Transfusion最新文献

{"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":"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":" ","pages":"2353-2363"},"PeriodicalIF":2.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11637290/pdf/","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":"OA","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":"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":" ","pages":"2247-2251"},"PeriodicalIF":2.5,"publicationDate":"2024-12-01","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}

{"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":"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":" ","pages":"2297-2305"},"PeriodicalIF":2.5,"publicationDate":"2024-12-01","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":"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":" ","pages":"2325-2331"},"PeriodicalIF":2.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11637287/pdf/","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":"OA","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":"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":" ","pages":"2222-2227"},"PeriodicalIF":2.5,"publicationDate":"2024-12-01","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":"Platelet storage failure-Metformin as causative agent.","authors":"Larry J Dumont, Kathleen Kelly, Travis Nemkov, Caroline Leite, Chris J Gresens, Crystal Stanley, Angelo D'Alessandro, Ralph R Vassallo","doi":"10.1111/trf.18063","DOIUrl":"10.1111/trf.18063","url":null,"abstract":"<p><strong>Background: </strong>Pathogen reduction technology (PRT)-treated apheresis platelets (APs) were returned without platelet swirl and with pH_22°C < 6.2. The platelet donor was taking prescription levothyroxine and metformin plus over-the-counter medications and supplements. We hypothesized that either PRT or medication was causative.</p><p><strong>Study design and methods: </strong>One AP from a double AP collection from this donor was PRT-treated, the other unit untreated. Units were assessed over 7-day storage with a standard panel of platelet assays and metabolomics using high resolution mass spectrometry. The dose effect of metformin on platelets over storage was evaluated in vitro using APs obtained from non-medicated donors.</p><p><strong>Results: </strong>This donor's PRT- and non-PRT treated paired units had pH values <6.2 by the end of day 2. Lactate generation rates in the PRT- and non-PRT units were very high compared to previously reported values and approached that reported for anaerobic storage. Metabolomic analysis revealed impairments in a number of energy metabolic pathways between PRT- and non-PRT platelets; however, this did not support a major causative role of PRT in the significant upregulation of lactic acid production. Metformin caused a dose-dependent upregulation of glycolysis, resulting in pH decline.</p><p><strong>Discussion: </strong>We conclude that metformin is the most likely cause for this donor's stored platelet pH failures. Metformin is commonly used to treat type 2 diabetes and is not a donor deferral medication. Further investigation is indicated into the potential impact of metformin on platelet storage characteristics, the potential implications for medication deferral, and the need for additional screening tools in the laboratory.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":"2405-2409"},"PeriodicalIF":2.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142648981","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 the critical shortage of Rh immune globulin in 2024: The transfusion medicine perspective.","authors":"Kerry O'Brien, Wen Lu","doi":"10.1111/trf.18058","DOIUrl":"https://doi.org/10.1111/trf.18058","url":null,"abstract":"","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":"64 12","pages":"2410-2411"},"PeriodicalIF":2.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142819341","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":"Thank You to Our Reviewers.","authors":"","doi":"10.1111/trf.18081","DOIUrl":"https://doi.org/10.1111/trf.18081","url":null,"abstract":"","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":"64 12","pages":"2416-2417"},"PeriodicalIF":2.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142819342","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 small molecule phagocytosis inhibitor, KB-208, ameliorates ITP in mouse models with similar efficacy as IVIG.","authors":"Melika Loriamini, Melissa M Lewis-Bakker, Beth Binnington, Lakshmi P Kotra, Donald R Branch","doi":"10.1111/trf.18060","DOIUrl":"10.1111/trf.18060","url":null,"abstract":"<p><strong>Background: </strong>The characteristic feature of immune cytopenias involves the process of extravascular phagocytosis, wherein macrophages in the spleen and/or liver engage in the destruction of blood cells that have been opsonized by auto- or alloantibodies. Therefore, new treatments that prevent phagocytosis will be advantageous, especially for short-term usage along with alternative options.</p><p><strong>Study design and methods: </strong>KB-208, a small molecule drug, previously shown to be efficacious for the in vitro inhibition of phagocytosis was synthesized. A passive antibody mouse model of immune thrombocytopenia (ITP) was used. Three different mouse strains (BALB/c, C57BL/6, CD1) were used to determine the efficacy of KB-208 compared with IVIG to ameliorate the ITP. Toxicity was investigated after 60-day chronic administration of KB-208 by a biochemistry panel, gross necroscopy and histopathology.</p><p><strong>Results: </strong>KB-208 showed similar efficacy to ameliorate the thrombocytopenia compared with IVIG in all three mouse strains. This small molecule drug was effective at 1 mg/kg in ameliorating ITP, in comparison with IVIG at 1000-2500 mg/kg. KB-208 did not affect other blood parameters or elevate serum biochemistry markers of toxicity nor were any abnormal histopathological findings found.</p><p><strong>Conclusion: </strong>KB-208 is similar to IVIG for the amelioration of ITP in multiple mouse strains. Chronic administration of KB-208 for 60 days did not demonstrate in vivo toxicity. These findings indicate that KB-208 is efficacious, without significant in vivo toxicities in mice, and is a potential small molecule candidate for further evaluation to be used in the treatment of ITP and possibly all immune cytopenias where phagocytosis is responsible for the pathophysiology.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":"2233-2240"},"PeriodicalIF":2.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11637249/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142606259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transfusion-transmissible coinfections among US blood donors.","authors":"Galen Conti, Edward P Notari, Roger Y Dodd, Jed Gorlin, Brian Custer, Rita Reik, Benyam Hailu, Barbee I Whitaker, Susan L Stramer","doi":"10.1111/trf.18050","DOIUrl":"10.1111/trf.18050","url":null,"abstract":"<p><strong>Background: </strong>Transfusion-transmissible infection (TTI) prevalence among US blood donors has been widely documented. Here we estimate the prevalence of donors presenting with ≥2 TTIs (multiple infections past or present referred to as coinfections) and describe their demographics and associations.</p><p><strong>Methods: </strong>Data from the Transfusion-Transmissible Infections Monitoring System were compiled for October 2020-September 2023 (3 years). Prevalence per million donations (pmd) was calculated for each TTI coinfection combination with demographic characteristics summarized. The odds of each TTI coinfection combination were estimated using logistic regression. Reactivity by NAT and/or serology (HIV, HBV, and HCV) defined donors as consensus positive (CP) for each infection while serology-based algorithms defined syphilis CP and the subset with active syphilis infections (ASIs).</p><p><strong>Results: </strong>About 22 million donations were included, with 212 coinfections (9.7 pmd). Around 2% of donations positive for any TTI (n = 10,516) were coinfections. Coinfection prevalence per TTI combination ranged from 0.3 pmd for HIV CP and HCV CP, to 4.3 pmd for HIV CP and syphilis CP. There were high proportions of coinfections from donors who were male, aged 25-54 years, white or black, first time, and residing in the southern US Census Region. The odds of a second TTI occurring in an individual donor with a TTI ranged from 23 (95% CI: 13, 41) times more likely for HBV CP and ASI to 395 (95% CI: 298, 524) times more likely for HIV CP and ASI.</p><p><strong>Conclusions: </strong>Coinfections are relatively uncommon among blood donors in the United States; however, associations exist among HIV, HBV, HCV, and syphilis infections.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":"2241-2246"},"PeriodicalIF":2.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11637907/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142475518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}