Transfusion Medicine最新文献

{"title":"Red blood cell-directed immune responses in COVID-19: Mechanisms, clinical evidence and implications for transfusion medicine.","authors":"Piotr Łojko, Alicja Tomasikiewicz","doi":"10.1111/tme.70114","DOIUrl":"https://doi.org/10.1111/tme.70114","url":null,"abstract":"<p><p>SARS-CoV-2 infection is associated with a broad spectrum of red blood cell (RBC)-directed immune responses, ranging from isolated direct antiglobulin test (DAT) positivity to autoimmune hemolytic anemia (AIHA) and transfusion-related diagnostic challenges. This narrative review integrates current evidence on the mechanisms underlying these abnormalities, their clinical manifestations, and their implications for transfusion medicine. Molecular mimicry, bystander B-cell activation, complement dysregulation, oxidative membrane injury, and structural erythrocyte remodeling appear to represent interconnected mechanisms promoting immune recognition and altered function of RBCs. DAT positivity is frequently observed in hospitalized patients with COVID-19, often in the absence of clinically significant hemolysis, emphasizing that a positive DAT should not be considered synonymous with AIHA. Autoantibodies, complement deposition, and occasional alloimmune responses may complicate antibody identification, compatibility testing, and selection of appropriate blood components. Available evidence remains limited by heterogeneous study designs and the predominance of observational studies and case reports. Recognition of RBC-directed immune responses as part of COVID-19-associated immune dysregulation may improve interpretation of immunohematological findings, facilitate appropriate transfusion support, and help distinguish clinically significant immune hemolysis from isolated serological abnormalities.</p>","PeriodicalId":23306,"journal":{"name":"Transfusion Medicine","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148901133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Managing pregnancy in women with the Rh-null phenotype: A structured narrative review of alloimmunisation, maternal-fetal outcomes and transfusion management.","authors":"Ehsan Shahverdi, Mostafa Moghaddam","doi":"10.1111/tme.70116","DOIUrl":"https://doi.org/10.1111/tme.70116","url":null,"abstract":"<p><p>The Rh-null phenotype is the rarest known red blood cell phenotype and is characterised by the complete absence of Rh antigens. During pregnancy, women with the Rh-null phenotype face unique challenges related to alloimmunisation against high-prevalence Rh antigens, haemolytic disease of the fetus and newborn, and the extremely limited availability of compatible blood for maternal or neonatal transfusion. We conducted a structured narrative review to identify published reports describing pregnancy-related or neonatal outcomes associated with the Rh-null phenotype, focusing on maternal antibody status, transfusion management, fetal monitoring, intrauterine intervention and maternal and neonatal outcomes. Eight reports published between 1983 and 2024 were identified. Anti-Rh29 was explicitly reported in three cases, whereas additional reports described panreactive antibody patterns consistent with antibodies directed against high-prevalence Rh antigens. Clinical outcomes ranged from mild neonatal haemolysis to severe fetal or neonatal disease. One pregnancy required intrauterine transfusion for severe fetal anaemia, and another neonate underwent repeated exchange transfusions because of severe haemolytic disease. Antenatal autologous blood donation was reported in one case as a proactive transfusion strategy. Pregnancy in women with the Rh-null phenotype requires advanced immunohaematologic investigation and specialised transfusion support. Early identification of Rh-null status, comprehensive antibody evaluation, coordinated maternal-fetal surveillance and proactive transfusion planning are central to management, ideally through multidisciplinary collaboration and access to rare donor resources.</p>","PeriodicalId":23306,"journal":{"name":"Transfusion Medicine","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148888560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Not all anti-CD38 antibodies are created equal: The epitope of felzartamab is partially DTT-resistant.","authors":"Anja Zeretzke, Philipp Trummer, Cora P Habicht, Clemens Schneeweiss","doi":"10.1111/tme.70112","DOIUrl":"https://doi.org/10.1111/tme.70112","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate anti-CD38 antibody candidates for their ability to bind to DTT-treated CD38 and red blood cells (RBCs).</p><p><strong>Background: </strong>Dithiothreitol (DTT) treatment of RBCs is routinely used to denature CD38 and mitigate interference from anti-CD38 antibodies, such as daratumumab and isatuximab, in immunohematology testing. However, new anti-CD38 antibodies are in development, some of which may be directed against linear or otherwise DTT-resistant epitopes.</p><p><strong>Methods/materials: </strong>Anti-CD38 antibody candidates were titrated in an enzyme-linked immunosorbent assay (ELISA) to assess their ability to bind to untreated and DTT-treated recombinant CD38. Antibody binding was subsequently confirmed by flow cytometry of RBCs. Daratumumab and felzartamab were then tested on a panel of native and DTT-treated RBCs in the indirect antiglobulin test (IAT).</p><p><strong>Results: </strong>All antibodies except felzartamab failed to bind to DTT-denatured CD38 in ELISA at concentrations up to 1.25 μg/mL. Flow cytometry confirmed this binding pattern. In the IAT, some DTT-treated cells remained positive with felzartamab, despite being negative with daratumumab.</p><p><strong>Conclusion: </strong>Not all epitopes of anti-CD38 antibodies are fully DTT-sensitive. This has important implications for handling of anti-CD38 antibody induced interference in immunohematology, and raises the question of whether DTT is an adequate solution for interference mitigation.</p>","PeriodicalId":23306,"journal":{"name":"Transfusion Medicine","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148875990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"HIV risk reduction via confidential unit exclusion (CUE): A retrospective analysis of four high-risk donor cases.","authors":"Xinwei Wang, Ruru He, Baoren He, Xipeng Yan, Linbin Huang, Shilin Li, Bin Li","doi":"10.1111/tme.70113","DOIUrl":"https://doi.org/10.1111/tme.70113","url":null,"abstract":"","PeriodicalId":23306,"journal":{"name":"Transfusion Medicine","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148866814","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From prediction to practice: Barriers to implementing artificial intelligence in blood inventory management and transfusion support.","authors":"Paulina Kasperska-Dębowska, Kornelia Kędziora-Kornatowska","doi":"10.1111/tme.70108","DOIUrl":"https://doi.org/10.1111/tme.70108","url":null,"abstract":"<p><strong>Background: </strong>Artificial intelligence (AI) is increasingly applied to blood-demand forecasting, donor management, inventory optimisation, wastage reduction and transfusion-related decision support; however, routine implementation remains limited.</p><p><strong>Objectives: </strong>To review current applications of AI in blood inventory management and transfusion support and identify the principal barriers to safe and sustainable implementation.</p><p><strong>Methods: </strong>A focused narrative review informed by structured searches of PubMed, Scopus, EBSCO and Google Scholar, supplemented by targeted searches of transfusion-specific and healthcare AI implementation literature. Evidence was synthesised thematically.</p><p><strong>Results: </strong>Published studies demonstrate technical feasibility across forecasting, donor-return prediction, inventory management and clinical decision support. Major implementation barriers include limited external and prospective validation, incomplete reporting, data-access and privacy constraints, poor interoperability, limited explainability, workforce training gaps and unclear governance.</p><p><strong>Conclusions: </strong>The principal challenge is no longer developing predictive models but integrating them safely and sustainably into routine transfusion services. Future progress requires multicentre evaluation, privacy-preserving data collaboration, workflow-integrated design, role-specific training and explicit governance with continued human oversight.</p>","PeriodicalId":23306,"journal":{"name":"Transfusion Medicine","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148670360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of safety, efficacy, and guideline compliance in home-based red blood cell transfusions: An 8.5-year retrospective study in suburban Tokyo.","authors":"Takeshi Hagino, Tomohiko Sato, Takenori Hayashi, Naoya Kaneko, Satoshi Noto, Daigo Hashimoto, Naoki Takezako, Takanori Teshima","doi":"10.1111/tme.70069","DOIUrl":"10.1111/tme.70069","url":null,"abstract":"<p><strong>Objectives: </strong>This study evaluated the safety, efficacy, and guideline adherence of home transfusions at a single institution over nearly a decade.</p><p><strong>Background: </strong>In Japan, demand for home-based red blood cell (RBC) transfusions is increasing due to population aging and promotion of community-based care. Although national guidelines were issued by the Japanese Society of Transfusion Medicine and Cell Therapy (JSTMCT) in 2017, evidence regarding their real-world application and safety remains limited.</p><p><strong>Methods/materials: </strong>We retrospectively reviewed 1007 planned RBC transfusion procedures in 181 patients (median age 81 years, range 37-97) between March 2016 and September 2024 in suburban Tokyo. Data included patient characteristics, transfusion details, haemoglobin (Hb) levels, adverse events, and JSTMCT guideline compliance. Paired Hb values were analysed using the Wilcoxon signed-rank test.</p><p><strong>Results: </strong>Malignancy was the most common underlying condition (173/181 patients, 95.6%), with haematological disorders predominant (102/181, 56.4%). Of 1007 planned procedures, 48 (4.8%) were cancelled. The median number of procedures per patient was 7 (range 1-232). Among 410 procedures with paired Hb values within 15 days, Hb increased significantly (median 6.8 g/dL pre- vs. 7.4 g/dL post-transfusion, p < 0.05). Mild adverse reactions occurred in 0.31% (3/959), lower than the JSTMCT-reported hospital rate of 0.64%. Compliance with JSTMCT guidelines was highest for caregiver presence (100%) but lowest for initial hospital-based transfusion (74.6%).</p><p><strong>Conclusion: </strong>Home-based RBC transfusions demonstrated excellent safety and efficacy profiles with lower adverse reaction rates than hospital-based transfusions. This study suggests that the JSTMCT guideline revisions should consider real-world practices, particularly initial transfusion requirements and hospital-clinic collaboration.</p>","PeriodicalId":23306,"journal":{"name":"Transfusion Medicine","volume":" ","pages":"335-344"},"PeriodicalIF":1.3,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13475145/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147285410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of the BioBox LAB10 for maintaining temperature and quality of packed red blood cells during in-hospital storage and transport.","authors":"Yohei Sakai, Takato Ozeki, Hideaki Matsuura, Rie Nakagawa, Yuya Ishihara, Hiroki Doi, Yasuo Miura","doi":"10.1111/tme.70073","DOIUrl":"10.1111/tme.70073","url":null,"abstract":"<p><strong>Background: </strong>Packed red blood cells (PRBC) are stored at 2°C-6°C to ensure quality. Improper temperature control during PRBC transport reduces the quality of downstream blood products and wastes PRBC units. This study evaluated the suitability of the BioBox LAB10 for in-hospital PRBC transport.</p><p><strong>Methods: </strong>Temperatures of the box interior and simulated formulation were measured to assess cooling capabilities. Quality was evaluated by measuring red blood cell count, haemoglobin concentration, haematocrit, pH, potassium concentration, and ATP concentration of PRBC samples. The storage capacity, size, weight, and cost of the BioBox was compared with that of the ATR700.</p><p><strong>Results: </strong>The BioBox cooled to ≤6°C within 14 min. PRBC temperature remained ≤6°C for approximately 19 h. None of the quality parameters, including ATP concentration, differed significantly between samples stored in the BioBox or in a refrigerator. The BioBox is smaller, lighter, and 84% less expensive than the ATR700, with an equivalent storage capacity.</p><p><strong>Conclusions: </strong>The BioBox effectively maintains temperature and PRBC quality during transport and provides a practical solution for in-hospital transport of blood for transfusion owing to its compact, lightweight design, and affordability.</p>","PeriodicalId":23306,"journal":{"name":"Transfusion Medicine","volume":" ","pages":"406-410"},"PeriodicalIF":1.3,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13475285/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147370470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The polymorphism of ABO gene regulatory regions in 120 individuals residing in Dalian, China.","authors":"Lin-Nan Shao, Yue-Xin Xia, Yi-Cheng Yang, Ning Li, Chun-Xiang Li, Li-Ying Wang, Wen-Qian Song, Shi-Hang Zhou, Ya-Xin Fan","doi":"10.1111/tme.70066","DOIUrl":"10.1111/tme.70066","url":null,"abstract":"<p><strong>Background: </strong>The ABO gene encodes glycosyltransferase A and B enzymes. Reduced enzyme activity is primarily caused by variations in the coding region and splicing sites. Additionally, variations in regulatory regions like the CCAAT binding factor (CBF)/NF-Y binding site, proximal promoter, and + 5.8-kb site may also diminish enzyme activities.</p><p><strong>Objective: </strong>This study enrolled 120 Chinese individuals (111 with abnormal serological phenotypes and 9 serologically normal family members of probands from five pedigree studies).</p><p><strong>Materials and methods: </strong>The entire ABO gene of each participant was sequenced using PacBio third-generation sequencing technology. Complete ABO gene sequences (~27.2 kb) were aligned, and phylogenetic analyses were conducted using MEGA11 software.</p><p><strong>Results: </strong>We identified 56 A-like (including cisAB), 85 B-like (including BA), 92 O, and 7 hybrid alleles. In the CBF/NF-Y region, all A-like alleles except A2.01 possessed one 43-bp repeat unit (nt.41A). A2.01, 42.3% of the O.01.01, and B-like alleles displayed four 43-bp repeats, with nt.41G in the first unit. Other O alleles had four 43-bp repeats, with the first repeat exhibiting nt.41C, except for one instance where an O.01.01 only contains the first three 43-bp repeats. Two instances of c.-35_-18del, cis-linked with the B.01 alleles, were detected in the proximal promoter. In the +5.8-kb region, six common variations forming five haplotypes were identified. Additionally, a rare variant in the RUNX1 binding region was observed. Regulatory region variations accounted for ~2.5% of serological abnormalities in our cohort. Additionally, seven recombinant ABO alleles were identified, representing 2.92% of the 240 total haplotypes.</p><p><strong>Conclusion: </strong>Our findings have rendered the characteristics of the regulatory regions more intuitive, thereby providing foundational data for future research and enhancing the practical applications in transfusion medicine.</p>","PeriodicalId":23306,"journal":{"name":"Transfusion Medicine","volume":" ","pages":"370-376"},"PeriodicalIF":1.3,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13475295/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146053989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Challenges associated with recall and referral strategies for HIV-reactive blood donors in India: Insights from a nationwide online survey.","authors":"Aikaj Jindal, Aseem Kumar Tiwari, Ankit Mathur, Deepa Bhuyan, Rajesh B Sawant, Suvro Sankha Datta","doi":"10.1111/tme.70067","DOIUrl":"10.1111/tme.70067","url":null,"abstract":"","PeriodicalId":23306,"journal":{"name":"Transfusion Medicine","volume":" ","pages":"411-413"},"PeriodicalIF":1.3,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13475294/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146087314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Circadian patterns in transfusion-associated circulatory overload.","authors":"Krishna G Badami, Anna Y Zhou","doi":"10.1111/tme.70074","DOIUrl":"10.1111/tme.70074","url":null,"abstract":"<p><strong>Objectives: </strong>To examine if transfusion-associated circulatory overload (TACO) shows a circadian pattern.</p><p><strong>Background: </strong>Non-urgent transfusions often take place during the night-time. This interferes with patient rest and patient monitoring. Also, transfusion reactions like TACO may be more likely during the night for pathophysiologic reasons.</p><p><strong>Materials and methods: </strong>Using New Zealand haemovigilance and transfusion data for the three-year period between January 2022 and December 2024, we compared the daytime and night-time rates of TACO and two other transfusion reactions (allergic reactions and transfusion-associated hypotension, TAH).</p><p><strong>Results: </strong>A quarter of transfusion episodes happened during the night-time. The night-time TACO rate was twice the daytime rate (p = <0.0001). This was also seen in males alone (p = <0.0001), but not in females. With allergic reactions, the daytime and night-time rates were similar. With TAH, it appeared to be higher, but our TAH numbers are small.</p><p><strong>Conclusion: </strong>The night-time TACO rate was higher than the daytime rate. As with cardiogenic acute pulmonary edema and other cardio- and cerebro-vascular conditions which are more frequent at night, this may involve biological clocks, external stressors (e.g. recumbency and transfusion), and individual risk factors. This is yet another reason to avoid overnight transfusions unless urgently needed.</p>","PeriodicalId":23306,"journal":{"name":"Transfusion Medicine","volume":" ","pages":"401-405"},"PeriodicalIF":1.3,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13475185/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147390955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}