Transfusion Medicine最新文献

{"title":"Development and validation of an indigenous questionnaire for assessing clinician's knowledge towards transfusion medicine and bedside transfusion practices.","authors":"Anubhav Gupta, Hari Krishan Dhawan, Romesh Jain, Ratti Ram Sharma, Vipin Kaushal, Amarjeet Singh, Neelam Marwaha","doi":"10.1111/tme.13130","DOIUrl":"https://doi.org/10.1111/tme.13130","url":null,"abstract":"<p><strong>Introduction: </strong>Due to the non-availability of formal training during residency for clinicians in transfusion medicine, there is a prevalent knowledge gap for transfusion practices, which leads to increased patient risks and elevated healthcare costs. There is no indigenous questionnaire available, which could be used for knowledge assessment. This study aims to develop and validate an Indigenous questionnaire to assess clinicians' knowledge of transfusion medicine and bedside transfusion practices.</p><p><strong>Materials and methods: </strong>The questionnaire was designed using a nominal group technique involving subject experts, considering the type of information required, themes, appropriate wording, layout, and presentation. The questionnaire consisted of 25 knowledge-based questions and 4 general questions. Piloting of the questionnaire was done to check for feasibility, validation, and reliability. Content validity was assessed by six experts using the Content Validity Index (CVI). Reliability was assessed using test-retest and split-half methods, with a sample of 56 participants. Cronbach's alpha and Kappa statistics were used to measure internal consistency and agreement, respectively.</p><p><strong>Results: </strong>The questionnaire displayed acceptable feasibility with a mean difficulty score of 6.93 on a scale of 1-10, with test-retest responses showing near-perfect agreement (kappa value 0.8-0.99). All experts gave more than 70% agreement on the relevance of content, with a mean CVI of 85%. Test-retest reliability showed near-perfect agreement (Kappa 0.8-0.99, p = 0.008) and good internal consistency (Cronbach's α = 0.806). The split-half method yielded a Cronbach's α of 0.89 and an intraclass correlation coefficient of 0.88 (95% CI 0.57, 0.97, p = 0.001) Construct validity was confirmed through factor analysis.</p><p><strong>Conclusion: </strong>The developed indigenous questionnaire is a reliable and valid tool for assessing the knowledge of clinicians towards transfusion medicine and bedside transfusion practices. The detailed, methodical strategy used to prepare and validate the questionnaire ensures its applicability and relevance in various clinical settings and can be easily adopted by others intending to prepare similar questionnaires. The questionnaire is available with the author and, on demand, may be provided for knowledge assessment.</p>","PeriodicalId":23306,"journal":{"name":"Transfusion Medicine","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433066","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":"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":"https://doi.org/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":""},"PeriodicalIF":1.5,"publicationDate":"2025-02-13","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":"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":"https://doi.org/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":""},"PeriodicalIF":1.5,"publicationDate":"2025-02-10","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":"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":"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":"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":"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}