Transfusion Medicine最新文献

{"title":"Retrospective analysis of hypotension incidence and related factors during double filtration plasmapheresis (DFPP) in critically ill patients.","authors":"Xiulin Ye, Mengyuan Zhang, Hui Zhou, Lihua Qiu, Yuanyuan Yao","doi":"10.1111/tme.70054","DOIUrl":"10.1111/tme.70054","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to investigate the incidence and risk factors associated with hypotension in critically ill patients undergoing double filtration plasmapheresis (DFPP) to improve treatment safety and optimise haemodynamic management strategies.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on critically ill patients who underwent DFPP in the intensive care unit between April 2022 and April 2024. Patients were classified into hypotension and non-hypotension groups based on blood pressure changes following DFPP. Clinical data including APACHE II and SOFA scores, DFPP treatment parameters, blood access methods, anticoagulation strategies and vasopressor usage were compared between the groups. Univariate and multivariate logistic regression analyses were performed to identify independent risk factors. Time to hypotension onset during DFPP was also analysed.</p><p><strong>Results: </strong>A total of 61 patients undergoing 190 DFPP sessions were included, with hypotension occurring in 86.8% of patients during one or more sessions. The APACHE II score was significantly higher in the hypotension group (p = 0.002). Logistic regression analysis identified systemic heparin anticoagulation (OR = 2.475, p = 0.013) and pre-existing vasopressor use (OR = 23.229, p = 0.002) as independent risk factors for hypotension. Additionally, single-needle blood access was associated with a higher incidence of hypotension (p = 0.023). Notably, 76.9% of hypotensive episodes occurred within the first 2 h of DFPP, with 41.7% occurring within the first hour.</p><p><strong>Conclusion: </strong>Systemic heparin anticoagulation and prior vasopressor use were significantly associated with an increased risk of hypotension during DFPP. These associations may reflect both treatment-related physiological effects and the intrinsic haemodynamic fragility of severely ill patients. Optimising vascular access, anticoagulation strategies and vasopressor management may help improve haemodynamic stability during DFPP, particularly in high-risk individuals. However, prospective studies are still needed to determine whether such adjustments can meaningfully reduce the incidence of DFPP-related hypotension.</p>","PeriodicalId":23306,"journal":{"name":"Transfusion Medicine","volume":" ","pages":"175-182"},"PeriodicalIF":1.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145946402","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":"Perceptions of donor screening-Do I always need to tell the truth?","authors":"Sheila F O'Brien, Lori Osmond, Mindy Goldman","doi":"10.1111/tme.70034","DOIUrl":"10.1111/tme.70034","url":null,"abstract":"<p><strong>Background: </strong>The Donor Health Assessment Questionnaire (DHQ) is fundamental to blood safety. We describe attitudes towards truthfulness among first-time donors who tested positive for transfusion transmissible infections and those who did not.</p><p><strong>Methods and materials: </strong>From 2005 to 2022 donors positive for infectious markers (cases) and demographically matched controls rated their agreement with statements about truthfulness, privacy and the value of the DHQ.</p><p><strong>Results: </strong>There were 798 (32% participation) cases and 3192 (39% participation) controls. Most said they read questions carefully (93% cases, 96% controls, p < 0.01) and answered truthfully (95% cases, 99% controls p < 0.01). Fewer thought the questions make the blood safer (79% cases, 80% controls, p = 0.39) and some agreed it is OK not to answer questions truthfully if you know your blood is safe (21% cases, 16% controls, p < 0.01). Privacy to answer personal questions was generally adequate (88% cases, 91% controls, p < 0.01). Attitudes were similar regardless of paper or electronic DHQ format.</p><p><strong>Conclusion: </strong>Most first time donors believe they answer screening questions truthfully, but some question the safety benefit to recipients and judge whether they need to be truthful. This was true for donors with positive infectious markers as well as their matched infection-negative controls.</p>","PeriodicalId":23306,"journal":{"name":"Transfusion Medicine","volume":" ","pages":"183-193"},"PeriodicalIF":1.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13077416/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145393090","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":"Implementation of a patient blood management programme for platelet therapy among haemato-oncology patients-A quasi-experimental study.","authors":"Vaidehi Prasanth, Daljit Kaur, Gita Negi, Gaurav Dhingra, Ashish Jain, Xavier Belsiyal, Chanchi B Khiamniungan","doi":"10.1111/tme.70016","DOIUrl":"10.1111/tme.70016","url":null,"abstract":"<p><strong>Background: </strong>The paucity of data pertaining to the implementation of the patient blood management (PBM) programme for platelet transfusion for improved patient outcomes with minimal risks motivated this study. The study aimed to implement an effective PBM programme for platelet transfusion therapy among haemato-oncology patients evaluating transfusion appropriateness and educational intervention for dedicated platelet transfusion practitioners (PtP).</p><p><strong>Study designs and methods: </strong>A quasi-experimental study was conducted for 1 year after Institutional ethics committee (IEC) (as shown in Annexure I) which included pre-intervention, intervention and post-intervention phases for four months each. The study involved platelet auditing, online survey questionnaires, educational intervention for the platelet transfusion practitioners (PtP) and feedback for user satisfaction.</p><p><strong>Results: </strong>The platelet audit showed statistically significant improvement (chi-square test, p < 0.05) in transfusion appropriateness, completeness of the forms filled, number of single donor apheresis procedures, ABO compatible transfusions and thereby reduction in platelet refractory cases during the post-intervention phase compared to the pre-intervention. The online survey showed improvement in self perceived knowledge and practice for all the stakeholders during the post-intervention period.</p><p><strong>Conclusion: </strong>The introduction of platelet transfusion practitioners and the educational sessions they underwent, had a significant impact in achieving transfusion appropriateness for platelet therapy and they gained the ability to prioritise medical emergencies, optimise platelet inventory management and minimise wastage. Educational interventions have enhanced practitioners knowledge and sensitised them to adhere to standard evidence-based platelet transfusion guidelines.</p>","PeriodicalId":23306,"journal":{"name":"Transfusion Medicine","volume":" ","pages":"165-174"},"PeriodicalIF":1.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145178923","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":"All blood discard does not amount to blood wastage-A critical technical reappraisal.","authors":"Karan Kumar, Priyadarsini Jayachandran Arcot, Suchet Sachdev, Aarushi Sahni, Sangeeta Kumari, Ratti Ram Sharma","doi":"10.1111/tme.70031","DOIUrl":"10.1111/tme.70031","url":null,"abstract":"<p><strong>Background: </strong>Blood centres, as part of their routine operations, generate various forms of waste during the collection-to-transfusion continuum. However, not all discarded blood components equate to 'wastage'.</p><p><strong>Methods: </strong>A critical technical appraisal distinguishing blood discard (necessary and regulatory-compliant) from blood wastage (preventable and avoidable) was done.</p><p><strong>Results: </strong>We propose clear operational definitions and introduce refined metrics such as blood discard rate (BDR), blood wastage rate (BWR) and total discard rate (TDR) to ensure accurate reporting. The concept of 'all-cause blood discard' encompassing both justified discards and true wastage is emphasised.</p><p><strong>Conclusion: </strong>Misinterpretation of data on discarding as wastage by technical personnel, policymakers, media and the public at large can lead to a trust deficit in transfusion services. Adoption of these distinctions and metrics will improve transparency, resource management and public confidence in blood services.</p>","PeriodicalId":23306,"journal":{"name":"Transfusion Medicine","volume":" ","pages":"194-198"},"PeriodicalIF":1.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145252799","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":"Rare combination of anti-In^b and anti-D in pregnancy: Challenges in diagnosis and transfusion management.","authors":"Naveen Reddy Ambati, Abhishekh Basavarajegowda, Aparna Krishna, K M Hari Priya, Dibyajyoti Sahoo","doi":"10.1111/tme.70051","DOIUrl":"10.1111/tme.70051","url":null,"abstract":"","PeriodicalId":23306,"journal":{"name":"Transfusion Medicine","volume":" ","pages":"205-208"},"PeriodicalIF":1.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145726394","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 ordering pattern following the introduction of a transfusion procedure based on haemoglobin concentration and anaemia symptoms: A retrospective study.","authors":"Julia Lipina, Piotr F Czempik","doi":"10.1111/tme.70019","DOIUrl":"10.1111/tme.70019","url":null,"abstract":"<p><strong>Introduction: </strong>Implementation of transfusion guidelines might be poor due to a lack of awareness and strong practice habits. The study aimed to evaluate the impact of a new guideline-based, locally adjusted transfusion procedure on physicians' ordering patterns in a large academic medical centre.</p><p><strong>Materials and methods: </strong>The study was a single-centre, retrospective study, analyzing period between January 2022 and December 2023. The study period was divided into three phases according to the procedure introduction: pre-introduction (January 2022-June 2022), introduction (July 2022-December 2022) and post-introduction (January 2023-December 2023, subdivided into 6-month periods). The new procedure was aimed at adult non-bleeding patients. Data on red blood cell (RBC) transfusions were obtained from a blood bank inventory and electronic health records. The appropriateness of transfusions was assessed against the newly introduced RBC procedure.</p><p><strong>Results: </strong>During the study period, 2413 out of 3686 (65.5%) RBCs were transfused for the indication of \"anaemia\". The number of transfused RBCs between 2022 and 2023 decreased by 467 (32.4%) units. The appropriateness of RBC transfusions increased from 53.6% in the pre-introduction phase to 79.1% by the end of the post-introduction phase. There was a decrease in median pre- and post-transfusion haemoglobin (Hb) concentration, from 73 (IQR 66-78) and 91 (IQR 80-99) to 67 (IQR 60-73) and 84 (IQR 75-93) g L^-1, respectively. The post-introduction phase showed sustained improvement in the appropriateness of RBC transfusions.</p><p><strong>Conclusions: </strong>The newly implemented RBC transfusion procedure, based on haemoglobin concentration and anaemia symptoms, supported by specific transfusion indications integrated into the computerised physician order entry system, resulted in a significant decrease in transfusions and an increase in appropriate transfusions. This improvement was sustained in the long term.</p>","PeriodicalId":23306,"journal":{"name":"Transfusion Medicine","volume":" ","pages":"133-141"},"PeriodicalIF":1.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13077419/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145070528","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":"Perinatal clinical management of a rare AB_h variant blood group.","authors":"Aritri Mandal, Laura Eastwood, Shane Grimsley, Louise Tilley, Clare Samuelson","doi":"10.1111/tme.70035","DOIUrl":"10.1111/tme.70035","url":null,"abstract":"<p><strong>Background: </strong>The H antigen, precursor of the A and B blood groups, is a high-prevalence antigen. Very few H antigen-negative (H-) blood donors are available in the United Kingdom.</p><p><strong>Case presentation: </strong>We present the case of a second pregnancy in a 28-year-old woman with the very rare AB_h phenotype, and the presence of anti-H, anti-A and anti-B. Only H- (O_h) and AB_h phenotype red cells were compatible. Given the rarity of individuals with these phenotypes, there were insufficient compatible red cell units for management of a major antepartum or postpartum haemorrhage. For this high-risk pregnancy, meticulous multidisciplinary team (MDT) planning took place between haematologists, obstetricians, anaesthetists, hospital laboratory staff and multiple teams within National Health Service Blood and Transplant including the National Frozen Blood Bank, Rare Donor Team and Red Cell Immunohaematology Laboratories. The MDT produced a birth management plan for various eventualities where blood transfusion may have been required. This process included the creation of our hospital's first vaginal cell salvage policy. A successful routine vaginal delivery was managed without transfusion.</p><p><strong>Conclusion: </strong>This case highlights the optimal care of a woman with an extremely rare blood group in pregnancy. The principles of management described here are also more widely applicable to women in whom transfusion is contraindicated, undeliverable or declined for other reasons.</p>","PeriodicalId":23306,"journal":{"name":"Transfusion Medicine","volume":" ","pages":"199-204"},"PeriodicalIF":1.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13077420/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145347471","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":"Intravenous immunoglobulin weaning evaluation with zero-shot large language model classification.","authors":"Emily Burton, Shrirajh Satheakeerthy, Rudy Goh, Brandon Stretton, Andrew E C Booth, Christina Gao, Nivida Dixit, Sarah Howson, Shaun Evans, Oliver Kleinig, Joe Lu, Joshua Kovoor, Aashray Gupta, Weng Onn Chan, Andrew Zannettino, Keith McNeil, Chantal Baldwin, Wilson Vallat, John Maddison, Samuel Gluck, James Triplett, Toby Gilbert, Stephen Bacchi","doi":"10.1111/tme.70020","DOIUrl":"10.1111/tme.70020","url":null,"abstract":"<p><strong>Objectives: </strong>The aims of this study were to determine the performance of a large language model (LLM) with a zero-shot strategy for the classification of several factors relevant to the consideration of intravenous immunoglobulin (IVIg) weaning.</p><p><strong>Background: </strong>In many cases, IVIg should be weaned to prevent excessive resource utilisation and adverse effects.</p><p><strong>Methods and materials: </strong>A cohort study was conducted examining neurology outpatients receiving regular IVIg in a 2-month period. Prespecified criteria were used to determine how many individuals were suitable for IVIg weaning. A LLM was applied to determine the level of performance with which the model could provide answers to the prespecified criteria.</p><p><strong>Results: </strong>In the inclusion period, 14 individuals were identified and four patients fulfilled the criteria for possible IVIg weaning. The total annual cost saving with IVIg weaning was conservatively estimated to be $84702.20 (1433.9 g of IVIg annually). The LLM achieved an overall classification accuracy of 78.6% (11/14) when a rule-based approach was applied to the individual criteria that it extracted from notes.</p><p><strong>Conclusion: </strong>Further research is indicated to determine the frequency with which patients suitable for IVIg weaning are identified at other centres and the degree to which LLM may be able to assist with this process.</p>","PeriodicalId":23306,"journal":{"name":"Transfusion Medicine","volume":" ","pages":"79-83"},"PeriodicalIF":1.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145446032","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":"Improvising neonatal thrombocytopenia management: Insights from split, volume-reduced, single-donor apheresis platelets (NeoVRs-SDAP).","authors":"Yashaswi Dhiman, Saikat Patra, Chinmay Chetan, Manish Raturi, Shoham Majumder, Rolika Nautiyal, Tushar Bhardwaj, Dushyant Singh Gaur","doi":"10.1111/tme.70024","DOIUrl":"10.1111/tme.70024","url":null,"abstract":"<p><strong>Introduction: </strong>Thrombocytopenia is common in neonates, managed with platelet transfusions at defined dose. The product type varies from neonatal-specific units using platelet additive solutions to adult products split into multiple paediatric units. In low-middle-income countries, whole blood-derived random donor platelets (RDP) are common while western countries use split adult single donor apheresis platelets (SDAP). We aimed to assess preliminary effectiveness of split, volume-reduced single donor apheresis platelets (NeoVRs-SDAP) in neonatal thrombocytopenia and observe early post-transfusion outcomes.</p><p><strong>Methods: </strong>Study was conducted from August 2024 to January 2025 at a tertiary healthcare centre. Persistent thrombocytopenic neonates admitted to the NICU were transfused with NeoVRs-SDAP prepared using Spectra Optia® with modified program yielding an adult dose (300 × 10⁹) in a reduced 100 mL of product volume. These were split into 2-5 aliquots for transfusion. Post-transfusion platelet increments and percentage recovery were assessed after 20-24 h.</p><p><strong>Results: </strong>Thirteen neonates' 77% preterm, 69.2% VLBW with sepsis received 46 NeoVRs-SDAP. 10 mL of this product contained nearly 3 times more platelets than RDP and 1.5 times more than adult SDAP of same volume. The mean transfused dose was 70.56 ± 14.21 × 10⁹ platelets. Median platelet increment was 64 500/μL versus 15 477/μL for RDP (p < 0.001). Platelet recovery ranged from 7.5%-52.5%. Split products reduced donor exposure by 56.5%. Survival was 62%, without any transfusion-related adverse events.</p><p><strong>Conclusion: </strong>NeoVRs-SDAP may be potential alternative in persistent neonatal thrombocytopenia, offering better increments and recovery, reduced donor exposure, and leukoreduction. Further RCTs comparing NeoVRs-SDAP and RDP are recommended.</p>","PeriodicalId":23306,"journal":{"name":"Transfusion Medicine","volume":" ","pages":"72-78"},"PeriodicalIF":1.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145551010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A framework checklist for implementing bedside electronic transfusion systems.","authors":"Josephine McCullagh, Suzanne Makki, Kirsty Hancock, Catherine Booth, Louise Bowles, Ollie Djurdjevic, Karen Farrar, Claudio Geraci, Sara Hammond, Helinor Mcaleese, Michael F Murphy, Florence Oyekan, Laura Green","doi":"10.1111/tme.70042","DOIUrl":"10.1111/tme.70042","url":null,"abstract":"<p><strong>Background: </strong>Every time a unit of blood is given to a patient, it is essential that all steps in the transfusion pathway are executed correctly to ensure that the right blood is transfused to the right patient. Bedside transfusion checks at the point of sampling for compatibility testing, sample labelling and blood administration are an essential part of the delivery of safe transfusion and avoidance of the wrong blood being given, which can have serious consequences. Implementation of bedside electronic transfusion systems that use barcode matching of patients' wristbands and blood units is now recommended as the best practice to ensure patients' safety in transfusion. However, there is limited information in the literature to guide hospitals on what aspects they should consider when introducing a bedside electronic transfusion system.</p><p><strong>Aims and methods: </strong>This paper aims to support hospitals considering implementing a bedside electronic transfusion system by providing a comprehensive checklist addressing planning, stakeholder coordination, device integration, and compliance with national standards and safety requirements.</p><p><strong>Results: </strong>The checklist is based on the experiences of two NHS Trusts in the UK and aims to provide organisations with a resource to support this change and reduce avoidable delays.</p>","PeriodicalId":23306,"journal":{"name":"Transfusion Medicine","volume":" ","pages":"3-9"},"PeriodicalIF":1.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12882753/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145523906","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}