Transfusion Medicine (Oxford, England)最新文献

{"title":"Understanding non-disclosure of deferrable risk: a study of blood donors with a history of intravenous drug use.","authors":"S F O'Brien,&nbsp;G Xi,&nbsp;Q-L Yi,&nbsp;M Goldman","doi":"10.1111/j.1365-3148.2009.00969.x","DOIUrl":"https://doi.org/10.1111/j.1365-3148.2009.00969.x","url":null,"abstract":"<p><p>Non-disclosure of deferrable risk has received little attention in the literature. We examined deferrable risk (history of intravenous drug use [IVDU]) and donor attitudes towards truthfulness, the screening process and interpretation of the screening question as well as risk profile. Donors negative for all markers with a self-reported history of IVDU (N = 30) and matched controls were identified from an anonymous mail-out survey. In a separate survey, hepatitis C virus (HCV)-positive donors participated in a telephone interview, from which all those with IVDU history (N = 29) were selected plus matched controls (combined total 59 IVDU, 236 controls). IVDU donors, when compared with matched controls, tended to believe that it is OK not to answer truthfully if one believes that her/his blood is safe (18.6% vs. 4.7%) and that some questions are a little too personal (35.6% vs. 21.7%). IVDU donors were more likely than controls to say they failed to acknowledge screening questions appropriately (23% vs. 2.2%) or to agree that IVDU questions are mainly about recent drug taking or sharing needles (29% vs. 11%) even though the screening question asked about IVDU ever without any such qualifiers. IVDU donors were also more likely to have other lifestyle/risk factors such as history of sex with IVDU (45.5% vs. 1.7%). Donors with deferrable IVDU history may rationalise that revealing their status is not necessary and may misinterpret the question. Failure to acknowledge risk behaviour is complex, and some degree of non-disclosure may be an inherent part of pre-donation screening.</p>","PeriodicalId":442504,"journal":{"name":"Transfusion Medicine (Oxford, England)","volume":" ","pages":"15-21"},"PeriodicalIF":1.5,"publicationDate":"2010-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1365-3148.2009.00969.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40046513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Platelet transfusions in adult patients with particular reference to patients undergoing surgery.","authors":"R Palo,&nbsp;L Capraro,&nbsp;R Hanhela,&nbsp;M Koivuranta,&nbsp;L Nikkinen,&nbsp;M Salmenperä,&nbsp;I Salonen,&nbsp;S Sjövall,&nbsp;A Tienhaara,&nbsp;M Vähämurto,&nbsp;T Mäki","doi":"10.1111/j.1365-3148.2009.00970.x","DOIUrl":"https://doi.org/10.1111/j.1365-3148.2009.00970.x","url":null,"abstract":"<p><p>Descriptive information on platelet (PLT) recipients, particularly during surgery, is limited. A description of the current epidemiology of PLT-transfused patients is required to optimize platelet transfusion care and to follow trends in PLT use. In 2004 and 2005, information was combined from several computerized medical systems. Participating hospitals (9 hospital districts of 21) handled approximately 64% of annual Finnish hospital admissions. A total of 6321 adult patients were transfused with 37,761 PLT products. Most PLT products (43.1%) were transfused to patients suffering from haematological malignancies. Only 1.0% of all surgical patients received PLTs (53.8% of PLT recipients and 35.8% of transfused PLTs). The most common single operation connected with PLT transfusion was coronary artery bypass while 27.1% of surgery-related PLTs were given to patients having an operation involving the digestive system or spleen. Only 36.4% of all PLT-transfused (operated and conservatively treated) patients were discharged directly home; in-hospital mortality was 9.5%. PLTs were given 40 products per 1000 hospital admissions requiring an operation in 2004, and 38 products in 2005. Perioperative PLT use is slightly decreasing in adult patients. As a single-operation type, coronary artery bypass patients receive most of the PLT products and have experienced no decline in PLT use over the years. Overall, PLT recipients have high in-hospital mortality.</p>","PeriodicalId":442504,"journal":{"name":"Transfusion Medicine (Oxford, England)","volume":" ","pages":"30-7"},"PeriodicalIF":1.5,"publicationDate":"2010-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1365-3148.2009.00970.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40042755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The James Blundell Award Lecture 2006: transfusion and the treatment of haemorrhage: past, present and future.","authors":"W H Dzik","doi":"10.1111/j.1365-3148.2007.00795.x","DOIUrl":"https://doi.org/10.1111/j.1365-3148.2007.00795.x","url":null,"abstract":"<p><p>In the early years of the 19th century, James Blundell reported in the Lancet the first clinical application of blood transfusion for the treatment of haemorrhage. Although these initial experiments may appear to us to have burst upon the medical world, Blundell had in fact done a decade of pre clinical research using animal models to establish principles to be brought to the clinic. His pivotal pre clinical experiments and the insights he gained are described in detail. Today, blood transfusion remains the cornerstone of treatment for serious bleeding - not only to restore oxygen carrying capacity but also to improve haemostasis, arrest and prevent bleeding. However, the indications for the use of blood components to treat bleeding remain ill-defined. In particular, despite the enormous volumes of fresh frozen plasma (FFP) transfused worldwide, the evidence that commonly used coagulation tests are reliable guides to transfusion with FFP is scant. Recent laboratory and clinical studies provide insight into the weaknesses of current coagulation tests as a guide to blood management. In the future, the application of genomics to haemostasis will uncover genetic polymorphisms leading to improved diagnostics and more tailored medical therapeutics. Examples of the emerging use of clinical genomics are presented. Ultimately, the application of widescale genomics testing will refresh our understanding of human physiology and will reassert the importance of the individual in patient care.</p>","PeriodicalId":442504,"journal":{"name":"Transfusion Medicine (Oxford, England)","volume":" ","pages":"367-74"},"PeriodicalIF":1.5,"publicationDate":"2007-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1365-3148.2007.00795.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41000769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Guidelines for policies on alternatives to allogeneic blood transfusion. 1. Predeposit autologous blood donation and transfusion.","authors":"F E Boulton,&nbsp;V James","doi":"10.1111/j.1365-3148.2007.00744.x","DOIUrl":"https://doi.org/10.1111/j.1365-3148.2007.00744.x","url":null,"abstract":"SUMMARY This is the first of a series of newly prepared guidelines on alternatives to allogeneic blood transfusion. Further guidelines including the use of cell salvage and of pharmacological approaches to blood conservation will be published in due course. Decades of clinical application demonstrate that it is quite feasible to auto-transfuse blood that has been collected and stored for an interval of up to 6 weeks in standard storage media, and that up to three standard collection volumes (approximately 500 mL) can be collected from normal-sized adults (over 50 kg) during that interval. Furthermore, systems have been developed to reduce risk to participants and to boost haemoglobin (Hb) production during and after the procedure. However, such pre-operative autologous donations (PAD) are not without risk, are of low clinical efficacy and are poorly cost-effective for the vast majority of patients in the UK. These guidelines update those previously issued by the BCSH and do not recommend the practice and use of PAD unless the clinical circumstances are exceptional. They also give an update on the legal regulatory circumstances pertaining to the UK following recent European Directives.","PeriodicalId":442504,"journal":{"name":"Transfusion Medicine (Oxford, England)","volume":" ","pages":"354-65"},"PeriodicalIF":1.5,"publicationDate":"2007-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1365-3148.2007.00744.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41000768","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The systematic monitoring of transfusion microbiology test kit performance.","authors":"M J Nightingale,&nbsp;S Ramskill,&nbsp;J Newham,&nbsp;A Kitchen,&nbsp;A Bukasa,&nbsp;D Wenham,&nbsp;I Reeves","doi":"10.1111/j.1365-3148.2007.00791.x","DOIUrl":"https://doi.org/10.1111/j.1365-3148.2007.00791.x","url":null,"abstract":"<p><p>The Transfusion Microbiology Test Systems Monitoring Group (TMTSMG) was established as a National Blood Service (NBS) working group to monitor the performance of the microbiology screening assays used within the NBS Testing Laboratories. The group's primary objective was to ensure that technical performance (especially sensitivity, specificity and wastage) remains consistent with that established during validation. This includes the identification and investigation of significant variation in performance and any untoward incidents. The group is also responsible for optimizing transfusion microbiology working practice across the NBS through nationally agreed standards and procedures. Over the past 9 years, a total of 44 assays from 15 suppliers have been monitored. Five assays have been withdrawn from use as a result of identified poor performance; two hepatitis B virus surface antigen assays owing to poor sensitivity, two syphilis agglutination assays with nonspecific (false) reactive rates sustained above contract limits and one human cytomegalovirus antibody assay that persistently failed the manufacturer's quality control criteria. This approach has enabled the differentiation of genuine kit performance issues from 'natural variation' in kit performance, and local instrumentation or training issues. The NBS has been able to address the issues with suppliers much earlier and resolve minor issues before they became major problems. In addition, a lot release system has been developed and implemented, comprising a formal, centralized initial scientific assessment of each new manufacturer's lot, followed by 'delivery acceptance' testing at each site. This system helps to ensure that the evaluated minimum sensitivity and specificity of the assays is maintained from 'lot to lot'.</p>","PeriodicalId":442504,"journal":{"name":"Transfusion Medicine (Oxford, England)","volume":" ","pages":"404-12"},"PeriodicalIF":1.5,"publicationDate":"2007-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1365-3148.2007.00791.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41001228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Net benefit of autologous compared with allogeneic blood transfusion.","authors":"G Caspari,&nbsp;V Kiefel","doi":"10.1111/j.1365-3148.2007.00779.x","DOIUrl":"https://doi.org/10.1111/j.1365-3148.2007.00779.x","url":null,"abstract":"","PeriodicalId":442504,"journal":{"name":"Transfusion Medicine (Oxford, England)","volume":" ","pages":"413-4"},"PeriodicalIF":1.5,"publicationDate":"2007-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1365-3148.2007.00779.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41001229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nucleic acids amplification technique (NAT) screening for parvovirus B19: the first Italian routine experience.","authors":"G Gessoni,&nbsp;P Barin,&nbsp;G Marchiori","doi":"10.1111/j.1365-3148.2007.00776.x","DOIUrl":"https://doi.org/10.1111/j.1365-3148.2007.00776.x","url":null,"abstract":"Dear Sir B19 can be transmitted through blood transfusions and plasma-derived products, but screening of blood donations for the presence of B19-DNA is not routine despite the fact that this virus is highly resistant (Prowse et al., 1997). In pooled plasma and bloodproducts, B19DNA levels lower than 10 IU mL may not be infectious, whereas those with viral load greater than 10 IU mL might be capable of transmitting infection (Daly et al., 2002). In 2004, the European Pharmacopoeia requested that plasma pools for production of anti-D immunoglobulin should not contain more than 10 IU mL of B19-DNA. Hence, highly viraemic blood donations have to be identified before the pooling process, and after the pooling process, the level of B19-DNAmust be determined (Hokymar et al., 2004; Koppelman et al., 2004). Moreover, European regulations (EMEA, 2004) for blood components require a risk assessment for B19 and an evaluation of potential infectivity of plasma source. In our Transfusion Service for biological qualification of blood units (BU), a triplex nucleic acids amplification technique (NAT) screening mini-pool (MP)-based strategy was adopted using Roche Ampliscreen methods (Roche Molecular System, Pleasaton, CA, USA). The aim of this study was to report the results of a 2-year study after introduction of a NAT screening for B19-DNA in a hospital-based Italian Transfusion Service. NAT screening was performed for hepatitis B virus (HBV), hepatitis C virus (HCV) and HIV using the Ampliscreen method (Roche Molecular System, Branchburg, NJ, USA). MP of 24 blood donations (BU) were prepared with Tecan Genesis pipettors (Tecan Trading AG, Mannedorf, Switzerland). Nucleic acids were isolated from plasma samples with the Multiprep Specimen Processing procedure for preparation of MP specimens and amplified and detected with the COBAS Ampliscreen HBV, HCV and HIV assay. As previously reported for B19-DNA extraction, we adopted the Multiprep Specimen Processing procedure (Gessoni et al., 2006). After the extraction process, an aliquot of purified nucleic acids was frozen at 280 C and stored until the tests for B19-DNAwere performed, before the shipment of plasma source to industrial fractionation process. All platelet and red cell concentrates confirmed to the Italian regulation and were transfusedwithout regard toB19-DNAscreening result. For quantitative detection of human parvovirus B19-DNA, we used a fully automated analyser for real-time PCR (Light Cycler) and a commercial method: Light Cycler Parvovirus B19 quantification kit; both analyser and kits were supplied by Roche. This method provides linear data between 10 and 10 IU mL (Schorling et al., 2004). By using the reported procedure for extraction and quantification ofB19-DNA,we achieved a satisfactory sensitivity: the detection limit 95% was 60 IU mL (Gessoni et al., 2006). In our Transfusion Service between April 2005 and March 2007, we tested for B19-DNA 51 274 BU in 2136 (MPs), each MP consisted of 24 B","PeriodicalId":442504,"journal":{"name":"Transfusion Medicine (Oxford, England)","volume":" ","pages":"417-9"},"PeriodicalIF":1.5,"publicationDate":"2007-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1365-3148.2007.00776.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41001231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A rapid gel agglutination test for the determination of fetomaternal haemorrhage.","authors":"A Agaylan,&nbsp;O Meyer,&nbsp;N Ahrens,&nbsp;J Dudenhausen,&nbsp;S Bombard,&nbsp;A Salama","doi":"10.1111/j.1365-3148.2007.00763.x","DOIUrl":"https://doi.org/10.1111/j.1365-3148.2007.00763.x","url":null,"abstract":"<p><p>Determination of fetomaternal haemorrhage (FMH) remains an area of difficulty. In most cases, prophylactic Rh immunoglobulin is usually administered to affected women without testing for foetal red blood cells (RBC). Here, we describe a new particle gel immunoassay (PaGIA) for the determination FMH (FMH-PaGIA). Superparamagnetic particles were coated with monoclonal anti-D and mixed with ethylenediaminetetraacetic acid-anticoagulated blood samples from D-negative pregnant women. The particles were isolated using a magnetic particle concentrator and then placed into the reaction chamber of a gel card. Agglutinated particles on top or dispersed through the gel matrix indicated the presence of D-positive cells. After the test was adapted to detect >or=0.3% D-positive RBC, randomly selected postpartum samples from 208 women were analysed in parallel with the Kleihauer-Betke test (KBT). In addition, all discrepancies were further analysed by flow cytometry. A total of 203 of the 208 postpartum samples were negative in both tests. One sample reacted positive with both assays. Two samples were strongly positive in the new FMH-PaGIA, but negative in the KBT. A serological re-examination revealed that both women were D positive. The KBT gave a false-positive result in two cases because of hereditary persistence of haemoglobin F. The new test is specific, easy to perform and can be done at any time in all laboratories.</p>","PeriodicalId":442504,"journal":{"name":"Transfusion Medicine (Oxford, England)","volume":" ","pages":"395-8"},"PeriodicalIF":1.5,"publicationDate":"2007-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1365-3148.2007.00763.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41001226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"BCSH guidelines for policies on alternatives to allogeneic blood transfusion. 1. Predeposit autologous blood donation and transfusion, August 2006.","authors":"T S Walsh,&nbsp;C Prowse","doi":"10.1111/j.1365-3148.2007.00751.x","DOIUrl":"https://doi.org/10.1111/j.1365-3148.2007.00751.x","url":null,"abstract":"","PeriodicalId":442504,"journal":{"name":"Transfusion Medicine (Oxford, England)","volume":" ","pages":"353; discussion 366"},"PeriodicalIF":1.5,"publicationDate":"2007-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1365-3148.2007.00751.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41000767","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictable and avoidable human errors in phlebotomy area - an exclusive analysis from a tertiary health care system blood bank.","authors":"P Pandey,&nbsp;R Chaudhary,&nbsp;R Tondon,&nbsp;D Khetan","doi":"10.1111/j.1365-3148.2007.00793.x","DOIUrl":"https://doi.org/10.1111/j.1365-3148.2007.00793.x","url":null,"abstract":"<p><p>Error is a direct reflection of system deficiency. Errors occurring in the phlebotomy area are grossly unreported. Though most of these errors does not lead to catastrophic outcome yet indicate system failure. The aim of the study was to identify errors that took place in phlebotomy area, analysing and classifying them. A prospective audit was conducted during an observational period of 8 months, in an overall cohort of 11 260 donors. The incidence of errors was 3.1%. Fifty-five percent errors were technical and remaining 44.9% were clerical. Of all the technical errors, 57.7% were classified as minor, whereas remaining 42.3% were of major category. Similarly, majority of clerical errors (89.9%) were of minor category. The trained staff accounted for all major events (27.8%). In the minor category, technical errors (73.2%) were more commonly done by trained staff, whereas for clerical errors (58.5%), newly recruited staff was responsible. Errors in phlebotomy area are benign but can compromise donor safety. The study helped to develop a consistent and straightforward classification system for errors and to reduce them by basic interventions. Errors committed mostly by our trained staff indicate the need of regular competency testing and an active system for detection of these deviations.</p>","PeriodicalId":442504,"journal":{"name":"Transfusion Medicine (Oxford, England)","volume":" ","pages":"375-8"},"PeriodicalIF":1.5,"publicationDate":"2007-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1365-3148.2007.00793.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41001225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}