Blood TransfusionPub Date : 2025-05-01Epub Date: 2025-01-21DOI: 10.2450/BloodTransfus.864
Elvira Grandone, Antonella Cromi, Marina Vincinguerra, Giovanni L Tiscia, Alexander Makatsariya, Jamilya Khizroeva, Viktoria Bitsadze, Antonio De Laurenzo, Donatella Colaizzo, Natale Sciannamè, Giuseppe Loverro, Ettore Cicinelli, Maurizio Margaglione, Angelo Ostuni, Luigi Nappi, Mario Mastroianno
{"title":"Perinatal outcome in pregnant women: the impact of blood transfusion.","authors":"Elvira Grandone, Antonella Cromi, Marina Vincinguerra, Giovanni L Tiscia, Alexander Makatsariya, Jamilya Khizroeva, Viktoria Bitsadze, Antonio De Laurenzo, Donatella Colaizzo, Natale Sciannamè, Giuseppe Loverro, Ettore Cicinelli, Maurizio Margaglione, Angelo Ostuni, Luigi Nappi, Mario Mastroianno","doi":"10.2450/BloodTransfus.864","DOIUrl":"10.2450/BloodTransfus.864","url":null,"abstract":"<p><strong>Background: </strong>Obstetric hemorrhage is a life-threatening complication of pregnancy. Systematic collection of data on transfusion practice during pregnancy and post-partum period are scarce, as well as data on fetal or neonatal outcomes of women transfused during pregnancy.We examined the prevalence of obstetric hemorrhage and outcome of pregnancies in hospitalized transfused women.</p><p><strong>Materials and methods: </strong>This is a retrospective cohort study collecting clinical and laboratory data of women transfused from 2015 to 2017 in three Italian Tertiary level Obstetrical Departments. Inclusion criteria were: 1) age >18 years; 2) antepartum or peripartum hospital admission and 3) transfusion during the hospital stay of at least one unit of packed red blood cell (RBC) units. Women below 18 years and/or with transfusion outside pregnancy were excluded.During the observation period, 18,495 women gave birth across the three Obstetrics Departments: transfusion rate was 1.7%.</p><p><strong>Results: </strong>315 women were included in the final analysis. Most (75.2%) needed transfusion from 35 weeks onwards. A percentage higher that that observed in general population of transfused women showed co-morbidities such as hypertensive disorders or diabetes (13.9 vs 5.5%). We recorded 90% of live births and 7.6% of Intra Uterine Fetal Demise or neonatal death. Perinatal outcomes were impacted by the dose of transfusion: logistic regression, correcting for age and assisted conception, showed that women transfused with 3 or more RBC units have about 3-fold higher risk of perinatal death (OR: 2.9, 95% CI: 1.0-8.4).</p><p><strong>Discussion: </strong>In this series, several known risk factors were associated with adverse feto-neonatal outcome. In addition, the number of RBC units transfused was significantly and independently associated with the perinatal outcome. Present data can be helpful to design prospective studies taking into account timing and dose of transfusion during pregnancy with the objective to improve feto-maternal outcome.</p>","PeriodicalId":49260,"journal":{"name":"Blood Transfusion","volume":" ","pages":"216-222"},"PeriodicalIF":2.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143416056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Blood TransfusionPub Date : 2025-05-01Epub Date: 2024-03-28DOI: 10.2450/BloodTransfus.724
Vanessa Agostini, Francesca Masiello, Stefania Vaglio, Eva Veropalumbo, Ursula La Rocca, Simonetta Pupella, Vincenzo De Angelis
{"title":"A Survey on the implementation of Patient Blood Management programs in Italy.","authors":"Vanessa Agostini, Francesca Masiello, Stefania Vaglio, Eva Veropalumbo, Ursula La Rocca, Simonetta Pupella, Vincenzo De Angelis","doi":"10.2450/BloodTransfus.724","DOIUrl":"10.2450/BloodTransfus.724","url":null,"abstract":"<p><strong>Background: </strong>Since 2012, in line with the World Health Organization (WHO) resolution WHA63.12 of 05/21/2010, the Italian National Blood Center has been promoting patient blood management (PBM). In order to verify the level of PBM implementation nationwide, we submitted a survey to all healthcare providers.</p><p><strong>Material and methods: </strong>In line with what was proposed in the international scientific literature in the field, a series of indicators was used derived from the four main blocks related to PBM strategies: the management of patient anemia; the optimization of hemostasis; blood conservation strategies; patient-centred decision-making. We also added two blocks containing important information on general PBM management and other PBM-related aspects.</p><p><strong>Results: </strong>The survey showed good implementation of anemia screening programs in accordance with the timelines established by national and international guidelines, and the single unit policy is used in line with national guideline recommendations. However, the survey also revealed limited auditing of PBM programs and reduced monitoring and reporting of clinical outcomes and indicators.</p><p><strong>Discussion: </strong>The first national survey on the level of PBM implementation in Italy shows widespread adoption of diagnostic-therapeutic care pathways aimed at the diagnosis and treatment of anemia in the perioperative setting.</p>","PeriodicalId":49260,"journal":{"name":"Blood Transfusion","volume":" ","pages":"223-231"},"PeriodicalIF":2.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140337446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Blood TransfusionPub Date : 2025-05-01Epub Date: 2024-08-05DOI: 10.2450/BloodTransfus.767
Geethika S Manchanayake, Elisenda Farssac Busquets, Ana García Buendia, Patrícia Ferrer, Gisela Palomar, Maria José Pelegay, Irene Ribera, Carmen Azqueta, Dinara Samarkanova, Jesus Fernandez-Sojo, Nerea Castillo Flores, Sergio Querol
{"title":"Efficiency assessment of cord blood banking and compatibility with delayed cord clamping.","authors":"Geethika S Manchanayake, Elisenda Farssac Busquets, Ana García Buendia, Patrícia Ferrer, Gisela Palomar, Maria José Pelegay, Irene Ribera, Carmen Azqueta, Dinara Samarkanova, Jesus Fernandez-Sojo, Nerea Castillo Flores, Sergio Querol","doi":"10.2450/BloodTransfus.767","DOIUrl":"10.2450/BloodTransfus.767","url":null,"abstract":"<p><strong>Background: </strong>There is debate whether delayed umbilical cord clamping following delivery, the current gold standard, affects the proportion of cord blood units (CBU) suitable for public cord blood banking. This study was designed to assess the impact of delayed cord clamping on the number of CBU suitable for therapeutic uses.</p><p><strong>Materials and methods: </strong>To minimize variability, data from the four most active collection centers within the Programa Concordia (Spain) were included. Data on CBU collected in utero from mothers following normal vaginal deliveries from July 2018 to December 2021 were analyzed. The weight of the collection bags (as a surrogate of volume) and total nucleated cell (TNC) count were analyzed according to three defined clamping times: 30 s, 60 s and ≥120 s. The CBU were stratified as suitable for stem cell transplantation (≥110 g and ≥1,500x10<sup>6</sup> TNC/unit) or other clinical applications (≥100 g but TNC count below the threshold).</p><p><strong>Results: </strong>There were 131 (18%), 548 (76%), and 40 (5%) CBU collected at 30 s, 60 s and ≥120 s, respectively. The median weight of the CBU decreased gradually with time, with a significant difference between units collected when the cord was clamped at 30 s or 60 s (p=0.036), so significantly fewer CBU met the minimal weight criterion (100 g) at 60 s than at 30 s (p=0.002). However, this was not reflected by the TNC available, resulting in non-statistical differences in CBU eligible for banking between these times. The major predictor of collection success was the neonate's birth-weight.</p><p><strong>Discussion: </strong>Despite decreases in the volume of cord blood collected when cord clamping at 30 s or 60 s, TNC count is maintained resulting in similar numbers of CBU eligible for banking. The different clamping delays investigated in this study are, therefore, compatible with public cord blood banking needs.</p>","PeriodicalId":49260,"journal":{"name":"Blood Transfusion","volume":" ","pages":"242-249"},"PeriodicalIF":2.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141972195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Evaluation of platelet function by Total Thrombus-Formation Analysis System (T-TAS®01) in term and preterm infants and its relationship with patent ductus arteriosus. A prospective observational pilot study.","authors":"Ester Capecchi, Valeria Cortesi, Genny Raffaeli, Irene Picciolli, Nicola Pesenti, Monica Fumagalli, Giacomo Cavallaro, Stefano Ghirardello, Gaia Francescato","doi":"10.2450/BloodTransfus.765","DOIUrl":"10.2450/BloodTransfus.765","url":null,"abstract":"<p><strong>Background: </strong>Newborns exhibit a pro-coagulant hemostatic profile despite platelet hyporeactivity and reduced coagulation factors. Assessing infant hemostasis, particularly in preterm infants, is challenging, with inconsistent findings regarding the relationship between platelet count and function in patients with patent ductus arteriosus (PDA).</p><p><strong>Materials and methods: </strong>This study aims to assess platelet function using the Total Thrombus-Formation Analysis System (T-TAS®01) in term and preterm newborns. T-TAS®01 measures the Occlusion Start Time (OST), Occlusion Time (OT), and the Area Under the Curve (AUC) at the end of thrombus formation. The study includes term and preterm newborns below 30 weeks' gestational age (GA) admitted to the Neonatal Intensive Care Unit. Blood samples were collected from preterm newborns on the 1<sup>st</sup> day of life (T0), between 48-72 hours of life (T1), between the 7<sup>th</sup> and 10<sup>th</sup> day of life (T2), and from term newborns at T0 and T2. Secondary endpoints include the relationship between T-TAS®01 parameters and significant PDA in preterm newborns and the correlation between T-TAS®01 parameters, GA, and complete blood count (CBC).</p><p><strong>Results: </strong>OST is delayed by 65.5 seconds in preterm infants at T0 (p<0.001) and by 46 seconds at T2 (p=0.041) compared to full-term newborns. OT is delayed by 164 seconds in preterm infants at T0 (p=0.002) and by 352 seconds at T2 (p=0.002). AUC at T0 is lower in preterm infants (p=0.028). There is no significant correlation between T-TAS®01 parameters and GA or CBC. Additionally, OST and OT are delayed, and AUC is reduced in preterm infants with PDA and hemodynamically significant PDA (hsPDA).</p><p><strong>Discussion: </strong>T-TAS®01 is a reliable tool for evaluating platelet function in term newborns. However, measurements show higher variability in preterm infants, with significantly lower platelet activity observed in preterm infants with PDA and hsPDA.</p>","PeriodicalId":49260,"journal":{"name":"Blood Transfusion","volume":" ","pages":"255-265"},"PeriodicalIF":2.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Blood TransfusionPub Date : 2025-05-01Epub Date: 2024-06-10DOI: 10.2450/BloodTransfus.759
Roberto Crocchiolo, Letizia Lombardini, Nicoletta Sacchi, Ilaria Lombardi, John Blake, David Allan, Mohamad Sobh, Francesca Puoti, Silvia Trapani, Anna Maria Gallina, Marco Sacchi, Simonetta Pupella, Paola Bergamaschi, Silvano Rossini, Massimo Cardillo
{"title":"Analysis of HLA matching between deceased organ donors and cord blood units from a National Bank Network as a basis for potential platforms for chimerism-based immune tolerance after solid organ transplantation.","authors":"Roberto Crocchiolo, Letizia Lombardini, Nicoletta Sacchi, Ilaria Lombardi, John Blake, David Allan, Mohamad Sobh, Francesca Puoti, Silvia Trapani, Anna Maria Gallina, Marco Sacchi, Simonetta Pupella, Paola Bergamaschi, Silvano Rossini, Massimo Cardillo","doi":"10.2450/BloodTransfus.759","DOIUrl":"10.2450/BloodTransfus.759","url":null,"abstract":"","PeriodicalId":49260,"journal":{"name":"Blood Transfusion","volume":" ","pages":"250-254"},"PeriodicalIF":2.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141471937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Blood TransfusionPub Date : 2025-05-01Epub Date: 2024-10-15DOI: 10.2450/BloodTransfus.776
Daniela Filipescu, Mihai-Gabriel Ștefan, Șerban Ion Bubenek Turconi, Dan Corneci, Gabriela Droc, Raluca Goicea, Ioana Grigoraș, Ioana M Grințescu, Liliana Mirea, Cornelia Predoi, Anca-Irina Ristescu, Silvius Negoiță, Dorel Săndesc, Ecaterina Scărlătescu, Liana Văleanu, Ștefan Andrei, Dana Tomescu
{"title":"Patient Blood Management in 2023: a Nationwide Survey of Anesthesiologists in Romania following the 2018 Guidelines.","authors":"Daniela Filipescu, Mihai-Gabriel Ștefan, Șerban Ion Bubenek Turconi, Dan Corneci, Gabriela Droc, Raluca Goicea, Ioana Grigoraș, Ioana M Grințescu, Liliana Mirea, Cornelia Predoi, Anca-Irina Ristescu, Silvius Negoiță, Dorel Săndesc, Ecaterina Scărlătescu, Liana Văleanu, Ștefan Andrei, Dana Tomescu","doi":"10.2450/BloodTransfus.776","DOIUrl":"10.2450/BloodTransfus.776","url":null,"abstract":"<p><strong>Background: </strong>In 2018, Romania established national guidelines for patient blood management (PBM), endorsed by the Romanian Society of Anesthesia and Intensive Care (SRATI) and approved by the Ministry of Health. These guidelines emphasize managing anemia, coagulation issues, and the cautious use of allogeneic transfusions to improve patient outcomes.</p><p><strong>Materials and methods: </strong>A national survey was conducted among Romanian anesthesiologists to assess PBM guideline adoption. It included 38 questions addressing PBM strategies, resources, transfusion practices, and barriers to implementation. The survey was distributed via email to the SRATI database.</p><p><strong>Results: </strong>Out of 512 professionals who opened the survey, 74% had adopted some PBM measures, and 97% recognized PBM's efficacy in improving outcomes. However, only 33% of anesthesiologists worked in hospitals with formal PBM groups, and 39% had attended PBM-related educational events. Preoperative anemia management was inconsistent, with only 33.5% routinely treating anemia. Access to diagnostic and therapeutic tools was limited; transferrin saturation testing was available in 27% of cases, and erythropoietin was used in 24%. Despite these limitations, 72% of respondents treated anemia with intravenous iron.The main challenges to implementation included insufficient time for pre-surgical assessments, lack of standardized procedures, and difficulties in surgeon-anesthetist collaboration.</p><p><strong>Discussion: </strong>The survey highlights the need for systemic improvements in PBM adoption. Recommendations include enhancing organizational structures, standardizing protocols, and improving interdisciplinary collaboration to boost PBM implementation in Romania. While progress has been made, a national program with dedicated funding and auditing could facilitate widespread PBM integration into clinical practice.</p>","PeriodicalId":49260,"journal":{"name":"Blood Transfusion","volume":" ","pages":"232-241"},"PeriodicalIF":2.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142511372","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Blood TransfusionPub Date : 2025-05-01Epub Date: 2025-03-12DOI: 10.2450/BloodTransfus.929
Daniele Prati, Flavio Caprioli, Luisa Stea, Alessandra Berzuini, Denise Pizzotti, Errica Petrillo, Elena Coluccio, Elisa Erba, Giuseppe Lamorte, Francesca Ferrari, Lisa Cariani, Chiara Amoroso, Anna C Preti, Alessandra Bandera, Annapaola Callegaro, Silvana Castaldi, Massimo Cardillo, Maurizio Vecchi, Luca Valenti, Vincenzo De Angelis
{"title":"A \"movement\" worth making: why and how Transfusion Services can play a role in Fecal Microbiota Transplant programs.","authors":"Daniele Prati, Flavio Caprioli, Luisa Stea, Alessandra Berzuini, Denise Pizzotti, Errica Petrillo, Elena Coluccio, Elisa Erba, Giuseppe Lamorte, Francesca Ferrari, Lisa Cariani, Chiara Amoroso, Anna C Preti, Alessandra Bandera, Annapaola Callegaro, Silvana Castaldi, Massimo Cardillo, Maurizio Vecchi, Luca Valenti, Vincenzo De Angelis","doi":"10.2450/BloodTransfus.929","DOIUrl":"10.2450/BloodTransfus.929","url":null,"abstract":"<p><p>Fecal Microbiota Transplantation (FMT) is an innovative therapy with growing applications, particularly for recurrent Clostridioides difficile infections (rCDI). However, the broader use of FMT is challenged by the complexities of donor recruitment, the necessity of stringent screening protocols, and the need for maintaining high-quality stool biobanks. This paper explores the integration of FMT programs within transfusion medicine departments, taking advantage of their expertise in donor management and biological material processing. Despite the complexities of donor screening, including a low eligibility rate, the collaboration between transfusion services and other hospital departments demonstrates a viable model for expanding FMT access. Additionally, the recent EU regulations on substances of human origin (SoHO) offer a framework for standardizing and scaling stool banking, enhancing the safety and efficacy of FMT procedures.</p>","PeriodicalId":49260,"journal":{"name":"Blood Transfusion","volume":" ","pages":"275-282"},"PeriodicalIF":2.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}