf life of platelet concentrates (PCs) has been extended from 5 to 7 days in France since 2018. Our study aimed to determine whether this increase in PC storage time has produced a significant impact on transfusion-related adverse reactions (ARs).</div></div><div><h3>Methods</h3><div>A retrospective study was conducted in the Grand Est region of France between January 2022 and December 2023 using data from the e-FIT hemovigilance database and the record of PCs transfused held by the “Etablissement Français du Sang” (EFS).</div></div><div><h3>Results</h3><div>In 2022 and 2023, 270 ARs related to platelet transfusions were reported in the Grand Est region of France, 240 of which were classified as possibly, probably or certain attributable to the transfusion. The majority of these immediate ARs were allergies, febrile non-hemolytic transfusion reactions and immunological incompatibilities. We found no significant correlation of the platelet storage time (≤3 days versus 4–7 days) with the three main immediate adverse reactions (<em>p</em> = 0.24), or with isolated alloimmunization (<em>p</em> = 0.55). The storage time did not affect the incidence of ARs following transfusion of either buffy coat PC or apheresis PC (<em>p</em> = 0.20). Finally, no association was observed between the age of PCs and the severity of ARs (<em>p</em> = 0.24).</div></div><div><h3>Conclusion</h3><div>Our results show that storage of platelets for 4 to 7 days has no significant effect on the occurrence or severity of ARs. Prospective studies will be necessary to assess the impact of platelet storage time on transfusion efficacy and the potential benefit of considering the age of the platelets for certain patients.</div></div>","PeriodicalId":23262,"journal":{"name":"Transfusion Clinique et Biologique","volume":"33 2","pages":"Pages 69-75"},"PeriodicalIF":1.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146032188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of the amotosalen/UVA process to reduce pathogens in platelet concentrates on transfusion efficiency in cardiac surgery","authors":"Belkacem Bouali ,&nbsp;Ayoub Rezzaoui ,&nbsp;Hind Hamzeh-Cognasse ,&nbsp;Anne-Claire Duchez ,&nbsp;Alexandre Mansour ,&nbsp;Cecile Aubron ,&nbsp;Zsuzsanna Wolf ,&nbsp;Nesrine Tebbeb ,&nbsp;Marie-Ange Eyraud ,&nbsp;Charles-Antoine Arthaud ,&nbsp;Amélie Prier ,&nbsp;Patricia Chavarin ,&nbsp;Julien Lanoiselée ,&nbsp;Kazra Azarnoush ,&nbsp;Jerome Morel ,&nbsp;Jean Charles Palao ,&nbsp;Fabrice Cognasse","doi":"10.1016/j.tracli.2026.02.005","DOIUrl":"10.1016/j.tracli.2026.02.005","url":null,"abstract":"<div><h3>Background</h3><div>Pathogen reduction treatment (PRT) of platelet concentrates (PC) is one of the most recent advances in improving blood safety and lowering the risk of transfusion-transmitted diseases. The characteristics of PR-treated PC differ slightly from those of untreated PC and may affect transfusion outcomes. We established how effective PRT methods, (INTERCEPT™ Blood System) PC are when transfused to cardiac surgery patients.</div></div><div><h3>Materials and methods</h3><div>This study examined the influence of PRT using amotosalen and UVA light in a population of cardiac surgery patients. We analysed bleeding and platelet drop following cardiopulmonary bypass (CPB) surgery. We selected 73 patients after considering the medical exclusion criteria: 46 patients transfused with untreated platelet concentrate versus 27 patients transfused with PRT-treated platelet concentrate.</div></div><div><h3>Results</h3><div>Data analysis concerns the readout after the first platelet concentrate transfusion. The decrease in patient platelet count between pre-operative and H0 [Intensive Care Unit (ICU) admission], and pre-operative and H6 post-surgery did not differ significantly with or without PRT. The volume of postoperative bleeding after CPB surgery did not differ significantly regardless of whether the patient was transfused with PRT-PC or untreated PC. No difference was documented between the groups in terms of postoperative pulmonary infection rate. Regardless of the use of platelet PRT, among the factors associated with bleeding, only Fg level was independently and significantly associated. A 1<!--> <!-->mg/L increase in fibrinogen (pre-operative) is associated with a 159<!--> <!-->mL decrease in bleeding 24<!--> <!-->hours post-surgery.</div></div><div><h3>Discussion</h3><div>In postoperative cardiac surgery, the use of platelets treated with amotosalen/UVA for pathogen reduction does not appear to affect transfusion effectiveness and postoperative bleeding.</div></div>","PeriodicalId":23262,"journal":{"name":"Transfusion Clinique et Biologique","volume":"33 2","pages":"Pages 97-105"},"PeriodicalIF":1.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147322659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Another Indication for CMV-Negative Units?","authors":"Yigit Baykara","doi":"10.1016/j.tracli.2025.10.007","DOIUrl":"10.1016/j.tracli.2025.10.007","url":null,"abstract":"","PeriodicalId":23262,"journal":{"name":"Transfusion Clinique et Biologique","volume":"33 1","pages":"Pages 59-60"},"PeriodicalIF":1.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145411355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perioperative red blood cell transfusion following high-risk oncologic surgery for tumor resection: a systematic review and meta-analysis","authors":"Xavier Chapalain ,&nbsp;Morgane Zaïna ,&nbsp;Jean-Philippe Metges ,&nbsp;Bogdan Badic ,&nbsp;Rosemary L. Sparrow ,&nbsp;Zoe McQuilten ,&nbsp;Olivier Huet ,&nbsp;Cécile Aubron","doi":"10.1016/j.tracli.2025.10.006","DOIUrl":"10.1016/j.tracli.2025.10.006","url":null,"abstract":"<div><h3>Background/Objectives</h3><div>Cancer-related anemia is associated with poorer quality of life and cancer progression. Red blood cell (RBC) transfusion might have an impact on perioperative outcomes after major oncologic surgery. We performed a systematic review and <em>meta</em>-analysis to evaluate whether RBC transfusion exposure (yes/no) and whether RBC transfusion strategies (‘liberal’ vs. ‘restrictive’) may impact on postoperative outcomes for patients admitted to an intensive care unit (ICU) following oncologic surgery.</div></div><div><h3>Methods</h3><div>We searched Pubmed, Embase and Cochrane Library to identify eligible articles published between 1st January 2000 to 31st December 2023. We included clinical trials and observational studies that evaluated RBC transfusion exposure and all studies that compared ‘liberal’ vs. ‘restrictive’ transfusion strategies, in adult critically ill patients admitted to ICU after oncologic surgery.</div></div><div><h3>Results</h3><div>Ten observational studies that compared transfused vs. non-transfused patients, and three comparative transfusion strategy studies (two randomized-controlled trials [RCTs] and one non-randomized) were included. In the observational studies, non-transfused patients had a better survival (OR 0.24 [0.06–0.92], <em>p</em> = 0.04; I² = 78 %), as well as reduced risks of sepsis (OR 0.37 [0.14–0.97], <em>p</em> = 0.04; I² = 91 %), acute kidney injury (OR 0.37 [0.21–0.65], <em>p</em> = 0.0005; I² = 83 %) and pneumonia (OR 0.32 [0.19–0.52], <em>p</em> &lt; 0.00001; I² = 59 %). Hospital length-of-stay was also lower for non-transfused patients: mean difference −4.7 days [−7.13 to −2.26], <em>p</em> = 0.0002 (I² = 94 %). In the two RCTs, no difference was found between ‘liberal’ and ‘restrictive’ transfusion strategies on main outcomes. However, the strength of evidence was ‘very low’ to ‘low’ quality for the two RCTs.</div></div><div><h3>Conclusions</h3><div>After major oncologic surgery, perioperative anemia requiring transfusion therapy may impact adversely on postoperative outcomes. Our <em>meta</em>-analysis revealed high heterogeneity in observational studies and low strength of evidence in the transfusion strategy RCTs. Further high-quality comparative studies are needed to investigate RBC transfusion in this setting.</div></div>","PeriodicalId":23262,"journal":{"name":"Transfusion Clinique et Biologique","volume":"33 1","pages":"Pages 30-39"},"PeriodicalIF":1.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145427243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}