Transfusion Medicine最新文献

{"title":"Blood transfusion in the Caribbean: Historical perspective in the context of Trinidad and Tobago.","authors":"Kenneth Stering Charles, Keith M O Wilson, David Roberts","doi":"10.1111/tme.13100","DOIUrl":"10.1111/tme.13100","url":null,"abstract":"<p><p>To compare the historical development of blood transfusion in Britain and a former British West Indian colony. International transfusion bodies recommend national coordination and exclusively voluntary non-remunerated donation as essential pre-requisites for blood safety. These ideals have been achieved in high-income countries including Great Britain, the United States of America and Canada. However, most West Indian countries have fragmented, hospital-based blood services that rely on family replacement and remunerated donors. Comparative historical analysis of blood transfusion service development in Great Britain and Trinidad and Tobago was undertaken to provide insight into their dichotomous development and inform policy decisions to bridge the gap between the two types of transfusion service. The British National Blood Transfusion service was based on voluntary non-remunerated blood donation from its inception but achieved national coordination over 50 years that included a period of regional control during which incoordination contributed to a tainted blood scandal. Failure to establish community voluntary non-remunerated donation in Trinidad and Tobago during the colonial period, before independence in 1962, allowed regionally-controlled family replacement and remunerated blood donation to become entrenched then perpetuated by path dependence. A university-led programme has recently used historically-proven methods, drawing on the experiences of the British National Blood Transfusion Service, to establish a model for developing a voluntary non-remunerated programme. The programme aims to avoid historical pitfalls during its national extension. Historical analysis provided information for introducing voluntary non-remunerated blood donation and planning a nationally-coordinated blood transfusion service.</p>","PeriodicalId":23306,"journal":{"name":"Transfusion Medicine","volume":" ","pages":"24-32"},"PeriodicalIF":1.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142393627","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":"Acute normovolemic haemodilution to reduce allogeneic red blood cell transfusion in patients undergoing coronary artery bypass grafting. An observational study.","authors":"Poonam Maheshwari, Muhammad Saad Yousuf, Muhammad Arslan Zahid, Hamid Iqil Naqvi, Saulat Fatimi, Khalid Samad","doi":"10.1111/tme.13114","DOIUrl":"10.1111/tme.13114","url":null,"abstract":"<p><strong>Background and objective: </strong>Patients undergoing cardiac surgery consume more than 50% of blood transfusions, and such transfusions have been associated with increased morbidity and mortality. Evidence in blood-saving techniques has increased the use of acute normovolemic haemodilution (ANH) in high-risk settings. The aim was to determine the incidence of allogeneic red blood cell transfusion perioperatively in acute normovolemic haemodilution (ANH) patients undergoing coronary artery bypass grafting (CABG).</p><p><strong>Materials and methods: </strong>This prospective observational cohort study was conducted in the Cardiac OR and ICU over 6 months, involving elective CABG patients aged 35-70 with ASA status III and IV. Haemoglobin and haematocrit levels were assessed preoperatively, intraoperatively and 24 h postoperatively.</p><p><strong>Results: </strong>In a cohort of 50 ANH patients, 44% (22/50) required allogeneic blood transfusion perioperatively, with 24% (12/50) intraoperatively, 14% (7/50) in the ICU and 6% (3/50) both intraoperatively and postoperatively. Lower intraoperative haemoglobin levels during CPB were significantly associated with increased transfusion odds in both univariable (OR, 0.25; 95% CI, 0.10-0.49, p = 0.001) and multivariable analyses (Adj. OR, 0.24; 95% CI, 0.09-0.62, p = 0.003), and prolonged surgical duration was a significant predictor in multivariable analysis (Adj. OR, 2.18; 95% CI, 1.01-4.73, p = 0.044). Additionally, prolonged wound healing was significantly more frequent in the patients requiring allogeneic blood transfusions (p = 0.044) highlighting potential postoperative complications.</p><p><strong>Conclusion: </strong>Our study highlights the varying RBC transfusion rates in CABG patients, with lower intraoperative haemoglobin levels and prolonged surgical duration significantly increasing transfusion needs. These findings emphasise the importance of optimising intraoperative management to minimise transfusions and improve patient outcomes.</p>","PeriodicalId":23306,"journal":{"name":"Transfusion Medicine","volume":" ","pages":"60-67"},"PeriodicalIF":1.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142693700","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":"Guideline for the investigation and management of red cell antibodies in pregnancy: A British Society for Haematology guideline.","authors":"Fiona Regan, Katy Veale, Fiona Robinson, Janet Brennand, Edwin Massey, Hafiz Qureshi, Kirstin Finning, Tim Watts, Christoph Lees, Esther Southgate, Susan Robinson","doi":"10.1111/tme.13098","DOIUrl":"10.1111/tme.13098","url":null,"abstract":"","PeriodicalId":23306,"journal":{"name":"Transfusion Medicine","volume":" ","pages":"3-23"},"PeriodicalIF":1.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143256844","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":"Blood donation practices, motivators and barriers in the Caribbean: A narrative review.","authors":"Latoya N Reid, Maureen J Miller, Kamille A West-Mitchell","doi":"10.1111/tme.13107","DOIUrl":"10.1111/tme.13107","url":null,"abstract":"<p><p>Adequacy and safety are the twin prerogatives of the blood transfusion service which in turn is an indispensable component of public health delivery; however, many Caribbean countries have inadequate blood supply for the current and projected demands of their health care systems. Understanding blood donor motivators and barriers is crucial to improving the rate of voluntary non-remunerated blood donation (VNRD) to meet World Health Organisation (WHO) targets. The objective of this study was to review current research on the landscape of blood donation practices and attitudes in the Caribbean. We undertook a systematic search of electronic databases through September 2023 to identify studies of blood donation practices, knowledge and attitudes, including motivators and barriers to donation in the English-speaking Caribbean. We identified eight (8) relevant studies of observational study design. VNRD remain relatively uncommon; family replacement or remunerated donations were most common. Barriers to blood donation included lack of a known recipient such as a family member who needed blood, never having been asked to donate, presumed ineligibility to donate, and fear of needles or adverse reactions. Study participants indicated willingness to donate blood if provided more information about the importance of blood donation. There is a paucity of published research regarding blood donor knowledge, motivators and barriers in the Caribbean context. Such research could indicate the necessary interventions for achieving the goals of an adequate and safe blood supply.</p>","PeriodicalId":23306,"journal":{"name":"Transfusion Medicine","volume":" ","pages":"33-40"},"PeriodicalIF":1.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11835541/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142628802","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":"Myoglobin saturation as an intracellular indicator for transfusion need in oncology patients.","authors":"Kenneth A Schenkman, Wayne A Ciesielski, Terry B Gernsheimer, Lorilee S L Arakaki","doi":"10.1111/tme.13090","DOIUrl":"10.1111/tme.13090","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to demonstrate the potential of myoglobin saturation as an indicator of oxygen delivery adequacy to help determine the need for red cell transfusion.</p><p><strong>Background: </strong>Modern blood management approaches have been established to optimise use of red blood cells for transfusions in patients with anaemia. However, most approaches make recommendations to transfuse based on haemoglobin or haematocrit levels and do not directly address adequacy of oxygen delivery. Intracellular oxygen determined by myoglobin saturation directly measures oxygen delivery at the tissue level.</p><p><strong>Methods/materials: </strong>A custom built spectrometer system with an optical fibre probe was used in this pilot study to measure muscle cell myoglobin saturation noninvasively from the first digital interosseous muscles in patients undergoing planned red blood cell transfusion. Patients were recruited from both the in-patient and out-patient oncology service at a major university medical centre. Measurements were made immediately before, immediately after, and 24 h following transfusion. Clinical data and tissue oxygen values from the Somanetics INVOS system were also collected.</p><p><strong>Results: </strong>Myoglobin saturation, and thus cellular oxygen increased in some, but not all patients receiving a transfusion, and was most pronounced in patients who initially had low myoglobin saturation compared with the group as a whole.</p><p><strong>Conclusion: </strong>Clinical decisions to transfuse based on haemoglobin or haematocrit thresholds alone are likely insufficient to optimise use of red blood cell transfusions. The combination of haemoglobin or haematocrit with myoglobin saturation may optimally determine who will benefit physiologically from a transfusion.</p>","PeriodicalId":23306,"journal":{"name":"Transfusion Medicine","volume":" ","pages":"68-74"},"PeriodicalIF":1.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11835544/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142081714","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":"PacBio third-generation sequencing detects a new variant, c.27delC, in exon 1 of the ABO gene resulting in a weak B phenotype.","authors":"L Shao, L Ma, J Y Xiao, L L Shi, T X Liu","doi":"10.1111/tme.13112","DOIUrl":"10.1111/tme.13112","url":null,"abstract":"","PeriodicalId":23306,"journal":{"name":"Transfusion Medicine","volume":" ","pages":"103-105"},"PeriodicalIF":1.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142640009","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":"A safety comparison of heparin and argatroban anticoagulation in veno-venous extracorporeal membrane oxygenation with a focus on bleeding.","authors":"Filip Burša, Jan Máca, Jiří Sagan, Peter Sklienka, Simona Němcová, Zuzana Kučerová, Tereza Romanová, Ondřej Jor, Adéla Kondé, Jaroslav Janošek, Michal Frelich","doi":"10.1111/tme.13102","DOIUrl":"10.1111/tme.13102","url":null,"abstract":"<p><strong>Background: </strong>Anticoagulation during extracorporeal membrane oxygenation (ECMO) might still lead to severe bleeding complications. Heparin is the most frequently used anticoagulant, but novel drugs could be promising. Argatroban is a new alternative to heparin. To date, no robust studies have confirmed the clear superiority of argatroban (AG) over heparin, although it has some advantages and may be safer.</p><p><strong>Study design and methods: </strong>An observational study was conducted in all adult veno-venous ECMO patients with COVID-19-associated acute respiratory distress syndrome admitted to the University Hospital Ostrava (n = 63). They were anticoagulated with heparin in the first period and with AG in the second period, targeting the same activated partial thromboplastin time (aPTT; 45-60 s). Bleeding complications requiring transfusion and life-threatening bleeding events were evaluated. The primary objective was to compare heparin and AG in terms of bleeding, transfusion requirements and mortality-related bleeding.</p><p><strong>Results: </strong>The total time on ECMO per patient was 16 days with an in-hospital mortality of 55.6%. The red blood cell consumption in the AG group (median 2.7 transfusions/week) was significantly lower than in the heparin group (median 4.2 transfusions/week, p = 0.011). Life-threatening bleeding complications were higher in the heparin group compared to the AG group (35.7% vs. 10.2%, p = 0.035), and mortality-related bleeding complications were also higher in the heparin group (21.4% vs. 2.0%, p = 0.032).</p><p><strong>Discussion: </strong>Argatroban is an interesting alternative to heparin with less bleeding, less need for red blood cell transfusions and improved safety of ECMO with less mortality-related bleeding.</p>","PeriodicalId":23306,"journal":{"name":"Transfusion Medicine","volume":" ","pages":"75-81"},"PeriodicalIF":1.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11833213/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142393626","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":"Validation of current commercially-available devices to thaw pooled, solvent/detergent-treated human plasma.","authors":"Andrea Heger, Michelle Gareis","doi":"10.1111/tme.13116","DOIUrl":"10.1111/tme.13116","url":null,"abstract":"<p><strong>Background: </strong>Proper thawing procedures are required to preserve the quality of human fresh frozen plasma (FFP). octaplasLG (Octapharma AG, Switzerland) is a frozen solution of solvent/detergent (S/D)-treated human plasma, produced to improve pathogen safety. This study aimed to validate the S/D plasma thawing process using the latest-generation of commercially-available thawing devices and to determine S/D plasma quality after thawing.</p><p><strong>Study design and methods: </strong>Thawing of S/D plasma units was investigated using a microwave oven (Transfusio-therm 3000) and dry tempering systems (SAHARA 4 and Plasmatherm V). Times to defrost plasma and reach 30°C product temperature, using the 37°C thawing programmes, were defined for all devices. Thawed S/D plasma units were tested against product release parameters, as well as for hemostatic capacity tested indirectly via global coagulation parameters, coagulation factors, protease inhibitors and markers of activated coagulation.</p><p><strong>Results: </strong>The fastest thawing was observed using the microwave oven; S/D plasma units were defrosted after 2-3 min. All S/D plasma units thawed by the different devices using optimised thawing conditions were clear and free of solid and gelatinous particles, indicating no local overheating or protein denaturation. Coagulation factor and inhibitor activities and hemostatic capacity of S/D plasma were comparable when thawed by the three different devices. With each device, all product parameters were within product release specification levels after thawing.</p><p><strong>Conclusions: </strong>S/D plasma can be thawed using the Transfusio-therm 3000, SAHARA 4 or Plasmatherm V thawing devices using the optimised settings defined for this plasma product, with no negative influence on plasma quality.</p>","PeriodicalId":23306,"journal":{"name":"Transfusion Medicine","volume":" ","pages":"97-102"},"PeriodicalIF":1.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11833212/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142717286","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":"An evaluation of diethylhexyl phthalate free top & bottom in-line blood collection set with a new soft housing filter.","authors":"Elena Danilova, Farshid Ezligini, Connie Stöckel, Masafumi Asakawa, Geir Hetland","doi":"10.1111/tme.13091","DOIUrl":"10.1111/tme.13091","url":null,"abstract":"<p><strong>Background and objectives: </strong>Di (2-ethylhexyl) phthalate (DEHP) plasticizer must be removed from polyvinylchloride (PVC) medical devices due to toxicity. DEHP/PVC blood bags were shown to provide stable quality under blood component production and to create good storage conditions for red blood cells concentrate (RBC). It is important that substitution of the DEHP maintains the RBC quality during storage, which should be achieved with Di (isononyl) cyclohexane-1,2-dicarboxylate (DINCH), although substitution of the plasticizer has been challenging.</p><p><strong>Materials and methods: </strong>A DEHP-free Top & Bottom in-line RBC set was validated in a tertiary hospital blood bank facility. Volunteer blood donors were randomly allocated for blood collection into DINCH/PVC or DEHP/PVC set. The groups were additionally divided according to additive solution/filter combination: PAGGS-M + DINCH/PVC filter (only with DINCH/PVC set), and SAG-M + DINCH/PVC filter and SAG-M + DEHP/PVC filter (only with DEHP/PVC set). Processing and storage effects were assessed in all components.</p><p><strong>Results: </strong>RBC concentrates, platelet concentrates and plasma that was processed and stored in DEHP-free set fulfilled European requirements for quality. The cells stored in PAGGS-M after filtration through DEHP-free PVC filter showed the same low haemolysis compared with conventional set at 49 days of storage. Platelets stored in DINCH/PVC bag provided a sufficient quality of platelets after 7 days of storage. Plasma maintained the coagulation factors during 12 months of storage.</p><p><strong>Conclusion: </strong>A new DINCH/PVC set allows production of blood components of satisfactory quality in DEHP-free environment.</p>","PeriodicalId":23306,"journal":{"name":"Transfusion Medicine","volume":" ","pages":"82-90"},"PeriodicalIF":1.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11833214/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142146328","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":"Transfusion sample mislabelling and wrong blood in tube in the UK: Insights from the national comparative audits of blood transfusion in 2012 and 2022.","authors":"Catherine Booth, Paul Davies","doi":"10.1111/tme.13092","DOIUrl":"10.1111/tme.13092","url":null,"abstract":"<p><strong>Background: </strong>Samples for transfusion rejected due to mislabelling can lead to harm when a patient has to be re-bled or has a transfusion or procedure delayed. Electronic labelling systems which scan the patient's identification band and generate a label at their side aim to reduce mislabelling and misidentification leading to wrong blood in tube (WBIT) errors. The 2022 National Comparative audit of sample collection aimed to compare national rates of sample mislabelling and WBIT to the 2012 audit and to examine the impact of electronic systems.</p><p><strong>Method: </strong>All UK hospitals were invited to provide data on rejected transfusion samples and WBIT incidents in 1 month (October 2022) and were asked if they had electronic labelling.</p><p><strong>Results: </strong>Twenty-three thousand five hundred and eighty-four rejected samples were reported by 179 sites in 1 month. The rejection rate of 4.4% represents a 47% increase compared to 2012 (2.99%). There were 92 WBIT incidents, an incidence of 1 in 5882 samples-a 45% increase compared to 1 in 8547 in 2012. Twenty-three percent of sites can print a sample label at the patient's side, up by 224%. The six sites using only electronic sample labelling had a 46.9% lower rejection rate than sites using only hand-labelling but still reported WBIT.</p><p><strong>Conclusions: </strong>The increase in sample rejection and WBIT may reflect pressures facing clinical staff, zero tolerance policies and the two-sample rule. A human factors approach to understanding and tackling underlying reasons locally is recommended. Electronic systems are associated with fewer labelling errors, but careful implementation and training is needed to maximise their safety benefits.</p>","PeriodicalId":23306,"journal":{"name":"Transfusion Medicine","volume":" ","pages":"41-47"},"PeriodicalIF":1.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142081715","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}