Transfusion最新文献

{"title":"Real‐time performance improvement optimizes damage control resuscitation best practice adherence: Results of a pilot prospective observational study","authors":"Daniela Schmulevich, Zhi Geng, Sarah M. Joergensen, Nathaniel R. McLauchlan, Eric Winter, Alea Zone, Kathleen E. Bishop, Alyson Hinkle, Sara Holland, Pamela Z. Cacchione, Erin E. Fox, Benjamin S. Abella, Christopher L. Meador, Charles E. Wade, Allyson M. Hynes, Jeremy W. Cannon","doi":"10.1111/trf.17970","DOIUrl":"https://doi.org/10.1111/trf.17970","url":null,"abstract":"BackgroundMaintaining balanced blood product ratios during damage control resuscitation (DCR) is independently associated with improved survival. We hypothesized that real‐time performance improvement (RT‐PI) would increase adherence to DCR best practice.Study Design and MethodsFrom December 2020–August 2021, we prospectively used a bedside RT‐PI tool to guide DCR in severely injured patients surviving at least 30 min. RT‐PI study patients were compared to contemporary control patients at our institution and historic PROMMTT study patients. A subset of patients transfused ≥6 U red blood cells (RBC) in 6 h (MT+) was also identified. The primary endpoint was percentage time in a high ratio range (≥3:4) of plasma (PLAS):RBC and platelet (PLT):RBC over 6 h. Secondary endpoints included time to massive transfusion protocol activation, time to calcium and tranexamic acid (TXA) dosing, and cumulative 6‐h ratios.ResultsIncluded patients (<jats:italic>n</jats:italic> = 772) were 35 (24–51) years old with an Injury Severity Score of 27 (17–38) and 42% had penetrating injuries. RT‐PI (<jats:italic>n</jats:italic> = 10) patients spent 96% of the 6‐h resuscitation in a high PLAS:RBC range, no different versus CONTROL (<jats:italic>n</jats:italic> = 87) (96%) but more than PROMMTT (<jats:italic>n</jats:italic> = 675) (25%, <jats:italic>p</jats:italic> &lt; .001). In the MT+ subgroup, optimal PLAS:RBC and PLT:RBC were maintained for the entire 6 h in RT‐PI (<jats:italic>n</jats:italic> = 4) versus PROMMTT (<jats:italic>n</jats:italic> = 391) patients for both PLAS (<jats:italic>p</jats:italic> &lt; .001) and PLT ratios (<jats:italic>p</jats:italic> &lt; .001). Time to TXA also improved significantly in RT‐PI versus CONTROL patients (27 min [22–31] vs. 51 min [29–98], <jats:italic>p</jats:italic> = .035).ConclusionIn this prospective study, RT‐PI was associated with optimized DCR. Multicenter validation of this novel approach to optimizing DCR implementation is warranted.","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141782657","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":"Three novel Er blood group system alleles and insights from protein modeling.","authors":"William J Lane, Sunitha Vege, Helen H Mah, Gorka Ochoa-Garay, Christine Lomas-Francis, Connie M Westhoff","doi":"10.1111/trf.17965","DOIUrl":"https://doi.org/10.1111/trf.17965","url":null,"abstract":"<p><strong>Background: </strong>The Er blood group system was recently shown to be defined by PIEZO1. The system consists of high prevalence antigens Er^a, Er3, ERSA, and ERAMA; and low prevalence antigen Er^b. Er^a/Er^b are antithetical with Er(a-b+) defined by the ER*B allele [c.7180G>A p.(Gly2394Ser)]. A nonsense variant c.5289C>G p.(Tyr1763*) is associated with a predicted Er_null phenotype, and a missense variant c.7174G>A p.(Glu2392Lys) in close proximity to p.2394 causes loss of both Er^a and Er^b expression.</p><p><strong>Study design and methods: </strong>We investigated PIEZO1 in four Er(a-) individuals who presented with anti-Er^a. Whole genome sequencing (WGS) and Sanger sequencing were performed. The location and structural differences of predicted protein changes were visualized using the predicted 3-D structure of Piezo1 created using AlphaFold2.</p><p><strong>Results: </strong>One individual was homozygous for the reported ER*B. A second had a novel heterozygous nonsense variant c.3331C>T p.(Gln1111*), but a second allelic variant was not found. In the remaining two individuals, two different heterozygous novel missense variants, c.7184C>T p.(Ala2395Val) or c.7195G>A p.(Gly2399Ser), were in trans to the reported c.7180G>A variant, ER*B. AlphaFold2 protein modeling showed that each of the missense variants is predicted to encode an altered structural conformation near Er^a and Er^b.</p><p><strong>Conclusions: </strong>Investigation of archived samples resulted in the identification of three novel PIEZO1 alleles including a predicted Er_null and two missense variants. Structural modeling suggests that the missense changes potentially alter Er^a/Er^b epitope expression with p.2399Ser resulting in a small increase in the negative electrostatic potential.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141761129","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 transfusion of labile blood product using intraosseous perfusion with multi-lumen extender: Why not?","authors":"J Aloird, P Bernard, O Javaudin, M Casse, M Richez, J-B Hitier, A Sarda, F Colleu, J Boissier, J-P Freiermuth","doi":"10.1111/trf.17964","DOIUrl":"https://doi.org/10.1111/trf.17964","url":null,"abstract":"<p><strong>Background: </strong>French prehospital military medical teams are provided with labile blood products to effectively address hemorrhagic shock. In combat environment, standard good medical practice may limit efficacy of therapeutic goals regarding damage control resuscitation.</p><p><strong>Study design and methods: </strong>We present here a case report describing the management of a soldier heavily wounded during a helicopter forward medical evacuation in Sahel region.</p><p><strong>Results: </strong>We report the challenge encountered by medical team using only a humeral intraosseous route available due to severity of lesions and challenging environment. In this configuration, multi-lumen extender enabled transfusion of two units of packed red blood cells and two units of plasma, and analgesia while limiting manipulation and dislodgment of the fragile intraosseous route. This situation, outside of usual good medical practice, raises issues of hemolysis, physicochemical compability of drugs and blood products, and consequences on flow rate reduction.</p><p><strong>Discussion: </strong>With this case, we emphasize the benefit of multi-lumen extender associated with intraosseous route for early management of heavy casualties in harsh prehospital environment. Literature suggests that hemolysis and physicochemical compability should remain limited. The main issue of this setting consists of flow reduction and can be addressed by prioritizing humeral route, and using counter pressure cuffs, until a second peripheral or central line is available and management can resume without the need for multi-lumen extender.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141761120","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 review of attitudes to urgent RhD-positive transfusions in female patients and the risk for hemolytic disease of the fetus and newborn.","authors":"Mark H Yazer, Philip C Spinella, John B Holcomb, Sarah Horvath, Molly R Sherwood, Stephen P Emery, Julie C Leonard, Christine M Leeper","doi":"10.1111/trf.17967","DOIUrl":"https://doi.org/10.1111/trf.17967","url":null,"abstract":"","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141752919","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":"Fatal posterior reversible encephalopathy syndrome after blood transfusion in a patient with myelodysplastic syndromes.","authors":"Ken Takigawa, Takahiro Shima, Chiaki Kubara, Shun Akamine, Sae Utsumi, Teruhiko Yoshino, Mariko Minami, Masayasu Hayashi, Yayoi Matsuo, Takuro Kuriyama, Reiko Yoneda, Shuichi Taniguchi, Tetsuya Eto","doi":"10.1111/trf.17968","DOIUrl":"https://doi.org/10.1111/trf.17968","url":null,"abstract":"<p><strong>Background: </strong>Posterior reversible encephalopathy syndrome (PRES) is known as a transfusion-related complication with typically favorable prognosis and no report fatalities. Pathological evaluation of PRES is also scarce.</p><p><strong>Case report: </strong>An 88-year-old female with myelodysplastic syndromes (MDS) attended our hospital because of a compression fracture and chronic heart failure with chronic anemia. While her hemoglobin levels improved from 4.6 to 8.0 g/dL and the pleural effusions substantially decreased following six units of red blood cell transfusion and diuretic therapy, a gradual decline in cognitive function and speech reduction was noted. PRES was diagnosed by magnetic resonance imaging of the head. Despite treatment of intensive supportive care, the patient fell into a coma by the 20th day and passed away on the 22nd day. Although the pathophysiological link between blood-transfusion-related PRES and its impact on survival is not fully understood, autopsy findings confirmed the diagnosis of PRES and revealed multiple cerebral hemorrhages that were not detected in earlier imaging studies.</p><p><strong>Conclusion: </strong>This case highlights the importance of vigilant monitoring and management of PRES, especially in high-risk populations such as elderly patients with multiple comorbidities or those with thrombocytopenia. Further studies are needed to elucidate the mechanisms of PRES in patients with hematologic diseases.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141752921","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":"Anti-HNA testing of allo-exposed COVID-19 convalescent plasma donors including genetic human neutrophil antigen screening to prevent anti-HNA antibody-mediated transfusion-related acute lung injury.","authors":"Katarzyna Guz, Patrycja Łopacz, Małgorzata Uhrynowska, Karolina Piaskowska, Beata Szczepaniak, Magdalena Krzemienowska, Sylwia Purchla-Szepioła, Anna Główka, Eliza Głodkowska-Mrówka, Agnieszka Orzińska","doi":"10.1111/trf.17962","DOIUrl":"https://doi.org/10.1111/trf.17962","url":null,"abstract":"<p><strong>Background: </strong>Transfusion-related acute lung injury caused by antibodies against human neutrophil antigens (HNA) is a serious but rare complication associated with blood transfusion. The presence of such antibodies is most probable in donors with a transfusion/pregnancy history. During the COVID-19 pandemic period convalescent plasma (CP) containing neutralizing antibodies against SARS-CoV-2 was widely used for COVID-19 patients as a therapy in the absence of any treatment. The aim of the study was to work out a simple diagnostic algorithm of anti-HNA testing of allo-exposed CP donors including genetic HNA screening.</p><p><strong>Materials and methods: </strong>A total of 457 anti-HLA-negative allo-exposed CP donors were genotyped for HNA-1a/1b, HNA-3a/3b, and HNA-2, and only donors with homozygous HNA-1a/1a; HNA-3b/3b; or HNA-2null genotypes were tested for anti-HNA antibody using LabScreenMulti (One Lambda) and homozygous HNA-1b/1b using the granulocyte immunofluorescence test (GIFT) but verified using LabScreenMulti.</p><p><strong>Results: </strong>Testing of 83 homozygous HNA-3b/3b; HNA-2null; or HNA-1a/1a donors revealed anti-HNA-3a antibody in one case. Testing of 181 HNA-1b/1b donors using GIFT gave 10 ambiguous results verified using LabScreenMulti which confirmed anti-HNA-1a antibody in one case. The frequency of FCGR3B*01 and *04 encoding HNA-1a was 0.34; FCGR3B*02, *03, and *05 encoding HNA-1b-0.66; SLC44A2*01 encoding HNA-3a-0.80; and SLC44A2*02 encoding HNA-3b-0.20. In 3.7% cases the HNA-2null genotype was revealed.</p><p><strong>Discussion: </strong>Due to applying HNA genotyping as a primary test before anti-HNA antibody testing the serological work was limited only to HNA-homozygous donors revealing two anti-HNA immunized donors. The distribution of HNA genotypes in the cohort was similar to other Caucasian populations.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141752920","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":"Updates to Association for the Advancement of Blood and Biotherapies Standards for blood banks and transfusion services, 34th edition.","authors":"Claudia S Cohn, Christopher Bocquet","doi":"10.1111/trf.17954","DOIUrl":"https://doi.org/10.1111/trf.17954","url":null,"abstract":"","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141731425","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":"Extracellular vesicles in fresh frozen plasma and cryoprecipitate: Impact on in vitro endothelial cell viability.","authors":"Ji Hui Hwang, John-Paul Tung, Damien G Harkin, Robert L Flower, Natalie M Pecheniuk","doi":"10.1111/trf.17959","DOIUrl":"https://doi.org/10.1111/trf.17959","url":null,"abstract":"<p><strong>Background: </strong>Transfusion-related acute lung injury (TRALI) remains a major contributor to transfusion-associated mortality. While the pathogenesis of TRALI remains unclear, there is evidence of a role for blood components. We therefore investigated the potential effects of fresh frozen plasma (FFP), cryoprecipitate, and extracellular vesicles (EVs) derived from these blood components, on the viability of human lung microvascular endothelial cells (HLMVECs) in vitro.</p><p><strong>Methods: </strong>EVs were isolated from FFP and cryoprecipitate using size-exclusion chromatography and characterized by nanoparticle tracking analysis, western blotting, and transmission electron microscopy. The potential effects of these blood components and their EVs on HLMVEC viability (determined by trypan blue exclusion) were examined in the presence and absence of neutrophils, either with or without prior treatment of HLMVECs with LPS.</p><p><strong>Results: </strong>EVs isolated from FFP and cryoprecipitate displayed morphological and biochemical properties conforming to latest international criteria. While FFP, cryoprecipitate, and EVs derived from FFP, each reduced HLMVEC viability, no effect was observed for EVs derived from cryoprecipitate.</p><p><strong>Conclusion: </strong>Our findings demonstrate clear differences in the effects of FFP, cryoprecipitate, and their respective EVs on HLMVEC viability in vitro. Examination of the mechanisms underlying these differences may lead to an improved understanding of the factors that promote development of TRALI.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141634631","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":"Masthead and Table of Contents","authors":"","doi":"10.1111/trf.17436","DOIUrl":"https://doi.org/10.1111/trf.17436","url":null,"abstract":"","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141721272","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":"How do we conduct a national transfusion related lookback program?","authors":"Nicole Priddee, Tiffany Pietrek, Lorna McLintock, Elizabeth Masterson, Megan Rowley, Kirsty Roy, Alan Yeung, Ike Anya, Daniel Carter, Stephen Barclay, Celia Jackson, Gill Hawkins, Nicola Steedman","doi":"10.1111/trf.17955","DOIUrl":"https://doi.org/10.1111/trf.17955","url":null,"abstract":"<p><strong>Background: </strong>Lookback investigations are conducted by blood services when a risk of transmission of infection from a donor to a recipient has been identified. They involve tracing transfusion recipients and offering them testing for the relevant infectious agent. Results are relayed to the recipient to provide reassurance that there has been no transmission or to ensure appropriate treatment and care if required, and blood services are able to learn lessons from the planning, delivery, and outcomes of the investigation. A national lookback exercise was conducted in Scotland following the introduction of a test to identify occult hepatitis B infection, as recommended by the UK Advisory Committee for the Safety of Blood, Tissues and Organs (SaBTO) in 2021.</p><p><strong>Methods and materials: </strong>This paper outlines the development and delivery of a national lookback program. It discusses the logistical, economic, ethical, regulatory, and scientific issues that were considered during the planning and delivery of the lookback exercise.</p><p><strong>Results: </strong>Development and delivery of a national lookback required robust governance, engagement of all relevant stakeholders and a shared understanding of aims, effective communication, systems, resources, limitations, and project management. Outcomes included a high testing uptake, low levels of reported anxiety, and a comprehensive data set.</p><p><strong>Conclusion: </strong>Key aspects for delivery of a successful large-scale lookback program include a patient-centered approach, clear and accessible communication, and whole-systems multiagency collaboration. Major challenges include stakeholder engagement and capacity.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141617168","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}