Vox Sanguinis最新文献

{"title":"Securing blood in crisis: Lessons from Japan's earthquake disasters and evolving preparedness.","authors":"Nelson H Tsuno, Hitoshi Okazaki, Yutaka Nagura, Yoshikazu Maruyama, Yoichi Koyama, Takeshi Ishii, Takaichi Otokuni, Noriko Namba, Tomohiko Sato, Shigeyoshi Makino, Kazuo Muroi, Shigeki Miyata, Shuichi Kino","doi":"10.1111/vox.70208","DOIUrl":"10.1111/vox.70208","url":null,"abstract":"<p><strong>Background and objectives: </strong>Japan's geographical and climatic vulnerability to natural disasters, including earthquakes, tsunamis and typhoons, presents significant challenges to maintaining a stable blood supply during emergencies. This review synthesizes lessons learned from three major earthquakes-the 1995 Great Hanshin-Awaji, the 2011 Great East Japan and the 2016 Kumamoto earthquakes-to inform disaster preparedness and blood service resilience.</p><p><strong>Materials and methods: </strong>Key measures implemented by the Japanese Red Cross Blood Services (JRCBS) were examined, with a focus on systemic challenges, disaster response protocols and technological innovations that enhanced service continuity during and after large-scale disasters.</p><p><strong>Results: </strong>The implementation of the Wide-Area Management System (WAMS) in 2012 enabled centralized testing, processing and real-time national inventory management, facilitating efficient redistribution of blood products during crises. Communication disruptions due to reliance on traditional telephone and fax lines remain a challenge. A recently introduced web-based ordering system has improved operational reliability. Transport logistics are also vulnerable; contingency strategies involving maritime routes, helicopters and drones are being explored. A potential large-scale earthquake beneath the Tokyo Metropolitan Area underscores the urgency of enhancing coordination with hospitals and developing multi-modal transport plans. JRCBS operational continuity guidelines provide structured protocols to ensure rapid recovery if key facilities are incapacitated.</p><p><strong>Conclusion: </strong>Japan's experience highlights the importance of integrated management systems, robust communication infrastructure and diversified transport options in maintaining blood supply during disasters. These strategies offer a model for enhancing blood service resilience in disaster-prone regions globally.</p>","PeriodicalId":23631,"journal":{"name":"Vox Sanguinis","volume":" ","pages":"1513-1524"},"PeriodicalIF":1.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146166917","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":"How to deal with emergency preparedness.","authors":"W Martin Smid, Claudia S Cohn, Agneta Wikman, Nelson H Tsuno","doi":"10.1111/vox.70355","DOIUrl":"10.1111/vox.70355","url":null,"abstract":"","PeriodicalId":23631,"journal":{"name":"Vox Sanguinis","volume":" ","pages":"1491-1493"},"PeriodicalIF":1.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148875927","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 supply continuity and emergency preparedness in natural and man-made disasters and in armed conflicts-The Nordic perspectives.","authors":"Agneta Wikman, Christian Medby, Denise Bäckström, Jarkko Ihalainen, Markus Lyyra, Patrik Nimberger-Hansson, Geir Strandenes, Jouni Lauronen, Torunn Apelseth","doi":"10.1111/vox.70242","DOIUrl":"10.1111/vox.70242","url":null,"abstract":"<p><p>Recent events have highlighted the urgent need for comprehensive blood preparedness plans at local, regional, national and cross-border levels within the Nordic countries. This article outlines the perspectives and strategies related to blood preparedness in Norway, Sweden and Finland, in the context of emergencies, disasters and armed conflicts. Norway, Sweden and Finland share long borders and similar geography, including vast rural areas with limited health care resources. Finland operates a centralized blood service, whereas Norway and Sweden maintain decentralized systems, with regional authorities responsible for their own blood supply. All three countries adhere to a total defence concept, wherein military forces depend on civilian transfusion services. In mass casualty events, the demand for transfusion services to provide urgent blood and blood components is expected to be high. Haemorrhage remains the leading cause of preventable prehospital death in trauma cases, and the availability of blood products in prehospital settings is critical in both civilian and military environments. Key priorities identified include: establishing stockpiles of shelf-stable blood products, developing surge capacity plans for rapid upscaling of blood collection and whole blood and component production, conducting joint training and exercises involving blood establishments, transfusion services, hospitals and military units, and collaboration in a pilot cross-border initiative-the Nordic Blood Preparedness Project-in northern Norway, Sweden and Finland, aimed at harmonizing regulations and procedures during emergencies. To effectively save lives during disasters and armed conflicts, it is essential to have well-documented and operational blood preparedness plans in place.</p>","PeriodicalId":23631,"journal":{"name":"Vox Sanguinis","volume":" ","pages":"1536-1544"},"PeriodicalIF":1.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13649365/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147475856","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":"Rates of severe acute respiratory syndrome coronavirus 2 infection in a highly exposed South African blood donor cohort, 2022-2023.","authors":"Marion Vermeulen, Ronel Swanevelder, Cordelia Mmenu, Tinus Brits, Josephine Mitchel, Eduard Grebe","doi":"10.1111/vox.70368","DOIUrl":"https://doi.org/10.1111/vox.70368","url":null,"abstract":"<p><strong>Background and objectives: </strong>A cohort of South African repeat blood donors was established to leverage the repeated presentation of blood donors for longitudinal serological surveillance of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections and reinfection incidence in a highly exposed population.</p><p><strong>Materials and methods: </strong>The prospective cohort was followed from January 2022 to December 2023, with a total of 7459 blood samples from 2155 donors captured and tested using the Roche anti-nucleocapsid (N) and anti-spike (S) total immunoglobulin antibody (Ab) assays. First infections were identified by anti-N seroconversion and reinfections by anti-N boosting (≥1.5-fold) in longitudinal testing, using a novel method to reduce misclassification from prolonged Ab maturation. Incidence was estimated, and correlates of infection were assessed using multivariable Cox proportional hazards regression.</p><p><strong>Results: </strong>A total of 948 infection events were observed during the study period-280 first infections and 668 reinfections, with up to 4 serial infection events in one donor. Total infection incidence was estimated at 64.2 infections/100 person-years (95% confidence interval [CI]: 60.2-68.4). In multivariable models, quartile of anti-N reactivity was a strong correlate of protection against reinfection with an adjusted hazard ratio of 0.26 (95% CI: 0.18-0.38).</p><p><strong>Conclusion: </strong>Longitudinal blood donor serosurveillance allowed quantification of continuing SARS-CoV-2 transmission after most individuals had been previously infected in the 2 years after relaxation of non-pharmaceutical interventions.</p>","PeriodicalId":23631,"journal":{"name":"Vox Sanguinis","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149040758","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":"Prospective multi-centre haemovigilance of amotosalen and ultraviolet A-treated platelets and plasma in routine clinical use.","authors":"Magdalena Łętowska, Anna Krukowska, Dariusz Piotrowski, Zofia Przybylska, Konrad Rosskopf, Angelo Ostuni, Margherita Giannoccaro, Rossella Procacci, Christine Ernst, Johannes Irsch, Laurence Corash, Richard J Benjamin, Kathy Liu, Linh Dinh, John P Pitman","doi":"10.1111/vox.70369","DOIUrl":"10.1111/vox.70369","url":null,"abstract":"<p><strong>Background and objectives: </strong>Amotosalen/ultraviolet A light (A/UVA) pathogen-reduced platelets and plasma have been approved for clinical use in Europe since 2003 and 2006, respectively. Cross-sectional safety haemovigilance (HV) studies have been conducted in 29 hospitals in 15 European countries since 2003. This report describes the most recent safety and utilization parameters for pathogen-reduced platelets and plasma at three European hospitals between 2019 and 2025.</p><p><strong>Materials and methods: </strong>All consecutive patients who received at least one A/UVA platelet or plasma component at participating hospitals in Austria, Poland and Italy were enrolled in a prospective, non-interventional HV study. Patient medical records were reviewed for transfusion reactions (TRs) within 24 h of each transfusion and for serious TRs within 7 days of transfusion. Descriptive per-patient and per-transfusion statistics were calculated for component use and safety variables at each site.</p><p><strong>Results: </strong>A total of 516 adults received 5331 A/UVA components. Of these, 475 patients received 3424 platelet components (PCs), 87 patients received 1907 plasma components and 46 patients received both components. Most patients received prophylactic platelet transfusions for haematology-oncology indications. Eight TRs were reported in seven recipients (six TRs in five platelet recipients; two TRs in two plasma recipients). All reactions were non-serious and consisted mainly of febrile non-haemolytic and allergic reactions; one instance of transfusion-associated dyspnoea was reported after platelet transfusion. No transfusion-related acute lung injury (TRALI), transfusion-associated circulatory overload (TACO), transfusion-transmitted infection, transfusion-associated graft-versus-host disease (TA-GVHD) or transfusion-related deaths were observed.</p><p><strong>Conclusion: </strong>A/UVA platelets and plasma were well tolerated in routine clinical use in three European centres with low TR rates and stable utilization.</p>","PeriodicalId":23631,"journal":{"name":"Vox Sanguinis","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149040775","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":"Right dose, right patient: Clinician-led implementation of a national cross-specialty strategy for immunoglobulin stewardship.","authors":"Claire Bethune, Michael P Lunn, Mark Foster, Rob Hollingsworth, Darryn Boardman, Siraj A Misbah","doi":"10.1111/vox.70373","DOIUrl":"https://doi.org/10.1111/vox.70373","url":null,"abstract":"<p><strong>Background and objectives: </strong>Global demand for immunoglobulin (Ig) continues to rise, driven by expanding clinical indications and limited plasma supply. In England, use increased annually despite earlier demand-management efforts, with substantial regional variation and prescribing for indications lacking evidence of benefit. This study reports the outcomes of a national, clinician-led Ig stewardship strategy implemented between 2018 and 2025.</p><p><strong>Materials and methods: </strong>National Health Service England introduced a three-part programme comprising a national evidence-based commissioning policy, establishment of 21 Sub-Regional Immunoglobulin Assessment Panels, and enhancement of the National Immunoglobulin Database. The strategy embedded cross-specialty clinical review, standardised approval processes, strengthened dosing guidance and improved national data capture. Outcomes were assessed through national audits, retrospective studies and analysis of usage trends.</p><p><strong>Results: </strong>All panels were operational by 2021, reporting improved governance, multidisciplinary collaboration and coordinated responses to supply pressures. Panel-led reviews enabled safe treatment withdrawal or dose reduction in selected long-term patients. Non-evidence-based prescribing declined from 8.5% to 1.7%. National Ig use fell by 12% over the first 5 years and, despite a recent increase in demand, Ig use in England in 2025 was almost half of the projected use had the stewardship strategy not been implemented.</p><p><strong>Conclusion: </strong>A nationally coordinated, clinician-led stewardship model based on rigorous evidence-based peer review can reduce inappropriate Ig use, optimise dosing, and improve equity of access while delivering substantial cost savings.</p>","PeriodicalId":23631,"journal":{"name":"Vox Sanguinis","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149031394","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":"Hemorrhagic shock in intensive care: Variation in blood product administration during resuscitation.","authors":"Merijn C Reuland, Senta Jorinde Raasveld, Dave A Dongelmans, Paul W G Elbers, Marcella C A Müller, Alexander P J Vlaar","doi":"10.1111/vox.70380","DOIUrl":"https://doi.org/10.1111/vox.70380","url":null,"abstract":"<p><strong>Background and objectives: </strong>Hemorrhagic shock requires timely resuscitation to maintain organ perfusion and hemostasis until source control is achieved. Most resuscitation strategies have been studied outside the intensive care unit (ICU), and optimal approaches in critically ill patients remain unclear. With this study, we aim to characterize variation in resuscitation practices for hemorrhagic shock with (near-)massive transfusion across public ICU datasets.</p><p><strong>Materials and methods: </strong>Red blood cell (RBC) transfusions were extracted from four public ICU datasets (AmsterdamUMCdb, HiRID, MIMIC-IV, and SICdb). Transfusions were stratified by 24-h intensity: near-massive (6-10 RBC units) and massive (≥10 units). Clinical parameters from 48 h before and after transfusion were analyzed. Continuous variables were compared using Kruskal-Wallis tests, with Dunn's post hoc tests and Bonferroni correction.</p><p><strong>Results: </strong>In near-massive transfusion, median nadir hemoglobin differed across datasets: AmsterdamUMCdb 6.6 g/dL (interquartile range [IQR], 5.6-7.7), HiRID 6.8 (6.1-7.3), MIMIC-IV 7.2 (6.2-8.0), and SICdb 6.2 (5.5-6.7) (p < 0.001). In massive transfusion, nadir hemoglobin was 6.4 (5.6-7.1), 6.9 (6.3-7.3), 7.1 (6.0-8.1), and 5.3 (4.3-6.3), respectively (p < 0.001). Post-resuscitation hemoglobin also differed: 9.5 (8.7-10.3), 9.1 (8.4-9.6), 10.4 (9.4-11.6), and 7.7 (6.9-8.5) (p < 0.001). Crystalloid use varied widely (3350-12,865 mL, p < 0.001), as did the mean arterial pressure at transfusion (60-76 mmHg, p < 0.001).</p><p><strong>Conclusion: </strong>Resuscitation practices vary substantially across ICU datasets, including differences in hemoglobin levels, fluid administration, and hemodynamic status at transfusion. These findings highlight the heterogeneity of real-world resuscitation strategies in hemorrhagic shock.</p>","PeriodicalId":23631,"journal":{"name":"Vox Sanguinis","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149031292","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":"Rotational thromboelastometry-guided transfusion in acute trauma: Less plasma, greater precision.","authors":"Radovan Dinić, Almira Šabani, Biljana Životić, Neda Horvacki, Nenad Mladenović, Jasmina Grujić","doi":"10.1111/vox.70378","DOIUrl":"https://doi.org/10.1111/vox.70378","url":null,"abstract":"<p><strong>Background and objectives: </strong>Effective transfusion management is essential in trauma patients with active bleeding. In this study, we aimed to evaluate the association between point-of-care rotational thromboelastometry (ROTEM)-guided management, blood-component utilization, and clinical outcomes.</p><p><strong>Materials and methods: </strong>We conducted a retrospective comparative cohort study of 200 trauma patients with active bleeding admitted between October 2023 and March 2025. One-hundred patients received ROTEM-guided management and 100 were managed using conventional coagulation tests. Blood-component utilization during the first 24 h and clinical outcomes were analyzed using multivariable models adjusted for relevant baseline variables.</p><p><strong>Results: </strong>ROTEM-guided management was associated with lower fresh frozen plasma utilization (adjusted incidence rate ratio [aIRR] 0.36, 95% confidence interval [CI]: 0.24-0.55), higher cryoprecipitate utilization (aIRR 1.92, 95% CI: 1.40-2.66), and shorter intensive care unit (ICU) stay. Adjusted red blood cell (RBC) and platelet utilization did not differ between groups. Maximum clot firmness in the fibrin-based thromboelastometry assay correlated strongly with fibrinogen concentration, and clot formation time in the extrinsically activated thromboelastometry assay correlated inversely with platelet count. Differences in transfusion-related complications and in-hospital mortality were not statistically significant.</p><p><strong>Conclusion: </strong>ROTEM-guided management was associated with lower plasma utilization, higher cryoprecipitate utilization, and shorter ICU stay. Given the retrospective, non-randomized design and low RBC exposure, these findings should not be interpreted as evidence that ROTEM reduced bleeding severity or RBC requirements, particularly in massive-transfusion populations. Prospective studies in trauma patients with massive hemorrhage are required to evaluate the utility of ROTEM in guiding specific hemostatic blood-product transfusions.</p>","PeriodicalId":23631,"journal":{"name":"Vox Sanguinis","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149031361","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":"Implementation of a patient blood management optimization flowchart for preoperative anemia using automated alerts: An 8-month follow-up.","authors":"Bas Calcoen, Morane Swennen, Birgit Loveniers, Ann-Marie Matthys, Tom Vauterin, Jan Van Droogenbroeck, Helena Devos, Jan Emmerechts, Barbara Cauwelier","doi":"10.1111/vox.70370","DOIUrl":"https://doi.org/10.1111/vox.70370","url":null,"abstract":"<p><strong>Background and objectives: </strong>Preoperative anemia (PA) and thrombocytopenia (PT) are associated with increased perioperative morbidity and mortality. We implemented an automated flowchart integrating automated diagnostic reflex testing with electronic notifications to the preoperative unit (POU) triggered by hemoglobin (Hb) concentration <10 g/dL and/or platelet count (PLT) <75 × 10⁹/L.</p><p><strong>Materials and methods: </strong>In this retrospective observational study, compliance and management of PA and PT were evaluated after routine implementation of the flowchart.</p><p><strong>Results: </strong>The flowchart was initiated for 41 patients (1.5% of POU orders). Hb was 8-10 g/dL in 34 patients and <8 g/dL in four patients. Three patients had PLT <75 × 10⁹/L with Hb >10 g/dL. At least one recommended action was undertaken in 88%, most frequently including documentation in the electronic medical record, communication with treating clinicians or referral to a hematologist. Etiology was established in 25 patients, with isolated iron deficiency as the most common cause of PA. Preoperative correction of anemia was performed in 26/41 patients and was primarily non-transfusion-based. Seven patients received transfusion therapy. Surgery was postponed in one case.</p><p><strong>Conclusion: </strong>A high compliance with the automated flowchart was observed and guided diagnostic and therapeutic interventions. Further optimization may improve standardized perioperative management of PA and PT.</p>","PeriodicalId":23631,"journal":{"name":"Vox Sanguinis","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149026007","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":"Importance of children's literature to introduce blood donation in early childhood.","authors":"Samantha Senavirathna","doi":"10.1111/vox.70379","DOIUrl":"https://doi.org/10.1111/vox.70379","url":null,"abstract":"","PeriodicalId":23631,"journal":{"name":"Vox Sanguinis","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149013032","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}