Transfusion最新文献

{"title":"Prevalence of HIV, HBV, and HCV in United States blood donations, 2015-2023: The transfusion-transmissible infections monitoring system (TTIMS).","authors":"Emilya Huseynova, James Haynes, Edward P Notari, Brian Custer, Rita Reik, Jed Gorlin, Artur Belov, Hong Yang, Roger Y Dodd, Susan L Stramer","doi":"10.1111/trf.18424","DOIUrl":"https://doi.org/10.1111/trf.18424","url":null,"abstract":"<p><strong>Background: </strong>The Transfusion-Transmissible Infections Monitoring System assesses trends in ~60% of the US blood supply. Donors with high-risk behaviors, including injection drug users, men having sex with other men, or those exchanging sex for money/drugs, were deferred for 12 months (12 M) from 2016 to 2020 and 3 months (3M) from 2020 to 2023. Here we evaluate HIV, HBV, and HCV donation prevalence annually from 2015 to 2023 and in two comparison periods of pre-3M (2015-2020) and 3M (2020-2023) to identify differences between the two periods.</p><p><strong>Methods: </strong>Annual prevalence was assessed for 8 TTIMS years (2015-2023) and compared between the pre-3M and 3M periods. HIV, HBV, and HCV prevalence/100,000 donations (phtd) was calculated based on serology and nucleic acid testing results. Negative binomial regression assessed prevalence using 1-year intervals. Fisher's exact test evaluated prevalence changes between the two periods (α = 0.05).</p><p><strong>Results: </strong>Annual HIV and HBV prevalence remained stable, changing slightly from year 1 to 8 (2.5-2.1 phtd for HIV and 6.3-6.6 phtd for HBV). HCV prevalence declined (19.7-9.6 phtd; p <.01). HIV (2.5-2.0 phtd) and HCV (18.4-9.8 phtd) prevalence decreased from pre-3M to 3M (p <.01), while HBV prevalence remained stable (6.5-6.2 phtd; p = .06).</p><p><strong>Conclusions: </strong>Despite reducing donor deferral periods for many infectious risk behaviors, HIV and HBV prevalence were stable, while HCV prevalence declined over 8 years. Either slight or significant declines occurred from the pre-3M to 3M period for all agents. Thus, changes in policy did not adversely impact the current safety of the blood supply with respect to the major infectious disease agents.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145233510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Concurrent neonatal alloimmune neutropenia and thrombocytopenia: Prevalence and antibody specificity and intensity in a large Brazilian cohort.","authors":"Leandra C Nogueira-Silva, José O Bordin, Samira A Abbas, Larissa B Lopes, Akemi K Chiba, Josefina A P Braga, Juliana O Martins, Renato Cerqueira, Karen N C Ziza, Dante Mario Langhi, Elyse Moritz","doi":"10.1111/trf.18429","DOIUrl":"https://doi.org/10.1111/trf.18429","url":null,"abstract":"<p><strong>Background: </strong>Fetal/neonatal alloimmune thrombocytopenia (FNAIT) and neonatal alloimmune neutropenia (NAIN) result from maternal alloantibodies targeting fetal human platelet antigen (HPA) and human neutrophil antigen (HNA) antigens, respectively. However, increasing evidence supports the pathogenic role of HLA class I alloantibodies in these conditions. Since the simultaneous occurrence of FNAIT and NAIN has not been systematically investigated, this study aimed to determine its prevalence, characterize the specificity and strength of associated alloantibodies, and correlate findings with neonatal cell counts.</p><p><strong>Study design and methods: </strong>In this cross-sectional study, 10,000 umbilical cord blood samples were analyzed for platelet and neutrophil counts. Neonates with thrombocytopenia and neutropenia were selected. Genotyping for HPA, HNA, and HLA class I was performed in mother-infant pairs to assess incompatibilities. Maternal sera were tested for anti-HPA, anti-HNA, and anti-HLA antibodies.</p><p><strong>Results: </strong>Ten cases (0.1%) of concurrent cytopenias were identified. Alloantibodies were detected in four cases: one with combined anti-HPA-5b, HNA-2, and HLA-A2 antibodies; and three with isolated high-mean fluorescence intensity (MFI) HLA antibodies (anti-HLA-A2, HLA-A3, HLA-B7). Anti-HLA-A2 was linked to the lowest neutrophil counts, and anti-HLA-B7 to severe thrombocytopenia. The estimated prevalence of simultaneous FNAIT and NAIN was 0.04% (1 in 2500 neonates).</p><p><strong>Discussion: </strong>This is the first large-scale study to document the co-occurrence of FNAIT and NAIN. Our findings explore the serological and molecular features of these immune syndromes and underscore the potential pathogenic role of maternal anti-HLA class I antibodies, even in the absence of detectable anti-HPA or anti-HNA, and support including HLA testing in the diagnostic workup of neonatal cytopenias.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145233441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Revisiting a \"new\" yet \"old\" approach: Reticulocyte hemoglobin and related hematological indices for iron deficiency screening for patient blood management.","authors":"Jesse Qiao, Gagan Mathur","doi":"10.1111/trf.18382","DOIUrl":"https://doi.org/10.1111/trf.18382","url":null,"abstract":"","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145207646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validating transport conditions of fresh frozen plasma units.","authors":"Yigit Baykara, Jesierose Poblacion, Jing Jin, Mrigender Virk","doi":"10.1111/trf.18435","DOIUrl":"https://doi.org/10.1111/trf.18435","url":null,"abstract":"<p><strong>Background: </strong>Thawed fresh frozen plasma (FFP) is subject to coagulation factor degradation, particularly factors V and VIII, prompting strict storage guidelines of 1-6°C post-thaw. However, real-world clinical practice often involves temporary deviations from ideal conditions, especially during transport. This study evaluated whether thawed FFP stored in standard transport coolers maintains coagulation factor integrity.</p><p><strong>Study design and methods: </strong>Fourteen FFP units were thawed at 30-37°C and divided into two groups: control units stored immediately at 4°C and experimental units exposed to simulated transport conditions in validated coolers for up to 6 h post-thaw. Samples were obtained at 0, 3, and 6 h for temperature measurement and coagulation testing, including factor V and VIII activity and prothrombin time (PT). A one-tailed t-test was used for statistical comparisons.</p><p><strong>Results: </strong>While cooler-stored units exhibited higher temperatures at 3 and 6 h (p < .001), no significant differences were observed in factor V or factor VIII activity or PT between experimental and control groups at any time point. Delta analysis confirmed the stability of coagulation parameters over time.</p><p><strong>Conclusion: </strong>Short-term storage of thawed FFP in validated transport coolers does not compromise coagulation factor activity or PT. These findings support the return of thawed plasma units to inventory when stored in transport coolers for up to 6 h, reducing unnecessary product waste without compromising product safety and efficacy.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145192908","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The whole is greater than the sum of its parts: Rethinking our approach to neonatal transfusion research.","authors":"Nina A M Houben, Camila Caram-Deelder, Enrico Lopriore, Suzanne Fustolo-Gunnink","doi":"10.1111/trf.18432","DOIUrl":"https://doi.org/10.1111/trf.18432","url":null,"abstract":"<p><p>Many preterm infants are exposed to multiple transfusion types during their admission in the neonatal intensive care unit. Yet, evidence supporting current practice consists of several randomized controlled trials and observational studies focusing on a single transfusion product at the time. Rather than approaching transfusions as three distinct categories as currently done in the literature, there may be benefit by accounting for the interconnected nature of these practices. In this Clinical Research Focus article, we advocate for a broader perspective in future research on neonatal transfusion practices. By looking at the whole instead of its parts, we can gain a more comprehensive understanding of the impact of transfusion exposure, potential associated adverse effects, and their implications for neonatal care.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145192884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unexpected manufacturing defects in transfusion tubing associated with product waste.","authors":"David Daniel, Herleen Rai, Evan M Bloch, Aaron A R Tobian, Lisa Shifflett, Jonathan Lindo, Elizabeth P Crowe","doi":"10.1111/trf.18413","DOIUrl":"https://doi.org/10.1111/trf.18413","url":null,"abstract":"","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145182105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Survey of cryoprecipitate production and cryoprecipitate and fibrinogen concentrate utilization in North America: Variable practices observed from July 2016 to June 2021, The BEST Collaborative Study.","authors":"Wen Lu, Umesh Singh, Alyssa Ziman, Ralph Vassallo, Jessica L Poisson, Andrew W Shih, Jay S Raval, Jessica Grandoni, Cyril Jacquot, Marc Germain, Nancy M Dunbar, Claudia Cohn, Pampee Young","doi":"10.1111/trf.18434","DOIUrl":"https://doi.org/10.1111/trf.18434","url":null,"abstract":"<p><strong>Background: </strong>Cryoprecipitated antihemophiliac factor (cryo) is primarily used to replenish fibrinogen in acquired coagulopathy. Little has been reported about its usage patterns within hospitals with respect to patient population, frequency of use, and dosing.</p><p><strong>Study design and methods: </strong>Cryo production and usage data were collected over 5 years from July 1, 2016, to June 30, 2021, from nationally based blood collection centers in the United States (U.S. n = 2) and Canada (n = 2) and from eight large academic hospitals, respectively. Usage data for a similar product, purified fibrinogen concentrate were also collected from four hospitals.</p><p><strong>Results: </strong>Two U.S. blood collectors reported increases in cryo production normalized to total whole blood collections from 17.4% in 2016 to 22.3% in 2021 and from 16.4% in 2016 to 20.2% in 2021. In contrast, in Canada cryo manufacturing increased slightly in one region (11.3%-12.9%) and decreased (8.0%-2.0%) in the other. Cryo utilization, defined as numbers of patients treated normalized to the inpatient census, and dose administered per patient did not consistently increase and differed significantly between hospitals participating in the study (p < .0001). Likewise, the departments that most frequently transfused cryo varied between hospitals. Similarly, variations in practice were observed for fibrinogen concentrate usage.</p><p><strong>Conclusion: </strong>While much of Canada and Europe have moved towards using fibrinogen concentrate, two large U.S. collectors have increased cryo distribution. The lack of standardization and variability in the clinical practice regarding the use of cryo and fibrinogen concentrate reported by study sites may be attributable to practitioner preference, availability, and/or cost rather than adherence to published evidence or guidelines.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145186591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hematological and iron status in infants with Rh hemolytic disease: A prospective cohort study.","authors":"Satya Prakash, Ankit Verma, Tushar Sehgal, Mukul Aggarwal, M Jeeva Sankar, Ramesh Agarwal, Anu Thukral","doi":"10.1111/trf.18430","DOIUrl":"https://doi.org/10.1111/trf.18430","url":null,"abstract":"<p><strong>Background: </strong>Infants with Rh hemolytic disease may have iron overload given the ongoing hemolysis. In these infants, iron supplementation may be unnecessary or potentially even harmful. However, there is a paucity of literature to make evidence-based recommendations.</p><p><strong>Methods: </strong>All neonates with Rh isoimmunization and evidence of fetal anemia were eligible for inclusion in this cohort study. Primary outcomes were serum ferritin and hemoglobin at birth, 3, 6, 9, and 12 months. Additional outcomes were the requirement of top-up transfusion and iron therapy during infancy. Iron supplementation was given only if ferritin was <30 mcg/L. Subgroup analysis was performed based on receipt of intrauterine transfusion (IUT).</p><p><strong>Results: </strong>Fifty-Six infants were enrolled (gestation 35 ± 2 weeks, weight 2490 ± 480 g). Thirty-Five neonates (62%) received IUT and 21 (38%) received exchange transfusion. Median ferritin (mcg/L) at birth, three- (n = 46), six- (n = 36), nine- (n = 38), and 12-months (n = 35) were 846 [626, 1433], 695 [263, 1041], 219 [105, 601], 122 [42, 242], and 77 [42, 168], respectively. Concomitant hemoglobin (g/dL) values were 14.3, 9.4, 10.9, 10.9, and 10.7, respectively. Serum ferritin was above age-specific cut-off in 53/56 (95%) infants at birth and remained elevated in 16/35 (46%) at 12 months. Top-up transfusion was required in 26/47 infants (55%). Iron supplementation was started in 14/46 infants (30%). Ferritin and top-up transfusion requirements were significantly higher in infants treated with IUT.</p><p><strong>Discussion: </strong>Infants with Rh isoimmunization demonstrate hyperferritinemia at birth, which can persist till 12 months, particularly in IUT-treated infants. Routine iron supplementation should be deferred in IUT-treated infants until 12 months.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145151098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transient severe anemia triggered by parvovirus B19 infection in a patient with homozygous RhAG deficiency.","authors":"Anna Hausdorf, Hans-Günter Derigs, Halvard Bonig, Erika Fleck, Susanne Braeuninger","doi":"10.1111/trf.18378","DOIUrl":"https://doi.org/10.1111/trf.18378","url":null,"abstract":"<p><strong>Background: </strong>Deficiency of Rh antigens affects the red blood cell (RBC) membrane integrity, thus reducing erythrocyte survival, clinically manifesting as chronic hemolytic anemia. Various mutations cause such Rh_null/mod phenotypes. Parvovirus B19 infection causes transient red cell aplasia, leading to potentially severe anemia in patients with chronic hemolytic disorders.</p><p><strong>Study design and methods: </strong>A patient with known, etiologically unclear mild chronic anemia presented with a syncopal event. Clinical and laboratory work-up, including targeted genetic analyses of RBC genes, was performed.</p><p><strong>Results: </strong>The patient was severely anemic with moderate signs of hemolysis and evidence of impaired erythropoiesis. Immunohematological work-up identified a lack of Rh antigen expression. A homozygous c.1034G>A missense mutation in RHAG adequately explains this finding, as well as the chronic hemolysis. Parvovirus B19 was identified as causal for the acute aplastic crisis.</p><p><strong>Discussion: </strong>This is the first clinical report of parvovirus B19-related red cell aplasia in a patient with the RHAG*01M.15 phenotype.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145151117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A novel RHD allele combining partial D (c.455A>C) and weak D (c.1154G>C) variants.","authors":"Glenn Ramsey, Kim Hue-Roye, Gorka Ochoa-Garay, Johnathon Pugh, Ricardo S Sumugod, Paul F Lindholm, Sunitha Vege","doi":"10.1111/trf.18433","DOIUrl":"https://doi.org/10.1111/trf.18433","url":null,"abstract":"","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145151120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}