Transfusion最新文献

{"title":"Continuing Medical Education.","authors":"","doi":"10.1111/trf.70394","DOIUrl":"https://doi.org/10.1111/trf.70394","url":null,"abstract":"","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":"66 10","pages":"2007"},"PeriodicalIF":2.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149196815","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 missense mutation c.655G>A in the A4GALT*02 allele from a Chinese individual with p phenotype.","authors":"Jing Zhang, Ying Zhang, Yingjian Wang, Tiejun Song, Feng Dai, Shoufang Xu, Yingying Zhang, Feiyu Jiang, Zhiwei Liu","doi":"10.1111/trf.70329","DOIUrl":"10.1111/trf.70329","url":null,"abstract":"","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":"2049-2051"},"PeriodicalIF":2.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148449580","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":"Clot contraction of whole blood diminishes during storage and can be restored by adding platelets.","authors":"Halen Turner, Monica Seadler, Youjie Zhang, Matteo Ferraresso, Christian Kastrup","doi":"10.1111/trf.70322","DOIUrl":"10.1111/trf.70322","url":null,"abstract":"<p><strong>Background: </strong>The contraction of blood clots is a dramatic platelet-dependent process that minimizes the impact of thrombosis and supports the closure of lacerations. Whole blood (WB) stored up to 35 days is increasingly used to treat hemorrhagic shock, but the clot contractibility of this stored blood is unknown. We hypothesized that clot contractibility decreases during storage but can be restored by adding platelets.</p><p><strong>Study design and methods: </strong>WB units from 6 donors were stored at 4°C for 35 days. Apheresis platelet units from 11 donors were stored for 5 days at 22°C with gentle oscillation. Clot contraction of WB and WB supplemented with platelets was measured daily in vitro using optical tracking. Platelets were added at a concentration of 30,000/μL.</p><p><strong>Results: </strong>Clot contraction of 6 WB samples diminished over 35 days of storage. The initial contraction rate and final contraction extent began declining at week 3. By week 5, the initial contraction rate was 67% slower, and the final contraction extent was 49% lower compared to week 1. Adding platelets at week 5 improved the initial contraction rate by 22% and the final contraction extent by 16%.</p><p><strong>Conclusion: </strong>WB stored at 4°C loses a portion of its clot contractility as early as 3 weeks of storage, which may affect patients receiving stored blood. The addition of room-temperature (RT) stored platelets can improve clot contraction, offering a potential strategy to enhance the effectiveness and safety of stored WB for hemorrhagic shock when fresh blood is unavailable.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":"2008-2016"},"PeriodicalIF":2.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148397869","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":"Downscaling to small-volume storage bags supports platelet quality and efficient use of cold-stored platelets for preclinical studies.","authors":"Janhavi Mahajan, Matthew P Padula, Denese C Marks, Lacey Johnson","doi":"10.1111/trf.70339","DOIUrl":"10.1111/trf.70339","url":null,"abstract":"<p><strong>Background: </strong>To maximize the utilization of cold-stored platelets (CSPs) in preclinical research, the use of small-volume storage bags (mini-bags) or tubes would allow multiple treatment groups to be investigated from a single component. It is necessary to determine the effect of using downscaled storage formats on CSP quality and function.</p><p><strong>Methods: </strong>Mini-bags were prepared by vacuum sealing platelet storage bags to ¼ the standard size. Apheresis platelets (n = 8) in 40% plasma/60% PAS-E (SSP+) were aseptically aliquoted into mini-bags (30 mL) or polypropylene tubes (15 mL; CSP-tubes), and the remaining volume (~190 mL) was retained in the original bag (control). Platelets were refrigerated (2-6°C), and in vitro quality parameters were assessed over 21 days.</p><p><strong>Results: </strong>Metabolic capacity was altered for CSP-tubes, with a significant decline in pH, mitochondrial membrane depolarization, and rapid glycolysis. CSP-tubes had greater storage-related activation, as evidenced by a higher proportion of annexin-V-positive platelets and a greater number of CD61+/annexin-V+ extracellular vesicles (EVs). Similarly, platelet functional capacity in CSP-tubes was compromised, with reduced clot strength compared to controls. CSPs stored in mini-bags remained comparable to controls, with the exception of a greater proportion of annexin-V-positive platelets and EVs at day 21. Importantly, despite these changes, no functional deficits were observed in mini-bag components.</p><p><strong>Conclusions: </strong>Storage in tubes markedly impairs the metabolic, structural, and functional quality of CSPs, indicating that this approach is unsuitable. In comparison, mini-bag storage preserves key in vitro parameters, supporting a scalable strategy that maximizes the utilization of CSPs for preclinical evaluation.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":"1952-1962"},"PeriodicalIF":2.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13674211/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148685816","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":"Massive fetomaternal hemorrhage and successful prevention of maternal RhD alloimmunization: A case report.","authors":"Sajjad Hassan, Angela Essa, Lauren Orr, Corina N Schoen, Chester Andrzejewski","doi":"10.1111/trf.70318","DOIUrl":"10.1111/trf.70318","url":null,"abstract":"<p><strong>Background: </strong>Massive fetomaternal hemorrhage can lead to significant fetal morbidity or mortality. RhD negative patients require appropriate treatment to prevent alloimmunization in subsequent pregnancies. Few cases with follow-up into future pregnancies have been reported.</p><p><strong>Case report and results: </strong>30-year-old gravida 3 para 1 presented at 40 weeks and 2 days gestation for late term evaluation. Ultrasonography identified an intrauterine fetal demise. The patient was O RhD negative and had previously received Rh immunoglobin (RhIG) at 26 weeks of gestation. The patient was induced and delivered a 3,450 gram stillborn fetus. Kleihauer-Betke testing performed and revealed massive fetomaternal hemorrhage with a result of 5.4-6.0%. The calculated fetomaternal hemorrhage was estimated to be 281.6 mL (approaching the total estimated fetal blood volume of 293 mL). The patient received 3 vials of intramuscular RhIG (300 μg/vial), 2 vials of intravenous RhIG (1,000 μg/vial), and 1 vial of intravenous RhIG (300 μg/vial) for a total RhIG dose of 3,200 μg, over a 3-day period, with no adverse clinical sequelae. Serological investigations for anti-D antibodies remained positive until 6 months and were inconclusive at 8 months postpartum. At 10 months postpartum, she was 9 weeks pregnant and no anti-D antibodies were detected. With this subsequent pregnancy, she was treated with routine RhIG and delivered a healthy RhD positive neonate.</p><p><strong>Conclusion: </strong>Adequate dosing of RhIG can be achieved to prevent alloimmunization, even in massive fetomaternal hemorrhages. After large doses of RhIG, anti-D antibodies may persist for several months and do not necessarily indicate maternal alloimmunization.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":"2017-2024"},"PeriodicalIF":2.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13674137/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148798232","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":"How does a national blood operator detect early infectious disease signals affecting blood and cellular therapy product safety and sufficiency?","authors":"Leisa Bruneau, Carmen L Charlton, Sandra Ramirez-Arcos, Dilini Kumaran, David Allan, Olivia Norman, Matthew Seftel, Evan M Bloch, Chantale Pambrun, Sheila F O'Brien, Cynthia Cranney, Steven J Drews","doi":"10.1111/trf.70388","DOIUrl":"10.1111/trf.70388","url":null,"abstract":"<p><strong>Background: </strong>Public access to up-to-date information on infectious diseases and outbreaks has grown rapidly with the advent of artificial intelligence platforms. While this information can improve patient care and support research, the sheer volume of available data coupled with the challenge of identifying misinformation and disinformation can be overwhelming. A key challenge is managing large information volumes and identifying early, subtle signals that may indicate risks or opportunities to prevent infection. The aim of this manuscript is to explain how a national blood operator identifies and evaluates subtle infectious disease signals generated by horizon scanning to proactively protect the blood supply, including biotherapy products.</p><p><strong>Methods: </strong>Horizon scanning protocols were developed to detect early signals of change (emerging/re-emerging pathogens, geopolitical/environmental changes, scientific and technological advances, new therapies/treatments for infectious diseases, and blood operator transfusion medicine changes). Communication strategies were created to alert national and international transfusion medicine decision makers of blood safety-related events.</p><p><strong>Results: </strong>Several key components of a horizon scanning approach are presented to illustrate how novel information can be identified, processed, and formulated into knowledge translation products. Efficient and cost-effective approaches are presented to enable horizon scanning activities with limited resources and time commitments.</p><p><strong>Discussion: </strong>Horizon scanning is an efficient and necessary activity to safeguard the blood supply. Here we present a collaborative group-based approach, which reduces operator bias and improves overall examination of multiple data sources. This approach does not require expensive technology, can focus on open-source information, and engages new scientists in learning about infectious diseases.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":"1902-1909"},"PeriodicalIF":2.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13674131/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149008961","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":"The blood system in Ukraine: Experience in martial law conditions.","authors":"Yevgen Chornenkyy, Mark Jedrzejczak, Marium Malik, Oleksandr Serhiienko, Dmytro Koval, Ricardo Sumugod, Margaret Fink, Paul Lindholm, Glenn Ramsey","doi":"10.1111/trf.70372","DOIUrl":"10.1111/trf.70372","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background/case studies: &lt;/strong&gt;Efficient blood and blood components supply is key to the stable operation of a health care system, especially to a civilian population and military under martial law. The blood system is an important component of a state's defense capability and national security. Since 2022, Ukraine has advanced experience in self-sufficiency with whole blood and blood components in the conditions of a land war, without importing blood components.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Study design/methods: &lt;/strong&gt;In October 2022, a Ukrainian transfusion medicine delegation-headed by Specialized State Institution «Ukrainian Transplant Coordination Center» (SSI «UTCC»), the national coordinator of Ukraine's blood system-visited several Midwestern US blood banks, including Northwestern Memorial Hospital, to exchange information on blood system organization, transfusion practice, and disaster preparedness. During a daylong seminar and follow-up communications, delegation members described the Ukrainian blood system, wartime challenges, and plans to meet European Union standards, while also learning about US laboratory standards, transfusion practices, and emerging blood components such as cold-stored platelets. The approaches presented during this exchange have since demonstrated sustained effectiveness and systemic resilience across subsequent years of full-scale conflict, through to the present day.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results/findings: &lt;/strong&gt;In 2021, Ukraine had 24 regional blood establishments and 385 hospital blood banks collecting whole blood and blood components. The donor rate was 7.5 per 1000 inhabitants, and 44% of donors were first-time donors. Most donors (95%) were voluntary donors aged 18-45 years. The national blood system served both civilian and military needs. Since the invasion, some blood establishments and hospital blood banks have been damaged, destroyed, or occupied. These disruptions created urgent challenges, including coordination of blood system activities to maintain a continuous blood supply for civilian and military healthcare systems, management of the donor pool, development and management of national whole blood and blood component inventories, implementation of new transfusion practices and basic transfusion training for the security and defense forces, and traceability and hemovigilance during the prehospital stage of medical evacuation. In response, the Ministry of Health of Ukraine established the Operational Headquarters to coordinate the blood system under martial law. Blood establishments now report blood stocks daily, and some operate on a 24-h cycle to increase collection volumes. New approaches to donor recruitment and blood collection were developed to improve donor safety, and organizational partnerships and national donor campaigns were launched, including \"Your blood can fight. Become a donor.\" The production, supply, logistics, and redistribution of whole blood and blood components to areas of need","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":"1884-1890"},"PeriodicalIF":2.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13674120/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148707793","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":"Hepatitis B virus infection with high HBsAg and undetectable DNA levels in untreated blood donors: Viral mechanisms and transfusion safety implications.","authors":"Maelenn Païline Delcourt, Marion Vermeulen, Aneta Kopacz, Manuela Miletic, Andrew Saville, Christoph Niederhauser, Jean-Michel Pawlotsky, Syria Laperche, Daniel Candotti","doi":"10.1111/trf.70334","DOIUrl":"10.1111/trf.70334","url":null,"abstract":"<p><strong>Background: </strong>Blood donor screening occasionally identifies individuals with high HBV surface antigen (HBsAg) levels despite undetectable or extremely low HBV DNA. Molecular basis and transfusion risk of this discordant profile remain unclear.</p><p><strong>Study design and methods: </strong>Seventy-five blood donors with HBsAg >100 IU/mL and undetectable or very low HBV DNA (<6 IU/mL), including 39 ID-NAT-nonreactive, were investigated. HBV DNA was further assessed using a second ID-NAT assay, confirmatory PCR following virion concentration, and sequencing. Sequences were compared with those from genotype-matched high-viremia controls. Selected basic core promoter (BCP) and core mutations were introduced into 1.18-mer replication-competent Hepatitis B virus (HBV) plasmids to assess effects on extracellular virion-associated DNA production.</p><p><strong>Results: </strong>Four (5%) samples were nonreactive by the two ID-NAT assays. HBV DNA was confirmed in all donors, often at unquantifiable levels, and all were anti-HBc positive. No consistent molecular signature was identified. Heterogeneous, case-specific mutations were detected in BCP, core, and PreS1, including variants predicted to affect pregenomic RNA transcription, encapsidation, or virion assembly, with no evidence of impaired polymerase activity. In vitro, selected BCP mutations significantly reduced extracellular HBV DNA without affecting HBsAg production. Most core mutations had minimal impact, although two strains carrying cN92T/cM93T or cS170F showed reduced virion-associated DNA. Some constructs exhibited impaired virion secretion or increased naked capsid production.</p><p><strong>Conclusion: </strong>HBsAg-positive/low-DNA profile largely reflects chronic inactive infection with minimal viremia. Diverse regulatory and structural mutations may contribute in a multifactorial manner. Persistent viral genomes and residual replication support continued HBsAg screening where NAT sensitivity is suboptimal and anti-HBc testing cannot be implemented.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":"1993-2006"},"PeriodicalIF":2.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13674214/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148537014","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":"A novel homozygous ABCB6 variant causing the Lan null phenotype and anti-Lan-mediated hemolytic disease of the fetus and newborn: A case report and a review of anti-Lan in pregnancy.","authors":"Jing Feng, Li Tian, Yan Zhang, Kai Zhu, Haijuan Wang, Hong Zhao, Luyi Ye, Jian Chen","doi":"10.1111/trf.70319","DOIUrl":"10.1111/trf.70319","url":null,"abstract":"<p><strong>Background: </strong>The Lan antigen is a high-prevalence red blood cell antigen encoded by the ATP binding cassette subfamily B member 6 (ABCB6) gene. Variants in this gene are responsible for Lan null and variant phenotypes. Individuals lacking the Lan antigen may develop anti-Lan antibodies following sensitizing events such as transfusion or pregnancy. Hemolytic disease of the fetus and newborn (HDFN) caused by anti-Lan antibodies is extremely rare.</p><p><strong>Case presentation: </strong>We report a case of a Chinese pregnant woman carrying a novel homozygous variant in exon 17 of the ABCB6 gene (NM_005689.4:c.2312_2313del), resulting in a Lan null phenotype. Anti-Lan antibodies were detected in maternal plasma, neonatal plasma, and cord blood eluate. The newborn developed mild HDFN, which resolved spontaneously without intervention, leading to a favorable outcome.</p><p><strong>Conclusion: </strong>This represents the first documented case of anti-Lan-mediated HDFN in an Asian population and the fifth case worldwide. Our findings expand the genetic diversity and geographic spectrum of this rare condition and provide important insights for clinical management.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":"2025-2030"},"PeriodicalIF":2.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148424321","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":"Emergency whole-tank transfer of cord blood units after cryogenic failure: A safe rescue strategy.","authors":"Jesus Fernandez-Sojo, Carmen Azqueta, Nerea Castillo-Flores, Mònica Linares, Elena Valdivia, Laura Medina-Boronat, Sergio Arteaga, Nuria Rubio, Sonia Poyatos, Alexander Guterres, Ana Garcia-Buendia, Sergi Querol, Joan R Grifols","doi":"10.1111/trf.70330","DOIUrl":"10.1111/trf.70330","url":null,"abstract":"<p><strong>Background: </strong>Cryogenic storage of cord blood units (CBUs) is critical to ensure long-term viability and safety. Loss of vacuum in liquid nitrogen (LN₂) tanks is an exceptionally rare but high-risk event that may lead to accelerated LN₂ evaporation and potential warming of stored units.</p><p><strong>Case report: </strong>We describe an emergency rescue transfer following suspected vacuum loss in a BioArchive cryogenic tank at a public cord blood bank. The tank contained 2880 CBUs, including 14 directed units. Progressive LN₂ consumption suggested structural failure, and in situ repair was not feasible. A rapid transfer procedure using a backup BioArchive-compatible tank was performed with the assistance of the manufacturer. The maneuver involved crane-assisted repositioning of the tank under the robotic system and was completed in 40 s. Continuous temperature monitoring confirmed stable vapor-phase conditions throughout the procedure. Six CBUs stored in upper tank positions (worst-case exposure) were evaluated post-thaw. Cell recovery, viability, and clonogenic capacity were preserved and met release criteria for transplantation.</p><p><strong>Conclusion: </strong>Emergency transfer of CBUs during cryogenic tank malfunction is feasible and can be performed safely without compromising product quality when executed under controlled conditions. This report provides practical guidance for managing rare but critical storage failures in cord blood banking using BioArchive system.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":"2037-2041"},"PeriodicalIF":2.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148431169","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}