Vox SanguinisPub Date : 2025-01-14DOI: 10.1111/vox.13796
Sheila F O'Brien, Kiyuri Naicker, Lori Osmond, Kelly Holloway, Steven J Drews, Mark Bigham, Mindy Goldman
{"title":"Notification of blood donors who test positive for transfusion-transmissible infections.","authors":"Sheila F O'Brien, Kiyuri Naicker, Lori Osmond, Kelly Holloway, Steven J Drews, Mark Bigham, Mindy Goldman","doi":"10.1111/vox.13796","DOIUrl":"https://doi.org/10.1111/vox.13796","url":null,"abstract":"<p><strong>Background and objectives: </strong>Despite screening procedures, a few blood donors confirm positive for transfusion-transmissible infections and are deferred. Effective notification of laboratory results is essential to ensure that donors are advised of confirmed results and to seek medical care. Here we report results from post-notification interviews of Canadian Blood Services donors.</p><p><strong>Materials and methods: </strong>Over 17 years, 2006-2022, all donors with confirmed positive results for hepatitis B virus (HBV), hepatitis C virus (HCV), human T-cell lymphotropic virus (HTLV) and syphilis were notified by registered mail of their result and advised to see a physician. In a separate communication, all donors were later invited to participate in a scripted interview asking whether they tested positive for an infection; if yes, which one, what their reaction was, whether they consulted a physician and whether public health contacted them. Frequencies of responses were calculated.</p><p><strong>Results: </strong>Of 2654 donors with confirmed positive test results, 876 (33%) participated; 90% said they were informed of a positive test result. Of these, about a quarter did not know for which infection they were positive. Most were surprised, and some were sad or disappointed. Most saw a physician after notification (77%). About two-thirds with HBV or HCV said they were contacted by public health, slightly fewer (58%) with syphilis, 27% of those with HTLV.</p><p><strong>Conclusion: </strong>Most donors recalled being notified and were aware of their positive test, but details of the infection were sometimes not understood or recalled, and not all donors consulted a physician about the infection.</p>","PeriodicalId":23631,"journal":{"name":"Vox Sanguinis","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142984828","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}
Vox SanguinisPub Date : 2025-01-08DOI: 10.1111/vox.13794
Saeede Bagheri, Fatemeh Hajiabadi, Reihaneh Vahabzadeh, Mohammad Hossein Ahmadi
{"title":"Investigating the impact of mitochondrial DNA: Insights into blood transfusion reactions and mitigation strategies.","authors":"Saeede Bagheri, Fatemeh Hajiabadi, Reihaneh Vahabzadeh, Mohammad Hossein Ahmadi","doi":"10.1111/vox.13794","DOIUrl":"https://doi.org/10.1111/vox.13794","url":null,"abstract":"<p><strong>Background and objectives: </strong>Although transfusion reactions occur in less than 2% of recipients, they are currently one of the most serious concerns in blood transfusion. Damage-associated molecular patterns (DAMPs) are released from injured, stressed or dead cells, leading to inflammation and immune system activation. One of the recognized DAMPs is mitochondrial DNA (mtDNA). It is found in various blood products, including fresh frozen plasma (FFP), red blood cell units (RBCUs) and platelet concentrates (PCs), and can induce adverse reactions in recipients by stimulating the innate immune system and inflammatory cellular pathways. The aim of this study was to investigate the factors influencing the release of mtDNA in various blood products and its subsequent impact on transfusion reactions.</p><p><strong>Materials and methods: </strong>In this study, mtDNA, mitochondrial DNA, mtDNA DAMPs, extracellular mtDNA, blood products, blood components and transfusion reactions between 2009 and 2023 were searched in Google Scholar, PubMed and Scopus databases.</p><p><strong>Results: </strong>This study has demonstrated the presence of mtDNA in the extracellular milieu of various blood products, including PCs, FFP and RBCUs. Understanding the determinants of mtDNA release and its implications for transfusion safety is critical. Strategies aimed at reducing mtDNA release, such as optimizing preparation techniques and donor selection criteria, hold promise for reducing transfusion-related complications.</p><p><strong>Conclusion: </strong>By addressing these factors, healthcare providers can enhance the safety and efficacy of blood transfusion practices, ultimately improving patient outcomes.</p>","PeriodicalId":23631,"journal":{"name":"Vox Sanguinis","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142955825","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":"Community screening for iron deficiency in reproductive aged women: Lessons learnt from Australia.","authors":"Beth MacLean, Jayne Lim, Jess Fuller, Riki Wylie, Judie Yeleen Joo, Annas Al-Sharea, Jaahnavi Cheyyur, Henry Ng, Sijing Zhang, Mubashshira Ahmed, Cory Dugan, Toby Richards","doi":"10.1111/vox.13750","DOIUrl":"10.1111/vox.13750","url":null,"abstract":"<p><strong>Background and objectives: </strong>Reproductive-aged women are at an increased risk of developing iron deficiency (ID). We aimed to develop a non-invasive screening tool to identify ID in women and assess the acceptability of screening.</p><p><strong>Study design and methods: </strong>We screened women (age 18-49 years) in the community of Western Australia.</p><p><strong>Primary outcome: </strong>acceptability of screening, assessed by the feasibility of recruiting the required sample size (n = 323).</p><p><strong>Secondary outcomes: </strong>Hand grip strength, finger prick haemoglobin concentration (Hb), prevalence of heavy menstrual bleeding (HMB), diet, pregnancy history, blood donation, symptoms of ID and history of ID or anaemia (Hb < 120 g/L). Those with Hb <130 g/L and no history of iron therapy in the past 2 years were given referrals for venous full blood count and ferritin sampling.</p><p><strong>Results: </strong>Across 5 days, we recruited 640 eligible women. Of which, 178 (28%) had HMB and 79 (12%) were anaemic. Mean age was 33.5 ± 9.2 years, and mean Hb was 132.4 ± 11.9 g/L. In the past 2 years: 335 (52%) were diagnosed with ID or anaemia; 322 (50%) had taken oral iron; and 210 (33%) had an intravenous iron infusion. Vegetarian diets were followed by 89 (14%); 40 (6%) were regular blood donors; 290 (45%) had a previous pregnancy. HMB increased the risk of symptoms of ID and having prior ID/anaemia diagnosis (67% vs. 47%) or treatment (p < 0.022). Hand grip strength showed a positive relationship with both Hb (adjusted R<sup>2</sup> = 0.012, p = 0.004) and ferritin (adjusted R<sup>2</sup> = 0.135, p = 0.005).</p><p><strong>Conclusion: </strong>ID screening was well accepted by women in the community, with high recruitment rates over a short period. Future screening tool development may consider incorporating hand grip strength and HMB assessment.</p>","PeriodicalId":23631,"journal":{"name":"Vox Sanguinis","volume":" ","pages":"22-31"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11753822/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142476035","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":"Quality of life in people with sickle cell disease treated with automated red blood cell exchange.","authors":"Koenraad Dierick, Beatriz Rodriguez-Grande, Ariadna-Gador Navarro-Aragall, Mickael Beraud","doi":"10.1111/vox.13757","DOIUrl":"10.1111/vox.13757","url":null,"abstract":"<p><strong>Background and objectives: </strong>This review aims to explore the impact of sickle cell disease (SCD) on patients' quality of life (QoL) and the effectiveness of different transfusion modalities, particularly automated red blood cell exchange (aRBCX), in managing the factors that impact QoL.</p><p><strong>Materials and methods: </strong>A systematic search was performed in PubMed to retrieve articles with data on QoL in SCD patients treated with aRBCX during the last 20 years. A targeted search for medical guidelines and a free search were added.</p><p><strong>Results: </strong>When assessing the impact of the transfusion modality on the QoL of patients with SCD, some studies indicated an improvement in health-related QoL when using aRBCX while others reported no differences. The benefits of aRBCX include a decrease in length of hospital stay, pain-related hospitalizations and procedure time. The drawbacks of aRBCX were also identified, including an increased number of procedure-related complications (despite the overall number of complications showing no significant differences) and a more complex vascular access. Chronic red blood cell exchange favours psychosocial factors such as anxiety and social functioning, but the impact of using aRBCX in these parameters is not determined yet.</p><p><strong>Conclusion: </strong>aRBCX, known to be an efficient procedure to manage SCD, appears to be promising in improving patients' QoL. However, more comprehensive studies incorporating patient-reported outcomes are needed to fully understand the impact of different transfusion modalities on QoL in SCD patients. An integrated care approach, including psychological support and pain management, may further enhance QoL.</p>","PeriodicalId":23631,"journal":{"name":"Vox Sanguinis","volume":" ","pages":"4-12"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11753823/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142509015","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}
Vox SanguinisPub Date : 2025-01-01Epub Date: 2024-10-27DOI: 10.1111/vox.13755
Joan Cid, Paola Charry, Miquel Lozano
{"title":"Response to comments from Heddle et al. on 'Therapeutic efficacy and safety of pathogen-reduced platelet components: Results of a meta-analysis of randomized controlled trials'.","authors":"Joan Cid, Paola Charry, Miquel Lozano","doi":"10.1111/vox.13755","DOIUrl":"10.1111/vox.13755","url":null,"abstract":"","PeriodicalId":23631,"journal":{"name":"Vox Sanguinis","volume":" ","pages":"106-107"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142509016","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}
Vox SanguinisPub Date : 2025-01-01Epub Date: 2024-10-07DOI: 10.1111/vox.13747
Peizhe Zhao, Qilu Lyu, Yi Xu, Yajun Liang, Yunxiang Wu, Qing Li, Hua Wang, Yao Yuan, Runjun He, Weiyi Fu, Demei Zhang, Yujie Kong
{"title":"A novel approach to simultaneous genotyping of human platelet antigen systems and human leucocyte antigen class I loci using PacBio long-read sequencing.","authors":"Peizhe Zhao, Qilu Lyu, Yi Xu, Yajun Liang, Yunxiang Wu, Qing Li, Hua Wang, Yao Yuan, Runjun He, Weiyi Fu, Demei Zhang, Yujie Kong","doi":"10.1111/vox.13747","DOIUrl":"10.1111/vox.13747","url":null,"abstract":"<p><strong>Background and objectives: </strong>Accurate human leucocyte antigen (HLA) and human platelet antigen (HPA) typing is essential for establishing a blood platelet donor bank to deal with refractoriness in patients undergoing multiple platelet transfusions. Current methods, such as Sanger and next-generation sequencing, encounter difficulties in haplotyping. Herein, the aim of this study was to establish a method for HLA and HPA typing based on the long read sequencing.</p><p><strong>Study design and methods: </strong>The HPA and HLA class I genotypes of 268 platelet donors from the Taiyuan Blood Center, China were identified using long-read sequencing on the PacBio platform. Allele frequencies for HPA systems and HLA class I genes were calculated, and genetic variability within HPA system genes was analysed.</p><p><strong>Results: </strong>Polymorphisms were identified in 8 of the 35 HPA systems (HPA-1 to HPA-6w, HPA-15 and HPA-21w), with the frequencies of the 'b' allele at 0.0187, 0.0709, 0.4086, 0.0075, 0.0149, 0.0317, 0.4310 and 0.0019, respectively. The alleles with the highest frequencies at the HLA-A, HLA-B and HLA-C loci are HLA-A02:01, B51:01, B46:01 and C06:02, respectively. Additionally, several genetic patterns in HPA systems were identified, including the c.166-1029C>T variant, which was found exclusively in samples carrying the HPA-1b allele.</p><p><strong>Conclusion: </strong>This study developed a targeted long-read sequencing method characterized by high throughput and simultaneity, capable of resolving allele ambiguities for effective HLA class I genotyping in establishing a platelet donor bank.</p>","PeriodicalId":23631,"journal":{"name":"Vox Sanguinis","volume":" ","pages":"63-70"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142393743","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}
Vox SanguinisPub Date : 2025-01-01Epub Date: 2024-11-18DOI: 10.1111/vox.13766
Nina Houben, Suzanne Fustolo-Gunnink, Camila Caram-Deelder, Remco Visser, Madeleen Bosma, Karin Fijnvandraat, Jeroen Eikenboom, Johanna van der Bom, Enrico Lopriore
{"title":"Coagulation assay results at birth in preterm infants: A cohort study highlighting the relevance of local reference values for interpretation.","authors":"Nina Houben, Suzanne Fustolo-Gunnink, Camila Caram-Deelder, Remco Visser, Madeleen Bosma, Karin Fijnvandraat, Jeroen Eikenboom, Johanna van der Bom, Enrico Lopriore","doi":"10.1111/vox.13766","DOIUrl":"10.1111/vox.13766","url":null,"abstract":"<p><strong>Background and objectives: </strong>Routine coagulation screens at birth are still standard in some European neonatal intensive care units (NICUs), although interpretation of these results is complex in preterm infants. It is unclear to what extent local coagulation assay results agree with published reference ranges when using different analysers and reagents. We aimed to assess coagulation assay results on day 1 of life in very preterm infants admitted to the NICU.</p><p><strong>Materials and methods: </strong>We included all preterm infants born below 32 weeks gestational age (GA) admitted to the Leiden University Medical Center between 2004 and 2020 in whom coagulation assays (prothrombin time [PT] and activated partial thromboplastin time [APTT]) were obtained during the first 24 h of life. Infants either diagnosed with major intraventricular haemorrhage or who received plasma transfusion before coagulation assay were excluded. We assessed coagulation assay results and compared the results between <28 weeks (extremely preterm) and 28-32 weeks (very preterm) GA groups.</p><p><strong>Results: </strong>Coagulation assays were obtained at birth in 144 infants (144/2577; 5.5%) of whom 104 fulfilled the inclusion criteria. We found similar median PT and APTT values for extremely and very preterm infants (PT: 18.1 vs. 18.7 s [p-value = 0.400]; APTT: 44.2 vs. 47.7 s [p-value = 0.252], respectively).</p><p><strong>Conclusion: </strong>We found similar coagulation assay results at birth for extremely and very preterm infants; however, results deviated considerably from some of the published reference ranges. This may be due to differences between analysers and reagents, underlining the need for reference ranges calibrated to the equipment used per NICU.</p>","PeriodicalId":23631,"journal":{"name":"Vox Sanguinis","volume":" ","pages":"55-62"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11753824/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142669167","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}
Vox SanguinisPub Date : 2025-01-01Epub Date: 2024-10-14DOI: 10.1111/vox.13751
Adam Irving, Anthony Harris, Dennis Petrie, Daniel Avdic, Julian Smith, Lavinia Tran, Christopher M Reid, Zoe K McQuilten
{"title":"Can clinical guidelines reduce variation in transfusion practice? A pre-post study of blood transfusions during cardiac surgery.","authors":"Adam Irving, Anthony Harris, Dennis Petrie, Daniel Avdic, Julian Smith, Lavinia Tran, Christopher M Reid, Zoe K McQuilten","doi":"10.1111/vox.13751","DOIUrl":"10.1111/vox.13751","url":null,"abstract":"<p><strong>Background and objectives: </strong>Previously published studies have consistently identified significant variation in red blood cell (RBC) transfusions during cardiac surgery. Clinical guidelines can be effective at improving the average quality of care; however, their impact on variation in practice is rarely studied. Herein, we estimated how variation in RBC use across cardiac surgeons changed after the publication of national patient blood management guidelines.</p><p><strong>Materials and methods: </strong>We performed a pre-post study estimating change in variation in RBC transfusions across 80 cardiac surgeons in 29 hospitals using a national cardiac surgery registry. Variation across surgeons was estimated using fixed-effects regressions controlling for surgery and patient characteristics and an empirical Bayes shrinkage to adjust for sampling error. RBC use was measured by three metrics-the total number of units transfused, the proportion of patients transfused and the number of units transfused, conditional on receiving RBC.</p><p><strong>Results: </strong>The primary analysis utilized 35,761 elective cardiac surgeries performed between March 2009 and February 2015 and identified a 24.5% reduction (p < 0.0001) in mean total units transfused accompanied by a 37.2% reduction (p = 0.040) in the variation across surgeons. The reduction in mean total units was driven by both the proportion of patients transfused and the number of units transfused, conditional on receiving RBC, while the reduction in variation was only driven by the latter.</p><p><strong>Conclusion: </strong>In our study of RBC transfusions across cardiac surgeons, the surgeons who used more RBC in the pre-guideline period experienced larger reductions in RBC use after the guidelines were published.</p>","PeriodicalId":23631,"journal":{"name":"Vox Sanguinis","volume":" ","pages":"47-54"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11753820/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142476034","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":"The potential benefits of extra screening for glycated haemoglobin, total cholesterol and low-density lipoprotein cholesterol on donor health management and retention.","authors":"Wen-Jie Liu, Yun-Yuan Chen, Jen-Wei Chen, Chih-Hung Lin, Sheng-Tang Wei, Sheng-Mou Hou","doi":"10.1111/vox.13749","DOIUrl":"10.1111/vox.13749","url":null,"abstract":"<p><strong>Background and objectives: </strong>An extra health screening, including glycated haemoglobin (HbA1c), total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C), was initiated for regular donors aged over 40 in Taiwan in November 2015. This study aimed to determine its benefits on donor health management and retention.</p><p><strong>Materials and methods: </strong>A stratified random mail survey was conducted among donors who received HbA1c, TC and LDL-C screening between November 2015 and June 2017 to investigate their awareness of the screening, medical histories and post-screening behaviours. Their subsequent screening results and donation records from 3 years before and after the initial screening were obtained up to December 2021.</p><p><strong>Results: </strong>In total, 2070 donors participated in the mail survey, with participation rates ranging 15.7%-23.2% across study groups. The screening newly detected hyperglycaemia in 1.6% (95% confidence interval [CI]: 1.2%-2.0%) and hyperlipidaemia in 1.0% (95% CI: 0.7%-1.4%) of participants, with 42.7% (95% CI: 40.3%-45.2%) of participants unaware of the screening. Participants with initially abnormal or borderline TC or LDL-C results showed significant decreases in the subsequent screening (all p values<0.05). No difference was found in participants' awareness of the screening. However, those who sought medical consultation or made specific lifestyle changes tended to show greater improvements. Awareness of the screening was associated with increased whole blood donations and donated units.</p><p><strong>Conclusion: </strong>The extra health screening has limited benefits for donor health management without additional interventions, but it may motivate donors to donate more frequently. Raising donors' awareness of the screening is also crucial to maximize its benefits.</p>","PeriodicalId":23631,"journal":{"name":"Vox Sanguinis","volume":" ","pages":"13-21"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142476037","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}