Transfusion最新文献

{"title":"Transfusion intensity in the ICU: Reasons and triggers.","authors":"Merijn C Reuland, Senta J Raasveld, Jimmy Schenk, Claudia van den Oord, Sanne de Bruin, Caroline M Schaap, Andrew W J Flint, Jan Bakker, Maurizio Cecconi, Aarne Feldheiser, Jens Meier, Thomas W L Scheeren, Tarikul Hamid, Michaël Piagnerelli, Tina Tomić Mahečić, Jan Benes, Lene Russell, Hernan Aguirre-Bermeo, Konstantina Triantafyllopoulou, Vasiliki Chantziara, Mohan Gurjar, Sheila Nainan Myatra, Vincenzo Pota, Muhammed Elhadi, Ryszard Gawda, Mafalda Mourisco, Marcus Lance, Vojislava Neskovic, Matej Podbregar, Juan V Llau, Manuel Quintana-Diaz, Maria Cronhjort, Carmen A Pfortmueller, Nihan Yapici, Nathan D Nielsen, Akshay Shah, Harm-Jan de Grooth, Zoe McQuilten, Cécile Aubron, Alexander P J Vlaar, Marcella C A Müller","doi":"10.1111/trf.70350","DOIUrl":"10.1111/trf.70350","url":null,"abstract":"<p><strong>Background: </strong>The reasons and physiological triggers for blood transfusion in critically ill patients are not well characterized. Beyond hemoglobin levels, hemodynamic instability is frequently cited, but its role across clinical contexts remains unclear.</p><p><strong>Aims: </strong>(1) To determine whether reasons and triggers for RBC transfusion differ across intensive care unit (ICU) days with varying transfusion intensity. (2) To describe reasons for non-RBC transfusions across these intensity groups.</p><p><strong>Methods: </strong>This sub-study of the prospective International Point Prevalence Study of Intensive Care Unit Transfusion Practices (InPUT) classified ICU days by transfusion intensity: nonmajor (1 RBC unit), major (≥2 units), and massive (≥6 units in a single event, ≥10 per day, or Massive Transfusion Protocol activation). ICU days without transfusion for active bleeding were classified as no bleeding.</p><p><strong>Results: </strong>Significant differences in the multivariate composition of reasons for RBC transfusion were observed across intensity groups on permutational analysis of variance (PERMANOVA). Hypotension was the most frequently cited physiological trigger in nonmajor (54%, n = 80/148) and major transfusions (68%, n = 196/288), but less frequent in massive transfusions (30%, n = 14/64). Tachycardia was the second most common trigger in nonmajor (37%, n = 80/148), major (40%, n = 116/288), and massive transfusions (22%, n = 19/64).</p><p><strong>Conclusion: </strong>RBC transfusions are administered for distinct, intensity-dependent combinations of reasons and triggers. Transfusion intensity and clinical context are therefore key factors in evaluating transfusion practices. Among bleeding critically ill patients, hypotension and tachycardia are the most frequently cited physiological triggers.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":"1963-1973"},"PeriodicalIF":2.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13674203/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148653791","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":"Utilization patterns of low-titer group O whole blood in a level 1 trauma center.","authors":"Maryam Asif, Alisha D Berry, Shafaq Zahid, Erin Tuott, Lynn G Stansbury, John R Hess","doi":"10.1111/trf.70332","DOIUrl":"10.1111/trf.70332","url":null,"abstract":"<p><strong>Background: </strong>Whole blood (WB) is an easy-to-use resuscitation fluid. As more low-titer group O WB has become available at our hospital, it is being used in an increasingly diverse range of situations, both pre-hospital and in-hospital.</p><p><strong>Study design and methods: </strong>We conducted a retrospective analysis of all WB units issued by our transfusion service during calendar year 2024. Data were obtained from the transfusion service database and linked to patient medical records to characterize indications, location of transfusion, and patient outcomes. Results are descriptive.</p><p><strong>Results: </strong>A total of 1915 WB units were issued. 1879 units (98.1%) were transfused to 524 patients, of which 237 units (12.6%) were prehospital. Of these, 1817 units (96.7%) were transfused to patients ultimately treated at HMC. Trauma accounted for the majority of in-hospital utilization (87.6%), with motor vehicle collisions (MVCs) and penetrating trauma the most common indications. Non-trauma indications accounted for 12.4% of transfused units and included gastrointestinal bleeding, vascular surgery, cardiac emergencies, necrotizing soft tissue infections, and other shock states. Among 477 admitted patients who received WB, in-hospital mortality was 29.6%. Operational strategies, including extended cooler validation and retention of inventory ownership until use, supported high utilization with minimal waste.</p><p><strong>Conclusions: </strong>Whole blood utilization was primarily driven by traumatic hemorrhage but extended across diverse acute care settings. Utilization patterns were shaped by supply limitations and operational considerations rather than clinical demand alone, underscoring the importance of incorporating logistics and utilization data into future whole blood research and implementation efforts.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":"1910-1915"},"PeriodicalIF":2.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13674113/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148431206","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 do I transition oncology patients from intravenous immunoglobulin to subcutaneous immunoglobulin in an outpatient clinic?","authors":"Dior Caruso, Hilary Weatherby, Schenell Rosario, Graham Dozois, Lani Lieberman","doi":"10.1111/trf.70353","DOIUrl":"10.1111/trf.70353","url":null,"abstract":"<p><strong>Background: </strong>Intravenous immunoglobulin (IVIG) treating secondary immunodeficiency (SID) for oncology patients causes strain for outpatient clinic capacity. Home-based subcutaneous immunoglobulin (SCIG) offers equivalent efficacy and improves patient convenience and resource utilization. Transition to home-based SCIG remains infrequent due to fragmented referral pathways, limited clinician awareness, and inconsistent patient education. The project objective was to increase the number of patients transitioning from IVIG to SCIG.</p><p><strong>Methods: </strong>A quality improvement initiative was established following a baseline assessment of the SCIG transition process and IVIG utilization patterns. A driver diagram informed change ideas tested across seven Plan-Do-Study-Act (PDSA) cycles. The outcome measure was the monthly SCIG referral rate. The process measures were the median monthly number of chronic, new start, and total IVIG users in the outpatient clinic. The balancing measures assessed if SCIG referrals had an effect on chair time and operational costs. Electronic referral process was developed, clinician education enhanced, nurse champion role created, and clinician and patient education materials were standardized.</p><p><strong>Results: </strong>Following the intervention, the number of patients transitioning from IVIG to SCIG increased from 3.7% to 8.5%. The number of monthly new start IVIG users remained the same while the number of monthly chronic IVIG users increased. The balancing measures indicate that SCIG referrals did not reduce chair time but generated significant cost avoidance.</p><p><strong>Discussion: </strong>Transitions from IVIG to SCIG have shifted care into the home, reducing outpatient pressure and costs. Long-term sustainability requires improved referral of chronic IVIG users and strategies to support patient engagement.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":"1893-1901"},"PeriodicalIF":2.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148631777","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":"Apparent reduction of anti-FXa activity after 4F-PCC Administration: True reversal or PCC-related analytical effect?","authors":"Gabor Erdoes, Andreas Koster, Ingvild Birschmann","doi":"10.1111/trf.70351","DOIUrl":"10.1111/trf.70351","url":null,"abstract":"","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":"2045-2046"},"PeriodicalIF":2.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148680050","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":"RBC depletion with Gelofusine in allogeneic hematopoietic stem cell transplantation.","authors":"Antonio Bruno, Gianpaolo Del Proposto, Gaspare Adorno, Michele Abignente, Paolo De Vita, Giulio Puleri, Aleandra Ferrantini, Raffaella Cerretti, Francesco Buccisano, Adriano Venditti","doi":"10.1111/trf.70356","DOIUrl":"10.1111/trf.70356","url":null,"abstract":"","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":"2047-2048"},"PeriodicalIF":2.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148593320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Erratum to \"Automated cell count for blood component quality control\".","authors":"","doi":"10.1111/trf.70360","DOIUrl":"10.1111/trf.70360","url":null,"abstract":"","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":"2068"},"PeriodicalIF":2.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148713484","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":"Normal thromboelastography with a markedly prolonged activated partial thromboplastin time in severe prekallikrein deficiency: Implications for perioperative hemostatic assessment.","authors":"Jeremy W Jacobs, Anton Matafonov, Patricia G Baxter, Qiufang Cheng, Garrett S Booth, Deva Sharma, Benjamin F Tillman, David Gailani","doi":"10.1111/trf.70327","DOIUrl":"10.1111/trf.70327","url":null,"abstract":"<p><strong>Background: </strong>Prekallikrein (PK) deficiency is a rare contact factor deficiency that can markedly prolong the activated partial thromboplastin time (aPTT) without a bleeding phenotype. Because viscoelastic hemostatic assays also rely on contact activation, their behavior in severe PK deficiency is relevant to perioperative evaluation of isolated aPTT prolongation. We describe thromboelastography (TEG) 6s findings in a patient with severe PK deficiency.</p><p><strong>Study design and methods: </strong>A 59-year-old woman without a bleeding history was evaluated for an isolated prolonged aPTT identified during preoperative testing. Studies included prothrombin time (PT), thrombin time, an anti-factor Xa assay, aPTT mixing studies including with PK-deficient plasma, and factor VIII, IX, XI, and XII activities. PK antigen was assessed by western immunoblotting. Whole blood viscoelastic testing was performed on a TEG 6s analyzer.</p><p><strong>Results: </strong>The patient had a markedly prolonged aPTT (87.4 s, reference range [RR]: 24.5-34.0 s) with normal PT, thrombin time, and a negative anti-factor Xa assay. The aPTT corrected on mixing with normal pooled plasma but not with PK-deficient plasma. Factor VIII, IX, XI, and XII activities were normal or modestly elevated. Western immunoblotting showed absent PK antigen, establishing cross-reactive material-negative PK deficiency. Despite the prolonged aPTT, TEG 6s parameters were normal, including the citrated kaolin R time (4.6 min, RR: 4.6-9.1 min). The patient underwent surgery without hemostatic complications or transfusion.</p><p><strong>Discussion: </strong>Severe PK deficiency may markedly prolong the plasma-based aPTT without parallel abnormalities on TEG 6s, highlighting assay-specific differences in sensitivity to PK deficiency.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":"2031-2036"},"PeriodicalIF":2.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13674170/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148449591","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 B variant (c.2T>C) affecting the start codon of the ABO gene is associated with weak B phenotype.","authors":"Jue Hou, Xiwei Wei, Xue Chen, Yue Luo","doi":"10.1111/trf.70355","DOIUrl":"10.1111/trf.70355","url":null,"abstract":"","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":"2055-2057"},"PeriodicalIF":2.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148607905","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 serological weak D phenotype caused by the c.872C>T single nucleotide variation.","authors":"Shuli Yu, Cheng Tong, Yixuan He, Yue Wu, Chunyan Qian","doi":"10.1111/trf.70375","DOIUrl":"10.1111/trf.70375","url":null,"abstract":"","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":"2058-2060"},"PeriodicalIF":2.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148722328","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":"Interpreting antibody identification tests with large language models: Critical role of tabular data formatting.","authors":"Jiwoo Lee, Yousun Chung, Dae-Hyun Ko, Eun Young Song, Hyungsuk Kim","doi":"10.1111/trf.70364","DOIUrl":"10.1111/trf.70364","url":null,"abstract":"<p><strong>Background: </strong>Antibody identification testing is essential for preventing hemolytic transfusion reactions from unexpected red cell antibodies. Although automated interpretation is desirable to improve efficiency and consistency, conventional algorithmic approaches show limited accuracy, particularly in complex cases. Large language models (LLMs) offer a potential alternative; however, their performance is known to be sensitive to tabular data, which is a standard format for antigen profiles in antibody identification.</p><p><strong>Study design and methods: </strong>We generated 100 simulated antibody identification cases comprising single alloantibodies, dual alloantibodies, autoantibodies, and unidentifiable patterns. Seven LLMs (GPT-4o, GPT-4.1, o3, GPT-5, Gemini 2.0 Flash, Gemini 2.5 Flash, and Gemini 2.5 Pro) were evaluated. Antigen profile tables were provided using five text-based formats (Markdown, CSV, JSON, list-based, and sentence-based serialization) and as uploaded spreadsheet files. Each model interpreted all cases 10 times per format, and accuracy was assessed overall and by antibody category.</p><p><strong>Results: </strong>Reasoning-capable LLMs significantly outperformed non-reasoning models, achieving a median accuracy of 84.5%. Among text-based formats, sentence-based serialization yielded the highest accuracy, whereas CSV performed poorest. The maximum accuracy difference between table formats reached 40.5 percentage points. GPT-5 and o3 performed comparably when antigen profiles were supplied as uploaded spreadsheet files, achieving accuracy similar to that of the sentence-based format.</p><p><strong>Conclusions: </strong>Reasoning LLMs demonstrated measurable baseline capability for interpreting antibody identification results when accompanied by appropriately structured antigen profile inputs. However, performance varied markedly with data representation and case complexity, and the use of LLMs in transfusion practice should remain limited to an assistive role under specialist supervision.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":"1983-1992"},"PeriodicalIF":2.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13674215/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148702052","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}