{"title":"Editorial commentary: The latest viewpoint on a statistical analysis of total analytical errors in diagnostic tools used for quantitative testing of medical devices in transfusion medicine & insights on the development of autoantibody isotypes to the Annexin A1 protein of the neutrophil in association with COVID-19-induced hyperinflammatory processes","authors":"Jerard Seghatchian","doi":"10.1016/j.transci.2024.104025","DOIUrl":"10.1016/j.transci.2024.104025","url":null,"abstract":"","PeriodicalId":49422,"journal":{"name":"Transfusion and Apheresis Science","volume":"63 6","pages":"Article 104025"},"PeriodicalIF":1.4,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142548559","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}
Jean Amiral , Rémy Ferol , Matthias H. Busch , Sjoerd A.M.E.G. Timmermans , Chris Reutelingsperger , Pieter van Paassen
{"title":"Laboratory measurement of autoantibodies to Annexin A1: Review and measurements in health and COVID-19","authors":"Jean Amiral , Rémy Ferol , Matthias H. Busch , Sjoerd A.M.E.G. Timmermans , Chris Reutelingsperger , Pieter van Paassen","doi":"10.1016/j.transci.2024.104027","DOIUrl":"10.1016/j.transci.2024.104027","url":null,"abstract":"<div><div>Annexin A1, a protein released by neutrophils, is a potent regulator of inflammation in the intact form, but loses this activity when cleaved. The presence of autoantibodies to this protein can impact its function. An immunoassay, developed to measure autoantibodies to Annexin A1 in plasma or serum, has been developed and performances are reported. The cut-off for the positive range is determined from the mean value and standard deviations measured in a healthy group. Anti-Annexin A1 autoantibodies were then tested in hospitalized COVID-19 patients, at baseline or at any time during hospitalization. Sixty-one out of 379 patients tested positive for at least one isotype, IgG, IgA, or IgM. Few patients presented with only 1 isotype (2 G, 12 A, 16 M), but the combination of 2 isotypes was observed in many of them, and 3 expressed the 3 isotypes all together. Some association was noted between the presence of these autoantibodies and the development of thrombosis or admission in Intensive Care Units. The specific clinical complication risk associated to each isotype is yet to be established as our study was mainly transversal. Complementary studies are required to better evaluate the diagnostic or prognostic values of the anti-Annexin A1 autoantibodies, which have already been reported in various clinical situations. They could potentially reduce the anti-inflammatory regulation potential of Annexin A1, a mechanism which could contribute to disease evolution and worsening.</div></div>","PeriodicalId":49422,"journal":{"name":"Transfusion and Apheresis Science","volume":"63 6","pages":"Article 104027"},"PeriodicalIF":1.4,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631406","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":"A non-parametric framework for evaluating total analytical error in in vitro diagnostic medical devices in transfusion medicine","authors":"Paulo Pereira","doi":"10.1016/j.transci.2024.104026","DOIUrl":"10.1016/j.transci.2024.104026","url":null,"abstract":"<div><div>The performance assessment of quantitative measurements is predominantly based on evaluating Total Analytical Error (TAE). This evaluation encompasses several key objectives critical to ensuring accurate, reliable, and clinically relevant test results. Traditional parametric methods often fall short due to data normality assumptions in the performance assessment of <em>in vitro</em> diagnostic medical devices (IVD-MDs). This study presents a non-parametric approach to estimating and evaluating the TAE in transfusion medicine, aiming to enhance the reliability and patient safety of IVD-MDs. A protocol to estimate TAE over diverse data distributions is suggested, employing a robust statistical definition and comparative measurement procedures. Results from 200 samples indicate that non-parametric methods provided a more accurate reflection of TAE. The findings assert that non-parametric TAE estimation is vital for ensuring the 'fitness for purpose' of clinical tests in transfusion medicine, directly impacting post-transfusion outcomes and patient care. The study concludes that adopting non-parametric methods in transfusion services can significantly improve test accuracy, aligning with the highest laboratory practice standards.</div></div>","PeriodicalId":49422,"journal":{"name":"Transfusion and Apheresis Science","volume":"63 6","pages":"Article 104026"},"PeriodicalIF":1.4,"publicationDate":"2024-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142570165","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":"People, places and things: The new WAA board","authors":"Gail Rock","doi":"10.1016/j.transci.2024.104023","DOIUrl":"10.1016/j.transci.2024.104023","url":null,"abstract":"","PeriodicalId":49422,"journal":{"name":"Transfusion and Apheresis Science","volume":"63 6","pages":"Article 104023"},"PeriodicalIF":1.4,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142560574","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}
Junaid Ahmad Wali , Muharrem Yunce , Naureen Narula
{"title":"Successful use of therapeutic plasma exchange for the management of acute lung transplant rejection secondary to immune checkpoint inhibitor therapy","authors":"Junaid Ahmad Wali , Muharrem Yunce , Naureen Narula","doi":"10.1016/j.transci.2024.104024","DOIUrl":"10.1016/j.transci.2024.104024","url":null,"abstract":"<div><div>The use of immune checkpoint inhibitors (ICIs) in individuals with a history of solid organ transplantation is fraught with the emergence of solid organ transplantation rejection (SOTR). The current recommendations for the management of SOTRs secondary to ICI include the use of high-dose steroids along with the escalation of immunosuppressive therapy. Therapeutic Plasma Exchange (TPE) has been described to be effective in managing various immune-related toxicities, however, the data for using TPE in the setting of acute SOTRs induced by ICIs are limited. Herein, we describe the successful use of TPE in a patient with a history of bilateral lung transplantation who developed an episode of mixed acute cellular and antibody-mediated lung transplant rejection after a single dose of PD-1 inhibitor Pembrolizumab for the treatment of underlying melanoma.</div></div>","PeriodicalId":49422,"journal":{"name":"Transfusion and Apheresis Science","volume":"63 6","pages":"Article 104024"},"PeriodicalIF":1.4,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142560575","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}
Nishaka William , Jason P. Acker , Jerard Seghatchian
{"title":"Advancement of blood donor factors in RBC and blood component therapy using modern practices and methodologies: How to make multifactorial clinical decisions amid growing complexity","authors":"Nishaka William , Jason P. Acker , Jerard Seghatchian","doi":"10.1016/j.transci.2024.104022","DOIUrl":"10.1016/j.transci.2024.104022","url":null,"abstract":"","PeriodicalId":49422,"journal":{"name":"Transfusion and Apheresis Science","volume":"63 6","pages":"Article 104022"},"PeriodicalIF":1.4,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631405","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}
Karthik Rengaraj , Steven Lionel , Sushil Selvarajan , Uday Prakash Kulkarni , N.A. Fouzia , Anu Korula , Aby Abraham , Kavitha Lakshmi , Alok Srivastava , Vikram Mathews , Biju George , Dolly Daniel , Mahasampath Gowri , Sharon Anbumalar Lionel
{"title":"GRAIN Study - Granulocytes Against Infections - Use of granulocyte transfusion in haematopoietic stem cell transplant","authors":"Karthik Rengaraj , Steven Lionel , Sushil Selvarajan , Uday Prakash Kulkarni , N.A. Fouzia , Anu Korula , Aby Abraham , Kavitha Lakshmi , Alok Srivastava , Vikram Mathews , Biju George , Dolly Daniel , Mahasampath Gowri , Sharon Anbumalar Lionel","doi":"10.1016/j.transci.2024.104020","DOIUrl":"10.1016/j.transci.2024.104020","url":null,"abstract":"<div><div>Granulocyte transfusions (GTx) combat infections in neutropenic patients. However, immune-mediated off-target effects in transplant settings are unknown. Between January 2020 and December 2021, all transplants that used GTx during the peri-transplant period were analysed. Engraftment, infections, and days to clearance were retrieved from clinical records. Overall survival is compared with the mean total PMN count and the different products. Pooled buffy coat was used in 110 patients (98 %), of which 38 (34 %) additionally received an apheresed product. The median days of GTx was 4. The median bags pooled to prepare a single buffy coat product was 4. The mean total PMN count was 0.98 × 10<sup>10</sup>/ L granulocytes per pooled buffy coat and 1.93 × 10<sup>10</sup>/L granulocytes per apheresis product. A higher PMN count (>1 × 10<sup>10</sup>/L) was achieved in 48 % with pooled buffy coat versus 85 % with apheresis. Respiratory worsening occurred in 39 % receiving GTx. All patients who received granulocytes had engrafted with a median time of 14 days for neutrophil and 20 days for platelet engraftment. Blood cultures cleared in 81 %, whereas only 28 % cleared other cultures. Fungal pneumonia cleared in 25 %, and invasive fungal sinusitis or otitis cleared in 50 %. Overall survival was 47 %, non-significantly higher (57 % vs 39 %, P = 0.1) with a higher PMN dose. The pooled buffy coat is an affordable alternative to apheresis for an effective PMN dose. Ease of availability and low cost of pooled buffy coat, with comparable overall survival points toward a safe and efficacious product, in the peri-transplant period.</div></div>","PeriodicalId":49422,"journal":{"name":"Transfusion and Apheresis Science","volume":"63 6","pages":"Article 104020"},"PeriodicalIF":1.4,"publicationDate":"2024-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142533499","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}
Alexandra Grudzinski , Brandon Tse , Russel Ombao , Marie E. Faughnan , Katerina Pavenski
{"title":"Red blood cell alloimmunization in transfused patients with hereditary hemorrhagic telangiectasia: A single centre retrospective study","authors":"Alexandra Grudzinski , Brandon Tse , Russel Ombao , Marie E. Faughnan , Katerina Pavenski","doi":"10.1016/j.transci.2024.104019","DOIUrl":"10.1016/j.transci.2024.104019","url":null,"abstract":"<div><h3>Background</h3><div>Hereditary hemorrhagic telangiectasia (HHT) is a genetic blood vessel disorder which may lead to chronic bleeding and red blood cell (RBC) transfusions. Data on transfusion requirements and complications in HHT patients are sparse.</div></div><div><h3>Study Design and Methods</h3><div>Retrospective chart review was conducted at St. Michael’s Hospital (SMH) in Toronto, Canada. All adults with a definite clinical diagnosis of HHT AND inpatient hospital visits between January 1, 2011 and December 31, 2020 AND had undergone transfusion compatibility testing at SMH, were identified. Data were abstracted from electronic medical records. Simple descriptive statistics were used to analyze data. Institutional Research Ethics Board approval was obtained.</div></div><div><h3>Results</h3><div>63 HHT patients underwent compatibility testing and were subsequently transfused at SMH. Median patient age at data abstraction was 70 years (Interquartile Range [IQR]: 18) and 35 (56 %) were female. RBC alloantibodies were found in 23 transfused patients (36.5 %) and were predominantly directed against Rh and Kell antigens: Anti-E (65 %), Anti-K (39 %) and Anti-c (22 %) were most common. Excluding an outlier who received 611 RBC units during the study period, the mean number of RBC units transfused per HHT patient at SMH was 22.1 units (Standard Deviation: 40.9, IQR: 17). Six (9.5 %) transfused patients experienced at least one transfusion reaction.</div></div><div><h3>Conclusion</h3><div>RBC alloimmunization rate was 36.5 % in our cohort of transfused HHT patients; this is much higher than described in the general population and another transfused HHT cohort. The most commonly observed alloantibodies were Rh and Kell, supporting our policy of prophylactic phenotypic matching for these antigens for all transfused patients with HHT.</div></div>","PeriodicalId":49422,"journal":{"name":"Transfusion and Apheresis Science","volume":"63 6","pages":"Article 104019"},"PeriodicalIF":1.4,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142511620","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}
Bhawna Kumari , Muhammad Hasan , Seema Irfan , Abdullah Khalid , Bushra Moiz
{"title":"Bacterial contamination of platelets concentrates in a lower middle-income country: Data from a single tertiary care hospital","authors":"Bhawna Kumari , Muhammad Hasan , Seema Irfan , Abdullah Khalid , Bushra Moiz","doi":"10.1016/j.transci.2024.104018","DOIUrl":"10.1016/j.transci.2024.104018","url":null,"abstract":"<div><h3>Background</h3><div>Transfusion of bacterially contaminated platelets may cause life threatening sepsis in the recipients. Cost of platelet screening is a major challenge for low middle income countries (LMICs). In this study, we evaluated the frequency of bacterial contamination in the platelet units (PUs) and the outcome of transfusing such platelets to the patients in a single institute at Pakistan.</div></div><div><h3>Material and methods</h3><div>During 2018–2022, whole blood-derived (WB-PU) and apheresis platelets (AP) were screened by BacT-ALERT® automated system. Single sample from each AP and samples from ≤ 5 WB-PUs were pooled and cultured within 24 h-post collection. An initial positive signal was followed by re-culture, Gram’s staining, pool resolution and bacterial identification. Results were interpreted as ‘confirmed positive’ or ‘indeterminate’ and ‘confirmed negative’ based on differences in initial-reactive and final results.</div></div><div><h3>Results</h3><div>A total of 84246 PUs (476 AP and 83770 WB-PU) was screened, and 239 (0.28 %) culture bottles were positive on day one. Individual cultures were performed on 1378 PUs (239 bottles) for pool resolution. Seven of 1378 (0.5 %) PUs were ‘confirmed positive’ while 1371 (99.4 %) were ‘indeterminate’. No bacterial growth was observed in 82868 (82392 WB-PU and 476 AP) of 84246 (98.3 %). Overall bacterial contamination rate was low at 1 in 12000 PUs approximately. Seven patients were transfused with contaminated PUs but no transfusion reaction was observed.</div></div><div><h3>Conclusion</h3><div>An insignificant risk of bacterial contamination was observed in this study but remains a concern for patient safety. LMICs need cost effective but efficient techniques to screen platelets for the presence of bacteria.</div></div>","PeriodicalId":49422,"journal":{"name":"Transfusion and Apheresis Science","volume":"63 6","pages":"Article 104018"},"PeriodicalIF":1.4,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142446089","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}