Transfusion最新文献

{"title":"Evaluation of an ABO antibody immunoadsorption column for reduction of anti-A and anti-B isoagglutinin titers in group O platelet units.","authors":"Melanie J Robbins, Susan Proffitt, Gillian Eastwood, Sian Huish, Kurt Nilsson, Rebecca Cardigan","doi":"10.1111/trf.70410","DOIUrl":"10.1111/trf.70410","url":null,"abstract":"<p><strong>Background: </strong>Clinical guidelines recommend transfusing ABO-identical platelets where possible. However, the short shelf life of platelets (5-7 days) and stock availability mean ABO-nonidentical platelet transfusions are sometimes unavoidable. Minor ABO-incompatible platelet transfusions carry a risk of hemolysis due to donor anti-A/B antibodies, and high-titer (HT)-negative units are preferred to mitigate this risk. To further mitigate this risk, we investigated whether an ABO antibody immunoadsorption column could reduce anti-A/B titers in group O platelet units while preserving platelet quality.</p><p><strong>Study design and methods: </strong>Six group O double dose apheresis platelet units were pooled with HT-positive group O plasma and split into three arms: untreated control, single-pass filtration (Glycosorb ABO A/B-column), and double-pass using the same column. Anti A and anti B IgM and IgG titers were measured pre- and post-filtration using a gel card method. Platelet count, platelet volume, coagulation factors, and markers of platelet quality and activation were assessed after filtration and during storage.</p><p><strong>Results: </strong>Anti-A and anti-B titers were decreased from titers of 128 to ≤4 (IgM) and from 512 to ≤8 (IgG) following a single pass through the immunoadsorption column. Reduced efficacy was observed following a second pass through the same column (≤32 (IgM) and ≤128 (IgG)). Filtration was not associated with substantial platelet loss, although changes in some metabolic and activation markers were observed during storage.</p><p><strong>Discussion: </strong>The ABO antibody immunoadsorption column effectively reduced anti-A/B titers in group O platelet units and may offer a strategy to increase the availability of low-titer platelets for transfusion.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149075875","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":"Diagnosis-based laboratory information system flags to support specialized transfusion protocols in sickle cell disease.","authors":"Caroline G Stanek, Ronald G Hauser, Katherine Madden, Bhushan Shah, Christopher A Tormey, Kerry Wallack, Nalan Yurtsever","doi":"10.1111/trf.70417","DOIUrl":"https://doi.org/10.1111/trf.70417","url":null,"abstract":"<p><strong>Objective: </strong>Patients with sickle cell disease (SCD) frequently require specialized transfusion support. However, the blood bank cannot readily identify these patients without a time-prohibitive chart review. To improve adherence to evidence-based practices involving the transfusion of patients with SCD, we developed a laboratory information system (LIS)-integrated flagging system.</p><p><strong>Study design and methods: </strong>Using a predefined set of SCD-related International Classification of Diseases-10 diagnosis codes, laboratory-facing flags were implemented within the LIS. Flags were displayed in multiple workflow locations, including the patient dashboard, blood bank specimen receiving interface, and blood bank outstanding work list.</p><p><strong>Results: </strong>Blood bank technologists used the flags to verify and apply the institution's existing sickle cell transfusion protocol within the blood bank information system (BBIS). Thirty-three new patients with confirmed SCD but without historical comment in the BBIS had a type and screen performed after the implementation of the flag. Upon review, 4 (12%) did not have SCD-related diagnosis in their problem list and therefore lacked the trigger for the flag. Twenty-nine (88%) patients had the diagnosis in the problem list and all of them (100%) correctly displayed the flag.</p><p><strong>Discussion and conclusion: </strong>The intervention provided additional alerts of patients with SCD across multiple laboratory workflows and aided in the recognition of eligible patients.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149075902","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":"Early plasma administration in traumatic brain injuries: A systematic review.","authors":"Umair Tahir, Ian R Drennan, Peter Kobal, Otis Weeks, Soha Khorsand, Carolyn Ziegler, Melissa McGowan, Brodie Nolan","doi":"10.1111/trf.70403","DOIUrl":"https://doi.org/10.1111/trf.70403","url":null,"abstract":"<p><strong>Background: </strong>Early plasma may improve trauma resuscitation by addressing shock and coagulopathy, but its role in traumatic brain injury (TBI) remains uncertain. This systematic review evaluated early plasma in TBI.</p><p><strong>Methods: </strong>This review followed Cochrane methodology and was registered in PROSPERO (CRD420261357882). MEDLINE, Embase, Cochrane databases, and Web of Science were searched on February 3, 2026 and rerun August 11, 2026. Comparative studies of prehospital or early in-hospital plasma in TBI were eligible. Risk of bias was assessed using RoB-2 and ROBINS-I, certainty using GRADE, and findings were synthesized narratively.</p><p><strong>Results: </strong>Fifteen studies including 183,253 patients were included. Studies varied in design, population, plasma product, timing, dose, comparator, and outcomes. A secondary analysis of a cluster-randomized trial found lower 24-h and 30-day mortality with prehospital plasma among patients at risk of hemorrhagic shock subsequently found to have CT-confirmed TBI; the association was observed among direct scene transports but not interfacility transfers, suggesting timing relative to injury may be important. Two small early in-hospital trials showed no mortality benefit; one reported similar mortality with plasma and saline, while the other reported higher mortality and more delayed or new intracranial hematomas with plasma. Observational findings were inconsistent and limited by confounding by indication, with variation by plasma timing, comparator, and TBI severity. Certainty of evidence was very low.</p><p><strong>Conclusions: </strong>Evidence is insufficient to determine whether early plasma benefits or harms patients with TBI. Future randomized trials should standardize indications, time-to-plasma, plasma protocols, and outcomes and clarify clinically relevant plasma timing windows.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149075935","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":"Supported communication is a donor-safety intervention, not an eligibility exception.","authors":"Yi-Chia Hung, Lien-Chung Wei","doi":"10.1111/trf.70416","DOIUrl":"https://doi.org/10.1111/trf.70416","url":null,"abstract":"","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149063495","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":"Prehospital whole blood transfusion versus component therapy-A scoping review.","authors":"Laura Muurinen, Timo Jama, Tom Silfvast, Jouni Lauronen","doi":"10.1111/trf.70413","DOIUrl":"https://doi.org/10.1111/trf.70413","url":null,"abstract":"<p><strong>Background: </strong>Whole blood has gained a foothold over component therapy in civilian emergency care, especially in emergency departments. In a prehospital setting, whole blood might be the logistically easier alternative compared to component therapy. However, most previous studies have been conducted in the emergency room setting. We performed a scoping review to explore what is known about the outcomes, safety and benefits of whole blood given prehospitally compared to component therapy in a primarily adult civilian population.</p><p><strong>Study design and methods: </strong>We formed a systematic search strategy and conducted a literature search in several databases. The study selection was done according to predefined inclusion and exclusion criteria. Our primary endpoint was survival at 24 h. Secondary endpoints were also analyzed.</p><p><strong>Results: </strong>The database search resulted in 1126 articles. After a systematic exclusion process, only six articles met the inclusion criteria. Whole blood usage was associated with similar mortality at 24 h and at other timepoints compared to component therapy. The analysis of secondary endpoints showed only minor or no differences between the groups.</p><p><strong>Discussion: </strong>The differences in the outcomes of interest between patients receiving prehospital whole blood versus component therapy were minor and, in most cases, not statistically significant. The analysis of the different endpoints showed whole blood not to be inferior to component therapy. There is a growing evidentiary support for the use of whole blood in prehospital emergency care, but to make treatment recommendations in the future, more published evidence is needed.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149064581","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 components to pharmaceuticals: A desirable evolution toward precision transfusion medicine.","authors":"Melissa M Cushing, Steven L Spitalnik","doi":"10.1111/trf.70402","DOIUrl":"https://doi.org/10.1111/trf.70402","url":null,"abstract":"","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149064569","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":"Massive transfusion practices and low-titer group O whole blood utilization before and after implementation in a low-volume level I trauma center: A six-year review.","authors":"Chinelo P Onyenekwu, Debra M Lehman, Brittany Trower, Paula Woywod, Joseph P Connor","doi":"10.1111/trf.70409","DOIUrl":"https://doi.org/10.1111/trf.70409","url":null,"abstract":"<p><strong>Background: </strong>Low-titer O whole blood (LTOWB) has been increasingly incorporated into trauma resuscitation and massive transfusion protocols (MTPs). Recent randomized trials have not demonstrated superiority of prehospital LTOWB over component-based resuscitation, while the utilization and sustainability of LTOWB programs, particularly in low-volume trauma systems, remain incompletely characterized.</p><p><strong>Study design and methods: </strong>This was a 6-year review (April 2019-April 2025) of trauma MTPs at a level 1 trauma center with a low MTP frequency. Transfusion service logs, trauma flowsheets, prehospital and electronic medical records were reviewed for product usage, LTOWB utilization and discard patterns, and clinical outcomes.</p><p><strong>Results: </strong>One hundred and twenty-five MTPs were identified (122 component-only and 11 LTOWB-supported), with predominantly male (70%) and 81% blunt trauma. Component MTPs had a median RBC utilization of 6 units; 45% required ≤1 MTP line. Prehospital LTOWB use was limited: 33% of units were transfused, and only 2 of 13 patients requiring an MTP received prehospital LTOWB. LTOWB-supported MTPs typically issued 10 units, and most patients received 1-2 units. Of 524 LTOWB units procured during the first 6 months, 201 were transfused and 323 discarded (62%), with a peak discard rate of 81% early in rollout. Overall, 30-day mortality was 54%, and 25% occurred within 4 h.</p><p><strong>Conclusions: </strong>LTOWB use was limited, and early wastage was substantial. LTOWB implementation in low-volume centers should align inventory and protocols with clinical demand; stewardship measures may reduce waste and improve sustainability.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149064606","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 functionally distinct HPA-1a-specific alloantibody associated with fetal/neonatal alloimmune thrombocytopenia that activates platelets via FcγRIIa.","authors":"Huiying Zhi, Cathy Paddock, Daniel Villalobos-Garcia, Janita Oosterhoff, Heng Zhang, Gestur Vidarsson, Renren Wen, Jieqing Zhu, Debra Newman, Peter J Newman","doi":"10.1111/trf.70411","DOIUrl":"10.1111/trf.70411","url":null,"abstract":"<p><strong>Background: </strong>Fetal/neonatal alloimmune thrombocytopenia (FNAIT) is caused by maternal alloantibodies directed against fetal platelet antigens, most commonly human platelet antigen-1a (HPA-1a). These antibodies mediate platelet destruction and can lead to fetal and neonatal thrombocytopenia severe enough to cause life-threatening organ bleeds. Antibody titer and isotype do not reliably predict disease severity, suggesting additional heterogeneity among anti-HPA-1a antibodies.</p><p><strong>Study design and methods: </strong>We evaluated the effects of five previously characterized HPA-1a-specific monoclonal antibodies (mAbs) on platelet activation, platelet aggregation, and induction of intracellular signaling. The involvement of FcγRIIa was examined using FcγRIIa-blocking antibody IV.3, protein tyrosine kinase inhibitors, and selected monoclonal antibody Fab fragments.</p><p><strong>Results: </strong>At saturating concentrations, all five mAbs inhibited thrombin-induced aggregation. At sub-saturating concentrations, however, mAb M-204 uniquely induced spontaneous aggregation and α-granule secretion in HPA-1a-positive human, but not mouse, platelets, which lack FcγRIIa. M-204-induced aggregation was abolished by mAb IV.3 and inhibitors of Src- and Syk-family kinases and was absent using M-204 Fab fragments. M-204 induced tyrosine phosphorylation of Syk and PLCγ2 in an FcγRIIa-dependent manner. Finally, despite persistent platelet activation induced by M-204, saturating concentrations of this antibody blocked the binding of the fibrinogen mimetic antibody, PAC-1, to HPA-1a homozygous, but not HPA-1a/1b heterozygous, platelets, consistent with the known ability of HPA-1a-specific antibodies to sterically interfere with ligand binding to HPA-1a-positive αIIbβ3.</p><p><strong>Conclusion: </strong>These findings identify a previously unrecognized, functionally distinct subset of HPA-1a antibodies capable of activating platelets via FcγRIIa, suggesting a potential mechanism contributing to variability in disease severity in FNAIT.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149064631","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":"Novel missense variants in the RHAG gene that result in Rh^mod phenotype.","authors":"Youmna Al Halabi, Peter C Ligthart, Giulia Iacono, Barbera Veldhuisen, Nurcan Yagci, Ahmad Javadi, Kerly Fu, Marjan J Cruijsen, Ignace H J T de Hingh, Daan van de Kerkhof, Matthieu C J Bosman, Gestur Vidarsson, Ellen van der Schoot, Emile van den Akker","doi":"10.1111/trf.70366","DOIUrl":"https://doi.org/10.1111/trf.70366","url":null,"abstract":"<p><strong>Background: </strong>Identification of variants causing Rh deficiency phenotypes is important to allow safe transfusions and prevent hemolytic disease of the fetus and newborn. During preoperative screening for pseudomyxoma peritonei, a patient presented with suspicion of Rh-deficiency syndrome. The effect of these variants on the expression of Rh and Rh associated proteins was studied.</p><p><strong>Study design & methods: </strong>Serotyping, MLPA genotyping, and next-generation sequencing were performed on the RBCs of the proband and their family members. The effect of the variants on membrane expression of RhAG, Rh proteins, as well as Rh complex membrane proteins was evaluated using flow cytometry and western blot. Transient transfection experiments were conducted to assay the consequences of the RhAG variants on RhAG, RhD, and RhCE membrane expression.</p><p><strong>Results: </strong>Two novel missense variants in RHAG, RHAG:c.172C>T and RHAG:c.242G>A were identified resulting in an Rh^mod phenotype. The novel RHAG variants decreased RhAG expression with a concomitant reduction in expression of Rh proteins and CD47 while a slight increase in band3 expression was observed in the proband. A reduction of CD44 expression was also observed. Transfection of c.172C>T did not lead to a lower RhAG expression, while in contrast, expression of c.242G>A was significantly decreased compared to RhAGwt. Both led to a reduction of RhD and RhCE expression. Co-transfection of RHAGwt with c.172C>T or c.242G>A led to a significant reduction in RhD and RhCE expression.</p><p><strong>Conclusion: </strong>Two novel RHAG variants leading to Rh^mod phenotype were identified. A decrease in CD44 expression not previously associated with this phenotype was observed.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149040801","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 commercialization of \"unvaccinated\" blood: A cross-sectional analysis of organizations marketing services based on donor COVID-19 vaccination status.","authors":"Jeremy W Jacobs, Garrett S Booth, Sheharyar Raza","doi":"10.1111/trf.70414","DOIUrl":"https://doi.org/10.1111/trf.70414","url":null,"abstract":"<p><strong>Background: </strong>Requests for blood from donors not vaccinated against COVID-19 persist despite evidence that donor vaccination does not affect transfusion recipients. We characterized organizations marketing services based on donor vaccination status.</p><p><strong>Study design and methods: </strong>We conducted a cross-sectional analysis of publicly available websites from organizations marketing access to unvaccinated blood. Between July 25 and July 26, 2026, we performed 30 prespecified Google searches in six languages and screened the first 50 results per query. We included organizations offering enrollment, paid access, documents, donor registration, matching, or assistance based on COVID-19 vaccination status. We coded geographic reach, payment, services, donor classification, diagnostic claims, blood handling, and operational limitations.</p><p><strong>Results: </strong>Eight organizations met inclusion criteria; four described international reach. All marketed an existing or planned donor registry or matching service, seven charged fees or offered paid access, six issued patient-facing documents, and seven advertised clinician directories, referrals, advocacy, or legal support. Donor status was classified through self-report, records, declarations, exemptions, social media screenshots, membership identification, or trust. One organization promoted unvalidated diagnostic tests. All depended on external clinicians, hospitals, or blood establishments; none described collecting, testing, processing, or storing blood components. Several acknowledged that matching was unavailable or not guaranteed or that hospital acceptance varied.</p><p><strong>Discussion: </strong>Organizations are monetizing vaccine misinformation by selling memberships, documents, donor registries, professional directories, and advocacy services. These products give vaccination status the appearance of a medically meaningful blood attribute and may channel unsupported directed donation requests to hospitals and blood establishments.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149040837","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}