Transfusion最新文献

{"title":"Approach to autologous stem cell transplantation in a patient with severe cold agglutinin disease, a case report.","authors":"Mathias Castonguay, Léa Bernard, Marylène Corriveau, Anik Castonguay, Geneviève Quenneville, Sandra Cohen, Sylvie Lachance, Imran Ahmad, Isabelle Cournoyer, Thomas Kiss, Isabelle Fleury, Luigina Mollica, Denis-Claude Roy, Jean Roy, Guy Sauvageau, Olivier Veilleux, Martin Giroux, Jean-Sébastien Delisle, Mélissa Boileau","doi":"10.1111/trf.18147","DOIUrl":"https://doi.org/10.1111/trf.18147","url":null,"abstract":"<p><strong>Background: </strong>Cold agglutinin disease (CAD) or syndrome (CAS) can be particularly challenging when autologous stem cell transplant (ASCT) is needed. Standard peripheral blood stem cell (PBSC) collection and manipulation involve ex vivo blood manipulations at lower than body temperature, predisposing to agglutination during graft collection, handling, processing, and infusion.</p><p><strong>Study design and methods: </strong>We describe the first case of ASCT for relapsing lymphoma in a patient with high-titer CAD requiring anti-complement therapy and chronic transfusion. To prevent agglutination, five therapeutic plasma exchange sessions were performed prior to PBSC collection. Optimal thermal conditions were maintained using various approaches to increase the temperature of the room, venous return lines, and the apheresis device. Ex vivo graft manipulation was conducted under similar conditions. An infusion test was performed with a fraction of the graft a month prior to ASCT to confirm tolerability.</p><p><strong>Results: </strong>The infusion test was performed without complications. A month later, the patient was admitted for ASCT. The aplasia phase was particularly challenging, as the patient experienced a rapid drop in hemoglobin levels due to hemolysis without compensatory reticulocytosis. Twelve months after ASCT, chronic hemolysis persists, but the patient is now transfusion-free, and the lymphoma remains in remission.</p><p><strong>Discussion: </strong>Performing ASCT in patients with clinically significant CAS or CAD is challenging but can be done safely. Strong coordination between the apheresis team, cell therapy laboratory, and clinical unit is paramount to the success of this procedure. The experience gained from this case may also be applicable to other cell therapy procedures.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143060705","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":"Syphilis-positive and false-positive trends among US blood donors, 2013-2023.","authors":"Galen Conti, Rahima Fayed, Paula Saa, Roger Y Dodd, Susan L Stramer","doi":"10.1111/trf.18145","DOIUrl":"https://doi.org/10.1111/trf.18145","url":null,"abstract":"<p><strong>Background: </strong>US blood donors are tested for syphilis because the bacterial agent is transfusion transmissible. Here we describe trends over an 11-year period of donations positive for recent and past syphilis infections, and donations classified as syphilis false positive (FP).</p><p><strong>Methods: </strong>Data from January 1, 2013, to December 31, 2023 (11 years) were compiled for all American Red Cross blood donations to evaluate demographics/characteristics and longitudinal trends in donors testing syphilis reactive/positive. The prevalence of recent, past, and total (combination of recent/past) infections were evaluated, along with syphilis FP donations. Classification was based on known serological methods using treponemal and non-treponemal tests.</p><p><strong>Results: </strong>Approximately 53 million donations were included with 10,365 total syphilis infections (3463 recent and 6902 past; 0.02% total) and 48,719 FP (0.09%). Donor demographics, characteristics, and HBV/HCV/HIV nucleic acid testing reactivity differed among syphilis-positive and FP compared with nonreactive donations. Donors with a FP donation had high rates of subsequent donations testing syphilis positive (0.3%) and FP (7.7%). Median time from first FP to subsequent FP was observed to be 3.6 months. Recent infections increased over the 11 years, with past infections peaking in 2014 followed by increases in 2021-2023 paralleling recent infections. Repeating cycles of seasonal FP spikes occurred in the fall of 2013 and from 2017 to 2022 corresponding with vaccine administrations.</p><p><strong>Conclusions: </strong>Syphilis infections in blood donors are trending upward, paralleling US population trends. Syphilis FP donors had high rates of subsequent FP and unexplained syphilis-positive donations. Seasonal syphilis FP spikes occurred for most years but are trending downwards.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143052628","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":"Cryofibrinogenemia as a cause of ABO forward/reverse discrepancy and positive antibody screen result.","authors":"Christian Green, Herman Israel Lungayan, Coen J Lap, Colleen W Gilstad","doi":"10.1111/trf.18132","DOIUrl":"https://doi.org/10.1111/trf.18132","url":null,"abstract":"","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143052582","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":"An international survey of patient blood management practices.","authors":"Richard Gammon, Aikaj Jindal, Rounak Dubey, Cathy Shipp, Amit Tayal, Srijana Rajbhandary, Christopher Bocquet","doi":"10.1111/trf.18136","DOIUrl":"https://doi.org/10.1111/trf.18136","url":null,"abstract":"<p><strong>Background: </strong>The Association for the Advancement of Blood and Biotherapies (AABB) conducted a global survey of patient blood management (PBM) practices. It determined changes in PBM practices since the last survey.</p><p><strong>Study design and methods: </strong>A working group of AABB's PBM Subsection and AABB staff designed the survey using the Qualtrics™ platform. The survey collected data from January 1, 2021, through December 31, 2021, and data analysis was conducted.</p><p><strong>Results: </strong>Responses were received from 274 facilities across five World Health Organization (WHO) regions, from which 205 (74.8%) were from North America (NA), and 25.2% (69/274) were from outside of NA or the rest of the world (RoW). Of all respondents, 46.0% (126/274) had a PBM program. NA at 50.2% (103/205) was significantly higher than RoW at 33.3% (23/69) (p = .0049). In NA AABB transfusion guidelines, 36.8% (179/486) were the most followed versus RoW, with the Ministry of Health at 23.2% (29/125). The hemoglobin transfusion threshold of ≤7.0 g/dL (inpatients and outpatients) and platelet transfusion threshold of 5000/μL -10,000/μL (prophylaxis for inpatients and outpatients) were most commonly followed. Areas of improvement since the last AABB 2013 survey included providing PBM training increased to 61.7% (103/167) from 36.5% (219/600) and evaluation of patients undergoing elective surgical procedures for factors predictive of anemia to 46.0% (125/272) from 28% (144/507).</p><p><strong>Conclusions: </strong>While gains have been made in certain areas of PBM, there remains room for improvement, as more than half of respondents did not have a PBM program.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143047770","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":"Correction to \"International review of blood donation screening for anti-HBc and occult hepatitis B virus infection\".","authors":"","doi":"10.1111/trf.18094","DOIUrl":"https://doi.org/10.1111/trf.18094","url":null,"abstract":"","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143024968","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 utilization in patients with sickle cell disease: A Canadian single-center experience.","authors":"Kelsey Uminski, Iris Perelman, Johnathan Mack, Alan Tinmouth","doi":"10.1111/trf.18103","DOIUrl":"https://doi.org/10.1111/trf.18103","url":null,"abstract":"<p><strong>Background: </strong>Red blood cell (RBC) utilization in patients with sickle cell disease (SCD) in Canada is poorly defined. This study describes RBC utilization in an SCD cohort at a single Canadian center.</p><p><strong>Study design and methods: </strong>All adults with SCD who received care at the Ottawa Hospital between January 2006 and May 2019 were included, and followed until December 2021. Data on hospital encounters and RBC transfusions were obtained from hospital databases.</p><p><strong>Results: </strong>Overall, 273 patients were included (median age: 25 years; 53.8% female; median follow-up: 8.1 years). During the study period, there were 23,127 hospital encounters (median: 45 [interquartile range (IQR) 18, 100] per patient), with 165 patients (60.4% of cohort) receiving 22,538 RBC units. Most RBC units (86.5%) were transfused in the outpatient setting. Although only 2.9% of patients had O-negative blood type, O-negative RBC units accounted for 29.1% of units transfused. One hundred forty-seven patients received 2205 RBC units (9.8% of total) as simple transfusions (median: 5 [IQR 3, 13] per patient), and 88 patients received 20,333 RBC units (90.2% of total) during 2702 red cell exchange (RCE) sessions (median: 14.5 (IQR 1, 47.5) RCE per transfused patient). A median of 7 RBC units (IQR 6, 9) were transfused per RCE session, with a median of 30 days (IQR 28, 40) between sessions.</p><p><strong>Discussion: </strong>Patients with SCD at our center frequently received O-negative units, and large RBC volumes were used for RCE. These results provide a utilization baseline for future education and quality improvement initiatives to optimize RBC stewardship.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143024972","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":"SARS-CoV-2 IgG antibodies in COVID-19 convalescent plasma and conventional plasma units.","authors":"Andrew Sulaiman, Isabella Sengsouk, Jodie L White, Christi Marshall, Reinaldo E Fernandez, Andrew D Redd, Yolanda Eby, Arturo Casadevall, David Sullivan, Kelly Gebo, Shmuel Shoham, Oliver Laeyendecker, Herleen Rai, Evan M Bloch, Elizabeth P Crowe, Aaron A R Tobian","doi":"10.1111/trf.18139","DOIUrl":"10.1111/trf.18139","url":null,"abstract":"<p><strong>Background: </strong>The Association for the Advancement of Blood and Biotherapies guidelines recommend the use of high-titer COVID-19 convalescent plasma (CCP) for patients with SARS-CoV-2 at high risk of disease progression, including those who are immunocompromised. We hypothesized that conventional plasma units have comparable neutralizing antibody levels to CCP.</p><p><strong>Study design and methods: </strong>Conventional plasma and CCP units were obtained from blood suppliers. Quantitatively measured antibodies to SARS-CoV-2 were assessed using the MesoScale Discovery multiplex electrochemiluminescence immunoassay. Binding antibody distributions were compared with Wilcoxon rank-sum tests. SARS-CoV-2 neutralizing antibodies were analyzed using the GeneScript ELISA-based neutralization assay. The proportion of conventional and CCP units with a percent signal inhibition of ≥80% (as defined by the United States Food and Drug Administration for CCP in 2021) and exact binomial confidence intervals (CIs) were calculated.</p><p><strong>Results: </strong>Among 218 conventional plasma units and 74 CCP units collected between September 2023 and July 2024, the distribution of total antibody binding levels largely overlapped between conventional plasma and CCP, though statistically significant differences in median nucleocapsid and spike Omicron variant concentrations were observed. Median percent signal neutralization was 97.5% (range 3.4%-98.6%) among conventional plasma units and 97.7% (range 95.4%-98.6%) among CCP units. For conventional plasma, 95.0% (95% CI = 91.2%-97.5%) met the neutralization antibody threshold for high-titer CCP. For CCP, 100% (95% CI = 95.1%-100.0%) met the neutralization threshold for high-titer CCP.</p><p><strong>Conclusion: </strong>Conventional plasma units demonstrate similar median antibody concentration to CCP units. In countries or regions where licensed CCP is unavailable and titers are unknown, transfusion of multiple conventional plasma units may be of clinical utility.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143024977","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 urate levels are linked to hemolysis in vitro and post-transfusion as a function of donor sex, population and genetic polymorphisms in SLC2A9 and ABCG2.","authors":"Alicia M Key, Eric J Earley, Vassilis L Tzounakas, Alkmini T Anastasiadi, Travis Nemkov, Daniel Stephenson, Monika Dzieciatkowska, Julie A Reisz, Gregory R Keele, Xutao Deng, Mars Stone, Steve Kleinman, Kirk C Hansen, Philip J Norris, Michael P Busch, Nareg H Roubinian, Grier P Page, Angelo D'Alessandro","doi":"10.1111/trf.18140","DOIUrl":"10.1111/trf.18140","url":null,"abstract":"<p><strong>Background: </strong>Storage of packed red blood cells (RBCs) for transfusion leads to biochemical and morphological changes, increasing hemolysis risk. Urate levels in blood bags at donation contribute to the molecular heterogeneity and hemolytic propensity of stored RBCs. However, studies to date have been underpowered to investigate at scale the contribution of donor demographics and genetics to the heterogeneity in urate levels across donations.</p><p><strong>Study design and methods: </strong>Urate levels were measured in 13,091 RBC units from the REDS study. Characteristics tested included hemolysis parameters (spontaneous, osmotic, oxidative) at storage end and post-transfusion hemoglobin (Hb) increments in recipients. Donor demographics, urate levels, and genetic variants were analyzed for associations with these outcomes.</p><p><strong>Results: </strong>Elevated urate levels were linked to male sex, older age, high BMI, and Asian descent. Units with high urate levels exhibited increased spontaneous and osmotic hemolysis, while oxidative hemolysis was unaffected. Genetic variants in SLC2A9 (V282I) and ABCG2 (Q141K) were strongly associated with elevated urate, particularly in Asian donors. Post-transfusion analyses revealed that units from female donors carrying these variants were associated with reduced Hb increments, with up to a 31% reduction in efficacy. This effect was not observed in male donors.</p><p><strong>Discussion: </strong>RBC urate levels and genetic traits significantly impact storage quality and transfusion outcomes. These findings highlight the importance of donor molecular characteristics for optimizing transfusion strategies. Moreover, genetic and metabolic insights may inform donor recruitment efforts, providing health feedback to volunteers while ensuring effective transfusion products.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143012276","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":"Associations between blood donors, component modifications, and the alloimmunization of transfusion recipients.","authors":"Han Yu, Matthew S Karafin, Christopher Anthony Tormey, Ruchika Goel, Bryan Ross Spencer, Jeanne E Hendrickson, Ronald George Hauser","doi":"10.1111/trf.18135","DOIUrl":"https://doi.org/10.1111/trf.18135","url":null,"abstract":"<p><strong>Background: </strong>Prior studies have evaluated transfusion recipient variables impacting red blood cell (RBC) alloimmunization, but few focused on potentially modifiable blood donor or blood component variables.</p><p><strong>Study design and methods: </strong>Data from the Recipient Epidemiology and Donor Evaluation Study (REDS)-III, which links donor, component, and patient data in an integrated database, were accessed. For any given RBC unit with sufficient blood donor and component data, we determined if the transfusion recipient experienced a new RBC alloimmunization event (\"case\") within 16 weeks of the transfusion or not (\"control\"). Recipient diagnoses were included in the case-control matching algorithm.</p><p><strong>Results: </strong>A total of 2676 cases were matched with 10,160 controls. In a multivariate conditional logistic regression analysis, recipients who received an RBC unit from donors with a different ABO group had a higher risk of alloimmunization (OR 1.60, 95% CI: 1.35-1.89, p < .001). Likewise, recipients who received RBCs from older donors had a higher risk of RBC alloimmunization (OR 1.01 per year of age, 95% CI: 1.00-1.01, p < .001). Irradiated RBCs were associated with a decreased risk of RBC alloimmunization in transfusion recipients (OR 0.52, 95% CI: 0.46-0.59, p < .001), though a sub-analysis of RBCs transfused to people with sickle cell disease showed no such association (p = .75). Recipients who received RBCs stored for a longer duration also had a lower risk (OR 0.99 per day of storage, 95% CI: 0.99-0.99, p < .001) of alloimmunization.</p><p><strong>Discussion: </strong>This case-control study identified donor and component variables associated with recipient RBC alloantibody formation. Future mechanistic studies exploring these associations are warranted.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143012274","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":"Cord blood for autologous transfusion in infants with congenital anomalies: Volumes, sterility, and stability during storage.","authors":"Olivia Nelson, Rebecca Jones, Julie S Moldenhauer, Natalie E Rintoul, Holly L Hedrick, Sara Kumar, Rachel Helton, Bingqing Zhang, Grace Linder, Allan F Simpao, Paul A Stricker, Stella T Chou","doi":"10.1111/trf.18134","DOIUrl":"10.1111/trf.18134","url":null,"abstract":"<p><strong>Background: </strong>Neonates with congenital anomalies frequently require perioperative allogeneic red blood cell (RBC) transfusion. Whole cord blood for autologous transfusion to neonates may provide an alternative RBC source, but whether sufficient volumes can be collected after delayed cord clamping to reduce allogeneic RBC requirements is unknown.</p><p><strong>Study design and methods: </strong>Inclusion criteria were mothers delivering a viable infant >34 weeks' gestation. Sterile cord blood collection from the umbilical cord was performed at delivery as per routine obstetric indications. During storage at 4°C, we performed weekly blood gases. Blood culture, complete blood count, and hemolysis tests were performed at baseline and day 21. We compared the whole cord blood volume collected with each infant's allogeneic transfusion requirements.</p><p><strong>Results: </strong>54 collection attempts yielded 49 collections with a mean volume of 54.1 mL (±20.3) after median delayed cord clamping of 46 seconds (IQR 12.0, 60.0). Among 39 blood cultures obtained, 3 grew organisms after vaginal delivery (3/27, 11.0% vs. 0/12, 0% cesarean delivery, p = .54). Hemolysis was stable during storage (baseline vs. day 21, median [IQR], 0.7% [0.4%-0.9%] vs. 0.7% [0.6%-1.1%], p = .08).</p><p><strong>Conclusions: </strong>Whole cord blood collection following delayed cord clamping was feasible, with volumes equal to 16.7 mL/kg, or one transfusion. Hemolysis was low, and although potassium increased during storage, it was consistent with patterns observed with adult donor stored whole blood. There were no positive blood cultures from collections during cesarean deliveries. Studies are needed to determine whether whole cord blood transfusions improve patient outcomes.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142984897","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}