Transfusion最新文献

{"title":"Red cell exchange removes apixaban in patients with sickle cell disease.","authors":"Kimberly Boyle, Mary Evans, Coral Mansfield, Maria Notini, Melanie E Garrett, Gowthami M Arepally, Grace M Lee","doi":"10.1111/trf.70257","DOIUrl":"https://doi.org/10.1111/trf.70257","url":null,"abstract":"<p><strong>Background: </strong>Many patients with sickle cell disease undergo red cell exchange (RCE) and are anticoagulated with apixaban for treatment and/or prevention of venous thromboembolism. Prior studies have demonstrated that apixaban can bind to red blood cells (RBCs). However, the effect of RCE on apixaban levels is unknown. We aimed to determine if RCE alters patient plasma apixaban levels.</p><p><strong>Methods: </strong>Plasma apixaban levels in patients were examined before/after RCE. Apixaban in the RCE collection bag and the hematocrit of the collection bag were quantified. The ability of washed RBCs from healthy donors or from patients on apixaban to inhibit FXa activity was determined using a chromogenic Direct Xa Inhibitor kit.</p><p><strong>Results: </strong>Seven patients underwent 72 RCE. Plasma apixaban levels declined significantly after RCE (mean decline in apixaban level 68.1 ± 20.7%, p < 0.0001). Apixaban was present in the plasma/supernatant of all RCE collection bags tested. The percent decline in patient plasma apixaban levels after RCE was weakly correlated with the hematocrit of the RCE collection bag (r = 0.36, p = ns). Incubation of FXa with RBCs from patients on apixaban resulted in significantly less FXa activity compared to RBCs from healthy donors (mean Xa activity [A405 nm] of healthy RBC 0.79 ± 1.8 vs. apixaban RBC 0.54 ± 0.22, p = 0.005).</p><p><strong>Discussion: </strong>We provide the first description of apixaban removal with RCE. Removal of apixaban is occurring via removal of incidental plasma and of RBC-bound drug and can result in undetectable drug levels in this high-risk population.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147843169","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":"How do we use smart blood refrigerators at our hospitals in North America?","authors":"Alexandra Jimenez, Dennis Chen, Jaclyn Spinelli, Stephanie Kinney, Rebecca Coward, Althea Rossier, Monique Huggins, Bruce Lyon, Denden Benabdessadek, Sabrina Racine-Brzostek, Robert A DeSimone, Tobias Cohen, Melissa M Cushing","doi":"10.1111/trf.70259","DOIUrl":"https://doi.org/10.1111/trf.70259","url":null,"abstract":"<p><strong>Background: </strong>Rapid, reliable, and safe access to blood products remains a persistent operational challenge in transfusion medicine, particularly in high-acuity and geographically dispersed clinical environments. Traditional centralized blood bank workflows may contribute to delays, increased laboratory workload, and risks associated with blood component transportation and storage. Smart blood refrigerators have emerged as an important strategy to support decentralized storage, controlled product access, and enhanced traceability; however, published data describing real-world implementation strategies and operational variability remain limited.</p><p><strong>Study design and methods: </strong>To characterize real-world adoption and use, we conducted a multi-institutional survey of North American institutions utilizing BloodTrack-integrated smart blood refrigerators. Survey findings were supplemented by targeted follow-up interviews representing a range of operational models and use cases.</p><p><strong>Results: </strong>Survey responses demonstrated substantial variability in deployment models, clinical workflows, and blood component storage practices. Smart refrigerators supported a wide range of transfusion service functions across diverse clinical environments, reflecting differing institutional, operational, and patient-care priorities. Commonly reported benefits included shorter time to transfusion, improved workflow efficiency, enhanced traceability, reduced staffing burden, and support for patient-specific blood product selection. Reported barriers primarily involved informatics integration, labeling workflows, serologic eligibility constraints, and training considerations.</p><p><strong>Conclusion: </strong>These findings illustrate how smart blood refrigerators are used across diverse transfusion service environments, highlighting the operational flexibility of these systems and providing practical insights for institutions seeking to implement, optimize, or expand smart refrigerator-supported transfusion workflows.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147843167","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":"Correction to \"From environmental impact to implementation pathways: Advancing life-cycle thinking for transfusion systems in a warming and unequal world\".","authors":"","doi":"10.1111/trf.70217","DOIUrl":"https://doi.org/10.1111/trf.70217","url":null,"abstract":"","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147843055","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":"Identification of a novel c.325T>G variant on the ABO*B.01 allele associated with a B₃ phenotype.","authors":"Xiaojun Yang, Tian Gao, Yurong Tang, Ji Zhao, Zhicheng Zhang","doi":"10.1111/trf.70239","DOIUrl":"https://doi.org/10.1111/trf.70239","url":null,"abstract":"","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147843223","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":"Pediatric transfusion camp: Developing, piloting and evaluation of a Canadian national pediatric transfusion medicine curriculum.","authors":"Ines Zuna, Valérie Arsenault, Kimmo Murto, Suzanne Beno, MacGregor Steele, Jennifer Young, Sarah Leir, Angela Punnett, Cheryl Peters, Lucille Barcat, Yulia Lin, Casey Kapitany, Sophie Chargé, Teresa Skelton, Lani Lieberman","doi":"10.1111/trf.70252","DOIUrl":"https://doi.org/10.1111/trf.70252","url":null,"abstract":"<p><strong>Background: </strong>Standardized post-graduate education in pediatric transfusion medicine remains limited. The objective of this study was to adapt an adult transfusion education program, Transfusion Camp, to include pediatric content and assess knowledge improvement in pediatric subspecialty trainees.</p><p><strong>Study design and methods: </strong>A steering committee of Canadian experts from pediatric subspecialties convened to adapt the content of an adult transfusion medicine curriculum to include pediatric-specific content using Kern's six-step approach to curriculum design. Pediatric anesthesiology and pediatric hematology-oncology trainees enrolled in Canadian training programs participated in a 4-day pilot of virtual didactic teaching/team-based learning during the 2024-2025 academic year. Knowledge was assessed using the validated 25-item Pediatric Transfusion Knowledge Test administered pre- and post-course. Trainees also completed surveys evaluating confidence and attitudes.</p><p><strong>Results: </strong>Twenty-eight trainees enrolled in the course, 26 trainees completed the pre-course assessment, and 21 completed the post-course assessment. Of these, 20 completed both pre- and post-course assessments, and 80% (16/20) attended all 4 days. Mean scores increased from 48.9% ± 13.3% to 64.6% ± 12.1%. Among trainees completing both pre- and post-course assessment (n = 20), the mean gain was +17.8% (95% confidence interval 11.2-24.4, p < .0001). Knowledge gaps persisted in transfusion reaction reporting and specialized transfusion topics, including platelet refractoriness and hemolytic anemia. Trainees reported improved confidence in applying transfusion medicine concepts, and course evaluations were highly positive.</p><p><strong>Discussion: </strong>Pediatric Transfusion Camp is a standardized, evidence-based curriculum that improves pediatric trainee transfusion knowledge. Engaging a multi-disciplinary steering committee enhanced educational rigor and supports future expansion toward standardized pediatric transfusion medicine training across Canada.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147843193","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":"Understanding public perspectives of prehospital trauma research: A qualitative community engagement study on consent and blood transfusion.","authors":"Katie N Dainty, M Bianca Seaton, Krystle Amog, Melissa McGowan, Brodie Nolan","doi":"10.1111/trf.70250","DOIUrl":"https://doi.org/10.1111/trf.70250","url":null,"abstract":"<p><strong>Background: </strong>Unintentional injuries are a major cause of death worldwide. Modern trauma systems have reduced morbidity and mortality through rapid prehospital care, yet trauma research faces challenges obtaining informed consent during emergencies. Because patients are often incapacitated and substitute decision makers are unavailable, studies commonly rely on deferred or waived consent. Despite their use, little is known about public perspectives on these models or on prehospital interventions such as paramedic-administered blood transfusion.</p><p><strong>Objective: </strong>To explore Canadian public perspectives on trauma research, alternative consent models, and prehospital blood transfusion.</p><p><strong>Methods: </strong>A multi-methods community engagement study, including a national survey and 96 in situ interviews in four rural Ontario communities. Survey and interview questions assessed trust in healthcare, views on research consent, and acceptance of prehospital blood transfusion. Quantitative data were summarized descriptively; qualitative data underwent thematic analysis.</p><p><strong>Results: </strong>Survey respondents reported strong trust in the healthcare system (75%) and support for clinical trials (80%). Acceptance of alternative consent was mixed, with only 40% finding it acceptable. Most agreed that data collected before withdrawal of consent should remain usable. Support for paramedic-administered blood transfusion was high (70%), grounded in urgency and trust in paramedic expertise, though concerns included safety and autonomy. Interviews reinforced these themes, emphasizing conditional acceptance of deferred consent, preference for timely communication, and strong trust in paramedics during life-threatening emergencies.</p><p><strong>Conclusion: </strong>Canadians support prehospital blood transfusion and recognize the need for trauma research, but acceptance of alternative consent models depends on transparency, perceived necessity, and respect for autonomy.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147843233","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":"Hold on to your units: Quality of red cell concentrates is only affected after multiple transient warming events.","authors":"Jayme Kurach, Mackenzie Brandon-Coatham, Nishaka William, Carly Olafson, Tracey R Turner, Anika Tahsin Rahman, Behrouz Ehsani-Moghaddam, Gwen Clarke, Jason P Acker","doi":"10.1111/trf.70253","DOIUrl":"https://doi.org/10.1111/trf.70253","url":null,"abstract":"<p><strong>Background: </strong>Cryopreserved red cell concentrates (RCCs) glycerolized using a high glycerol (40%) method can be stored below -65°C for up to 30 years; however, units may be inadvertently warmed above -65°C due to freezer failures, human errors, or routine inventory management. RCCs known to have experienced transient warming events (TWEs) or storage temperatures ≥-65°C are frequently discarded.</p><p><strong>Study design: </strong>Six groups of ABO/Rh matched RCCs were pooled-and-split (n = 9), glycerolized using the ACP 215 (Haemonetics), and frozen. Three types of TWEs were performed: (1) \"Fast\" TWEs (warming at room temperature [RT] to -25°C), (2) \"Slow\" TWEs (exposure to -25°C for 2 h), and (3) \"Thaw\" TWEs (single warming to RT). Units (n = 6) were exposed to 0 (control), 1, 10, or 30 \"Slow\" or \"Fast\" TWEs. RCCs were deglycerolized using the ACP 215, stored at 1-6°C, and tested at 0, 1, 7, and 14 days post-deglycerolization for red blood cell (RBC) quality.</p><p><strong>Results: </strong>No significant differences among RCCs over hypothermic storage were found when exposed to \"Fast\" or \"Slow\" single or \"Thaw\" TWEs, although a significant decrease in the quality of RCCs was observed when units were subjected to 10 or more \"Fast\" or \"Slow\" TWEs.</p><p><strong>Discussion: </strong>Our data suggests the single TWEs examined in this study do not significantly impact the quality of RCCs post-deglycerolization. Based on these observations, TWE exposure considerations should be made on a unit-by-unit basis, with additional policy support for unit retention.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147843158","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 study on the impact of blood large-scale long-distance airdrop on storage quality of suspended red blood cells.","authors":"Lei Liu, Yiming Li, Lidong Zhang, Yong Qi, Jinbing Du, Wanbing Liu","doi":"10.1111/trf.70247","DOIUrl":"https://doi.org/10.1111/trf.70247","url":null,"abstract":"<p><strong>Background: </strong>Blood airdrop is a rapid transfusion supply for humanitarian, disaster relief, and military needs. Yet, large-scale, long-distance blood airdrops has never been explored.</p><p><strong>Methods: </strong>Twenty bags of suspended red blood cells were randomly divided into two groups. The control group RBCs were stored at (4 ± 2)°C in the storage refrigerator. The airdrop group was subjected to the procedures of airdrop that involved a 74 h transportation journey covering 8220 km. The storage-lesion including RBCs morphology, physiological and biochemical indicators were measured on days 5, 14, 28, and 35 from the day of blood collection.</p><p><strong>Results: </strong>Compared with the control group, the massive and distant airdrop procedures did not cause significant differences in physical, chemical and metabolic properties of RBCs during the storage period. However, the airdrop group RBCs possessed the less Glu consumption and LAC accumulation (p < .05) on the 14th and 28th day compared with the control group. By the end of the storage period, each of the Glu consumption and LAC accumulation between the two groups tended to be the same. At the end of the storage period (35th day), the average hemolysis rate of the airdrop group RBCs was 0.12%, and the highest value was 0.24%, both of which were not higher than those of the control group and met the blood quality standard requirement that the hemolysis rate should be less than 0.8%.</p><p><strong>Conclusions: </strong>The blood large-scale long-distance airdrop did not have a significant negative impact on the quality of suspended RBCs products.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147782142","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":"Managing Acute Bleeding: A new section of TRANSFUSION.","authors":"Richard M Kaufman","doi":"10.1111/trf.70232","DOIUrl":"https://doi.org/10.1111/trf.70232","url":null,"abstract":"","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147782184","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":"Concomitant acquired and inherited von Willebrand disease: A challenging bleeding disorder.","authors":"Nikita J Sareen, Kenneth D Friedman, Mia J Sullivan, Maria T De Sancho","doi":"10.1111/trf.70251","DOIUrl":"https://doi.org/10.1111/trf.70251","url":null,"abstract":"<p><strong>Background: </strong>Inherited von Willebrand disease is the most common inherited bleeding disorder and is characterized by mucocutaneous bleeding resulting from impaired platelet adhesion and aggregation at sites of vascular injury. Acquired von Willebrand disease is an often-underrecognized bleeding disorder caused by structural or functional abnormalities of von Willebrand factor secondary to autoimmune, lymphoproliferative, myeloproliferative, plasma cell dyscrasias, malignancy, cardiovascular, or other systemic disorders. The coexistence of inherited and acquired von Willebrand disease should be suspected in patients with a previously stable bleeding phenotype who develop unexplained clinical worsening and requires a high index of clinical suspicion. This scenario presents a significant diagnostic challenge, as laboratory findings may be similar between inherited and acquired forms.</p><p><strong>Case report: </strong>96-year-old woman with known type 2A von Willebrand disease and a previously mild bleeding phenotype who developed worsening bleeding due to acquired von Willebrand disease secondary to previously unrecognized severe aortic stenosis. Genetic sequencing identified a germline variant in exon 28 and an acquired variant in exon 31. Transcatheter aortic valve replacement resulted in rapid improvement of the bleeding phenotype and discontinuation of replacement therapy.</p><p><strong>Conclusion: </strong>This case underscores the importance of considering acquired von Willebrand disease in patients with inherited von Willebrand disease who present with new-onset or worsening bleeding symptoms, as early recognition enables targeted treatment of the underlying condition and may significantly improve clinical outcomes.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147782062","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}