Transfusion最新文献

{"title":"Effective combined immunotherapy for severe hemolytic disease of the fetus.","authors":"Annina Capraru, Michael Daskalakis, Martin Mueller, Luigi Raio, Behrouz Mansouri Taleghani, Sacha Zeerleder","doi":"10.1111/trf.70426","DOIUrl":"https://doi.org/10.1111/trf.70426","url":null,"abstract":"<p><strong>Background: </strong>Maternal anti-Kell and anti-Rhesus D-alloimmunization cause severe hemolytic disease of the fetus and newborn (HDF) by crossing the placenta, leading to anemia and hydrops fetalis. Early-onset HDF from anti-K and anti-RhD alloimmunization often requires multiple, early intrauterine transfusions (IUTs), with higher complication rates and decreased sensitivity after the first intervention. Mortality remains high.</p><p><strong>Case report: </strong>We report the successful treatment of three pregnant women with high-titer red cell alloantibodies-two with anti-K and one with anti-RhD-during the first trimester, a period with otherwise limited therapeutic options. We applied a novel triple therapy consisting of immunoadsorption (IA), high-dose intravenous immunoglobulin (IVIG), and rituximab (Rtx) (IIR). This approach resulted in a marked reduction of antibody titers: anti-D decreased from 1:1024 to 1:16, and anti-K from 1:8192 and 1:2048 to 1:32, respectively. One patient presented at 19 weeks of gestation with fetal hydrops, severe anemia, and thrombocytopenia. IIR reduced the need for invasive procedures (intrauterine transfusions) and led to resolution of fetal thrombocytopenia. In the remaining two high-risk cases, IIR prevented the onset of fetal anemia. All neonates were delivered healthy and without anemia.</p><p><strong>Conclusion: </strong>This case series presents a novel, safe personalized prophylactic and therapeutic approach that may delay anemia onset and reduce invasive procedures in high-risk patients with limited options and resulted in healthy neonates without apparent comorbidities.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149228756","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":"Passive acquisition of hepatitis B virus antibodies after allogeneic hematopoietic cell transplantation.","authors":"Takaaki Konuma, Maki Monna-Oiwa, Etsuko Nagai, Seiko Kato, Shohei Andoh, Junichi Kuroda, Satoshi Takahashi, Yasuhito Nannya","doi":"10.1111/trf.70448","DOIUrl":"https://doi.org/10.1111/trf.70448","url":null,"abstract":"<p><strong>Background: </strong>Newly positive hepatitis B virus (HBV) serologic results after allogeneic hematopoietic cell transplantation (HCT) may reflect passive antibody transfer from blood-derived products rather than HBV infection. We investigated the incidence and temporal patterns of hepatitis B surface antibody (anti-HBs) and antibody to hepatitis B core antibody (anti-HBc) acquisition after allogeneic HCT.</p><p><strong>Study design and methods: </strong>We retrospectively evaluated 193 adults who underwent allogeneic HCT for hematologic diseases between May 2012 and March 2025 at a single institution in Japan. Anti-HBs, anti-HBc, and hepatitis B surface antigen (HBsAg) were assessed before and after HCT.</p><p><strong>Results: </strong>Among 180 patients who were anti-HBc negative before HCT, 6 (3.3%) developed anti-HBc positivity after HCT. Among 164 patients who were anti-HBs negative before HCT, 49 (29.9%) developed anti-HBs positivity. All patients with newly detectable antibodies remained HBsAg negative, and available HBV DNA measurements showed no evidence of active HBV infection. Among patients with subsequent follow-up measurements, anti-HBc disappeared in 3 of 3 evaluable patients after a median of 240 days, whereas anti-HBs declined or disappeared in 30 of 32 evaluable patients after a median of 119 days. Among patients receiving neither fresh frozen plasma nor intravenous immunoglobulin, anti-HBs concentrations increased significantly after HCT (p< .0001), with a greater increase among those receiving ≥24 versus ≤23 platelet transfusions (p = .0437).</p><p><strong>Discussion: </strong>Newly detectable HBV antibodies were common after HCT without virologic evidence of infection, suggesting passive antibody transfer from cellular blood components, particularly platelets.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149228775","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":"Long-term temporal trends in hepatitis B and C among blood donors in Brazil: Prevalence, incidence, and demographic correlates from the REDS multicenter program.","authors":"André Rolim Belisário, Paulo Jeng Chian Suen, Isabelle Rocha de Oliveira, Teresa Cristina Abreu de Ferrari, Maisa Aparecida Ribeiro, Carolina Miranda, Marcio Oikawa, Luiz Amorim, Edyla Almeida, Allyson Guimarães da Costa, Cesar de Almeida-Neto, Eduard Grebe, Renata Buccheri, Michael P Busch, Sarah Fortier Wilson, Brian Custer, Ester C Sabino","doi":"10.1111/trf.70446","DOIUrl":"https://doi.org/10.1111/trf.70446","url":null,"abstract":"<p><strong>Background: </strong>Viral hepatitis remains a major public health challenge. We evaluated long-term trends in hepatitis B virus (HBV) and hepatitis C virus (HCV) prevalence, incidence, and force of infection (FOI) among blood donors from five Brazilian blood centers and investigated associated demographic factors.</p><p><strong>Study design and methods: </strong>Data from the NHLBI Recipient Epidemiology and Donor Evaluation Study program were analyzed. Prevalence was estimated among 2,062,816 first-time donors for HBV (2008-2023) and 1,673,745 for HCV (2012-2023). Incidence was estimated among 1,346,256 repeat donors for HBV and 1,151,209 for HCV. Active HBV infection was defined by reactive HBsAg and anti-HBc or reactive HBV nucleic acid testing (NAT), and active HCV infection by reactive NAT. Historical FOI was estimated using a Bayesian serocatalytic model.</p><p><strong>Results: </strong>Active infection prevalence was 136.2 per 100,000 donors (95% CI, 131.2-141.3) for HBV and 57.4 (95% CI, 53.8-61.1) for HCV. Incidence rates were 3.54 (95% CI, 3.01-4.11) and 3.99 (95% CI, 3.33-4.72) per 100,000 person-years, respectively. Prevalence decreased annually by 7.6% for HBV and 11.0% for HCV. Higher prevalence and incidence were associated with male sex, older age, lower educational attainment, and Black or mixed-race skin color. Regional differences persisted, and FOI declined markedly for both infections.</p><p><strong>Discussion: </strong>HBV and HCV prevalence, incidence, and FOI declined substantially among Brazilian blood donors, suggesting reduced transmission, although improved donor selection and screening may also have contributed. Persistent demographic and regional disparities support continued surveillance and targeted prevention.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149224890","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 RHD allele c.1136C>A (p.Thr379Lys) encodes a serologic weak D phenotype in a Han Chinese individual.","authors":"Xiaoyu Guan, Mengdan Li, Jiaxun Zhang, Jue Wang, Zhong Liu, Ling Li","doi":"10.1111/trf.70437","DOIUrl":"https://doi.org/10.1111/trf.70437","url":null,"abstract":"","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149220784","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":"Quality improvement program for transfusion reaction reporting and management.","authors":"Erica Martel, Kenneth Forte, Elizabeth Tremblay, Andriana Foiles, Cheryl Green, Todd Lane, Lisa Krause, Sheyla Marranca, Wei Teng, Christopher A Tormey, Edward L Snyder, Nalan Yurtsever","doi":"10.1111/trf.70449","DOIUrl":"https://doi.org/10.1111/trf.70449","url":null,"abstract":"<p><strong>Background: </strong>Transfusion reactions are underreported, with reported rates up to 87% lower than expected for serious reactions such as transfusion-associated circulatory overload (TACO). We implemented a multicomponent quality improvement initiative to improve recognition and reporting of transfusion reactions.</p><p><strong>Study design and methods: </strong>The initiative combined standardized nursing education with an electronic medical record (EMR)-integrated structured workflow, the Care Signature Transfusion Reaction Pathway, to standardize recognition, evaluation, and management of suspected reactions. We also developed an automated transfusion reaction dataset to retrospectively audit transfusion events and identify reactions not captured through routine reporting.</p><p><strong>Results: </strong>Transfusion reaction education was incorporated into the institutional learning management system for nursing staff. During its initial six-month rollout, the Care Signature Transfusion Reaction Pathway was accessed 258 times. Retrospective surveillance identified 36 previously unreported reactions across the health system, including 22 TACO cases. Combined with the 17 TACO reactions reported to the blood banks, these additional cases represented a 129% increase in TACO identification. Following implementation, the overall transfusion reaction reporting rate at the index site increased from 0.627% to 0.683%, and the TACO identification rate increased by 293%.</p><p><strong>Conclusion: </strong>A multicomponent intervention comprising standardized nursing education, an EMR-integrated transfusion reaction pathway, and automated retrospective surveillance improved transfusion reaction recognition and reporting. The intervention identified 36 previously unreported reactions, particularly TACO, and increased TACO identification both across the health system and at the index site. This approach used existing health-system infrastructure to enhance surveillance across diverse hospital settings and may be scalable to other health systems.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149220764","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 RHCE*01.48 allele associated with weak clone-dependent E-like reactivity: Serologic, molecular, and computational analysis.","authors":"Higinio Estrada-Juárez, Rocio Trueba-Gómez, Brianna Mackey, Stephanie Miller, Gregory A Denomme, Bradley Lanford, Marianne Stef","doi":"10.1111/trf.70424","DOIUrl":"https://doi.org/10.1111/trf.70424","url":null,"abstract":"<p><strong>Background: </strong>The polymorphic nature of the RH blood group system frequently causes serologic discrepancies relevant to transfusion practice. We describe a novel RHCE variant associated with weak, clone-dependent E-like reactivity and explore its molecular and structural correlates.</p><p><strong>Methods: </strong>Serologic investigation was performed by standard tube testing using multiple commercial monoclonal anti-E reagents. Molecular characterization utilized Illumina next-generation sequencing (NGS). Computational analyses included I-TASSER-based model generation, integration into the 7UZQ cryogenic electron microscopy (cryo-EM) erythrocyte membrane scaffold, FoldX energy calculations, three-dimensional (3D)-Surfer surface comparison, CASTp cavity analysis, and membrane-orientation simulations.</p><p><strong>Results: </strong>Donor red blood cells showed discrepant reactivity with anti-E reagents, demonstrating weak positive reactions (1+) with clones GAMA402, MS-260, and DEM1, but no reactivity with clone 906 or single-source anti-E plasma. NGS identified a novel c.680T>C variant in one of two RHCE*01 alleles on a c.676G homozygous background, predicting a p.Leu227Pro substitution. The allele was provisionally designated RHCE*01.48 by the International Society of Blood Transfusion (ISBT) (GenBank: PZ350914). The amino acid change p.Leu227Pro is immediately adjacent to the canonical residue 226 E/e determinant and modeling identified localized differences in surface topology, cavity architecture, and solvent exposure relative to the reference ce model.</p><p><strong>Conclusion: </strong>RHCE*01.48 is a novel RHCE allele associated with weak, clone-dependent E-like reactivity. Structural modeling generated a plausible hypothesis that localized conformational differences near the canonical E/e determinant may contribute to the observed serologic phenotype. Recognition of such variants may help resolve genotype-phenotype discrepancies and support accurate Rh typing.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149216848","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 FUT1 variant c.35C>A associated with an H-deficient phenotype in a Palestinian family.","authors":"Alex Ballout, Ihab Hilo, Tareq Hindi, Bassil Leghrouz, Maram Eid, Hani Saleh, Khadra Salami, Mahmoud Ramlawi, Musa Hindiyeh","doi":"10.1111/trf.70440","DOIUrl":"https://doi.org/10.1111/trf.70440","url":null,"abstract":"","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149207987","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 sickling pressure index predicts hemoglobin S target achievement during chronic red cell exchange in sickle cell disease.","authors":"Austin Choi, Menatalla Nadim, Nicholas Parisi, Yamac Akgun","doi":"10.1111/trf.70444","DOIUrl":"https://doi.org/10.1111/trf.70444","url":null,"abstract":"<p><strong>Background: </strong>Chronic automated red cell exchange (RCE) reduces hemoglobin S (HbS) in patients with sickle cell disease (SCD), but procedural success varies across patients in ways standard exchange parameters do not explain. We introduce the Sickling Pressure Index (SPI), derived from each patient's daily rate of HbS rise (ROR) and daily rate of hematocrit fall (ROF).</p><p><strong>Study design and methods: </strong>This retrospective single-center cohort study included 19 patients with SCD undergoing chronic automated RCE and contributing 115 procedures over 40 months. ROR was calculated as the inter-procedure rise in HbS% per day, ROF as the inter-procedure hematocrit decline per day, and SPI as ROR/ROF. Patients were classified as Low SPI (n = 8) or High SPI (n = 11). Group differences were assessed by Mann-Whitney U test, and procedure-level target achievement by Fisher's exact test and generalized estimating equations (GEE).</p><p><strong>Results: </strong>High-SPI patients had a significantly higher ROR (median 0.635 vs. 0.511 %HbS/day; p = .026) and lower ROF (0.068 vs. 0.129 %Hct/day; p = .002). The pre-procedure HbS target was met at 70.8% (34/48) of Low-SPI encounters versus 47.6% (30/63) of High-SPI encounters (OR 2.67; p = .020; GEE-adjusted OR 2.65, 95% CI 1.07-6.59; p = .036). Groups did not differ in exchange interval, fraction of cells remaining, or units transfused per day, though High-SPI patients trended toward higher absolute RBC use per procedure (p = .090).</p><p><strong>Conclusion: </strong>The SPI identifies patients with SCD on chronic RCE whose intrinsic HbS accumulation kinetics, rather than procedural factors, drive target failure. Calculable from routine apheresis data, the SPI may support individualized scheduling.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149196880","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":"Backflow of patient blood during transfusion causing clotting.","authors":"Vendela Brismar, Daniel Wessman, Stella Larsson","doi":"10.1111/trf.70425","DOIUrl":"https://doi.org/10.1111/trf.70425","url":null,"abstract":"","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149196804","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":"Erratum to \"Assessment of the efficacy of large volume delayed sampling primary culture and pathogen reduction in preventing septic reactions from platelet transfusions\".","authors":"","doi":"10.1111/trf.70407","DOIUrl":"https://doi.org/10.1111/trf.70407","url":null,"abstract":"","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149196869","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}