Transfusion Medicine最新文献

{"title":"Factors affecting the efficacy of human leukocyte antigen-selected platelet provision: A large retrospective study in the United Kingdom.","authors":"W M Howell, L Quaye, L Mumford, S Phillips, K Mepani, S Mohamed, C J Brown","doi":"10.1111/tme.13123","DOIUrl":"10.1111/tme.13123","url":null,"abstract":"<p><strong>Background: </strong>A large, retrospective study was designed to interrogate current NHS Blood and Transplant (NHSBT) HLA matching strategies for the provision of HLA selected platelets (HLA SP) and to determine whether additional factors such as ABO blood group matching, patient diagnosis, patient and/or donor age, sex, ethnicity, age of platelet unit at transfusion and possibly seasonal variation also play a role in transfusion efficacy.</p><p><strong>Materials and methods: </strong>Data for 56 640 HLA SP transfusions over a 3-year period were collected. Transfusions with missing data for any factor under consideration were excluded, resulting in a cohort of 13 044 transfusions for analysis. Univariable and multivariable regression models were used to determine if any factors influenced an increase in platelet count of ≥10 × 10⁹/L. A stepwise logistic regression was applied, such that each influential factor was adjusted for effects on other factors included in the study.</p><p><strong>Results: </strong>HLA match grade was confirmed as a significant factor in transfusion efficacy, with ABO mismatched units 20% less likely to give an adequate platelet increment (≥10 × 10⁹/L). Platelet donor age, gender and ethnicity were not significant. Conversely, patient diagnosis, ethnicity, gender and age showed significant associations with platelet increments. Some seasonal variation in efficacy of platelet transfusion was also demonstrated.</p><p><strong>Conclusion: </strong>This study has demonstrated the efficacy of HLA SP transfusions in refractory patients with a wide range of diagnoses, the importance of HLA match grade, plus the marginal effect of ABO matching. A wide range of donor-related factors was excluded, while a number of patient-related factors were identified, requiring more extensive investigation in ongoing and independent studies, with implications for donor registry, clinical and laboratory practices.</p>","PeriodicalId":23306,"journal":{"name":"Transfusion Medicine","volume":" ","pages":"205-214"},"PeriodicalIF":1.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143012453","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":"Early alloimmunization in an infant to red cell antigens-Rare but possible in the 'right' circumstances.","authors":"Anwen Maddock, Sue Warrington, Amanda Lyver, Krishna G Badami","doi":"10.1111/tme.13132","DOIUrl":"10.1111/tme.13132","url":null,"abstract":"<p><strong>Background: </strong>Red blood cell (RBC) alloimmunization is rarely reported in infants less than 4-6 months of age.</p><p><strong>Methods/materials: </strong>Blood group and antibody screening used the gel card technique. All blood products were leukoreduced. All RBC doses transfused were group O, E-neg, K-neg but the pooled platelets transfused on day 45 and 61 included donors who were K-pos, and that transfused on day 61 also included an E-pos donor.</p><p><strong>Results: </strong>We report a group O neonate with haemophagocytic lymphohistiocytosis (HLH) who developed alloantibodies to E and K antigens at 65 days (9 weeks) of age.</p><p><strong>Conclusion: </strong>HLH is an inflammatory, 'hyperimmune' state, and alloimmunization is more likely when inflammation is present. If significant inflammation is present, transfusions should be avoided if possible.</p>","PeriodicalId":23306,"journal":{"name":"Transfusion Medicine","volume":" ","pages":"291-296"},"PeriodicalIF":1.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143392019","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":"D-- phenotype in a South Indian family: A multicentric approach to workup and management.","authors":"Soumee Banerjee, Pooja D Kshirsagar, Ankit Mathur, Swati Kulkarni, T V Reddy","doi":"10.1111/tme.13137","DOIUrl":"10.1111/tme.13137","url":null,"abstract":"<p><strong>Background: </strong>The Rh system is an extremely important blood group system with over 50 antigens, 5 of which (D, C, E, c and e) are considered most clinically significant. Rare Rh deficient phenotypes include D--, which is a blood group characterised by the lack of expression of C, c, E and e and exalted expression of the D antigen on the red cells due to mutations in both alleles of the RHCE gene. This is a multicentre approach to a case of the rare D-- phenotype.</p><p><strong>Case report: </strong>A 56-year-old lady with bad obstetric history presenting with severe anaemia had to be evaluated for a panreactive antibody affecting cross-matching. On identifying a D-- phenotype by serology, a thorough family study was performed on 18 of her first and second-degree relatives. Three family members were also found to be of the rare phenotype, one of whom was pregnant. This relative was counselled appropriately and provided with an overview of her phenotype for her obstetric care team. Molecular analysis by QMPSF confirmed the serological findings. This case eventually became the motivation behind an institutional \"rare donor\" registry programme.</p><p><strong>Results: </strong>Serology revealed a panreactive antibody affecting cross-matches. Her Rh phenotype was D+, C-, c-, E-, e-, K-, k+. Molecular analysis on her and three family members suggested homozygous CE-D hybrid alleles causing the D-- phenotype: RHCE-D(3-9)-CE.</p><p><strong>Conclusion: </strong>D-- is an uncommon phenotype and was found to occur in a cluster in this family. Like most difficult immunohematological cases, it mandated a multicentric and a multi-technique approach to resolve.</p>","PeriodicalId":23306,"journal":{"name":"Transfusion Medicine","volume":" ","pages":"297-303"},"PeriodicalIF":1.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143773357","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":"Mapping the blood transfusion supply in the west region of Cameroon: A cross-sectional study.","authors":"Armand Willy Nguemnang Nguemnang, Ketina Hirma Tchio-Nighie, Carine Mbianda Tchingué, Collins Buh Nkum, Jérôme Ateudjieu","doi":"10.1111/tme.13148","DOIUrl":"10.1111/tme.13148","url":null,"abstract":"<p><strong>Background: </strong>Blood transfusion is one of the priorities of a health system. However, this topic is poorly documented in under developing countries.</p><p><strong>Objective: </strong>Describe the supply of blood transfusion in the West Region of Cameroon.</p><p><strong>Methods/materials: </strong>This was a descriptive cross-sectional study conducted in health facilities that handles blood transfusion in the West Region of Cameroon from March to May 2022. Data were collected using an observational grid and a questionnaire administered face-to-face to the health personnel involved in blood transfusion to collect informations on blood transfusion practices. These data were analysed using SPSS 20 software for proportions and ArcGIS 10.3.1 for blood transfusion maps.</p><p><strong>Results: </strong>90/877 health facilities of the West Region supplied blood transfusion. Each of the 20 health districts had at least one health facility supplying blood transfusion service. Among the 90 health facilities supplying blood transfusion service, 86 (95.5%) consented to participate in the study. A mean of 4.5 health facilities carried out blood transfusion per health district with 3.8 health facilities per 100,000 occupants. Of the 90 health facilities, 14 (16.3%) had a blood bank, with 03 (21.4%) being non-functional, for a mean of 0.4 blood bank for 10,000 occupants. A total of 18 health facilities supplying blood transfusion were found around a radius of 5 km from a functional blood bank. Among the 86 health facilities, 12 (13.8%) had a blood conservation room; the main source of blood for transfusion was family donors 62 (72%); the type of blood product most frequently administered was whole blood 82 (96.5%); 3 (3.4%) had a plasma extractor/manual separator; 19 (22.1%) performed the ELISA chain, and the Cross match was performed in 57 (66.3%) health facilities.</p><p><strong>Conclusion: </strong>The results of the study reveal limited geographic access of populations to health facilities supply blood transfusion and to blood banks in the West Region of Cameroon.</p>","PeriodicalId":23306,"journal":{"name":"Transfusion Medicine","volume":" ","pages":"226-234"},"PeriodicalIF":1.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144102762","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":"Extracellular vesicles in ageing cold-stored whole blood may not compensate for the decreasing haemostatic function in vitro.","authors":"Petra Ilvonen, Sanna Susila, Ulla Impola, Reetta Pusa, Tuukka Helin, Lotta Joutsi-Korhonen, Saara Laitinen, Jouni Lauronen, Minna Ilmakunnas","doi":"10.1111/tme.13122","DOIUrl":"10.1111/tme.13122","url":null,"abstract":"<p><strong>Background: </strong>Extracellular vesicles (EVs) have procoagulative properties. As EVs are known to accumulate in stored blood products, we compared the EV content and coagulation capacity of leukoreduced cold-stored whole blood (CSWB) with current prehospital and in-hospital component therapies to understand the role of EVs in the haemostatic capacity of ageing CSWB.</p><p><strong>Materials and methods: </strong>Blood was obtained from 12 O RhD-positive male donors. CSWB was compared with in-hospital component therapy of red blood cells (RBCs), OctaplasLG and buffy-coat platelets and prehospital component therapy of RBC and lyophilized plasma. Samples were drawn on Days 1 and 14 of CSWB and RBC cold storage. Blood count, haemolysis markers, rotational thromboelastometry, sonorheometry and thrombin generation were analysed. EVs were analysed using nanoparticle tracking analysis and cellular origin was determined using imaging flow cytometry.</p><p><strong>Results: </strong>There was a trend towards increased production of both platelet and RBC-derived EVs during CSWB storage. Particle count increased during storage, whereas thrombin generation slowed down and in viscoelastic assays, clotting times prolonged, clot formation became impaired, and stiffness of the resulting clot decreased.</p><p><strong>Conclusion: </strong>Both platelet and RBC-derived EVs increased in number in CSWB during storage. This did not appear to compensate for the in vitro decreasing haemostatic capacity of ageing CSWB, suggesting EVs produced during storage may not have active procoagulative effects, but rather reflect the ageing of blood cells.</p>","PeriodicalId":23306,"journal":{"name":"Transfusion Medicine","volume":" ","pages":"275-286"},"PeriodicalIF":1.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12174729/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143047912","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":"Anti-Ce in haemolytic disease of the foetus and newborn.","authors":"Rebecca O'Grady, Joan Fitzgerald, Jan Miletin, Carmen Regan, Fergus Guilfoyle, Edel Scally, Catherine Flynn","doi":"10.1111/tme.13134","DOIUrl":"10.1111/tme.13134","url":null,"abstract":"<p><strong>Objectives: </strong>To report a delayed case of severe haemolytic disease of the foetus and newborn (HDFN) due to Anti-Ce.</p><p><strong>Background: </strong>HDFN due to maternal antibodies is potentially fatal. As a result, antibody levels and foetal anaemia are periodically monitored and risk assessed throughout pregnancy. HDFN due to Anti-Ce is rare.</p><p><strong>Case report: </strong>A 29-year-old Caucasian female with low titre Anti-Ce and Anti-e antenatally delivered a term baby girl that required multiple transfusions and hospital admissions early in life. The apparent clinical severity of HDFN resulted in investigative testing of a maternal admission sample at delivery for titre levels. Anti-Ce was identified as the cause of HDFN in this case, following an eightfold increase in titre levels from week 28 gestation (titre = 4) to term (titre = 32).</p><p><strong>Discussion: </strong>The severe HDFN outlined in this case was unexpected due to the antibody specificity and low titres antenatally. The Anti-Ce with a titre of 32 implicated in this study is on the threshold for specialist foetal team involvement and vigilant monitoring as per BSH guidelines.</p><p><strong>Conclusion: </strong>Anti-Ce titre monitoring beyond 28 weeks gestation and specialist foetal team involvement early in pregnancy should be considered despite current BSH Guidelines, along with extended neonatal monitoring.</p>","PeriodicalId":23306,"journal":{"name":"Transfusion Medicine","volume":" ","pages":"287-290"},"PeriodicalIF":1.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12174758/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568342","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":"Prevalence of anaemia among blood donors in eastern Morocco: The need for pre-donation haemoglobin assessment.","authors":"Ihab Belmokhtar, Karam Yahya Belmokhtar, Saida Lhousni, Redouane Boulouiz, Zaina Sidqi, Mohammed Choukri, Rachid Seddik, Mohammed Bellaoui","doi":"10.1111/tme.13133","DOIUrl":"10.1111/tme.13133","url":null,"abstract":"<p><strong>Background: </strong>Anaemia remains the main cause of deferral in blood donation. However, in Morocco, pre-donation haemoglobin measurement is not systematic.</p><p><strong>Objectives: </strong>The aim of this study was to determine the prevalence of anaemia and associated factors such as sex, age and iron deficiency among blood donors in eastern Morocco in order to improve donor management practices.</p><p><strong>Methods/materials: </strong>The study involved 2013 blood donors from the BRO Biobank. Blood samples were analysed using an automatic blood cell analyser for complete blood counts. Serum ferritin was measured by chemical and immunological analyser. Anaemia was defined as haemoglobin levels less than 13 g/dL in men and 12 g/dL in women, according to the WHO recommendation.</p><p><strong>Results: </strong>The overall prevalence of anaemia in eastern Morocco was 9.84% and it varied significantly by region. The majority of anaemic individuals were iron-deprived (88.64%). Anaemia was much higher in females (14.74%) than in males (5.46%). The highest prevalence of anaemia among females was in the age group of 18-20 years (25.2%), while among males it was in the age group of 61-65 years (18.52%).</p><p><strong>Conclusions: </strong>The high prevalence of anaemia among blood donors in eastern Morocco highlights the need to implement pre-donation haemoglobin assessment in donor selection guidelines and to consider optional ferritin testing for at-risk populations. Moreover, educating donors about iron deficiency and iron-rich diets is essential for sustaining donor health and eligibility.</p>","PeriodicalId":23306,"journal":{"name":"Transfusion Medicine","volume":" ","pages":"243-249"},"PeriodicalIF":1.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143415355","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":"Review of transfusion practice for beta thalassaemia major patients in Scotland after removal of age criteria for red cell transfusion.","authors":"Nicole Priddee, Katie Hands, Jennifer Laird, Louisa McIlwaine, Fernando Pinto, Susan Baird","doi":"10.1111/tme.13147","DOIUrl":"https://doi.org/10.1111/tme.13147","url":null,"abstract":"","PeriodicalId":23306,"journal":{"name":"Transfusion Medicine","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144175018","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":"Pure red cell aplasia after ABO incompatible allogeneic stem cell transplantation treated with therapeutic plasma exchange: A case report.","authors":"Abhijit Baheti, Brinda Kakkar, Sameer Melinkeri, Anusree Prabhakaran, Urmi Sheth, Vijaya Gadage, Sanjiv Ketkar","doi":"10.1111/tme.13153","DOIUrl":"https://doi.org/10.1111/tme.13153","url":null,"abstract":"<p><p>Pure red cell aplasia (PRCA) is a known complication of major/bi-directional ABO incompatible allogeneic stem cell transplantation (ABOi allo-SCT). Persistence of recipient's antibodies against the donor's red blood cells (RBCs) leads to delay in recovery of RBCs which can last up to several months. This complication can result in patients becoming transfusion dependent. There is no standard treatment but a combination of different treatment strategies which includes tapering immunosuppression/discontinuation, steroid, erythropoietin, anti-CD-20 monoclonal antibody, daratumumab and therapeutic plasma exchange (TPE). Here we report a case of PRCA after ABOi allogeneic peripheral blood SCT treated successfully with TPE.</p>","PeriodicalId":23306,"journal":{"name":"Transfusion Medicine","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144161204","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":"Ferritin-guided management of blood donors with a marginally low pre-donation haemoglobin and its effect on the number of donations in the following 3 years.","authors":"Sandra Cutajar, George Galea, Monique A Debattista, Monique Borg Inguanez","doi":"10.1111/tme.13149","DOIUrl":"https://doi.org/10.1111/tme.13149","url":null,"abstract":"<p><strong>Background: </strong>The handling of donors with a marginally low haemoglobin is difficult and problematic and various methodologies have been applied to address this issue.</p><p><strong>Aims: </strong>The aim of this study was to assess whether measurement of serum ferritin and subsequent management of donors with a marginally low haemoglobin had any impact on the number of subsequent donations.</p><p><strong>Materials and methods: </strong>Such donors were prospectively randomised into an intervention group whereby their serum ferritin was measured and those in the control group where routine assessments were done as per current SOPs. In the intervention group, action was taken depending on how low the serum ferritin was. The comparator in both study arms was the number of donations that were given during the follow-up period of 3 years.</p><p><strong>Results: </strong>We could not find any significant consequence due to this intervention.</p><p><strong>Discussion and conclusion: </strong>The potential reasons are discussed, and we are proposing further studies on subsets of donors who are more prone to iron deficiency.</p>","PeriodicalId":23306,"journal":{"name":"Transfusion Medicine","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144151835","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}