Transfusion Medicine最新文献

{"title":"Alloanti-Hy in antenatal patients: A multi-case review.","authors":"S Lewis, N Kirkpatrick, A Nawrocki, L Reyland, B Jones, R Laundy, A McNeil, V Karamatic Crew, T Stutt, D Clinton, A Anbazhagan, C Harris, I Skidmore, T Bullock, M Hazell","doi":"10.1111/tme.13124","DOIUrl":"10.1111/tme.13124","url":null,"abstract":"<p><strong>Introduction: </strong>Introduction The Hy antigen is one of ten red cell antigens belonging to the Dombrock blood group system, with an antigen frequency of almost 100% in the majority of populations. Alloantibodies to high prevalence antigens cause difficulties with antibody identification and exclusion in serological investigations.</p><p><strong>Case presentation: </strong>This review describes the management of four antenatal cases where the presence of alloanti-Hy had been identified. Hy-red blood cell units may be required for the transfusion of patients with alloanti-Hy, but currently, there are no published reports of alloanti-Hy causing haemolytic disease of the fetus and newborn (HDFN). A previous case report involving the care and management of antenatal patients with alloanti-Hy antibodies indicates a lack of evidence that alloanti-Hy causes clinical HDFN.</p><p><strong>Results: </strong>All cases discussed in this review demonstrate a reduction in the strength of alloanti-Hy levels as pregnancy progressed. Signs or symptoms of HDFN were not observed with any of the pregnancies.</p><p><strong>Conclusion: </strong>Factors such as antibody levels, antigenic expression, and varying clinical responses enhance our understanding of why alloanti-Hy has not been known to cause clinical HDFN. The cases presented here aim to improve understanding of alloanti-Hy in pregnancy and how to manage such cases.</p>","PeriodicalId":23306,"journal":{"name":"Transfusion Medicine","volume":" ","pages":"197-202"},"PeriodicalIF":1.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143047893","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":"An unusual case of reagent interference in transfusion medicine workup: Pan reactive indirect antiglobulin test caused by commercial saline solution.","authors":"Martin Tøffner Pedersen, Helle Bach-Hansen, Kristina Fruerlund Rasmussen, Mark H Yazer, Ulrik Sprogøe","doi":"10.1111/tme.13113","DOIUrl":"10.1111/tme.13113","url":null,"abstract":"<p><strong>Background: </strong>At the regional transfusion service in the Region of Southern Denmark, serological investigations are primarily carried out using column agglutination techniques. This case study examines an unusual instance of reagent interference in pretransfusion testing using column agglutination at the Hospital of Southern Denmark, Aabenraa.</p><p><strong>Case presentation: </strong>A 72-year-old male patient presented for pretransfusion testing prior to hernia surgery. He typed as O RhD negative without discrepancies, but the antibody screen showed weakly positive reactions. Routine investigations showed discrepancies, leading to further investigations.</p><p><strong>Methods: </strong>Various serological tests were performed using in-house and commercial red test cells suspended in different suspension media and with different column agglutination cards and cassettes. Further investigations included washing of test cells, testing alternative saline solutions, varying incubation temperatures, testing without antihuman-globulin, and applying proteolytic enzymes.</p><p><strong>Results: </strong>Reactivity was present with red cells suspended in ID-CellStab (BioRad) but not in Red Cell Diluent (Quidel-Ortho). Reactivity was abolished by using trypsin-treated cells, indicating either the presence of an antibody reacting with-or unspecific agglutination depending on-a trypsin-sensitive protein, in both cases enhanced by ID-CellStab.</p><p><strong>Conclusion: </strong>This case highlights the importance of recognising reagent-dependent reactivity in serological testing. Adjustments to the suspension media resolved the incompatibility. Immunohematology laboratories should consider potential reagent interference when unexpected agglutination occurs.</p>","PeriodicalId":23306,"journal":{"name":"Transfusion Medicine","volume":" ","pages":"192-196"},"PeriodicalIF":1.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11998997/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142644630","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":"Exploring barriers and facilitators to blood donation in secondary schools in Malawi.","authors":"Effie Chipeta, Princess Kaira, Patani Mhango, Emmanuel Singogo, Victor Mwapasa, Adamson S Muula, Andrew Likaka, Titus Chiwindo, Mina C Hosseinipour, Bridon M'baya","doi":"10.1111/tme.13110","DOIUrl":"10.1111/tme.13110","url":null,"abstract":"<p><strong>Background and objective: </strong>Despite the Malawi Blood Transfusion Service (MBTS) increasing the amount of blood collected since its inception in 2004, Malawi remains with a 27% deficit in required blood supplies nationally. We sought to understand the facilitators and barriers to blood donation among secondary school students in Malawi.</p><p><strong>Methods: </strong>We utilised a qualitative exploratory design, with a sample of 135 participants purposefully selected from 16 secondary schools across Malawi. Data collection methods included in-depth interviews with 20 participants (inclusive of first-time and repeat donors, lapsed and non-donors), 20 key informant interviews (including community leaders, policy-level stakeholders and MBTS staff), and 16 focus group discussions involving 95 participants (community stakeholders and all donor categories). We used the consolidated framework for implementation research (CFIR) to assess barriers and facilitators of blood donation, focusing only on four CFIR domains: internal and external factors; the implementation process and individual characteristics influencing blood donation.</p><p><strong>Results: </strong>Blood donation among students are facilitated by altruism, incentives including milestone awards, knowledge, motivation, transport, peer pressure and individual health status. Common barriers cited included: negative experiences with the blood donation process, fear, unsupported environment, poor incentives, privacy issues and the donation activities starting late than scheduled.</p><p><strong>Conclusion: </strong>While there have been efforts to motivate students to donate blood, significant barriers to blood donation still exist. Intensifying education and awareness campaigns may help dispel misconceptions and fears surrounding donation experiences and blood usage. Also, continuing with the provision of appropriate incentives including milestone awards may also encourage students.</p>","PeriodicalId":23306,"journal":{"name":"Transfusion Medicine","volume":" ","pages":"125-137"},"PeriodicalIF":1.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11999001/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142795225","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":"Frequency of RHD variants among blood donors in the central region of Iran, Yazd province.","authors":"N Seddighi, A Oodi, F Zare, H Javadzadeh Shahshahani","doi":"10.1111/tme.13135","DOIUrl":"https://doi.org/10.1111/tme.13135","url":null,"abstract":"<p><strong>Background and aims: </strong>D antigen is a crucial factor in both blood transfusions and haemolytic disease of foetus/newborn (HDFN). Some variants of the D antigen can produce anti-D and should be considered Rh-negative, while others are Rh-positive and can receive Rh-positive blood. Efficient and cost-effective genotype tests in the management of Rh-negative blood usage and preventive management of HDFN require knowledge of the distribution of RHD variant alleles among different populations. The aim of this study was to determine the frequency of weak D/partial D variants in blood donors of Yazd Blood Center.</p><p><strong>Materials and methods: </strong>Between October 2022 and October 2023, 43 blood samples with weak D antigen expression from blood donors at Yazd Blood Center were analysed. The samples' phenotypes were identified using serological methods to detect the e, c, E, C, and D antigens. The D variant-associated alleles were evaluated using polymerase chain reaction-SSP, restriction fragment length polymorphism, and DNA sequencing techniques.</p><p><strong>Results: </strong>The result showed four different weak D and one Partial D allele. The highest prevalence was related to RHD* weak partial 15 (48.8%), followed by RHD*01W.80 (18.6%), RHD*01W.1 (4.6%), and RHD*01W.4 (2.3%). There were seven cases (16.2%) of RHD*Partial DLO. This study showed the association between weak D type 15 and antigens E.</p><p><strong>Conclusion: </strong>The results of this study highlight the specific pattern of RHD variants in the Yazd population. Weak D type 15 showed the highest prevalence, while weak D type 80 was particular to the Yazd region.</p>","PeriodicalId":23306,"journal":{"name":"Transfusion Medicine","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765118","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":"Factors influencing white blood cell mobilisation in healthy granulocyte donors.","authors":"Roman Gonta, Jason M Schenkel, Kimberly Klein, Fernando Martinez, Mayrin Correa Medina","doi":"10.1111/tme.13115","DOIUrl":"10.1111/tme.13115","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Granulocyte transfusions represent a therapeutic option for severely neutropenic patients with bacterial or fungal infections that are otherwise unresponsive to conventional therapy. Prior clinical studies suggest that patients receiving higher granulocyte doses achieve superior outcomes. Consequently, suboptimal donor stimulation and collection leading to lower granulocyte doses likely correlate with worse clinical outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Study design: &lt;/strong&gt;A retrospective analysis was conducted on mobilisation data from 312 granulocyte collections from healthy donors between January 2020 and May 2023. This study was performed in a single blood donor center exclusively supporting a comprehensive cancer center. Donors underwent stimulation with 480 mcg of filgrastim (granulocyte colony stimulating factor [G-CSF]) subcutaneously and 8 mg of dexamethasone orally administered 12 to 14 h before collection. The correlation between donor characteristics (age, gender, body weight (BW), body mass index (BMI), baseline haemoglobin (Hgb), and platelet (PLT) counts) and mobilisation efficiency (Δ WBC, defined as post-mobilisation WBC count-baseline WBC count) was examined to identify factors associated with enhanced mobilisation efficiency. Additionally, the impact of multiple donations on Δ WBC in repeat donors was assessed.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The median donor age was 43 years (range 18-81), with 224 male and 88 female donors. Female donors exhibited significantly higher baseline PLT counts and post-mobilisation WBC counts. However, donor gender did not significantly affect Δ WBC. A negative correlation was observed between Δ WBC and age (r = -0.235, p = 0.001), with older donors (61-81 years) exhibiting significantly lower mobilisation efficiency. BW and BMI differences had no significant effect on Δ WBC. A positive correlation was identified between baseline PLT count and Δ WBC (r = 0.140, p = 0.014), with females having significantly higher baseline PLT counts (p = 0.0004). No correlation was found between Δ WBC and baseline Hgb (r = 0.004, p = 0.477). Repeat donors showed no statistically significant change in Δ WBC with subsequent donations, with a mean interval of 136.5 days between collections.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Mobilisation efficiency was not impacted by donor BW or BMI suggesting that BW-based G-CSF stimulation is not essential for optimising WBC mobilisation. Rather, a fixed single dose of 480 mcg of G-CSF and 8 mg of dexamethasone was sufficient to mobilise donors, thus reducing the procedural costs and the potential risks for medication-related side effects. The positive correlation found between baseline PLT count and Δ WBC suggests that PLT count could be used as a potential predictor of mobilisation efficiency. Mobilisation response in up to four collections in repeat granulocytes donors was not affected in subsequent donations. However, sample size is a limitation, and more d","PeriodicalId":23306,"journal":{"name":"Transfusion Medicine","volume":" ","pages":"177-183"},"PeriodicalIF":1.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142732780","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":"Red blood cell inventory management: Insights from transfusion laboratory technologists in British Columbia, Canada.","authors":"Jasdeep Dhahan, Douglas Morrison, Andrew W Shih, Deb McDonald, Robby Chen, Lillian Hao, Kristin Rosinski, Sarah Buchko, John Blake, Alexander Rutherford","doi":"10.1111/tme.13131","DOIUrl":"10.1111/tme.13131","url":null,"abstract":"<p><strong>Background and objectives: </strong>There is concern about sustaining the O negative blood supply, especially in areas with many rural/remote hospitals like British Columbia. Red blood cells are perishable, making inventory management challenging. Demand must be met without wasting this precious resource. Inventory management challenges stem from data scarcity and human factors. Transfusion medicine technologists, who manage inventory daily, are key to understanding the human factors in inventory management. We conducted a qualitative study to understand technologists' inventory management perspectives and experiences, particularly for group O negative red blood cells, aiming to inform future inventory modelling to address human factors.</p><p><strong>Materials and methods: </strong>We interviewed transfusion laboratory technologists and technical leads from all health authorities and a blood product supplier representative for the Province of British Columbia. Thematic analysis of the interview transcripts was conducted.</p><p><strong>Results: </strong>We found five themes that influence technologist decision-making on RBC inventory management, key challenges for O-negative RBCs, and identified inventory management strategies. We compare the top three inventory practices from our results with literature.</p><p><strong>Conclusions: </strong>Our findings help bridge the knowledge gap concerning human factors in RBC inventory management, with potential generalizability to other jurisdictions. They hold promise for informing the safeguarding of donors' altruistic contributions.</p>","PeriodicalId":23306,"journal":{"name":"Transfusion Medicine","volume":" ","pages":"116-124"},"PeriodicalIF":1.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11998998/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442114","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":"Syphilis in a blood bank in Argentina: Prevalence trends and risk factors.","authors":"Ana Rios Trevisan, Carolina Fernandez, Mónica Puppo, Mirta Cristina Remesar, Macarena Roel, Silvina Kuperman","doi":"10.1111/tme.13121","DOIUrl":"10.1111/tme.13121","url":null,"abstract":"<p><strong>Background: </strong>Worldwide, there has been a worrying increase in the prevalence of syphilis. Blood banks have a major role in monitoring the trend of these events, despite the bias due to the altruistic donation strategy.</p><p><strong>Objectives: </strong>To determine the seroprevalence of syphilis and analyse its association with defined risk factors among blood donors at the regional blood center at Hospital Prof. Dr. J. P. Garrahan, period 2016-2022.</p><p><strong>Materials and methods: </strong>Donor screening was performed with treponemal and non-treponemal tests to determine the prevalence of active and past syphilis. Sociodemographic characteristics of donors were analysed and the association with potential risk factors was assessed.</p><p><strong>Results: </strong>A total of 72 874 donations were processed during the study period. The overall prevalence of specific anti-Treponema pallidum antibodies was 0.69% (95% CI = 0.63-0.75). Active syphilis seroprevalence was 0.30% (95% CI = 0.25-0.33). Not active syphilis seroprevalence was 0.39% (95% CI = 0.35-0.44). Anti-T. pallidum seroprevalence among first-time donations was 1.26% (95% CI = 1.14-1.38) while in repeat donations it was 0.16% (95% CI = 0.12-0.21). In univariate analysis, we found an association between syphilis and having a history of any sexually transmitted infection (OR: 5.09, 95% CI = 2.20-11.70, p < 0.01) and being first-time donors (OR: 3.48, 95% CI = 1.70-7.09, p = 0.0001).</p><p><strong>Conclusion: </strong>Although the overall prevalence of syphilis is 0.69%, among repeat donors prevalence as low as 0.16% was found. This demonstrates the need to maintain and improve screening strategies and promotion of voluntary, altruistic and repeat donation.</p>","PeriodicalId":23306,"journal":{"name":"Transfusion Medicine","volume":" ","pages":"184-191"},"PeriodicalIF":1.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143034133","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":"Transfusing selected RhD negative patients with RhD positive packed red cell concentrates resulted in lower frequency of anti-D development and saved almost two thousand RhD negative concentrates during 5 years.","authors":"Inger Margit Alm, Elin Brenna, Çiğdem Akalın Akkök","doi":"10.1111/tme.13118","DOIUrl":"10.1111/tme.13118","url":null,"abstract":"<p><strong>Background: </strong>The Blood Bank at Oslo University Hospital implements restrictions when the stocks of blood groups O and A RhD negative packed red blood cell concentrates (PRBCCs) drop below 60 units due to high demand and low donor availability. Restrictions entail transfusing RhD negative male patients and women >50 years with RhD positive units, to provide RhD negative units to those who should not receive RhD positive units. Earlier studies have reported that up to 50% of RhD negative patients developed anti-D after RhD positive blood transfusion. We aimed to investigate the rate of anti-D alloimmunization using this restriction strategy in our population.</p><p><strong>Study design and methods: </strong>This retrospective study was performed at Oslo University Hospital between 2006 and 2011. Antibody screen results were included throughout 2019 for the patients readmitted to the hospital.</p><p><strong>Results: </strong>607 RhD negative mostly cancer patients and patients having surgery for cardiovascular conditions received 1926 RhD positive PRBCCs. Post-transfusion antibody screen was available for 401 patients (66.1%), and 76 patients (22.2%) developed anti-D. In 15 of the 76 patients (19.7%), anti-D became evanescent in the follow-up.</p><p><strong>Discussion: </strong>The proportion of anti-D immunisation in RhD negative patients receiving RhD positive PRBCCs in this study was consistent with findings from other reports. To our knowledge, this is the first study reporting a high proportion of evanescence of anti-D. Transfusing selected RhD negative patients with RhD positive PRBCCs when RhD negative stocks are low, contributed saving 1926 RhD negative PRBCCs during the study period of 64 months.</p>","PeriodicalId":23306,"journal":{"name":"Transfusion Medicine","volume":" ","pages":"138-143"},"PeriodicalIF":1.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11998999/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142772574","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 8-year retrospective review of human albumin solution use August 2015 to March 2023; Guy's and St Thomas' NHS Foundation Trust.","authors":"Asma Tameez Ud Din, Patrick Harrington, Danaee Anicee, Andrew Retter, Llywelyn Cadman-Davies, Muhammad Sajid Yazdani, Paul Holmes, Vickie McDonald, Susan E Robinson","doi":"10.1111/tme.13138","DOIUrl":"https://doi.org/10.1111/tme.13138","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this study is to critically assess the diverse indications for HAS administration over the past 8 years at a prominent tertiary care institution in the United Kingdom.</p><p><strong>Background: </strong>This is timely and relevant, given recent developments in the field. The International Collaborative Transfusion Medicine Group (ICTMG) issued updated guidance on intravenous albumin use in March 2024, reflecting a shift towards more stringent criteria for its application, which necessitates a re-evaluation of current practices.</p><p><strong>Method: </strong>We conducted a retrospective analysis of the usage of HAS from August 2015 to March 2023. Records of all patients who received HAS during this study period were extracted from the Electronic Patient Records (EPR) of Guys and St Thomas' NHS Foundation Trust London (GSTFT). Data analysis was performed using SPSS version 20.</p><p><strong>Results: </strong>A total of 4816 patients received HAS during the audit period, with 21 231 HAS infusions. The majority of infusions were for 20% HAS, with 16 772 (79% of total) infusions for 20% HAS in 4145 patients. A total of 4459 (21%) infusions were recorded for 4.5 and 5% HAS.</p><p><strong>Conclusion: </strong>Our study provides a comprehensive analysis of albumin utilisation and TPE indications over the past 8 years at our institution, establishing a crucial baseline for refining our practices.</p>","PeriodicalId":23306,"journal":{"name":"Transfusion Medicine","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744047","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}