Transfusion Medicine最新文献

{"title":"Seroprevalence of hepatitis B and C in asymptomatic blood donors in Saudi Arabia: A systematic review and meta-analysis.","authors":"Mohammad S Alzahrani, Majed A Algarni, Safa Boujemaa","doi":"10.1111/tme.70107","DOIUrl":"https://doi.org/10.1111/tme.70107","url":null,"abstract":"<p><p>Viral hepatitis remains a serious risk to transfusion safety, despite being considerably reduced by donor screening. Objectives: The aim of this study was to evaluate the seroprevalence of HBV and HCV among asymptomatic blood donors in Saudi Arabia in the past 15 years (2010-2025). A literature search has been conducted on seven databases. Prevalence rates with 95% confidence intervals (CIs) were pooled via a random effects model. Twelve studies, examining 597 820 blood donors, were included in this study. The overall pooled prevalence rate of HBV and HCV among blood donors was 0.455% (95% CI: 0.334%-0.619%) and 0.195% (95% CI: 0.130%-0.292%), respectively. Although a high heterogeneity was detected across studies (I² >80%, p = 0.000), sensitivity analysis revealed strong reliability, and no publication bias was detected. Subgroups and meta-regression analyses demonstrated that publication period, geographic location, and diagnostic methods were the main factors contributing to heterogeneity in prevalence estimates for HBV and HCV. According to our findings, the prevalence of positive blood donors for HBV and HCV is low across Saudi Arabia. We suggest that vaccination campaigns and public education regarding the modes of transmission should be improved in order to reduce the prevalence of blood-borne viruses.</p>","PeriodicalId":23306,"journal":{"name":"Transfusion Medicine","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148649089","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":"HTLV screening and confirmatory testing among blood donors in São Paulo: A cross-sectional study.","authors":"Suzete C Ferreira, Anna S Nishyia, Jerenice E Ferreira, Claudia Di Lorenzo Oliveira, Cesar de Almeida-Neto, Tila Fanciani, Katia C Dantas, Juliana Derriga, Silvia Petrossi Gallo Polato, Nanci Salles, Vanderson Rocha, Alfredo Mendrone-Junior","doi":"10.1111/tme.70106","DOIUrl":"https://doi.org/10.1111/tme.70106","url":null,"abstract":"<p><strong>Introduction: </strong>Human T-cell lymphotropic virus types 1 and 2 (HTLV-1/2) are transfusion-transmissible retroviruses associated with severe diseases, and blood donor screening is mandatory in Brazil. Increasing HTLV-related discard rates at our institution prompted this study to determine the prevalence and incidence of HTLV-1/2 and to investigate the presence of HTLV-3 among donations reactive in the ARCHITECT rHTLV-I/II CMIA assay.</p><p><strong>Methods: </strong>A retrospective cross-sectional study was conducted among 220 340 volunteer blood donors at Fundação Pró-Sangue/Hemocentro de São Paulo, Brazil, between September 2019 and July 2021. Real-time PCR assays for HTLV-1/2 and HTLV-3 were performed. INNO-LIA HTLV-I/II was used as the confirmatory test for samples reactive in screening with the ARCHITECT rHTLV-I/II CMIA assay.</p><p><strong>Results: </strong>Among 220 340 donations, 404 (0.18%) were initially reactive by CMIA, and 223 (0.10%) were further analysed. Of these, 59 (26.5%) were confirmed HTLV-1/2 positive by INNO-LIA, and 42 (18.8%) were indeterminate. Annual rates of initially reactive donations were 0.20% (2019), 0.20% (2020), and 0.15% (2021). Overall HTLV prevalence was 0.027%, and incidence was 1.36 per 100 000 donations. Real-time PCR detected HTLV DNA in 54 (24.2%) samples; no HTLV-3 cases were identified. An S/CO cutoff ≥4.0 increased the positive predictive value from 47.6% to 66.1%.</p><p><strong>Conclusion: </strong>These findings highlight the epidemiological and diagnostic challenges of HTLV-1/2 in blood donors. Reliance solely on serological screening thresholds is limited, reinforcing the essential role of confirmatory molecular and serological testing to ensure accurate diagnosis and strengthen blood safety in Brazil.</p>","PeriodicalId":23306,"journal":{"name":"Transfusion Medicine","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148607985","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":"Research and application of machine learning models based on multimodal big data for precise transfusion management in acute myeloid leukaemia.","authors":"Jiaheng Li, Xuezhe An, Zhongcui Jing, Ying Li","doi":"10.1111/tme.70105","DOIUrl":"https://doi.org/10.1111/tme.70105","url":null,"abstract":"<p><p>Acute myeloid leukaemia (AML) is a highly heterogeneous haematologic malignancy in which transfusion support represents an essential component of comprehensive patient care. This review aims to provide an updated synthesis of recent progress in the development and clinical application of machine learning models based on multimodal big data for precision transfusion management in AML, addressing the persistent limitations of conventional, empirically guided transfusion practices. We systematically reviewed the literature on multimodal data integration-including electronic health records, genomic, proteomic and other high-dimensional datasets-in the context of AML transfusion management. The applications of machine learning algorithms such as decision trees, random forests and neural networks were analysed in the contexts of transfusion demand prediction and transfusion reaction risk assessment, with reference to representative clinical case studies demonstrating their practical utility. Multimodal big data demonstrates substantial value in optimising transfusion strategies for AML patients. Machine learning models have shown promising performance in predicting transfusion demand and assessing transfusion reaction risks, with clinical case studies supporting their practical utility. However, major challenges persist, including data privacy protection, data standardisation across platforms and model interpretability for clinical adoption. The integration of multimodal big data with advanced machine learning methodologies holds substantial promise for enabling precision, individualised transfusion management in AML. Future directions involving federated learning and explainable artificial intelligence are anticipated to address current limitations, ultimately contributing to improved transfusion safety and clinical outcomes in AML patients.</p>","PeriodicalId":23306,"journal":{"name":"Transfusion Medicine","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148585268","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":"Tranexamic acid dosing in cardiac surgery: Preserving the evidence framework.","authors":"Antoine Premachandra, Baptiste Monnier, Sylvain Diop","doi":"10.1111/tme.70104","DOIUrl":"https://doi.org/10.1111/tme.70104","url":null,"abstract":"","PeriodicalId":23306,"journal":{"name":"Transfusion Medicine","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148563112","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":"Just one thing to reduce bleeding: Put tranexamic acid on the safe surgical checklist at your hospital.","authors":"Ian Roberts, Katharine Ker","doi":"10.1111/tme.70101","DOIUrl":"https://doi.org/10.1111/tme.70101","url":null,"abstract":"<p><strong>Objectives: </strong>To highlight tranexamic acid (TXA) as 'just one thing' that every hospital could implement to reduce surgical bleeding and blood transfusions.</p><p><strong>Background: </strong>TXA is a low-cost antifibrinolytic agent that inhibits the breakdown of fibrin blood clots. Developed in Japan in the 1960s, it has been shown to reduce surgical bleeding. TXA is also effective in traumatic and postpartum haemorrhage, with no proven increase in thrombosis.</p><p><strong>Methods: </strong>Evidence from clinical trials, national guidelines, and policy reports was reviewed, including NICE recommendations and the UK Infected Blood Inquiry report. Patterns of TXA use and barriers to implementation were examined.</p><p><strong>Results: </strong>There is strong evidence for the safety and effectiveness of TXA in surgery. However, despite inclusion in NICE guidelines since 2016, approximately one quarter of eligible surgical patients in the UK do not receive TXA, with similar underuse reported internationally. This results in missed opportunities to improve patient outcomes and reduce costs. The UK Infected Blood Inquiry recommended inclusion of TXA on surgical checklists, supported by regular audit and reporting.</p><p><strong>Conclusion: </strong>TXA represents an effective intervention to improve surgical outcomes and reduce transfusion. Increased uptake requires stronger leadership, audit systems, training, patient advocacy and alignment of clinical incentives with evidence-based practice.</p>","PeriodicalId":23306,"journal":{"name":"Transfusion Medicine","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148521003","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":"Novel variants of the KLF1 gene associated with the In(Lu) phenotype lead to alterations in protein structure.","authors":"Minghao Li, Aijing Li, Ziyan Zhu, Luyi Ye","doi":"10.1111/tme.70100","DOIUrl":"https://doi.org/10.1111/tme.70100","url":null,"abstract":"<p><strong>Background: </strong>The rare erythrocyte Lutheran inhibitor (In(Lu)) blood group phenotype is characterised as a Lu_mod phenotype and primarily caused by heterozygous variants in the erythroid-specific Krüeppel-like factor 1 (KLF1) gene.</p><p><strong>Objectives: </strong>This study aimed to analyse the genetic background of the In(Lu) phenotype in the Chinese population.</p><p><strong>Methods: </strong>Four apparent Lu_null samples were identified among 3466 Chinese blood donors using flow cytometry. These samples were typed for Lu^a and Lu^b antigens using the gel card method. Targeted next-generation sequencing (NGS) was performed to identify potential variants in blood group genes and two transcription factors, KLF1 and GATA1, which were confirmed using Sanger and clonal sequencing. Homology modelling for both wild-type and mutant residues was performed using the Robetta platform, whereas changes in protein stability resulting from variants were assessed using the DynaMut web server. The functional impact of these variants was evaluated using the PolyPhen-2 and PROVEAN software tools.</p><p><strong>Results: </strong>Four samples were identified as In(Lu). Two KLF1 variants had been previously reported, while two were novel: c.1004G>A (p.G335E) and c.1067 T>G (p.L356W). Three-dimensional molecular models indicated that both the p.E335 and p.W356 substitutions altered the distance to nearby amino acid sites. The p.W356 substitution also reduced ionic interactions between p.W356 and p.D352. Both variants were predicted to adversely affect protein function.</p><p><strong>Conclusion: </strong>Two novel KLF1 variants, c.1004G>A (p.G335E) and c.1067 T>G (p.L356W), were detected in two Chinese donors, suggesting an association with the In(Lu) phenotype.</p>","PeriodicalId":23306,"journal":{"name":"Transfusion Medicine","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148391684","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":"Simple image analysis for reliability control of column agglutination test in pretransfusion testing.","authors":"Martin Töffner Pedersen, Tharisa Rajaguru, Albert Ashong, Ramis Arbi, Niko Hildebrandt, Thor Skovsted","doi":"10.1111/tme.70103","DOIUrl":"https://doi.org/10.1111/tme.70103","url":null,"abstract":"<p><strong>Objectives: </strong>A novel meniscus-based analysis provides a rapid method to identify analytical errors related to unrecognised pipetting errors.</p><p><strong>Background: </strong>The indirect antihuman globulin test (IAT) is part of pretransfusion testing, enabling detection of erythrocyte alloantibodies. Failure to detect such antibodies may result in transfusion complications. In column agglutination technique (CAT)-based IAT, correct separation of the different liquids by an air gap during incubation is essential. Penetration of this air gap due to pipetting errors can cause neutralisation of AHG, resulting in false-negative or weak test results.</p><p><strong>Materials and methods: </strong>We investigated the fluid dynamics of CAT-based IAT and developed a simple image-based quality control approach to detect air gap penetration. Using routinely generated analyser images, the meniscus contact angle was quantified with the software ImageJ in 132 simulated crossmatch tests.</p><p><strong>Results: </strong>Receiver operating characteristic analysis demonstrated high discriminatory performance (AUC 0.935). Additional experiments using bovine serum albumin solutions confirmed that increased protein concentration significantly reduces meniscus contact angle, supporting the proposed mechanism of error prediction.</p><p><strong>Conclusion: </strong>While further validation across platforms and laboratories is required, this approach has the potential to enhance test reliability, support troubleshooting, and improve patient safety in routine IAT CAT workflows.</p>","PeriodicalId":23306,"journal":{"name":"Transfusion Medicine","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148391698","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":"First identification and molecular characterisation of a rare D- - donor in Saudi Arabia.","authors":"Maymoon M Madkhali, Abdullah A Meshi, Mahdi Osman, Abdulrahman Alnefaie, Hosain Almalky, Mayisah Khormy, Khaled Ghazwani, Hassan A Hamali, Marianne Stef","doi":"10.1111/tme.70098","DOIUrl":"10.1111/tme.70098","url":null,"abstract":"<p><strong>Background and objectives: </strong>The D- - phenotype is an exceptionally rare Rh configuration characterised by the expression of the D antigen but absence of all RHCE-encoded antigens. A few molecularly defined cases have been documented globally.</p><p><strong>Materials and methods: </strong>Gel microcolumn techniques were employed in this work to conduct serologic testing. Genotyping using ID RHD XT and ID CORE XT assays was performed, after which next-generation sequencing was performed on the RH promoter, exons 1-10 and introns 2-3 to enable definitive alleles to be identified.</p><p><strong>Results: </strong>Serologic phenotyping showed D+ C- c- E- e-. Molecular analysis identified homozygosity for the RHCE*CeN.08 allele (RHCE*02N.08) a hybrid in which RHCE exons 3-9 are replaced by the corresponding RHD sequence together with two conventional RHD*01 alleles, consistent with the D- - phenotype.</p><p><strong>Conclusion: </strong>This is the first molecularly confirmed D- - donor reported in Saudi Arabia and the wider Middle East, and the first description of the RHCE*CeN.08 allele in this region. The finding extends the geographic distribution of this rare hybrid and underscores the value of combined serologic and high-resolution molecular testing for identifying and supporting D- - donors and patients.</p>","PeriodicalId":23306,"journal":{"name":"Transfusion Medicine","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148377130","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":"Identification and protein modelling analysis of a homozygous FUT1*01W.09 variant in a Thai patient with the para-Bombay phenotype.","authors":"Prakarn Sawatdee, Yan Quan Lee, Martin L Olsson, Jill R Storry, Oytip Nathalang, Kamphon Intharanut","doi":"10.1111/tme.70102","DOIUrl":"https://doi.org/10.1111/tme.70102","url":null,"abstract":"<p><strong>Objective: </strong>To characterise a Thai patient with a para-Bombay phenotype associated with homozygosity for a variant FUT1 allele and explore the underlying mechanism of reduced enzymatic activity.</p><p><strong>Background: </strong>The para-Bombay phenotype is a rare red blood cell phenotype characterised by absent or markedly reduced ABH antigens on erythrocytes, with preserved expression in secretions, typically resulting from FUT1 mutations affecting α1,2-L-fucosyltransferase 1 (α1,2FucT1).</p><p><strong>Materials and methods: </strong>Serological testing was performed using standard methods. ABO, FUT1 and FUT2 genotypes were determined by whole-exome and Sanger sequencing. Structural modelling of the FUT1 variant was conducted using AlphaFold3 and ChimeraX, and functional effects were predicted using ProtVar.</p><p><strong>Results: </strong>Serology identified a para-Bombay B_h phenotype with anti-HI and autoantibodies. Genotyping revealed homozygosity for ABO*B.01, FUT1 c.658C>T (p.Arg220Cys; rs574691621; FUT1*01W.09), and FUT2 c.390C>T (a silent variant, p.Asn130). Structural modelling suggested that the p.Cys220 substitution does not alter overall protein conformation or stability but may impair substrate binding and local intermolecular interactions.</p><p><strong>Conclusion: </strong>This report presents the first Thai case of para-Bombay B_h phenotype associated with homozygosity for the weakened FUT1*01W.09 allele. In silico modelling predicted that the variant impairs α1,2FucT1 activity and substrate binding without compromising protein stability, supporting safe transfusion practice.</p>","PeriodicalId":23306,"journal":{"name":"Transfusion Medicine","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148377092","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 Haemoglobin response after single-unit red blood cell transfusion predicts repeat transfusion in hospitalised adults: A prospective cohort study and clinical prediction model.","authors":"Rudraksh Kesharwani, Ritika Agarkar, Shubhangi Nagpal, Dhruvin Patel, Rehan Ali, Amar Karda, Angel Parul Luka","doi":"10.1111/tme.70099","DOIUrl":"https://doi.org/10.1111/tme.70099","url":null,"abstract":"<p><strong>Background: </strong>Restrictive transfusion strategies and patient blood management programs increasingly recommend administration of single-unit red blood cell (RBC) transfusions followed by reassessment. However, clinicians often lack objective indicators to determine whether additional transfusion may subsequently be administered after the initial unit. Early haemoglobin response may provide clinically useful information regarding post-transfusion haematologic response and the likelihood of repeat transfusion.</p><p><strong>Methods: </strong>We conducted a prospective observational cohort study including 518 hospitalized adults who received single-unit RBC transfusion. Haemoglobin concentrations for the primary analysis were measured at baseline and 24 h following transfusion. The primary predictor variable was the 24-h haemoglobin increment (ΔHb24). The primary outcome was repeat RBC transfusion within 48 h. A multivariable logistic regression model incorporating haemoglobin response and clinical variables was developed. Model performance was evaluated using receiver operating characteristic analysis, calibration assessment, and decision curve analysis.</p><p><strong>Results: </strong>Among the 518 patients included in the study, 42 (8.1%) received repeat transfusion within 48 h. Patients who received additional transfusion demonstrated significantly smaller haemoglobin increments compared with those who did not. In multivariable analysis, ΔHb24 emerged as the strongest independent predictor of repeat transfusion, with increasing haemoglobin increments associated with lower risk. The prediction model demonstrated moderate discrimination (AUC 0.74) and acceptable calibration. Risk stratification showed that patients with ΔHb24 <1 g/dL had substantially higher probability of repeat transfusion, whereas those with ΔHb24 >1.5 g/dL had low risk. Decision curve analysis demonstrated positive clinical net benefit across clinically relevant threshold probabilities.</p><p><strong>Conclusion: </strong>Early haemoglobin response may provide clinically useful prognostic information regarding repeat transfusion risk following single-unit RBC transfusion. These findings support structured reassessment following single-unit transfusion and demonstrate that early haemoglobin response may assist in identifying patients more likely to receive repeat transfusion.</p>","PeriodicalId":23306,"journal":{"name":"Transfusion Medicine","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148377095","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}