Vox Sanguinis最新文献

{"title":"Barriers and enablers to non-remunerated plasma donation: A meta-synthesis of the qualitative literature using the theoretical domains framework.","authors":"Cole Etherington, Ashutosh Upreti, Amira Brehaut, Megan Bennett, Maximillian Labrecque, Kyle Rubini, Emily Gibson, Manavi T Maharshi, Amelia Palumbo, Samantha Meyer, Terrie Foster, Joyce Dogba, Risa Shorr, Vivian Welch, Justin Presseau, Elisabeth Vesnaver","doi":"10.1111/vox.70312","DOIUrl":"10.1111/vox.70312","url":null,"abstract":"<p><strong>Background and objectives: </strong>Plasma is an essential component of therapies used to treat immune deficiencies, coagulation disorders and other serious conditions. Despite increasing global demand, many countries, including Canada, remain dependent on imported plasma products. Understanding the psychological, social and structural factors influencing plasma donation is critical to designing strategies that strengthen domestic supply. This meta-synthesis aimed to identify barriers and enablers to plasma donation using the theoretical domains framework (TDF).</p><p><strong>Materials and methods: </strong>A systematic search of Medline, Embase, Scopus, PsycINFO and CINAHL (up to August 2023) identified qualitative studies describing experiences and perceptions of plasma donation. Using directed content analysis, qualitative data were coded to TDF domains, and belief statements summarizing barriers and enablers were generated and synthesized narratively.</p><p><strong>Results: </strong>Twenty studies (n = 1310 participants) conducted in non-remunerated contexts met inclusion criteria. A total of 131 belief statements were mapped to 13 of 14 TDF domains. The largest number occurred in Environmental Context and Resources (e.g., accessibility, scheduling, staff support), followed by Knowledge, Social/Professional Role and Identity, Social Influences, and Emotion. Barriers centred on logistical constraints, limited understanding and negative emotional responses, whereas enablers reflected trust in institutions, supportive staff, identity as a donor and feelings of pride and altruism.</p><p><strong>Conclusion: </strong>Plasma donation behaviour is shaped by interacting informational, emotional, social and structural determinants. Addressing practical barriers while leveraging enablers such as donor identity, social support and transparent communication may enhance recruitment and retention. Our findings can inform the design of theory-based, donor-centred interventions to strengthen national plasma collection systems.</p>","PeriodicalId":23631,"journal":{"name":"Vox Sanguinis","volume":" ","pages":"1290-1300"},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13563490/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148377395","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":"Current practices for recruitment and retention of plasma donors across 17 countries: A short report.","authors":"Marloes L C Spekman, Eva-Maria Merz","doi":"10.1111/vox.70314","DOIUrl":"10.1111/vox.70314","url":null,"abstract":"<p><strong>Background and objectives: </strong>Donated plasma is required for the manufacture of plasma medicines, which are essential for prophylaxis and patient treatment. Because of social, geopolitical or economic challenges, this important raw material can become at risk of supply interruption, leading to a lack of essential products for patients. The plasma supply chain depends on the willingness of individuals to donate. To increase the number of donors and donations, collection institutes use various information, recruitment and retention strategies to increase individual willingness to repeatedly donate plasma. In this short report, we provide an overview of current (plasma) donor recruitment and retention strategies across 17 European countries.</p><p><strong>Materials and methods: </strong>An online survey, consisting of questions on information, communication, recruitment and retention efforts, was sent to collection institutes via e-mail. Between July and October 2023, 17 respondents replied to the survey on behalf of their organization.</p><p><strong>Results: </strong>The majority of organizations (10) were governmental or state public bodies, while 5 were non-governmental or non-state not-for-profit organizations and 2 were hospital-based. All 17 organizations collect whole blood, 16 collect platelets, 12 collect plasma and 7 collect combinations of blood products. The majority (nine) indicated they do not collect enough to meet national demand and are thus (partially) dependent on plasma from other countries.</p><p><strong>Conclusion: </strong>While blood establishments currently employ a broad portfolio of strategies, varying and targeted content and different media and channels to reach their audiences, there is very limited data and knowledge available on the evaluation, effectiveness and impact of these strategies.</p>","PeriodicalId":23631,"journal":{"name":"Vox Sanguinis","volume":" ","pages":"1430-1435"},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13563481/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148259549","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":"Fibrinogen recovery in cryoprecipitate prepared from thawed plasma stored for 5 days post-thaw.","authors":"Anna Yoshimine, Hideaki Matsuura, Yuya Ishihara, Yurina Yoshida, Yuri Kato, Yohei Sakai, Rie Nakagawa, Hiroki Doi, Yasuo Miura","doi":"10.1111/vox.70319","DOIUrl":"10.1111/vox.70319","url":null,"abstract":"<p><strong>Background and objectives: </strong>Thawed plasma (TP) can be stored for several days to facilitate rapid emergency transfusion. However, in Japan, the 24-h post-thaw shelf life limit raises concerns about plasma wastage. We evaluated fibrinogen recovery in cryoprecipitate prepared from TP that was stored for 5 days after thawing.</p><p><strong>Materials and methods: </strong>Cryoprecipitate was prepared using the one-step method (OSM, n = 12), two-step method (TSM, n = 15) and the TP stored for 5 days post-thaw (n = 15). Cryoprecipitate was prepared using three protocols: OSM, in which fresh frozen plasma (FFP) was thawed once at 2-6°C for 24-30 h; TSM, in which FFP was thawed at 2-6°C, refrozen at -30°C and then thawed again at 2-6°C for 24-30 h; and TP, in which FFP was stored at 2-6°C for 5 days after initial thawing, then refrozen and thawed as in the TSM. All samples were centrifuged after the final thawing to collect the cryoprecipitate. Fibrinogen recovery was calculated from fibrinogen concentrations, and bacteriological testing was performed on the cryoprecipitate prepared from TP.</p><p><strong>Results: </strong>Fibrinogen recovery differed significantly among the groups (p < 0.001), with the highest recovery in the TSM group, followed by the TP and OSM groups. Recovery in the TP group was significantly higher than that in the OSM group. No bacterial growth was detected in any of the samples.</p><p><strong>Conclusion: </strong>Using stored TP to prepare cryoprecipitate could offer a more efficient way to manage resources while supporting emergency transfusion readiness.</p>","PeriodicalId":23631,"journal":{"name":"Vox Sanguinis","volume":" ","pages":"1436-1439"},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13563486/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148303237","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":"International Forum on the Prevention of ABO Incompatible Red Blood Cell Transfusion: Summary.","authors":"Aline Mirrione-Savin, Michael F Murphy, Richard Schäfer, Pierre Tiberghien, Satyam Arora, Seema Dua, Markus M Mueller, Torsten Tonn, Saliou Diop, Moussa Seck, Zainab Al Fana Alarimi, Maha A Badawi, Tomohiko Sato, Aimi Miyajima, Silvano Wendel, Roberta Fachini, Tanya Petraszko, Johnathan Mack, Irene Cuppari, Daniele Prati, María Antonieta Nuñez, Edgardo Saa, Claudia S Cohn, Brian S Engel, Erica Wood, James Daly, Yanli Ji, Yang Zhao, Fanny Angelot Delettre, Veronique Bourcier, Veronica Pons, Andrea Espasa, Willem van der Merwe, Petro-Lize Wessels, Shirley Owusu-Ofori, Dilys John-Teye, Shruthi Narayan, Nicola Swarbrick, Arwa Z Al-Riyami, Nancy Dunbar","doi":"10.1111/vox.70326","DOIUrl":"10.1111/vox.70326","url":null,"abstract":"","PeriodicalId":23631,"journal":{"name":"Vox Sanguinis","volume":" ","pages":"1440-1450"},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13563469/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148680107","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":"Incidence and determinants of red cell alloimmunization and autoimmunization in paediatric thalassaemia: A North Indian cohort study.","authors":"Akshay Paliwal, Satyam Arora, Nita Radhakrishnan, Seema Dua, Anupa Pokhrel, Anuj Singh, Arisha Khan","doi":"10.1111/vox.70304","DOIUrl":"10.1111/vox.70304","url":null,"abstract":"<p><strong>Background and objectives: </strong>Thalassaemia requires lifelong red cell support, which increases the risk of alloimmunization and autoimmunization. This prospective study aimed to determine the incidence of red cell sensitization and investigate the factors influencing sensitization in paediatric thalassaemia patients.</p><p><strong>Materials and methods: </strong>A prospective observational study was conducted from April 2024 to March 2025 on 109 paediatric thalassaemia patients. At every transfusion visit, ABO/RhD typing, direct antiglobulin test and antibody screening were performed. Positive screens underwent antibody identification and provision of antigen-negative units. Demographic variables, transfusion history and product characteristics were analysed to identify significant factors influencing sensitization.</p><p><strong>Results: </strong>Among 109 patients (mean age 6.14 ± 4.98 years), 7.34% (n = 8) developed alloantibodies and 16.51% (n = 18) developed autoantibodies; the overall immune sensitization rate was 23.85%. Rh system antibodies predominated (75%), including anti-D, anti-E, anti-C and anti-Cw. Factors influencing alloimmunization were significantly associated with older age (p = 0.011), RhD negativity (p = 0.02) and age at first transfusion >1 year (p = 0.015). Factors influencing autoimmunization were significantly associated with later initiation of transfusion (p = 0.003). No significant associations were found with gender, ABO group or total transfusion number. Both alloimmunization (18.6 ± 10.5 days) and autoimmunization (21.9 ± 10.8 days) influenced the transfusion intervals.</p><p><strong>Conclusion: </strong>The factors influencing sensitization in paediatric thalassaemia patients were early initiation of transfusion (<1 year), RhD blood group and overall cumulative red cell exposure. Routine antibody screening at every visit and provision of Rh and Kell-matched red cell units are essential to minimize risk and enhance transfusion safety in paediatric thalassaemia patients on regular transfusion.</p>","PeriodicalId":23631,"journal":{"name":"Vox Sanguinis","volume":" ","pages":"1401-1409"},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13563471/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148144717","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":"International survey on the management of IgA deficiency: The BEST Collaborative Study.","authors":"Renée Bazin, Mindy Goldman, Quentin G Eichbaum, Torunn Oveland Apelseth, Catherine Latour, Antoine Lewin, Nancy Robitaille","doi":"10.1111/vox.70311","DOIUrl":"10.1111/vox.70311","url":null,"abstract":"<p><strong>Background and objectives: </strong>Selective immunoglobulin A (IgA) deficiency is the most common human immunodeficiency, affecting approximately 1 in 500-800 individuals of European ancestry. It is defined by a serum IgA level below 7 mg/dL, with normal immunoglobulin G (IgG) and immunoglobulin M (IgM) levels. Since 1968, severe allergic transfusion reactions have been reported in IgA-deficient patients, often linked to anti-IgA antibodies. This led to recommendations for using IgA-deficient blood components in affected individuals. However, due to the rarity of such reactions, standardized and evidence-based guidelines are lacking, while blood services face logistical challenges maintaining registries of IgA-deficient donors and inventories of compatible products.</p><p><strong>Materials and methods: </strong>An international survey was conducted to assess current practices in managing IgA deficiency. The survey explored the frequency of transfusion reactions involving IgA/anti-IgA, detection methods for IgA deficiency and anti-IgA antibodies, reasons for requesting IgA-deficient products, product availability and strategies to facilitate access to IgA-deficient products.</p><p><strong>Results: </strong>Participants from 14 countries/regions across four continents reported a wide variability in defining IgA deficiency, criteria for recommending IgA-deficient products and anti-IgA testing practices.</p><p><strong>Conclusion: </strong>These findings highlight the need for international reference standards and harmonized recommendations to improve the management of IgA-deficient patients. Establishing harmonized best practices and evidence-based guidelines should enhance patient safety and support clinical decision making globally.</p>","PeriodicalId":23631,"journal":{"name":"Vox Sanguinis","volume":" ","pages":"1385-1392"},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13563477/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148219874","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":"Survey of national and regional rare donor programmes regarding Immunoglobulin A deficiency.","authors":"Margaret A Keller, Tanya Powley, Christine Lomas-Francis, Sandra Nance, Thierry Peyrard, Inna Sareneva, Nicole Thornton, Nor Hafizah Ahmad, Eva Alonso-Nogués, M Luisa Antelo, Aida Azcárate, Enric Casanovas, Lilian Castilho, Gwen Clarke, Elena Beatrice Coluccio, Roberta Fachini, Dolores Fernández, Gema Fornés, Tor Hervig, Marina Izak, Luís Larrea, Sofia Lejon-Crottet, Irene Lucea, Beate Mayer, Debbie McLinden, Jorge Monge-Ruiz, Eduardo Muniz Diaz, Nuria Nogues, Cinzia Paccapelo, Ruwayda Soeker, Francesca Truglio, Chiara Vendramin, Naoko Watanabe-Okochi, Christof Weinstock, Matthew Yan, Ziyan Zhu, Linda Bodecker Zingmark, Vered Yahalom","doi":"10.1111/vox.70313","DOIUrl":"10.1111/vox.70313","url":null,"abstract":"<p><strong>Background and objectives: </strong>Immunoglobulin A (IgA) deficiency is common and typically defined as <5-7 mg/dL. Individuals with absolute IgA deficiency (aIgA def) have extremely low levels, can produce allo-anti-IgA and may be at risk for anaphylactic transfusion reactions. There is no globally-accepted definition of aIgA def. We sought to determine how rare donor programmes define IgA deficiency (IgA def), how they test for it and how they manage requests for aIgA def blood products.</p><p><strong>Materials and methods: </strong>We queried rare blood donor programmes that participate in the International Society of Blood Transfusion Working Party on Rare Donors using an email survey sent to 39 members representing 35 programmes in 28 countries.</p><p><strong>Results: </strong>Responses were obtained from 23 programmes in 16 countries. Seventeen included IgA def as a rare phenotype, with nine classifying IgA def as levels <0.05 mg/dL. Eight of the 14 programmes indicated that fulfilment of requests for IgA-deficient products requires clinical consultation and 8 programmes require patients to have detectable anti-IgA. Programmes reported provision of a small number of IgA-deficient products in the past 5 years.</p><p><strong>Conclusion: </strong>While respondents from rare donor programmes in 17 countries include aIgA def as a rare blood phenotype, programmes in 5 countries do not. The level of IgA used to define IgA def varies among programmes and, in some cases, across programmes within the same country. Further study is needed to better understand IgA-mediated anaphylactic transfusion reactions. A recommendation is provided for managing transfusion support of patients considered at risk.</p>","PeriodicalId":23631,"journal":{"name":"Vox Sanguinis","volume":" ","pages":"1330-1337"},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13563473/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148309629","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":"International Forum on the Prevention of ABO Incompatible Red Blood Cell Transfusion: Responses.","authors":"Aline Mirrione-Savin, Michael F Murphy, Richard Schäfer, Pierre Tiberghien, Satyam Arora, Seema Dua, Markus M Mueller, Torsten Tonn, Saliou Diop, Moussa Seck, Zainab Al Fana Alarimi, Maha A Badawi, Tomohiko Sato, Aimi Miyajima, Silvano Wendel, Roberta Fachini, Tanya Petraszko, Johnathan Mack, Irene Cuppari, Daniele Prati, María Antonieta Nuñez, Edgardo Saa, Claudia S Cohn, Brian S Engel, Erica Wood, James Daly, Yanli Ji, Yang Zhao, Fanny Angelot Delettre, Veronique Bourcier, Veronica Pons, Andrea Espasa, Willem van der Merwe, Petro-Lize Wessels, Shirley Owusu-Ofori, Dilys John-Teye, Shruthi Narayan, Nicola Swarbrick, Arwa Z Al-Riyami, Nancy Dunbar","doi":"10.1111/vox.70327","DOIUrl":"10.1111/vox.70327","url":null,"abstract":"","PeriodicalId":23631,"journal":{"name":"Vox Sanguinis","volume":" ","pages":"1451-1485"},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13563479/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148680079","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":"Diagnostic accuracy of reticulocyte haemoglobin content in detecting iron deficiency without anaemia in blood donors: A systematic review and meta-analysis.","authors":"Peerawit Yanyiam, Kanoot Jaruthamsophon, Kantarat Kusolthammarat","doi":"10.1111/vox.70321","DOIUrl":"10.1111/vox.70321","url":null,"abstract":"<p><strong>Background and objectives: </strong>Iron deficiency without anaemia (IDWA) is a significant concern among blood donors. Reticulocyte haemoglobin content (RHC) has been increasingly investigated as an alternative biomarker to evaluate iron status, but its diagnostic performance remains unclear. We aim to assess the diagnostic accuracy of RHC for detecting iron deficiency in non-anaemic blood donors.</p><p><strong>Materials and methods: </strong>PubMed, Embase, Scopus, Web of Science, Cochrane Library, ProQuest Dissertations & Theses, trial registries and reference lists were searched. Study quality was assessed using the Revised Tool for Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2), and the certainty of evidence was assessed using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. The pooled sensitivity, specificity, likelihood ratios (LRs) and summary receiver operating characteristic area under the curve (SROC_AUC) were estimated.</p><p><strong>Results: </strong>Thirteen studies involving 5853 donors were included. The pooled sensitivity, specificity, positive LR (LR+) and negative LR (LR-) of RHC to evaluate iron deficiency compared to tests using ferritin, soluble transferrin receptor or a combination of parameters were 0.70 (95% confidence interval [CI]: 0.60-0.79), 0.85 (95% CI: 0.74-0.92), 4.84 (95% CI: 2.59-9.04) and 0.35 (95% CI: 0.25-0.48), respectively; the SROC_AUC was 0.82. The certainty of evidence was rated as very low to low.</p><p><strong>Conclusion: </strong>Evidence from this review is insufficient to support the widespread use of RHC as a standalone screening test for IDWA in blood donors. Further studies are needed to improve RHC-based screening strategies.</p>","PeriodicalId":23631,"journal":{"name":"Vox Sanguinis","volume":" ","pages":"1301-1311"},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13563474/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148431092","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":"Marginal anaemia and perioperative transfusion in female patients undergoing cardiac surgery.","authors":"Mihai Ștefan, Daniela Filipescu, Cornelia Predoi, Anamaria Dumitrescu, Alice Stegaru, Liana Văleanu, Cosmin Bălan, Șerban-Ion Bubenek-Turconi, Ștefan Andrei, Dana Tomescu","doi":"10.1111/vox.70315","DOIUrl":"10.1111/vox.70315","url":null,"abstract":"<p><strong>Background and objectives: </strong>Females undergoing cardiac surgery frequently require allogeneic blood transfusion, yet sex-specific haemoglobin (Hb) thresholds may underestimate physiological vulnerability in these patients. Recent evidence suggests that Hb values between 12.0 and 12.9 g/dL may represent marginal anaemia with clinically relevant consequences. This study assessed the impact of preoperative Hb on perioperative transfusion in females undergoing elective cardiac surgery. Anaemia categories were defined as follows: World Health Organization (WHO) anaemia (<12 g/dL in females); marginal anaemia (Hb 12.0-12.9 g/dL in females); and patient blood management (PBM)-defined anaemia (<13 g/dL irrespective of sex).</p><p><strong>Materials and methods: </strong>We conducted a retrospective analysis of 1174 cardiac surgery patients, including 399 females. Females were stratified into three groups: Hb ≥13 g/dL, 12-13 g/dL and <12 g/dL. Perioperative outcomes and predictors of packed red blood cell (PRBC) transfusion were evaluated using multivariable logistic regression. Model performance was assessed using receiver operating characteristic (ROC) curve analysis.</p><p><strong>Results: </strong>Transfusion rates increased stepwise across Hb strata: 57.3% (≥13 g/dL), 69.6% (12.0-12.9 g/dL) and 87.0% (<12 g/dL) (p <0.001). Females with marginal anaemia (12.0-12.9 g/dL) received more PRBC units per patient than both non-anaemic females and males in the same Hb range. In multivariable analysis, marginal anaemia (odds ratio [OR] 2.05; 95% confidence interval [CI]: 1.39-3.03) and overt anaemia (OR 6.33; 95% CI: 4.40-9.97) remained independent predictors of transfusion.</p><p><strong>Conclusion: </strong>Marginal anaemia in females undergoing cardiac surgery is associated with an increased risk of perioperative transfusion. Females with marginal anaemia had higher transfusion rates than those with Hb ≥13 g/dL, although quantitatively distinct from overt anaemia.</p>","PeriodicalId":23631,"journal":{"name":"Vox Sanguinis","volume":" ","pages":"1393-1400"},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13563470/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148266382","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}