Transfusion Clinique et Biologique最新文献

{"title":"Neonatal exchange transfusion in a transitioning healthcare system: a 23-year national trends analysis from Serbia","authors":"Ljiljana Zdelar Stojanović ,&nbsp;Bojana Petrović ,&nbsp;Radovan Dinić ,&nbsp;Dragiša Šljivančanin ,&nbsp;Milena Perišić Mitrović ,&nbsp;Anja Vojvodić ,&nbsp;Ljubinka Nikolić ,&nbsp;Jasmina Grujić","doi":"10.1016/j.tracli.2025.10.005","DOIUrl":"10.1016/j.tracli.2025.10.005","url":null,"abstract":"<div><h3>Background</h3><div>Neonatal hyperbilirubinemia remains a common neonatal condition. While Rh immunoprophylaxis and phototherapy have dramatically reduced exchange transfusion (ET) use in high-income countries, ET remains essential in selected cases, particularly in transitioning healthcare systems. Comprehensive data from Southeast Europe are limited.</div></div><div><h3>Aim</h3><div>To evaluate 23-year trends in neonatal ET use, indications, and outcomes at a Serbian tertiary referral center.</div></div><div><h3>Methods</h3><div>This retrospective cohort study (2001–2023) included all neonates undergoing ET at the University Clinical Center of Serbia. Data were collected from medical, transfusion, and laboratory records. Primary outcome was ET rate trend; secondary outcomes included indications and complications.</div></div><div><h3>Results</h3><div>Among 145,702 deliveries, 243 ETs were performed in 206 neonates. ET rates declined significantly from 6.4 to 0 per 1000 deliveries (<em>p</em> &lt; 0.001), mirroring trends observed in high-income countries. Hemolytic disease of the newborn accounted for 67 % of cases, primarily due to anti-D alloimmunization (65.9 %), a profile characteristic of settings with Rh prophylaxis gaps. Non-immune indications included anemia (36.7 %), infections (28.3 %), and other causes (35.0 %). Most procedures were double-volume ET (61.3 %). No ET-related mortality occurred; complications were transient. RhD-negative mothers showed high sensitization rates (82.1 %).</div></div><div><h3>Conclusion</h3><div>The significant decline in ET rates in Serbia reflects successful perinatal care improvements, yet the persistent burden of anti-D alloimmunization underscores challenges shared with many transitioning health systems. Strengthening Rh immunoprophylaxis programs and expanding access to bilirubin monitoring are essential public health strategies to further reduce ET need in similar healthcare settings worldwide.</div></div>","PeriodicalId":23262,"journal":{"name":"Transfusion Clinique et Biologique","volume":"33 1","pages":"Pages 25-29"},"PeriodicalIF":1.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145423796","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 preventing post-transfusion platelet refractoriness: a systematic review and meta-analysis","authors":"Yanling Zhuang,&nbsp;Mingquan Wang","doi":"10.1016/j.tracli.2025.12.001","DOIUrl":"10.1016/j.tracli.2025.12.001","url":null,"abstract":"<div><h3>Background</h3><div>Post-transfusion platelet refractoriness (PTR) is a major complication in transfusion medicine. While non-immune factors are the most common cause, immune-mediated PTR, often caused by alloimmunization against human leukocyte antigens (HLA), leads to ineffective platelet transfusions, increased bleeding risks, and poorer outcomes in patients with hematologic malignancies or undergoing allogeneic hematopoietic stem cell transplantation (allo-HSCT).</div></div><div><h3>Objective</h3><div>To assess the effectiveness of platelet antibody screening, particularly anti-HLA antibody detection using mean fluorescence intensity (MFI) thresholds, in reducing the incidence of immune-mediated PTR and improving transfusion-related outcomes.</div></div><div><h3>Methods</h3><div>This systematic review and <em>meta</em>-analysis, conducted in accordance with PRISMA guidelines, involved a comprehensive search of databases including PubMed, Embase, Cochrane Library, Scopus, and Web of Science. The outcomes include post-transfusion PTR incidence, survival rates, and transfusion-related complications. To assess the effectiveness of platelet antibody screening, relative risks (RRs) and odds ratios (ORs) were calculated, with further subgroup analyses performed based on mean fluorescence intensity (MFI) thresholds, patient populations, and screening methodologies.</div></div><div><h3>Results</h3><div>The final analysis included seven retrospective cohort and case-control studies, encompassing a total of 2865 patients. Patients who underwent antibody screening had a significantly lower PTR incidence (15.4 %, 95 % CI: 12.1–18.7 %) compared to unscreened patients (28.6 %, 95 % CI: 23.7–33.5 %), reflecting a 46 % reduced risk (RR: 0.54, 95 % CI: 0.41–0.71). High MFI thresholds (&gt;10,000) showed stronger specificity for predicting PTR, while lower thresholds (&gt;5000) demonstrated greater sensitivity. Secondary outcomes included reduced mortality, improved engraftment, and fewer transfusion-related complications in patients identified via screening who subsequently received compatible transfusions.</div></div><div><h3>Conclusions</h3><div>Platelet antibody screening is an effective strategy for identifying patients at risk for immune-mediated PTR. This screening enables the implementation of targeted transfusion protocols (e.g., HLA-matched platelets), which mitigate PTR and improve clinical outcomes, particularly in high-risk populations. Standardizing MFI thresholds and protocols is essential for broader clinical application. Further prospective research is needed to validate these findings and assess cost-effectiveness.</div></div>","PeriodicalId":23262,"journal":{"name":"Transfusion Clinique et Biologique","volume":"33 1","pages":"Pages 50-57"},"PeriodicalIF":1.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145795906","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":"Exploring the association between blood donation and anemia: A cross‑sectional study based on the NHANES","authors":"Cong Lv ,&nbsp;Ling Zeng ,&nbsp;Wenhui Zhu ,&nbsp;Zhilan Wu","doi":"10.1016/j.tracli.2025.11.004","DOIUrl":"10.1016/j.tracli.2025.11.004","url":null,"abstract":"<div><h3>Background</h3><div>Blood donation is essential for maintaining an adequate blood supply, but repeated donation can lead to iron depletion and anemia. Evidence from nationally representative populations is limited.</div></div><div><h3>Methods</h3><div>We conducted a cross-sectional analysis of adults (≥18 years) from the National Health and Nutrition Examination Survey (NHANES) 2011–2018. Blood donation within the past 12 months was self-reported. Outcomes included anemia (hemoglobin &lt;13.0 g/dL in men, &lt;12.0 g/dL in women), iron deficiency (serum ferritin &lt;70 µg/L), and iron deficiency anemia (IDA, both conditions). Secondary outcomes included serum ferritin, serum iron, total iron-binding capacity (TIBC), and transferrin saturation. Multivariable logistic regression was used to estimate odds ratios (ORs) with 95 % confidence intervals (CIs), adjusting for sociodemographic, lifestyle, and clinical factors.</div></div><div><h3>Results</h3><div>Among 16,619 adults, 738 (4.4 %) reported blood donation in the past year. Donors were younger, more often male, physically active, and had lower prevalence of hypertension and diabetes. Compared with non-donors, donors had significantly lower serum ferritin (98.8 vs. 160.2 µg/L), serum iron (78.3 vs. 84.5 µg/dL), and transferrin saturation (22.3 vs. 25.1), but higher total iron-binding capacity (360.4 vs. 345.2 µg/dL). Iron deficiency anemia was more common among donors (5.7 % vs. 1.3 %, <em>p</em> &lt; 0.001). Donation was strongly associated with IDA (adjusted OR 3.72, 95 % CI 2.33–5.95, <em>p</em> &lt; 0.001), but not with overall anemia.</div></div><div><h3>Conclusions</h3><div>Blood donation is independently associated with iron deficiency anemia but not with overall anemia in U.S. adults. Enhanced donor monitoring and preventive strategies may help safeguard donor health while maintaining blood supply.</div></div>","PeriodicalId":23262,"journal":{"name":"Transfusion Clinique et Biologique","volume":"33 1","pages":"Pages 45-49"},"PeriodicalIF":1.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145575103","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":"The Crimson Laureate’s vision: Establishing a Paw Blood Bank for all creatures great and small","authors":"Manish Raturi ,&nbsp;Purshotam Paudel","doi":"10.1016/j.tracli.2025.12.002","DOIUrl":"10.1016/j.tracli.2025.12.002","url":null,"abstract":"","PeriodicalId":23262,"journal":{"name":"Transfusion Clinique et Biologique","volume":"33 1","pages":"Page 64"},"PeriodicalIF":1.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145829361","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":"Response to Dr. Baykara’s letter: transfusion safety and immune considerations in astronaut health","authors":"Yamac Akgun","doi":"10.1016/j.tracli.2025.11.003","DOIUrl":"10.1016/j.tracli.2025.11.003","url":null,"abstract":"","PeriodicalId":23262,"journal":{"name":"Transfusion Clinique et Biologique","volume":"33 1","pages":"Page 61"},"PeriodicalIF":1.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145575165","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":"Quality assessment tool for Outdoor Blood Donation Drives: an Indian perspective","authors":"Vinu Rajendran ,&nbsp;Amita Radhakrishnan Nair ,&nbsp;Debasish Gupta ,&nbsp;Prinu Jose ,&nbsp;Ravi Prasad Varma ,&nbsp;George Paul Thaliath ,&nbsp;Angel Mary Sam ,&nbsp;Shivanand H. Kumatagi ,&nbsp;Punkesh Patel ,&nbsp;Meethu Muraleedharan","doi":"10.1016/j.tracli.2025.10.002","DOIUrl":"10.1016/j.tracli.2025.10.002","url":null,"abstract":"<div><h3>Background and objectives</h3><div>Assessing the quality of blood donation drives is imperative for maintaining blood safety. Currently, there are no validated tools for evaluating the Outdoor Blood Donation Drive (OBDD). This study intends to develop and validate a quality assessment tool for OBDD in India.</div></div><div><h3>Materials and methods</h3><div>This cross-sectional study was conducted over 12 months at a tertiary-care blood centre in India. Three phases of the study were tool development and validation, OBDD quality assessment, and mini-tool development. Internal consistency was assessed using Cronbach’s alpha. Spearman’s correlation matrix assessed variable correlations’ direction and strength. Psychometric tests, including Bartlett’s sphericity test and Kaiser-Meyer-Olkin score, were used. For factor analysis, Principal Axis Factoring with Oblimin rotation was utilized.</div></div><div><h3>Results</h3><div>A 30-item questionnaire was developed to assess OBDD quality. The tool had high content validity (mean I-CVI: 0.93) and reliability (Cronbach’s alpha: 0.89). Out of 100 ODBB assessed, around 67 % scored Grade B and 17 % scored Grade C. Scores were low for aspects such as display of IEC materials, restroom facility, grade of registration, grade of collection, and pre-drive awareness. Following an iterative process based on the KMO Measure of Sampling Adequacy (MSA), communality values, and factor loadings, a 15-item tool was developed. The Cronbach’s alpha of the tool was 0.80, denoting good internal consistency.</div></div><div><h3>Conclusion</h3><div>The developed comprehensive and mini quality assessment tool, comprising 30 and 15 parameters, was found valid and reliable. This can be adapted as per the required customisation across blood centres globally.</div></div>","PeriodicalId":23262,"journal":{"name":"Transfusion Clinique et Biologique","volume":"33 1","pages":"Pages 10-15"},"PeriodicalIF":1.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145277006","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":"Haemolysis of red cell concentrates during storage – The impact of donor factors","authors":"J. Ljubičić,&nbsp;J. Gulan Harcet,&nbsp;I. Jukić,&nbsp;T. Vuk","doi":"10.1016/j.tracli.2025.11.001","DOIUrl":"10.1016/j.tracli.2025.11.001","url":null,"abstract":"<div><h3>Background</h3><div>The stability of red cell concentrates (RCCs) during storage is routinely assessed by measuring haemolysis, which must remain below 0.8 % in Europe and 1.0 % in the USA. Haemolysis during storage is influenced by both technical factors (e.g., additive solutions, leukoreduction) and donor-related characteristics, such as age and gender.</div></div><div><h3>Objective</h3><div>To investigate the influence of donor age, gender, donation frequency and collection time on haemolysis in RCCs during storage.</div></div><div><h3>Materials and methods</h3><div>A retrospective study was conducted on 768 RCCs prepared at the Croatian Institute of Transfusion Medicine over a 13-year period (2011–2023). Haemolysis was assessed on day 35 of storage. Haematological parameters were measured using an Abbott Cell-Dyn Ruby analyser, and free haemoglobin levels using a Plasma/Low Hb photometer, with subsequent calculation of haemolysis percentage. Donor demographic data (age, gender, donation frequency) were retrieved from the blood bank software e-Delphyn. Statistical analyses, including independent-samples t-tests, ANOVA, and correlation analysis, were performed using IBM SPSS Statistics software.</div></div><div><h3>Results</h3><div>A total of 768 RCC units were analysed. Male donors exhibited significantly higher haemolysis levels compared to female donors (<em>P</em> &lt; 0.001), particularly among younger age groups. In female donors older than 50 years, the median of haemolysis was significantly higher than in those under 50 years (<em>P</em> = 0.022). A weak but statistically significant correlation was observed between haemolysis and donation frequency (rho = 0.163; <em>P</em> &lt; 0.001). However, donation frequency and collection time were not major contributors to haemolysis in regression analysis.</div></div><div><h3>Conclusion</h3><div>Donor gender and age significantly influence the level of haemolysis in stored RCCs, with higher haemolysis observed in male and older donors. Donation frequency and collection time were not identified as major contributors to haemolysis in regression analysis. These findings support previous research and highlight the importance of considering donor-related factors when aiming to optimize RCC quality and storage outcomes.</div></div>","PeriodicalId":23262,"journal":{"name":"Transfusion Clinique et Biologique","volume":"33 1","pages":"Pages 40-44"},"PeriodicalIF":1.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145472304","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":"Acknowledgments to our reviewers","authors":"","doi":"10.1016/S1246-7820(26)00026-1","DOIUrl":"10.1016/S1246-7820(26)00026-1","url":null,"abstract":"","PeriodicalId":23262,"journal":{"name":"Transfusion Clinique et Biologique","volume":"33 1","pages":"Page 65"},"PeriodicalIF":1.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147404590","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":"Enhancing blood centre operations through Lean Six Sigma methodologies – A prospective interventional study in the blood donor area of a tertiary care blood centre","authors":"Rowena D.L. Robins,&nbsp;Hari Haran,&nbsp;Sriraman Punniakoti,&nbsp;Suresh Kumar,&nbsp;Sahayaraj James","doi":"10.1016/j.tracli.2025.10.001","DOIUrl":"10.1016/j.tracli.2025.10.001","url":null,"abstract":"<div><h3>Background and objectives</h3><div>Efficient workflow in blood donation centers is crucial for timely collections, donor safety, and effective staff utilization. However, issues such as redundant documentation, inefficient layouts, communication interruptions, and inventory disruptions often lead to increased donor waiting times and decreased satisfaction. To address these inefficiencies, a study was conducted employing Lean Six Sigma (LSS) methodology to identify and reduce non-value-added activities (NVA) in the donor area.</div></div><div><h3>Materials and methods</h3><div>Utilizing the DMAIC (Define–Measure–Analyze–Improve–Control) framework over seven months, the study involved baseline observations, time-motion studies, staff interviews, and spaghetti diagrams to uncover bottlenecks. Targeted interventions included workflow zoning, digital registration, inventory dashboards, structured communication protocols, and role delegation. The quantitative outcomes were measured pre- and post-intervention (October–December 2024 vs. January–April 2025) were performed using SPSS software (version 29).</div></div><div><h3>Results</h3><div>The results demonstrated a statistically significant improvement in post-intervention: donor registration time reduced by 52.7 %, waiting times decreased by 49.6 %, and NVA activities dropped from 20 % to 9 % of staff time. Documentation errors fell by 65 %, inventory disruptions decreased to under 10 min per day, and staff movement dropped by over 40 %. Additionally, donor throughput increased by 25 %, and satisfaction scores improved from 61 % to 86 %, while communication delays were reduced from over 90 min to 25–30 min daily demonstrating a significant large-sized effect with meaningful difference.</div></div><div><h3>Conclusion</h3><div>The application of LSS significantly enhanced workflow efficiency, documentation accuracy, and service delivery, presenting a scalable and sustainable model for quality improvement in healthcare settings.</div></div>","PeriodicalId":23262,"journal":{"name":"Transfusion Clinique et Biologique","volume":"33 1","pages":"Pages 3-9"},"PeriodicalIF":1.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145277095","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":"Comparison of cryoprecipitate preparation methods: changes in plasma fibrinogen levels","authors":"Yuya Ishihara ,&nbsp;Hideaki Matsuura ,&nbsp;Takeshi Miyawaki ,&nbsp;Hayato Kojima ,&nbsp;Takato Ozeki ,&nbsp;Mai Hasegawa ,&nbsp;Sumie Fujii ,&nbsp;Yasuo Miura","doi":"10.1016/j.tracli.2025.10.003","DOIUrl":"10.1016/j.tracli.2025.10.003","url":null,"abstract":"<div><h3>Background and Objectives</h3><div>Reports on the changes in plasma fibrinogen levels in patients receiving cryoprecipitates synthesized using different methods are lacking. Therefore, we investigated these changes in patients who underwent cardiovascular surgery.</div></div><div><h3>Materials and Methods</h3><div>We included 309 patients who underwent cardiovascular surgery and received 12 cryoprecipitate units between February 2020 and March 2024 and 204 patients were selected by propensity score matching. The cryoprecipitates were prepared using two methods. Fresh frozen plasma (FFP) was thawed at 2 to 6 °C for 24 h and centrifuged to remove the supernatant in the one-step method, whereas FFP was thawed, refrozen at −20 °C, and subsequently rethawed in the two-step method. We investigated the association between different cryoprecipitate preparation methods and ICU admission for ≥1 week, with in-hospital mortality considered as a competing risk in the analysis. In addition, we evaluated the changes in plasma fibrinogen levels before and after cryoprecipitate administration.</div></div><div><h3>Results</h3><div>Baseline plasma fibrinogen levels were significantly higher in the two-step method group than in the one-step method group. Differences in cryoprecipitate preparation methods were not significantly associated with ICU admission for ≥1 week, in the analysis that considered in-hospital mortality as a competing risk (<em>P</em> = 0.93). The increase in plasma fibrinogen levels after cryoprecipitate administration was significantly higher with the two-step method than with the one-step method (36 mg/dL vs. 51 mg/dL, <em>P</em> = 0.020).</div></div><div><h3>Conclusion</h3><div>The cryoprecipitates synthesized using the two-step method showed a higher increase in plasma fibrinogen levels than those prepared using the one-step method. These findings may help guide appropriate transfusion protocols by confirming intraoperative plasma fibrinogen levels.</div></div>","PeriodicalId":23262,"journal":{"name":"Transfusion Clinique et Biologique","volume":"33 1","pages":"Pages 16-24"},"PeriodicalIF":1.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145369433","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}