Vox Sanguinis最新文献

{"title":"Quality indicators for blood establishments and hospital blood banks: A report by the ISBT Quality Management Working Party.","authors":"Tomislav Vuk, Christian Seidl, Lesley Bust, Yan Qiu, Nigar Ertuğrul Örüç","doi":"10.1111/vox.70036","DOIUrl":"10.1111/vox.70036","url":null,"abstract":"<p><strong>Background and objectives: </strong>Quality monitoring is a key component of the quality management system, closely related to the concept of quality improvement. The implementation of quality indicators (QIs), as a valuable quality monitoring tool, contributes to the achievement of quality objectives.</p><p><strong>Materials and methods: </strong>During 2010, discussions about the importance and use of QIs in transfusion medicine intensified, and 3 years later, the Quality Management Working Party (QM-WP) of the International Society of Blood Transfusion (ISBT) published a set of QIs for blood establishments and hospital blood banks. QIs defined by ISBT QM-WP were further developed and revised considering data obtained from an international survey on QIs, targeted consultations with members of the ISBT QM-WP and individual expert opinions.</p><p><strong>Results: </strong>Several revisions of quality indicators proposed by ISBT QM-WP have been published. The latest version from 2023 is presented in this paper and contains data on 50 QIs. Each indicator is defined, its importance is explained and the numerator and denominator required for its calculation are defined. The indicators are divided into seven groups according to areas of activity in the transfusion chain.</p><p><strong>Conclusion: </strong>This paper underlines the importance of QIs and provides resources for their selection, implementation and monitoring.</p>","PeriodicalId":23631,"journal":{"name":"Vox Sanguinis","volume":" ","pages":"734-745"},"PeriodicalIF":1.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144050331","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":"Comparison of conventional tube technique with automated gel microcolumn assay for antenatal antibody monitoring.","authors":"Kati Sulin, Mikko Arvas, Suvi Toivonen, Katri Haimila, Jaana Mättö, Inna Sareneva, Riina Jernman, Anna Parhamaa, Susanna Sainio","doi":"10.1111/vox.70042","DOIUrl":"10.1111/vox.70042","url":null,"abstract":"<p><strong>Background and objectives: </strong>Timely identification of pregnancies at risk of severe haemolytic disease of the fetus and newborn (HDFN) requires accurate and reproducible antibody titration. This study aimed to establish a critical titre for the gel microcolumn assay (GMA) corresponding to the critical titre of ≥16 for the conventional tube technique (CTT) and to evaluate GMA's suitability for routine antenatal antibody titration.</p><p><strong>Materials and methods: </strong>Altogether, 147 antenatal plasma samples with clinically significant antibodies were studied, including eight pregnancies requiring intrauterine transfusions (IUTs). Twofold serial dilution titres with CTT were made in parallel with automated GMA. Single-dose red blood cells were used with a concentration of 3.5% for CTT and 0.8% for GMA. The critical titre for GMA was compared with CTT as the gold standard.</p><p><strong>Results: </strong>GMA titres were on average 2.88 (95% confidence interval [CI]: 2.72-3.05) dilutions higher than CTT titres. At a CTT titre of 16, the sensitivity and specificity of GMA titration were maximum (94%, 95% CI: 81-99 and 92%, 95% CI: 85-96, respectively) at a titre of 128, but one of the eight fetuses (12.5%) requiring IUTs would have been missed. At a GMA titre of ≥64, sensitivity and specificity were 100% (95% CI: 100-100) and 77% (95% CI: 68-84) respectively, but the number of pregnancies requiring clinical monitoring more than doubled (2.5×).</p><p><strong>Conclusion: </strong>A GMA titre ≥64 could be considered a safe critical value for high-risk assessment. Despite being a fully automated method benefiting the screening laboratory, the additional workload and costs caused by unnecessary monitoring at delivery hospitals were unacceptable.</p>","PeriodicalId":23631,"journal":{"name":"Vox Sanguinis","volume":" ","pages":"708-713"},"PeriodicalIF":1.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12286668/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144030336","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 contemporary management of haemolytic disease of the fetus and newborn.","authors":"Mark D Kilby, James B Bussel, Kenneth J Moise","doi":"10.1111/vox.70027","DOIUrl":"10.1111/vox.70027","url":null,"abstract":"<p><p>Haemolytic disease of the fetus and newborn (HDFN) remains an important cause of perinatal mortality and morbidity. The pathogenesis underlying this condition is maternal red cell alloimmunization, with immunoglobulin G (IgG) antibodies produced in response to 'non-self', inherited paternal antigens expressed upon fetal erythrocytes. The IgG antibodies cross the placenta into the fetal circulation causing red cell destruction and fetal anaemia. Intrauterine transfusion (IUT) remains the cornerstone therapy with fetal survival rates up to 97%, but it is an invasive, technically challenging surgical procedure performed at specialized medical centres. The procedure-related risk of IUTs is increased at gestational age before 24 weeks. This has stimulated interest in maternal medical therapies that attenuate the risk of severe fetal anaemia, increase the gestational age of first IUTs, and reduce perinatal mortality and morbidity. This review summarizes current evidence for such treatments: intravenous immunoglobulin therapy and neonatal fragment crystallizable (Fc) receptor blockade for managing severe HDFN.</p>","PeriodicalId":23631,"journal":{"name":"Vox Sanguinis","volume":" ","pages":"644-652"},"PeriodicalIF":1.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144036968","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":"Feasibility of conducting a randomized controlled trial to explore the muscular influence of post-operative intravenous iron treatment for anaemia after major abdominal surgery.","authors":"Beth MacLean, Robert U Newton, Jayne Lim, Toby Richards","doi":"10.1111/vox.70037","DOIUrl":"10.1111/vox.70037","url":null,"abstract":"<p><strong>Background and objectives: </strong>Iron deficiency anaemia is common in patients recovering from major surgery and is associated with poorer post-operative outcomes. We designed a randomized controlled trial treating post-operative anaemia with iron therapy to observe the influence on post-operative recovery.</p><p><strong>Materials and methods: </strong>Anaemic patients (haemoglobin [Hb] < 120 g/L for women, Hb < 130 g/L for men) recovering from major abdominal surgery at Fiona Stanley Hospital were recruited. Patients were double-blind randomized 1:1 to ferric carboxymaltose (FCM) or saline administered 4 weeks post-discharge and included in a 12-week exercise programme. Iron indices, quality of life (QoL) questionnaires and muscle function tests were conducted at 4 weeks (baseline), 8-, 12- and 16-weeks post-discharge. This pilot study primarily aimed to assess the feasibility of recruiting 20 patients per intervention arm.</p><p><strong>Trial registration: </strong>ACTRN12622001447741.</p><p><strong>Results: </strong>Of 205 eligible patients screened between 5 May 2023 and 31 August 2023, only four patients were recruited, of which one completed the study. After randomization to FCM, results obtained from the sole participant that completed the trial suggested a trend towards improvement in QoL outcomes, Hb and muscle function.</p><p><strong>Conclusion: </strong>Recruitment to a randomized controlled trial exploring the influence of iron therapy on muscle function after major abdominal surgery was not feasible.</p>","PeriodicalId":23631,"journal":{"name":"Vox Sanguinis","volume":" ","pages":"678-682"},"PeriodicalIF":1.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12286669/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144042501","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":"How much furosemide should be administered to prevent transfusion-associated circulatory overload? Results of a dose-finding study.","authors":"Lianne Rotin, Liying Zhang, Chantal Armali, Amie Malkin, Sophia Massin, Harley Meirovich, Daniel Roque, Samia Saeed, Shangari Vijenthira, Yulia Lin, Jacob Pendergrast","doi":"10.1111/vox.70038","DOIUrl":"10.1111/vox.70038","url":null,"abstract":"<p><strong>Background and objectives: </strong>Transfusion-associated circulatory overload (TACO) is a common and life-threatening transfusion complication. Because of uncertainty regarding dosing, pre-transfusion furosemide prophylaxis is not widely endorsed. The aim of this study was to generate a furosemide dose-response curve in TACO-susceptible patients using the multiple comparisons procedure and modelling (MCP-Mod) methodology.</p><p><strong>Materials and methods: </strong>Inpatients aged ≥50 years receiving intravenous (IV) furosemide were screened for eligibility at two academic hospitals. Exclusion criteria were active bleeding, haemodynamic instability, glomerular filtration rate (GFR) < 30 mL/min/1.73 m² and diuretic therapy administered within 24 h or albumin administered within 8 h. The primary outcome measure was 6-h urine output post furosemide administration. After incorporation of age, sex, chronic diuretic use, mean arterial pressure, GFR and serum albumin as covariates of diuretic response, MCP-Mod was applied after every 50th enrolment until a weight-adjusted dose-response curve was identified with 100 mL precision.</p><p><strong>Results: </strong>One-hundred forty-nine patients were enrolled. Urine output varied widely at each furosemide dose. Because of the presence of outliers and a paucity of patients receiving higher doses, only those receiving doses up to 0.6 mg/kg (n = 132) were included. After incorporating covariates, linear-log was identified as the best fitting model. Application of this formula revealed that, depending upon patient characteristics, 10-40 mg of furosemide IV would be required to achieve a diuresis volume of 400 mL, which is sufficient to offset 1 red blood cell unit.</p><p><strong>Conclusion: </strong>We report a novel furosemide dose-response model for TACO-susceptible patients. Once validated, this model will guide furosemide dosing for a planned controlled trial evaluating furosemide for TACO prevention.</p>","PeriodicalId":23631,"journal":{"name":"Vox Sanguinis","volume":" ","pages":"683-693"},"PeriodicalIF":1.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12286670/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143988551","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":"Characterization of the in vitro quality parameters of cold-stored platelets containing aggregates.","authors":"Lacey Johnson, Christopher Roan, Pearl Lei, Denese C Marks","doi":"10.1111/vox.70064","DOIUrl":"https://doi.org/10.1111/vox.70064","url":null,"abstract":"<p><strong>Background and objectives: </strong>Cold-stored platelets (CSP) are being used more widely for the treatment of bleeding because of their longer shelf life. However, storage at low temperatures can induce the formation of platelet aggregates. We aimed to study the impact of aggregate formation on platelet quality and function.</p><p><strong>Materials and methods: </strong>Apheresis platelets (40% plasma/60% platelet additive solution [PAS-E]) were refrigerated (2-6°C) for 21 days. CSP that developed aggregates (n = 44) were compared with CSP with no aggregates (controls; n = 45). A subset of aggregated CSP (n = 15) was tested before and after being passed through a transfusion administration set containing a 200-μm filter. Donor- and collection-related parameters and in vitro quality parameters were assessed.</p><p><strong>Results: </strong>Aggregates were identified in 10.9% of CSP, primarily being found following extended storage (median: 16 days). The platelet count was not different between the aggregated (928 ± 158 × 10⁹/L) and control (931 ± 136 × 10⁹/L; p = 0.920) components at day 21. The pH of aggregated components was lower, and the platelets in aggregated components displayed a greater loss of GPIbα, externalization of CD62P and annexin-V, release of extracellular vesicles and degranulation, compared to controls. Functionally, aggregated CSP had potentiated aggregation responses but reduced clot strength (thromboelastography maximum amplitude [TEG MA]) compared to controls. Filtration reduced aggregates in CSP but retained the platelet count and functional properties. Donor-related factors did not correlate with aggregate formation, although certain collection parameters may be implicated.</p><p><strong>Conclusion: </strong>Platelets within components that contained aggregates were more activated than non-aggregated controls. The propensity for aggregate formation should be considered when selecting a shelf life for CSP.</p>","PeriodicalId":23631,"journal":{"name":"Vox Sanguinis","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144326994","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":"Pieter Ferdinand van der Meer (1970-2025).","authors":"Thomas R L Klei, Rebecca Cardigan","doi":"10.1111/vox.70066","DOIUrl":"https://doi.org/10.1111/vox.70066","url":null,"abstract":"","PeriodicalId":23631,"journal":{"name":"Vox Sanguinis","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144318059","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":"Identification of an A_weakB phenotype caused by significant ABO gene deletion in a Chinese woman.","authors":"Tian Gao, Feiyu Jiang, Shoufang Xu, Yingying Zhang, Weiwei Zheng, Xinhui Wang, Zhiwei Liu","doi":"10.1111/vox.70008","DOIUrl":"10.1111/vox.70008","url":null,"abstract":"<p><strong>Background and objectives: </strong>The A_weakB is a rare phenotype in the ABO blood group system. Here, we first report a novel ABO mutation discovered in a Chinese woman with an A_weakB. Third-generation sequencing was employed to investigate the molecular mechanisms underlying A_weakB. By correctly identifying the phenotype, it was useful for increasing the safety of blood transfusion.</p><p><strong>Materials and methods: </strong>ABO blood group was identified by the standard ABO serological test and polymerase chain reaction with sequence-specific primers (PCR-SSP). To analyse the ABO gene sequence, single-molecule real-time (SMRT) sequencing was performed to obtain full-length sequencing of the ABO gene.</p><p><strong>Results: </strong>The Chinese individual was serologically identified as A_weakB subtype, and SMRT sequencing analysis revealed that there were large fragment deletion mutations in the promoter (c.1-1326_1-1321del, c.1-1010_1-975del, c.1-952_1-1del) and Exon 1 region (c.1_28del).</p><p><strong>Conclusion: </strong>We report for the first time that large fragment deletions represent a novel molecular basis for the A_weakB. These deletions may potentially influence the expression of the A antigen.</p>","PeriodicalId":23631,"journal":{"name":"Vox Sanguinis","volume":" ","pages":"625-629"},"PeriodicalIF":1.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617156","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":"Electronic health records reveal variations in the use of blood units by hour and medical specialty.","authors":"Esa Turkulainen, Elissa Peltola, Markus Perola, Miika Koskinen, Mikko Arvas, Minna Ilmakunnas","doi":"10.1111/vox.70016","DOIUrl":"10.1111/vox.70016","url":null,"abstract":"<p><strong>Background and objectives: </strong>Efficient blood supply chain requires accurate demand estimates. Blood demand is created by clinicians making transfusion decisions based on patient status. To better understand the use of blood units, we tracked their use hourly and across a large hospital organization.</p><p><strong>Materials and methods: </strong>We analysed blood use in adult patients over 2021-2022 at HUS Helsinki University Hospital, serving a population of 1.7 million and consuming a third of blood units used in Finland. We utilized electronic health records (EHR) to map transfusions to patient demographics, diagnoses, medical specialties, treatment events, surgical procedures and laboratory values. Data were matched to transfusions of red blood cells, platelets and plasma using timestamps and treatment episodes.</p><p><strong>Results: </strong>In total, 107,331 units were transfused to 19,637 unique patients in 50,978 transfusion episodes. Most transfusions occurred in emergency settings, with 61.5% of use driven by emergency department admissions. The most common diagnoses were malignant neoplasms, anaemia and cardiovascular diseases. In total, 47.9% of transfusions were associated with a surgical procedure. Of these, 72.9% were for urgent surgery. Blood use peaked in the early evening and was lowest during morning office hours.</p><p><strong>Conclusion: </strong>The study offers a comprehensive picture of blood use in one of the largest European hospital organizations. In addition to elective use, a significant portion of blood demand is driven by urgent and emergency needs, which introduce some uncertainty in predicting blood use. Future studies should aim to understand both elective and emergency blood use to help improve demand estimates.</p>","PeriodicalId":23631,"journal":{"name":"Vox Sanguinis","volume":" ","pages":"584-596"},"PeriodicalIF":1.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12187620/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029519","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":"Blood collection technique and processing impact the nucleosomes and complement contents of platelet products.","authors":"Yasmin E S de Wit, Ido J Bontekoe, Rick van Andel, Thomas R L Klei, Anja Ten Brinke, Sacha S Zeerleder","doi":"10.1111/vox.70031","DOIUrl":"10.1111/vox.70031","url":null,"abstract":"<p><strong>Background and objectives: </strong>Platelet concentrates (PCs) available for transfusion are prepared either from whole blood donations or by platelet aphaeresis procedures. These different preparation methods may potentially affect damage-associated molecular patterns (DAMPs) and complement activation products in PC, which are associated with adverse reactions (ARs).</p><p><strong>Materials and methods: </strong>The objective of this study is to perform a comparison of platelet activation, nucleosome, mitochondrial DNA (mtDNA), haem and complement activation between differently produced leukoreduced PC. Single donor aphaeresis-PC stored in either plasma or platelet additive solution (PAS)-E and pooled buffy-coat (BC)-PC stored in PAS-E were produced in a regional setting of the Dutch Blood Establishment. For BC-PC, a pool of five BC-independent donors was used, and BC-PCs were grouped based on the time of donation (morning vs. afternoon). Directly after production, samples were collected from PC, and CD62P+ platelets, nucleosomes, mtDNA, haem and complement activation products were measured. A comparison was made between aphaeresis-PC and BC-PC.</p><p><strong>Results: </strong>Higher levels of CD62P+ platelets were observed after stimulation in aphaeresis-PC than BC-PC. The levels of nucleosomes and C4b/c were significantly increased in BC-PC compared to aphaeresis-PC. In addition, the levels of elastase-α1-antitrypsin complexes (EA) were higher in BC-PC from morning blood collections than in aphaeresis-PC or BC-PC from afternoon blood collections, which indicates increased neutrophil activation.</p><p><strong>Conclusion: </strong>Aphaeresis-PC can be better activated than BC-PC. BC-PC contains higher levels of nucleosomes and EA, most likely due to the presence of neutrophils in the BC. In addition, higher levels of complement activation products were observed in BC-PC.</p>","PeriodicalId":23631,"journal":{"name":"Vox Sanguinis","volume":" ","pages":"566-573"},"PeriodicalIF":1.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144034760","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}