Transfusion最新文献

{"title":"Cord blood red cell concentrates for preterm neonate transfusion: Insights from the multicenter BORN trial.","authors":"Claudio Pellegrino, Patrizia Papacci, Carlo Dani, Francesco Cresi, Giulia Remaschi, Giulia Ansaldi, Carmen Giannantonio, Maria Francesca Campagnoli, Barbara Vania, Marco Fabbri, Roberta Penta de Vera d' Aragona, Anna Molisso, Enrico Beccastrini, Antonella Dragonetti, Tina Pasciuto, Sabrina Gabbriellini, Silvia Baroni, Francesca Serrao, Velia Purcaro, Genny Raffaeli, Stefania Villa, Daniele Prati, Isabella Mondello, Alessandra Falcone, Maria Letizia Patti, Tiziana Boggini, Paola Bergamaschi, Iolanda Mozzetta, Caterina Giovanna Valentini, Emanuela Locatelli, Roberto Albiani, Federico Genzano Besso, Giulia Vanina Cantone, Alessandra Coscia, Alfonso Trimarchi, Anita Capone, Stefano Ghirardello, Giovanni Vento, Luciana Teofili","doi":"10.1111/trf.70241","DOIUrl":"https://doi.org/10.1111/trf.70241","url":null,"abstract":"<p><strong>Background: </strong>The BORN trial suggested that using cord blood-red blood cells (CB-RBCs) to transfuse severely preterm neonates significantly improves clinical outcomes compared to standard adult donor RBCs (A-RBC).</p><p><strong>Study design and methods: </strong>The study illustrates CB-RBC concentrate production and inventory management across nine CB banks participating in the BORN trial. Quality requirements were those established by the European regulation for leukocyte-depleted RBC concentrates in additive solution. The compliance rate among centers was reported.</p><p><strong>Results: </strong>During the BORN study, 451 CB-RBC units were processed and 107 were transfused to 69 patients in the intervention arm. However, for 67 transfusion requests, no compatible CB-RBC units were available and adult-RBCs were given. The CB-RBC inventory comprised a minor fraction of CB units collected during the study period, suggesting that many did not meet the protocol-defined volume threshold of 67 mL at collection. Quality control results showed that 84.0% of units achieved target hematocrit (Htc) levels (50-70%), with higher success rates in centers processing more CB units. All centers met quality standards, maintaining residual leukocytes below 1 × 10⁶ and end-storage hemolysis below 0.8% in more than 90% of cases. CB-RBC availability was significantly limited by the time required for bacterial testing results and the need for γ-irradiation.</p><p><strong>Discussion: </strong>These data suggest that the standardized CB-RBC production is reproducible. Moreover, extending CB-RBC storage to 21 days could maximize the inventory utility.</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":"147782122","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":"Clinical application of a modified platelet desialylation test for mechanistic characterization of platelet transfusion refractoriness.","authors":"Karen Ziza, Thamy Silva, Mateus Domentino, Marina Conrado, João Oliveira, Elyse Moritz, Akemi Chiba, Vanderson Rocha, Alfredo Mendrone-Junior, José Bordin, Langhi Dante, Carla Dinardo","doi":"10.1111/trf.70246","DOIUrl":"https://doi.org/10.1111/trf.70246","url":null,"abstract":"<p><strong>Background: </strong>Platelet transfusion refractoriness (PTR) is a major challenge in transfusion medicine and may result from both immune and non-immune mechanisms. Although alloantibodies are well-established contributors, Fc-independent pathways such as platelet desialylation have emerged as alternative mechanisms of clearance.</p><p><strong>Study design and methods: </strong>In this prospective diagnostic study, 81 patients with suspected PTR were evaluated using an integrated approach combining the platelet immunofluorescence test (PIFT) to detect antibody-mediated refractoriness and a modified platelet desialylation test (PDT) to assess Fc-independent clearance. Demographic, clinical, and laboratory variables were analyzed using non-parametric tests, including Mann-Whitney U, Kruskal-Wallis, and binomial tests.</p><p><strong>Results: </strong>The cohort exhibited severe thrombocytopenia and diverse clinical profiles. PIFT detected platelet-bound antibodies in 63/81 cases (78%), while PDT identified desialylation in 41/81 patients (50%). PIFT positivity was similar between PDT-positive (80.5%) and PDT-negative (76.9%) groups, with no significant association (χ² = 0.15, p = .69). Although mean fluorescence intensity (MFI) varied across diagnostic categories, no significant differences were observed (p = .3095). Fever was the only clinical variable significantly associated with reduced desialylation (median MFI 401 vs. 1328.3; p = .0109), while splenomegaly, infection, antifungal use, and bleeding had no significant effects. PDT status was not significantly associated with the number of pooled platelet transfusions (p = .391) or apheresis procedures (p = .515), indicating that desialylation alone does not predict transfusion demand.</p><p><strong>Discussion: </strong>PTR occurs both independently and in parallel with antibody-mediated pathways. The combined PIFT-modified PDT approach improves mechanistic characterization and enhances diagnostic accuracy, in cases of platelet refractoriness of immune and non-immune etiology.</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":"147782152","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":"From battlefield to community: Simulation-based education for walking blood bank whole blood transfusion.","authors":"Christian Gerhardus, Alexander Bowers, John C Myers, Ross Willis, Rachelle Jonas, Sam Manoharan, David Limon, Amanda M Baines, Maxwell Braverman, Michael Sippel, James Bynum, David Wampler, Angelo Ciaraglia, Sondra Epley, Steven G Schauer, William Bullock, Brian Eastridge, Donald Jenkins, Erika Brigmon, Susannah Nicholson","doi":"10.1111/trf.70203","DOIUrl":"https://doi.org/10.1111/trf.70203","url":null,"abstract":"<p><strong>Background: </strong>Field transfusion of whole blood is vital for patients in hemorrhagic shock, particularly in austere or resource-limited environments. Military use of warm fresh whole blood (WFWB) has inspired civilian interest in walking blood banks (WBBs) for rural, prehospital, and mass casualty settings where blood product access is limited. However, standardized training and proficiency benchmarks are lacking. This project developed a checklist and established validity evidence to assess provider proficiency in WFWB collection and transfusion.</p><p><strong>Study design and methods: </strong>A multidisciplinary panel created a checklist and modified an existing training video for WFWB collection and transfusion. Using simulation, medical students, nurses, nurse practitioners, physicians, and emergency medical service providers were evaluated to validate the checklist and define proficiency thresholds. Participants (n = 41) were categorized as novice (n = 12), intermediate (n = 13), or expert (n = 16) based on experience. After reviewing the video, participants performed simulated procedures graded by independent evaluators. The maximum score was 47 points, with competency defined by expert performance.</p><p><strong>Results: </strong>Analyses of variance revealed significant differences between novice and intermediate (p <.01) and novice and expert (p<.01) groups, but not between intermediate and expert (p = .09). Mean rubric scores and completion times were: novice (31/47; 41 min 17 s), intermediate (38/47; 33 min 7 s), expert (41/47; 29 min 19 s). The competency threshold was set at 41/47 and 33 min 27 s.</p><p><strong>Discussion: </strong>The validated checklist and training video provide a foundation for standardized WFWB education and proficiency assessment, supporting safe WBB implementation in military and civilian settings.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147782112","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.150dup variant on the ABO*B.01 allele associated with a weak B phenotype.","authors":"Cuihua Fan, Liangyuan Chen, Jiandong Zhang, Dongbiao Qiu, Xiaojun Yang","doi":"10.1111/trf.70245","DOIUrl":"https://doi.org/10.1111/trf.70245","url":null,"abstract":"","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147782125","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 risk of transfusion transmissible infection in a civilian walking blood bank using rapid diagnostic tests: A modeling study.","authors":"Neil Thivalapill, Zhaohui Geng, Nikathan Kumar, Elizabeth Stoeger, Nobhojit Roy, Bopaya Bidanda, Nakul Raykar","doi":"10.1111/trf.70183","DOIUrl":"https://doi.org/10.1111/trf.70183","url":null,"abstract":"<p><strong>Background: </strong>Civilian walking blood banks (WBBs) can transfuse fresh whole blood from mobilized donors who are screened using rapid diagnostic testing (RDT) for transfusion transmissible infections (TTIs) to preserve life when banked blood is unavailable. However, concerns regarding TTI risk using an RDT process instead of laboratory-based testing methods persist. We aimed to understand the additional risk of TTI using an RDT-based strategy compared to a laboratory-based strategy with a simulation model and accompanying online tool.</p><p><strong>Study design and methods: </strong>We modeled expected TTIs per 100,000 donations from initial collection to transfusion and infection. Parameters included TTI prevalence, donor risk stratification, efficacy of stratification tools, TTI testing rates, platform test performance, and probability of infection.</p><p><strong>Results: </strong>A baseline TTI prevalence of 1% (95% confidence interval [CI]: 0.25%, 1.75%) resulted in 56 TTIs (95% CI: 23, 91) when the RDT sensitivity was 90% (95% CI: 88%, 92%), 30 TTIs (95% CI: 12, 52) when the RDT sensitivity was 95% (95% CI: 93%, 97%), and 12 TTIs (95% CI: 4, 23) when the RDT sensitivity was 99% (95% CI: 97, 100%) per 100,000 donations. Compared to lab-based testing, 15,351 donations would need to be made under a high-sensitivity RDT testing strategy in order to incur one additional TTI.</p><p><strong>Discussion: </strong>In a simulated WBB model, modern RDT platforms demonstrated favorable test characteristics, with low absolute rates of TTI, particularly when low-risk donors are selected. These findings support WBB implementation as an emergency transfusion strategy in settings lacking banked blood.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147782068","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":"Rare antigen-negative red blood cells from pluripotent stem cells for precision transfusion medicine.","authors":"Naomi Gunawardena, Hyun Hyung An, Randall W Veliquette, Edmund Carvalho, Sambit Dalui, Kaoru Takasaki, Eric Wafula, Deborah L French, Giulia Pavani, Stella T Chou","doi":"10.1111/trf.70243","DOIUrl":"https://doi.org/10.1111/trf.70243","url":null,"abstract":"<p><strong>Background: </strong>Blood bank identification of antibodies against high-prevalence antigens remains a challenge due to the scarcity of antigen-negative reagent red cells sourced from blood donors. The MAM antigen, encoded by EMP3, is one such antigen associated with red cell alloimmunization and hemolytic disease of the fetus and newborn.</p><p><strong>Study design and methods: </strong>We used CRISPR-Cas9 gene editing to generate an EMP3 knockout (EMP3KO) induced pluripotent stem cell (iPSC) line from a type O, Rh null parent line, enabling production of rare MAM-negative red blood cells. Since a prior study suggested that loss of EMP3 may enhance erythroid proliferation, we hypothesized that EMP3KO could both yield a rare reagent cell and potentially improve erythroid expansion to support scalable production. Transcriptomic analysis allowed us to further investigate the effect of EMP3 loss in late erythroblasts.</p><p><strong>Results: </strong>EMP3KO cells differentiated efficiently into erythroid cells, showing >95% CD235/CD71 co-expression and orthochromatic erythroblast morphology. Compared to unedited cells, no proliferative advantage was observed, contrasting with prior non-isogenic cell models. Agglutination assays confirmed complete loss of MAM antigen and demonstrated the diagnostic utility for identifying MAM antibodies. Transcriptomic profiling of EMP3KO erythroblasts revealed expression of key erythroid genes, as well as regulators of proliferation and heme metabolism, was comparable to the parent line.</p><p><strong>Discussion: </strong>This study demonstrates that iPSC technology combined with gene editing can generate rare antigen-negative RBCs for immunohematology applications. Beyond MAM, this platform offers a strategy to create additional rare RBC phenotypes, advancing precision transfusion medicine and improving antibody identification against high-prevalence antigens.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147782208","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":"Red blood cell transfusion thresholds in acute leukemia: Current practice and physician perspectives from a national survey.","authors":"Dimpy Modi, Brett L Houston, Brian Leber, Erin Jamula, Nancy Heddle, Chris Hillis, Michelle P Zeller, Tobias Berg, Donald M Arnold","doi":"10.1111/trf.70202","DOIUrl":"https://doi.org/10.1111/trf.70202","url":null,"abstract":"<p><strong>Background: </strong>Red blood cell (RBC) transfusions are part of essential supportive therapy in patients with acute leukemia, where patients often present with anemia and thrombocytopenia. Together these cytopenias increase bleeding risk; however, optimal hemoglobin (Hb) thresholds for RBC transfusion remain undefined, and current recommendations for restrictive strategies (<7 g/dL) are based on low-certainty, indirect evidence.</p><p><strong>Study design and methods: </strong>A national web-based survey was distributed to 43 physicians (24 centers, Canada) to assess current RBC transfusion practice in patients with acute leukemia, perceptions of a liberal threshold (11 g/dL) in the context of a clinical trial, and feasibility considerations. The survey included categorical responses and open-text fields.</p><p><strong>Results: </strong>Of 38 eligible physicians, 34 responded (89%). For stable, non-bleeding patients receiving induction chemotherapy, 27/34 (79%) used a Hb threshold of 7 g/dL, 6/34 (18%) used 8 g/dL, and 1/34 (3%) used 9 g/dL. Fourteen (14/34, 41%) respondents indicated that a Hb threshold of 11 g/dL was reasonable for the liberal arm of a clinical trial, while 20/34 (59%) did not. For such a trial, 32/34 (94%) would consider enrolling patients in the trial and 2/34 (6%) would not.</p><p><strong>Discussion: </strong>A Hb threshold of 7 g/dL was most reported as standard-of-care. Most respondents supported enrolling their patients in a clinical trial comparing a liberal RBC transfusion strategy of 11 g/dL with standard-of-care. The feasibility of 11 g/dL should be tested with clear justification, appropriate study outcomes, and attention to safety risks and resource demands.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147782220","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":"Safety and tolerability of amustaline/glutathione pathogen-reduced red blood cells in neonatal rats.","authors":"Anne North, Laurence Corash, Richard J Benjamin, Nina Mufti","doi":"10.1111/trf.70240","DOIUrl":"https://doi.org/10.1111/trf.70240","url":null,"abstract":"<p><strong>Background: </strong>Amustaline (S-303)/glutathione (GSH) pathogen-reduced red blood cells (PR-RBCs) are in development for all adult and pediatric RBC transfusion indications, including neonates and infants. A neonatal rat model evaluated the safety and tolerability of PR-RBCs during growth and maturation.</p><p><strong>Study design and methods: </strong>Repeated transfusions of 10 mL/kg syngeneic untreated (control) RBCs, PR-treated (study) or \"high-degradant\" PR-RBCs were transfused three-times weekly to neonatal Sprague-Dawley rats from post-natal day (PND) 4 through adolescence (PND 64). The high-degradant PR-RBCs utilized amustaline concentrations 5-fold higher than in the clinical process, without a terminal wash step. Toxicokinetic characteristics of the major amustaline degradant (S-300) were determined on PNDs 15, 29 and at study termination. Animal well-being, weight, sexual maturation, and cognitive development (using the Morris water maze) were monitored. On PND 65-68 terminal necropsy and pathological analyses were performed.</p><p><strong>Results: </strong>All recipient groups demonstrated normal and comparable weight gain, sexual maturation, and cognitive development. There were no PR-RBC-related effects on clinical signs, clinical chemistry, gross- or histopathology, although all rats had polycythemia (Hb 16.6-17.0 g/dL) with reduced reticulocytes (0.6-1.4%) at study end. S-300 was cleared rapidly (<60 min in the study group) and did not accumulate in the blood. The high-degradant PR-RBC group, with 6.2-fold reduced species-specific scaling for increased basal metabolic rate, were exposed to ~11.8-fold higher S-300 exposure than expected in repeatedly-transfused patients, without apparent adverse effects.</p><p><strong>Conclusion: </strong>The neonatal rat study demonstrates the safety and tolerability of amustaline/GSH PR-RBCs for transfusion and supports clinical use in pediatric patients.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147780898","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":"Increased mortality in children with severe trauma and bleeding: Hypotheses and methods to reduce the risk.","authors":"Ashley M Wilson, Matthew A Borgman, Charles S Cox, Katherine T Flynn-O'Brien, Christine M Leeper, Julie C Leonard, Robert T Russell, Adam M Vogel, Philip C Spinella","doi":"10.1111/trf.70109","DOIUrl":"https://doi.org/10.1111/trf.70109","url":null,"abstract":"","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147782055","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":"Clarifying transfusion-associated graft-versus-host disease risk in modern Hodgkin lymphoma survivorship.","authors":"Christin B DeStefano, Jeremy Perkins, Wendy Cozen, James Long","doi":"10.1111/trf.70242","DOIUrl":"https://doi.org/10.1111/trf.70242","url":null,"abstract":"","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147782095","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}