Transfusion最新文献

{"title":"Laboratory detection of donors implicated in transfusion-transmitted malaria.","authors":"Susan A Galel","doi":"10.1111/trf.18061","DOIUrl":"10.1111/trf.18061","url":null,"abstract":"<p><strong>Background: </strong>Transfusion-transmitted malaria (TTM) is rare in non-endemic areas (non-EAs) but can potentially be fatal. This review analyzes the laboratory results of donors causing TTM in non-EAs, to assess the detectability of their Plasmodium infection by molecular or antibody tests.</p><p><strong>Study design and methods: </strong>TTM cases in the United States, Canada, and Europe since 2010 were identified through a literature review. Authors and laboratories were contacted for missing details about sample types and laboratory methods. Results of Plasmodium polymerase chain reaction (PCR) and antibody tests were summarized.</p><p><strong>Results: </strong>Twelve cases of TTM and one bone marrow transplant transmission were identified. Of the 13 source donors, 12 were tested by PCR, 10 were positive on at least one sample; the 2 negative donors were tested only on retained segments of blood refrigerated for several weeks. All donors were PCR positive on a fresh sample except one who was positive on a retained but not a fresh sample. These PCRs targeted Plasmodium DNA with sensitivities in the range of 1000-10,000 parasites/mL. Antibody EIA was positive in only three of seven donors tested.</p><p><strong>Discussion: </strong>This review found that antibody EIAs failed to detect four of the seven TTM donors tested. DNA-based PCRs were able to detect Plasmodium infection in all donors tested except for two tested only on samples likely to have deteriorated from prolonged storage. Recently developed ribosomal RNA-based molecular donor screening assays are approximately 1000 fold more sensitive than these DNA-based PCRs, holding promise as a potential method to further reduce TTM.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142584358","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":"Splitting apheresis platelets as a contingency measure for inventory shortages.","authors":"Herleen Rai, Kyle Forsythe, Nyle Smith, Heather Smetana, Melissa A Neally, Christi Marshall, Ivo M B Francischetti, Paul M Ness, Evan M Bloch, Aaron A R Tobian, Elizabeth P Crowe","doi":"10.1111/trf.18055","DOIUrl":"https://doi.org/10.1111/trf.18055","url":null,"abstract":"<p><strong>Background: </strong>Splitting apheresis platelet (PLT) units increase available inventory during shortages. The impact of prolonged storage in gas-impermeable aliquot bags on PLT quality in vitro and transfusion outcomes in patients remains uncertain.</p><p><strong>Study design and methods: </strong>We assessed in vitro PLT quality and thromboelastography (TEG) in PLTs stored for 8 or 24 h in aliquot bags compared with baseline (T0). Retrospective assessment of response (PLT increment and corrected count increment (CCI)) was conducted among adults (≥18 years) transfused with split platelet units from January 2021 to June 2022.</p><p><strong>Results: </strong>No differences were observed in PLT and white blood cell (WBC) counts, mean platelet volume, or TEG parameters during storage, except for an increase in TEG R time (mean ± SD) at 24 h (6.1 ± 0.5 min) compared to T0 (4.4 ± 0.8 min), p = 0.0031 one-way ANOVA. Eighty-one patients were transfused 119 split units with a median [IQR] PLT yield of 2.1 × 10¹¹[1.9 × 10¹¹ to 2.3 × 10¹¹] and storage duration of 1.6[0.7-9.1] h. The overall median PLT count increment was 6.0 × 10³/uL and CCI was 5.0 × 10³, correlating negatively with split unit storage duration (Spearman rho = -0.218, p = 0.017). Compared with split transfusions of pathogen-reduced (PR) PLTs, non-PR splits were associated with higher median platelet count increments (7.0 × 10³/μL vs. 4.0 × 10³/μL, p = 0.0263 Mann-Whitney U) and higher CCIs (6.5 × 10³ vs. 3.9 × 10³, p = 0.0116 Mann-Whitney U) despite no differences in PLT yields (2.1 × 10¹¹/μL vs. 2.1 × 10¹¹/μL).</p><p><strong>Discussion: </strong>Storing PLTs in aliquot bags for 8 or 24 h does not adversely affect their quality in vitro. Splitting apheresis PLTs are feasible for adult transfusions during shortages. It may be advisable to prioritize non-PR PLTs for splitting given improved patient responses.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142584382","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":"Longitudinal outcomes of chronically transfused adults with sickle cell disease and a history of childhood stroke.","authors":"Jennifer M Jones, Julia Wool, Elizabeth P Crowe, Evan M Bloch, Lydia H Pecker, Sophie Lanzkron","doi":"10.1111/trf.18041","DOIUrl":"https://doi.org/10.1111/trf.18041","url":null,"abstract":"<p><strong>Background: </strong>Many children with sickle cell disease (SCD) who suffer a stroke receive chronic transfusion therapy (CTT) indefinitely; however, their adulthood neurologic outcomes have not been reported. Understanding these outcomes is critical to inform decisions regarding curative therapy in childhood.</p><p><strong>Study design and methods: </strong>In this retrospective study, we described a cohort of adults with SCD and a history of childhood stroke who received care at a single center and compared their outcomes with matched subjects without childhood stroke using chi² and Mann-Whitney U tests.</p><p><strong>Results: </strong>Of 42 subjects with childhood stroke, all received CTT for secondary stroke prophylaxis. Five (11%) developed recurrent stroke. The rate of stroke was similar in subjects with and without childhood stroke (0.7 vs. 1.1 per 100 person·years, p = .63). Both cohorts exhibited evidence of iron overload (median ferritin 2227 vs. 1409 ng/dL, p = .10) and alloimmunization (45% vs. 45%, p = 1.0), despite receiving care in a comprehensive SCD program.</p><p><strong>Discussion: </strong>For adults with SCD who had a childhood stroke, our results suggest CTT returns the risk of stroke to that of age-matched stroke naïve patients with SCD.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142584378","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":"High-frequency whole blood donation and its impact on mortality: Evidence from a data linkage study in Australia.","authors":"Md Morshadur Rahman, Surendra Karki, Andrew Hayen","doi":"10.1111/trf.18049","DOIUrl":"https://doi.org/10.1111/trf.18049","url":null,"abstract":"<p><strong>Background: </strong>Previous reports suggest that blood donors have a lower mortality risk, which may partially reflect the \"healthy donor effect\" (HDE). HDE arises in donors due to selection bias and confounding if not appropriately addressed.</p><p><strong>Study design and methods: </strong>Using the Sax Institute's 45 and Up Study data linked with blood donation history, we used a \"5-year exposure window\" method to select donors into regular high-frequency whole blood (WB)donors (at least two donations per exposure year) and low-frequency donors (remaining donors) with an active donation career of 5 years. To further reduce the confounding, we used statistical approaches like the inverse probability weighted (IPW) marginal structural model and the doubly robust targeted minimum loss-based estimator (TMLE), which incorporated machine learning algorithms and time-varying analyses.</p><p><strong>Results: </strong>We selected 4750 (64.7%) low-frequency and 2588 (35.3%) high-frequency donors in the analyses. A total of 69 (1.5%) from the low-frequency and 45 (1.7%) donors from the regular high-frequency group died during the 7-year follow-up period. We did not find any statistically significant association between regular high-frequency blood donation and mortality (IPW RR = 0.98 95% CI 0.68, 1.28). TMLE model also showed similar results to IPW (RR = 0.97 95% CI 0.80, 1.16). Time-varying TMLE did not find any significant association between high-frequency donation and all-cause mortality either (RR = 0.98 95% 0.74, 1.29).</p><p><strong>Conclusions: </strong>We did not find a significant association between regular high-frequency WB donation and all-cause mortality when appropriate methods were employed to minimize the HDE.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142569170","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":"Risk of introducing Zika virus in the Canadian cord blood supply: A risk analysis.","authors":"Antoine Lewin, Sheila F O'Brien, Matthew Seftel, Catherine Latour, David Allan, Marie-Claude Chouinard, Diane Fournier, Christian Renaud","doi":"10.1111/trf.18056","DOIUrl":"https://doi.org/10.1111/trf.18056","url":null,"abstract":"<p><strong>Background: </strong>In Canada, as many as 24% of mothers are deferred from cord blood (CB) donation due to risk factors for Zika virus (ZIKV). However, the ZIKV epidemic has waned considerably since 2016, and there has not been any report of ZIKV transmission by CB transplantation, which questions this policy. Thus, we performed an analysis of the risk of introducing ZIKV in the CB supply maintained by Héma-Québec (HQ) and Canadian Blood Services (CBS).</p><p><strong>Study design and methods: </strong>This simulation considered the following parameters: the risk of travel exposure in a high-risk ZIKV country, the duration of travel, the daily risk of acquiring ZIKV in a high-risk country, the probability of materno-fetal ZIKV transmission, the probability of asymptomatic fetal viremia, and the probability of sexual transmission. A hundred million Monte Carlo simulations were run.</p><p><strong>Results: </strong>In the most-likely scenario (probability of traveling to a high-risk ZIKV country while pregnant = 0.178), the risk was estimated at 0.9 ZIKV-positive donations per million donations (95% confidence interval [CI] = 0.4-1.6)-or one every 868 years at HQ and one every 453 years at CBS. In the pessimistic model (probability of traveling to a high-risk ZIKV country while pregnant = 0.240), the risk was estimated at 1.2 ZIKV-positive donations per million donations (95% CI = 0.6-2.1)-or one every 644 years at HQ and one every 340 years at CBS.</p><p><strong>Discussion: </strong>We conclude that the risk of introducing ZIKV in the Canadian CB supply is too small to justify maintaining the current policy.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142576617","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":"Interactive transfusion dashboard with capability to monitor key performance indicators in a healthcare system.","authors":"Addisalem T Makuria, Kari Martin, Fnu Poonam, Aparna Thombare, Walter Pofahl, John T Fallon","doi":"10.1111/trf.18048","DOIUrl":"https://doi.org/10.1111/trf.18048","url":null,"abstract":"","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142564055","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":"Exposure of cryopreserved red cell concentrates to real-world transient warming events has a negligible impact on quality.","authors":"Jayme Kurach, Mackenzie Brandon-Coatham, Carly Olafson, Tracey R Turner, Celina Phan, Mahsa Yazdanbakhsh, Rafay Osmani, Behrouz Ehsani-Moghaddam, Gwen Clarke, Jason P Acker","doi":"10.1111/trf.18054","DOIUrl":"https://doi.org/10.1111/trf.18054","url":null,"abstract":"<p><strong>Background: </strong>Red cell concentrates (RCCs) may be cryopreserved at Canadian Blood Services (CBS) for up to 10 years; however, inadvertent warming of these units over the prescribed storage temperature (≤ -65°C) may occur. These units may be discarded from inventory to avoid potential adverse transfusion outcomes. This study aimed to assess the quality of RCCs that experienced unintentional transient warming events (TWEs) related to freezer failures.</p><p><strong>Study design: </strong>Thirty cryopreserved RCCs with known TWEs were selected for this study and classified into three different experimental groups (Event 1 (n = 5) TWE > -65°C for 34 min; Event 2 (n = 23) TWE > -65°C for 48 h; and both Event 1 and Event 2 (n = 2) TWE > -65°C for 34 min and 48 h). Ten additional RCCs with no known TWEs, cryopreserved over the same period, were selected as controls. Thawed RCCs were deglycerolized using the Haemonetics ACP 215, and in vitro quality was assessed throughout hypothermic storage.</p><p><strong>Results: </strong>RCCs from the control and all three experimental groups met the Canadian Standards Association (CSA) guidelines for hematocrit, total hemoglobin, and hemolysis at expiry. RCCs experiencing a singular TWE had similar in vitro quality to control RCCs.</p><p><strong>Discussion: </strong>This study's findings revealed that single exposures to specific documented TWEs did not significantly impact the quality of RCCs post-deglycerolization. While units should still be assessed on a case-by-case basis upon TWE, our work provides the first-ever evidence that supports a broader policy of unit retention by blood centers.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142558870","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 two novel variants, c.-35A>T and c.[-35A>T, 725T>G], in the FUT1 gene in a patient exhibiting the para-Bombay phenotype.","authors":"Kamphon Intharanut, Piyathida Khumsuk, Sarisa Chidtrakoon, Kantaphon Glab-Ampai, Oytip Nathalang","doi":"10.1111/trf.18053","DOIUrl":"https://doi.org/10.1111/trf.18053","url":null,"abstract":"<p><strong>Background: </strong>Reduced or absent H antigens on red cells with the (para-)Bombay phenotype can arise from FUT1 gene mutations, impacting the structure and function of 1,2-L-fucosyltransferase 1 (1,2-L-FucT1). Here, we identified the novel mutations in one patient displaying the para-Bombay phenotype and examined the potential molecular mechanisms underlying this phenotype.</p><p><strong>Materials and methods: </strong>ABH antigens and antibodies were detected in patient's blood and saliva using serological methods. The genotypes of ABO, FUT1, and FUT2 were imputed using the genetic variations discovered in the whole exome sequencing data. Three-dimensional (3D) models of FUT1 variants were built using Deepmind's AlphaFold2 and HDOCK, and the possible effects of the variants were predicted to evaluate using DynaMut2 and Polyphen-2.</p><p><strong>Results: </strong>Serological analysis confirmed the para-Bombay B phenotype producing anti-HI and exhibiting normal genotypes ABO*B.01/O.01.02 and FUT2*01.09/01.09. Remarkably, the phenotype is caused by a compound heterozygous genotype: one allele containing the novel c.-35A>T mutation and the known c.725T>G mutation (p.Leu242Arg) of FUT1, and the other allele containing the c.-35A>T mutation. From the computerized stimulation analysis, p.Arg242 of the FUT1 variant may be detrimental, destabilizing, and probably damaging to 1,2-L-FucT1, although not altering the 3D structure of the entire enzyme. The c.-35A>T promoter DNA left at the binding interface of both ZID and c-Rel transcription factors may enable regulation of 1,2-L-FucT1 function at gene promoters.</p><p><strong>Conclusion: </strong>We identified the two novel variants, c.-35A>T and c.[-35A>T, 725T>G], in the FUT1 causing the para-Bombay phenotype. This finding may clarify the molecular mechanisms and enhance blood transfusion safety.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142547660","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":"Management of human leukocyte antigen-mediated platelet transfusion refractoriness: Brief synopsis and recent literature review.","authors":"Sandhya R Panch, Ralph R Vassallo, Sharon Adams, Dayand P Borge, Richard Gammon, Manish J Gandhi, Mary Philogene, Harold C Sullivan, YanYun Wu, Patricia Kopko","doi":"10.1111/trf.18036","DOIUrl":"https://doi.org/10.1111/trf.18036","url":null,"abstract":"","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142508733","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":"Shared decision-making for patients with vaccine-related concerns of blood transfusion: A single institution experience.","authors":"David J Cho, Allan M Klompas, Jessica A Gonzalez, Jamie L Petsch, Jen M Burt, Daryl J Kor, Jeffrey L Winters, Camille M van Buskirk, Matthew A Warner","doi":"10.1111/trf.18052","DOIUrl":"https://doi.org/10.1111/trf.18052","url":null,"abstract":"<p><strong>Background: </strong>Some patients express concerns regarding receipt of allogeneic blood transfusions from donors potentially vaccinated against SARS-CoV-2 (COVID-19). However, limited information exists about patients' expression of these concerns or how to address them during the blood transfusion consent process. In this study, we describe our experience of working collaboratively with patients with vaccine-related transfusion concerns prior to elective surgery, summarizing treatment decisions and clinical outcomes.</p><p><strong>Study design and methods: </strong>This observational descriptive study includes patients seen in our Bloodless Medicine and Surgery clinic between June 2022 and June 2024 for vaccine-related transfusion concerns prior to elective surgery. A shared decision-making framework was employed to foster conversation, share information, provide reassurance, reconcile conflict, and match preferences with available care options. Patient characteristics, treatment decisions, and surgical outcomes were reviewed and summarized.</p><p><strong>Results: </strong>Thirty-five patients were included, with median (1st, 3rd quartile) age of 61 (53, 69) years. Cardiac surgery was the most common type of surgery (29%). Twelve patients (34%) were anemic preoperatively, and all received preoperative treatment. After discussion with a Bloodless Medicine specialist, 24 (68.6%) decided to consent to the use of all blood products, 5 (14.3%) accepted only red blood cells, and 6 (17.1%) declined all blood products. Among 28 patients undergoing surgery, only 4 (14%) received allogeneic transfusion perioperatively.</p><p><strong>Conclusion: </strong>Many patients concerned about the vaccination status of blood donors may ultimately consent to allogeneic blood products after shared decision-making with a Bloodless Medicine specialist, highlighting the importance of patient empowerment and collaborative care.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142508734","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}