Transfusion最新文献_第2页

Increasing use of CAR-T therapy occurs in conjunction with decreasing stem cell transplants with stable resource usage over a 6-year period: Resource utilization implications.

IF 2.5 3区医学

Transfusion Pub Date : 2025-02-17 DOI: 10.1111/trf.18167

Aswath P Chandrasekar, Margret A DiGuardo, Jeffrey L Winters, Carl W Greiner, David Dingli, Hassan B Alkhateeb, Eapen K Jacob

{"title":"Increasing use of CAR-T therapy occurs in conjunction with decreasing stem cell transplants with stable resource usage over a 6-year period: Resource utilization implications.","authors":"Aswath P Chandrasekar, Margret A DiGuardo, Jeffrey L Winters, Carl W Greiner, David Dingli, Hassan B Alkhateeb, Eapen K Jacob","doi":"10.1111/trf.18167","DOIUrl":"https://doi.org/10.1111/trf.18167","url":null,"abstract":"Background: Since FDA approval in 2017, CAR-T therapy has seen rapid clinical adoption. Shifting clinical trends have emerged with increasing utilization of CAR-T therapies and a downward trend in HSCTs. Given the overlapping resources required for the manufacture and storage of these products, we sought to examine trends over a 6-year period.Methods: The apheresis patient database and Lab database were reviewed to compile a list of patients that underwent either CAR-T or HSCT (autologous) collections, and/or received CAR-T or autologous HSCT infusions between January 1, 2018 and December 12, 2023. This was further examined by year and disease group.Results: The total number of patients collecting for CAR-T increased from 52 in 2018 to 150 in 2023 (slope = 21.97; p = .0013), accompanied by a decrease in the number of patients collecting for HSCT, from 425 in 2018 to 341 in 2023 (slope = -21.2; p = .0177). Neither total number (calculated as number of HSCT + CAR-T) of patients collected (mean 476 + 20.4 per year), nor collection procedures (mean 972 ± 75.8 per year) changed significantly over the 6-year period. The total number of CAR-T infusions increased from 24 in 2018 to 111 in 2023 (slope = 17.7; p = .004), with a decrease in auto-HSCT from 400 to 289 (slope = -28.7; p = .008). The overall number of infusions (calculated as number of HSCT + CAR-T) did not change significantly (slope = -10.9; p = .13) over the 6-year period.Discussion: Our findings confirm the increasing adoption of CAR-T therapy occurring alongside a decreasing stem-cell transplants, with stable overall resource utilization.","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433897","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}

引用次数: 0

Expanded use of liquid plasma in non-emergency transfusions: A single academic institution experience.

IF 2.5 3区医学

Transfusion Pub Date : 2025-02-14 DOI: 10.1111/trf.18163

Joseph P Connor, Soumya Jaladi, Wenjing Cao, Debra M Lehman, Thomas J Raife

{"title":"Expanded use of liquid plasma in non-emergency transfusions: A single academic institution experience.","authors":"Joseph P Connor, Soumya Jaladi, Wenjing Cao, Debra M Lehman, Thomas J Raife","doi":"10.1111/trf.18163","DOIUrl":"https://doi.org/10.1111/trf.18163","url":null,"abstract":"Background: Liquid plasma (LP) is isolated from whole blood donations, never frozen, and can be immediately transfused. Its primary indication is initial treatment of patients undergoing massive transfusion. To minimize wastage of this resource, we expanded the use of LP to include surgical and routine transfusions.Methods: Our medical record was queried for plasma transfusions with at least one unit of LP issued. Chart review identified the indications for transfusion (emergency use, surgical use, or routine transfusion) and assessed effects of LP on coagulopathy, the use of additional blood products, and mortality. LP cases were categorized into two groups based on the fraction of LP transfused (≤50% or >50% LP). A control group of routine transfusion using only thawed plasma (TP) was reviewed and statistically compared to those cases where LP was included.Results: Eight hundred ninety cases were studied including 34% emergency/massive transfusion events, 44% surgical cases, and 11% routine transfusions. In surgeries using LP, there were no significant differences in outcomes based on higher fractions of LP transfused. The correction of coagulopathy, the need for additional blood products, and the encounter-specific mortality were consistent across both routine transfusions with higher fractions of LP and comparing LP transfusion events to control TP transfusion events.Conclusion: The utilization of LP in surgical cases and routine plasma transfusions was not associated with worse clinical outcomes and effectively prevented product waste. This report supports the broader use of and further study of LP in patient care.","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426319","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}

引用次数: 0

How do we implement a prehospital whole blood administration program for shock trauma patients on a statewide basis?

IF 2.5 3区医学

Transfusion Pub Date : 2025-02-13 DOI: 10.1111/trf.18160

Robert A Rosenbaum, Mollee Dworkin, Justin Eisenman, Paul Cowan, Kyle Burch, Jordan Dattoli, David Aber, Kelli Starr-Leach, John Wright, Robert Mauch, Michael Nichols, Mark Logemann, Christopher Johnson, Britany Huss, Michelle E Jones, Dawn Shane, Sydney Kappers, Bruce S Sachais, Kristin M Frederick

{"title":"How do we implement a prehospital whole blood administration program for shock trauma patients on a statewide basis?","authors":"Robert A Rosenbaum, Mollee Dworkin, Justin Eisenman, Paul Cowan, Kyle Burch, Jordan Dattoli, David Aber, Kelli Starr-Leach, John Wright, Robert Mauch, Michael Nichols, Mark Logemann, Christopher Johnson, Britany Huss, Michelle E Jones, Dawn Shane, Sydney Kappers, Bruce S Sachais, Kristin M Frederick","doi":"10.1111/trf.18160","DOIUrl":"https://doi.org/10.1111/trf.18160","url":null,"abstract":"Background: Since bleeding is a major cause of early mortality in trauma, there is continued interest in providing transfusion support as early as possible to trauma patients. Various approaches have been taken to accomplish this, including the rapid provision of blood products upon arrival at the hospital, as well as a variety of prehospital approaches. However, implementing prehospital blood availability statewide for use in all populations has been limited.Study design and methods: The program described for prehospital transfusion identifies a direct partnership between state EMS providers and the local blood center. Predictive modeling is compared to early outcome data of the first 100 patients who received whole blood from this program. Additional discussion contains key elements of the program, including planning, validation, and implementation.Results: Between May 2023 and July 2024, an average of 11 prehospital whole blood units were transfused per month against the projected average of 10-16 units administered per month, with the median time to transfusion of 29.2 min. The leading reason for blood administration was due to blunt trauma. Of the patients who were not in prehospital cardiac arrest prior to paramedic arrival or excluded for other reasons, approximately 95% survived to hospital discharge.Discussion: Implementation of prehospital whole blood across the state has demonstrated effectiveness early within the first year of the program. Continued process improvements will be implemented with statewide ground paramedic agency utilization of whole blood as well as expansion into aviation divisions for more expedient whole blood administration times.","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143415348","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}

引用次数: 0

Exploring the experiences of hemochromatosis (HHC) patients who undergo therapeutic venesection at a blood collection agency.

IF 2.5 3区医学

Transfusion Pub Date : 2025-02-12 DOI: 10.1111/trf.18153

Rachel Thorpe, Barbara Masser, Carley N Gemelli, Elizabeth Knight, Carol Jos, Peter J Bentley, Jan Maddern, Justine O'Donovan, Athina Kakkos, Marijke Welvaert

{"title":"Exploring the experiences of hemochromatosis (HHC) patients who undergo therapeutic venesection at a blood collection agency.","authors":"Rachel Thorpe, Barbara Masser, Carley N Gemelli, Elizabeth Knight, Carol Jos, Peter J Bentley, Jan Maddern, Justine O'Donovan, Athina Kakkos, Marijke Welvaert","doi":"10.1111/trf.18153","DOIUrl":"https://doi.org/10.1111/trf.18153","url":null,"abstract":"Background: People with hereditary hemochromatosis (HHC) require therapeutic phlebotomy on an ongoing basis. Little is known about the facilitators and barriers they experience in donating at a blood collection agency (BCA), nor how these impact their willingness to engage in an ongoing relationship with a BCA. This study explored the experiences of HHC donors undergoing therapeutic phlebotomy at the Australian Red Cross Lifeblood (Lifeblood) in Australia.Study design and methods: All HHC donors who had made at least one donation at Lifeblood in the last 2 years were invited to complete a survey. In this paper, we report the findings on enablers and barriers to donating at Lifeblood, donor and patient identity, communication, knowledge of blood use and of plasma, interest in donating plasma, and engagement in positive word of mouth about donating.Results: Data were obtained from 4350 therapeutic donors. Responders identified more enablers than barriers to donating at Lifeblood and 61.8% reported that Lifeblood used their blood. Responders were more likely to identify as donors than patients, and those with a stronger donor than patient identity were significantly more likely to report that their blood was used, had greater interest in donating plasma, and reported engaging in more positive word of mouth about donating.Discussion: Findings indicate that BCAs can do more to educate donors with HHC about how their blood is used to help others. Doing so may help to retain them as donors and can be beneficial for the blood supply, as well as for the donors themselves.","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143411097","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}

引用次数: 0

Deglycerolization of manually glycerolized, frozen red cell concentrates using a closed system cell processor.

IF 2.5 3区医学

Transfusion Pub Date : 2025-02-10 DOI: 10.1111/trf.18156

Anita Howell, Jayme Kurach, Nishaka William, Angela Hill, Brandie Dennis, Jason P Acker

{"title":"Deglycerolization of manually glycerolized, frozen red cell concentrates using a closed system cell processor.","authors":"Anita Howell, Jayme Kurach, Nishaka William, Angela Hill, Brandie Dennis, Jason P Acker","doi":"10.1111/trf.18156","DOIUrl":"https://doi.org/10.1111/trf.18156","url":null,"abstract":"Background: Historically, red cell concentrates (RCCs) have been manually glycerolized and deglycerolized using an open system (COBE 2991, Terumo). Implementation of a closed system cell processor (ACP-215, Haemonetics) for glycerolization and deglycerolization of RCCs creates a challenge for management of the historic cryopreserved RCC inventory. A study was undertaken to determine whether manually glycerolized frozen RCCs could be deglycerolized using the closed system processor, as the open system processors are being discontinued.Study design and methods: Thirteen ABO/Rh matched RCCs were pooled and split to produce six large (approximately 354 mL) and six small (approximately 244 mL) RCCs. All units were stored for 14 days post-collection, manually glycerolized and frozen at ≤ -65°C for ≥72 h. Half of the units of each size were deglycerolized using the COBE 2991 and resuspended in 0.9% saline, and the remaining units were centrifuged, deglycerolized on the ACP-215, and resuspended AS-3. RBC quality was tested at 24 ± 2 h post-deglycerolization.Results: All units deglycerolized on the ACP-215 had significantly lower hemolysis (p < .001) levels than those processed on the COBE2991. Large ACP-215 deglycerolized units had lower hematocrits (p < .05), hemoglobin (p < .01), and recovery (p = .001) than did large units deglycerolized on the COBE 2991. All ACP-215 units met the regulatory standards for hemolysis, hematocrit, hemoglobin, and recovery.Discussion: The closed-system ACP-215 processor significantly reduced post-deglycerolization hemolysis in all units, and hemoglobin content in large units. The ACP-215, in combination with a centrifugation step, is suitable for processing cryopreserved RCCs that have been manually glycerolized.","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143383406","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}

引用次数: 0

Genetic background of anti-CD99 producers in Japan and analysis of hemolytic transfusion reactions due to anti-CD99.

IF 2.5 3区医学

Transfusion Pub Date : 2025-02-10 DOI: 10.1111/trf.18126

Naoko Watanabe-Okochi, Hatsue Tsuneyama, Makoto Kumamoto, Sho Tanaka, Tomoko Nakazono, Kuninori Ichinomiya, Yumi Suzuki, Kenichi Ogasawara, Makoto Uchikawa, Shinichi Naganuma, Sumie Hayashi, Hiroyuki Igarashi, Nelson-Hirokazu Tsuno, Kazuo Muroi

{"title":"Genetic background of anti-CD99 producers in Japan and analysis of hemolytic transfusion reactions due to anti-CD99.","authors":"Naoko Watanabe-Okochi, Hatsue Tsuneyama, Makoto Kumamoto, Sho Tanaka, Tomoko Nakazono, Kuninori Ichinomiya, Yumi Suzuki, Kenichi Ogasawara, Makoto Uchikawa, Shinichi Naganuma, Sumie Hayashi, Hiroyuki Igarashi, Nelson-Hirokazu Tsuno, Kazuo Muroi","doi":"10.1111/trf.18126","DOIUrl":"https://doi.org/10.1111/trf.18126","url":null,"abstract":"Background: The XG blood group system comprises two antigens, Xga and CD99. CD99 is known to be carried on both the X and Y chromosomes in pseudoautosomal region 1. We identified five unrelated Japanese individuals with anti-CD99 and investigated their genomic background as well as the clinical significance of anti-CD99.Study design and methods: Analysis of CD99 expression on RBCs and a modified monocyte monolayer assay was performed using flow cytometry. Genomic DNA was obtained from the five anti-CD99 producers to identify the deleted region responsible for the lack of CD99, and we conducted a long polymerase chain reaction using primer pairs specific for CD99 and GYG2.Results: CD99 expression from the Y chromosome was higher than that from the X chromosome. The five anti-CD99 plasma samples gave varied agglutination strengths with the red blood cells (RBCs) expressing high and low CD99 levels, in the antiglobulin test. The phagocytosis rate of anti-CD99-sensitized RBCs was 76.6% in one case indicating a risk of hemolytic transfusion reactions (HTR), and it correlated with the level of CD99 expression. The deleted region spanned 115 kb, from CD99 exon 3 to GYG2 exon 1. All five anti-CD99 producers were homozygous for the large deletion allele.Discussion: All five anti-CD99 producers were females with a history of pregnancy in Kyushu, Japan, and this deletion allele may thus be endemic. Our results indicated the possibility of HTR due to anti-CD99, and the risk is low when transfusing RBC products from Xg(a-) females with a low expression of CD99.","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143383408","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}

引用次数: 0

Low-titer group O whole blood implementation in a tertiary care hospital in Estonia.

IF 2.5 3区医学

Transfusion Pub Date : 2025-02-05 DOI: 10.1111/trf.18137

Riin Kullaste, Marika Pikta, Mari Loot, Stanislava Russakova, Eve Laansoo, Kadri Rohtla, Gulara Khanirzajeva, Ene Vadi, Dina Ljahh

引用次数: 0

Use of an anti-D-alloimmunization kinetics model to correct the interval censored D-alloimmunization rate following red blood cell transfusions.

IF 2.5 3区医学

Transfusion Pub Date : 2025-02-05 DOI: 10.1111/trf.18138

Emil Ainsworth Jochumsen, Kathleen Selleng, Jay S Raval, Carolina Bonet Bub, Jose M Kutner, Ulrik Sprogøe, Mark H Yazer

{"title":"Use of an anti-D-alloimmunization kinetics model to correct the interval censored D-alloimmunization rate following red blood cell transfusions.","authors":"Emil Ainsworth Jochumsen, Kathleen Selleng, Jay S Raval, Carolina Bonet Bub, Jose M Kutner, Ulrik Sprogøe, Mark H Yazer","doi":"10.1111/trf.18138","DOIUrl":"https://doi.org/10.1111/trf.18138","url":null,"abstract":"Introduction: The rate of D-alloimmunization amongst RhD-negative recipients of RhD-positive red blood cell (RBC) transfusions is not certain. Recipients with a short duration between the index RhD-positive transfusion and the last antibody detection test that did not show anti-D might become D-alloimmunized in the future. A regression model was developed to predict how often such patients might develop D-alloimmunization in the future to help account for the immunohematological uncertainty that accompanies having short serological follow up periods.Methods: Using the published literature on recipients who were intentionally transfused with RhD-positive RBCs and serially followed with antibody screens, as well as unpublished datasets, a regression model was constructed to demonstrate the timing of D-alloimmunization for recipients who became D-alloimmunized within 6 months following the index transfusion. The model was then applied to a series of RhD-negative hospitalized recipients of at least one unit of RhD-positive RBCs who did not become D-alloimmunized but who had fewer than 6 months of serological follow up to weight their contribution to the D-alloimmunization rate.Results: Overall, the rate of D-alloimmunization was 21/105 (20.0%). There were 39 patients whose last documented antibody screen was performed between 14 days and 6 months after the index RhD-positive transfusion, and these patients were entered into the weighted model. After applying the model, the D-alloimmunization rate rose to 26.3%.Conclusion: Using a weighted model can help reduce the immunohematological uncertainty that accompanies the inclusion of patients with relatively short serological follow up in studies of RBC alloimmunization.","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143256767","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}

引用次数: 0

An in silico simulation of the frequency of administering HLA-incompatible low titer group O whole blood units when the donor pool includes unscreened female donors.

IF 2.5 3区医学

Transfusion Pub Date : 2025-02-05 DOI: 10.1111/trf.18141

Mark H Yazer, Samantha Ngamsuntikul, Manish Gandhi, Torunn Apelseth, Audra Taylor, Jansen N Seheult

{"title":"An in silico simulation of the frequency of administering HLA-incompatible low titer group O whole blood units when the donor pool includes unscreened female donors.","authors":"Mark H Yazer, Samantha Ngamsuntikul, Manish Gandhi, Torunn Apelseth, Audra Taylor, Jansen N Seheult","doi":"10.1111/trf.18141","DOIUrl":"https://doi.org/10.1111/trf.18141","url":null,"abstract":"Background: As low titer group O whole blood (LTOWB) increases in popularity, blood centers are finding innovative ways of maintaining the supply. One potential way is collecting LTOWB from parous female donors without testing for HLA antibodies. This in silico simulation predicted the risk of an LTOWB unit containing an HLA antibody and the subsequent risk for an HLA-incompatible transfusion.Methods: An LTOWB blood bank with 1 million units was simulated consisting of male, nulliparous, and parous female donors. The proportion of each donor type was modeled after the sex distribution at US blood centers. The parity of female donors was calculated based on the average number of live births per female depending on her age. HLA-alloimmunization risk was determined by her parity status. The HLA haplotypes of the simulated recipients were derived from the 100 most common HLA haplotypes in the US National Marrow Registry Program database. The proportion of different race/ethnic groups in the US was used to simulate 100,000 LTOWB recipients to whom between 1 and 10 units were administered.Results: Overall, the risk of an LTOWB unit containing at least one HLA antibody was 12.2% and the rate of receiving an HLA-incompatible unit was 21.3%. The risk of receiving an HLA-incompatible unit rose from 4.8% after receipt of one unit to 36.5% after 10 units.Conclusion: Blood collectors and hospitals should evaluate the potential TRALI risk against the benefit of a potentially expanded inventory of LTOWB before collecting plasma-containing products from non-HLA-tested parous female donors.","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143256834","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}

引用次数: 0

An updated assessment of low titer O whole blood use in the Trauma Quality Improvement Program registry.

IF 2.5 3区医学

Transfusion Pub Date : 2025-02-05 DOI: 10.1111/trf.18123

Steven G Schauer, Maxwell A Braverman, Julie A Rizzo, Susannah E Nicholson, Mark H Yazer

引用次数: 0