Blood transfusion = Trasfusione del sangue最新文献

{"title":"Regional implementation, guideline landscape, and economic impact of blood component leukoreduction: a systematic literature review.","authors":"Nil Comasòlivas, Joan Cid, Hugo Fabre","doi":"10.2450/BloodTransfus.1373","DOIUrl":"https://doi.org/10.2450/BloodTransfus.1373","url":null,"abstract":"<p><strong>Background: </strong>Blood component leukoreduction reduces transfusion reactions, but its worldwide implementation is heterogeneous, largely due to economic barriers. This systematic review aimed to synthesize the available evidence on the implementation of leukoreduction, related policies and guidelines, and its economic impact.</p><p><strong>Materials and methods: </strong>We searched Ovid^® MEDLINE and Embase for studies published between 2015 and 2025. Eligible studies evaluated (1) the implementation of leukoreduction across countries, (2) policies and recommendations, and (3) its impact on healthcare costs and resource utilization. Titles and abstracts were screened by two reviewers, and key findings were gathered in a predefined data extraction form.</p><p><strong>Results: </strong>A total of 38 studies were included from 1,623 screened records. Regional implementation of leukoreduction varied widely. Some countries, such as the United States, reached a near-universal implementation of leukoreduction over the study period, whereas limited data from the Asia-Pacific, Middle East, and African regions suggested low leukoreduction implementation. In Europe, national estimates were heterogeneous, although increasing trends were observed in some countries. Guidelines recommend leukoreduction to prevent febrile non-hemolytic transfusion reactions, HLA alloimmunization, and transfusion-transmitted infections, with some recommending its use for specific patient subgroups. Few studies assessed the incremental cost of leukoreduction, with one study from Uganda estimating an additional cost of USD 37 per unit. Some studies reported shorter durations of mechanical ventilation and reduced lengths of hospital stay among recipients of leukoreduced components.</p><p><strong>Discussion: </strong>Over the past decade, published studies on leukoreduction implementation have remained sparse, and the available literature indicates that the field has advanced little in many regions. Implementation remains heterogeneous globally, and robust evidence on its economic impact is still limited, underscoring the need for further cost-effectiveness studies.</p>","PeriodicalId":520572,"journal":{"name":"Blood transfusion = Trasfusione del sangue","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148972910","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":"IgA driven autoimmune hemolytic anemia: a monocentric Italian report and literature review.","authors":"Elisa Tarasconi, Nicoletta Revelli, Giacinto L Pedone, Marta Bortolotti, Wilma Barcellini, Bruno Fattizzo","doi":"10.2450/BloodTransfus.1337","DOIUrl":"https://doi.org/10.2450/BloodTransfus.1337","url":null,"abstract":"<p><strong>Background: </strong>Atypical autoimmune hemolytic anemias (AIHA) include DAT-negative forms and those driven by IgA autoantibodies. IgA-mediated AIHA is rare, with limited evidence on clinical severity and management beyond first-line steroids. We revised our series of IgA-mediated AIHA and reviewed the literature.</p><p><strong>Materials and methods: </strong>We retrospectively evaluated patients with IgA-positive AIHA followed at a tertiary hematologic center in Milan since May 1978. Published reports from 2010 to January 28, 2025 were also reviewed.</p><p><strong>Results: </strong>Thirteen patients with IgA-mediated AIHA were identified among 409 AIHA cases. Median age was 60 years, and 69.2% were female. Fatigue was the most common symptom; mean hemoglobin was 7.9 g/dL. Dual IgA/IgG positivity occurred in 69.2%, while triple IgA/IgG/IgM positivity occurred in 7.7%. All but one patient received corticosteroids, 33% rituximab, 16.6% IVIg, and 23.1% transfusions. One patient received bortezomib followed by mycophenolate mofetil and plasma exchange. During a median follow-up of 36 months, 63.6% relapsed. Infections and thrombotic events occurred in 16.7% each, with no deaths. The literature review included 35 patients from 19 studies. Most were female (62%), aged 3 months to 77 years. Tachycardia and dyspnea were the most common symptoms; mean hemoglobin was 5.6 g/dL. DAT showed dual IgA/IgG or IgA/IgM positivity in 54.3%. Corticosteroids were administered to all reported patients, IVIg and rituximab to 14% and 23%, respectively. Splenectomy was performed in 6%, and 93% received transfusions. Infections occurred in 14%, thrombotic events in 7.1%, and one patient was refractory and died.</p><p><strong>Discussion: </strong>IgA-mediated AIHA is a rare, heterogeneous subtype characterized by frequent dual antibody positivity, suboptimal corticosteroid response, and substantial risks of relapse and complications, requiring careful monitoring and individualized management. These findings highlight the need for improved recognition of IgA-mediated disease and prospective studies to define optimal second-line therapies and outcomes in affected patients.</p>","PeriodicalId":520572,"journal":{"name":"Blood transfusion = Trasfusione del sangue","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148972920","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":"Identification of a novel B allele with c.298T>A giving rise to a weak B phenotype in Chinese voluntary blood donors.","authors":"Jian-Cheng Liu, Wei Zhang, Feng Shao, Xiao-Yin Mao, Xiao-Yun Bu, Jie Yang, Jing Hai","doi":"10.2450/BloodTransfus.1245","DOIUrl":"10.2450/BloodTransfus.1245","url":null,"abstract":"","PeriodicalId":520572,"journal":{"name":"Blood transfusion = Trasfusione del sangue","volume":" ","pages":"370-372"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13614860/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147470712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"AI and transfusion medicine in Europe: why public leadership cannot wait.","authors":"Massimo La Raja, Vincenzo De Angelis, Giovanni Camisasca, Luis Larrea","doi":"10.2450/BloodTransfus.1434","DOIUrl":"10.2450/BloodTransfus.1434","url":null,"abstract":"","PeriodicalId":520572,"journal":{"name":"Blood transfusion = Trasfusione del sangue","volume":" ","pages":"430-431"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13614861/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148538000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"RBCs of Asian-type DEL do not undergo antibody-mediated phagocytosis by macrophages.","authors":"Qi Ren, Tong Li, Ziyue Mi, Yudi Xie, Lushu Cao, Yan Xia, Haixia Xu, Honghong He, Li Tian, Zhong Liu","doi":"10.2450/BloodTransfus.1263","DOIUrl":"10.2450/BloodTransfus.1263","url":null,"abstract":"<p><strong>Background: </strong>In the Rhesus (Rh) blood group system, D is the most immunogenic antigen. RhD-negative patients with anti-D must be transfused RhD-negative red blood cells (RBC) to avoid hemolytic transfusion. RBC of Asian-type DEL phenotype are typed as RhD-negative by routine blood group serological methods because they have very weak expression of D antigen. The prevalence of Asian-type DEL phenotypes was 30% in RhD-negative Chinese donors. Therefore, this DEL type can be transfused to RhD-negative patients with anti-D. However, there is a lack of direct evidence regarding the safety of this practice and potential mechanisms in act.</p><p><strong>Materials and methods: </strong>The proportion of Asian-type DEL donors that serologically tested RhD-negative was investigated by using genotyping. Furthermore, a model system for in vivo clearance was established to assess antibody-mediated phagocytosis of Asian-type DEL RBC by macrophages.</p><p><strong>Results: </strong>We identified six serologically RhD-negative donors, 16 Asian-type DEL donors according to polymerase chain reaction polymerase chain reaction with sequence-specific primers (PCR-SSP), and six PCR-SSP RhD-positive donors across various regions in China. Our study revealed that antibody-mediated RBC clearance was not observed following co-culture of opsonized Asian-type DEL RBC with macrophages.</p><p><strong>Discussion: </strong>Incompatible transfusion of Asian-type DEL RBC may not result in significant RBC clearance.</p>","PeriodicalId":520572,"journal":{"name":"Blood transfusion = Trasfusione del sangue","volume":" ","pages":"349-355"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13614865/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148537986","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Salvianolic acid B alleviates red blood cell storage lesion with GPX4 preservation and reduced lipid peroxidation.","authors":"Chuan'ai Chen, Dekun Wang, Yang Yu, Pengpeng An, Yumiao Yang, Haolong Li","doi":"10.2450/BloodTransfus.1322","DOIUrl":"10.2450/BloodTransfus.1322","url":null,"abstract":"<p><strong>Background: </strong>Red blood cell (RBC) storage lesion is a cascade of biochemical and physical alterations that impair transfusion efficacy and safety. This study explored the role and underlying mechanism of salvianolic acid B (Sal B) against RBC storage lesion, with a specific focus on a ferroptosis-like process.</p><p><strong>Materials and methods: </strong>RBC from healthy volunteers were stored in MAP additive solution for 35 days, and samples were analyzed at weekly intervals. Ferroptosis was determined by the levels of cytosolic reactive oxygen species (ROS), antioxidant enzymes superoxide dismutase and glutathione peroxidase, 4-hydroxy-2-nonenal (4-HNE), malondialdehyde (MDA), and glutathione peroxidase 4 (GPX4). Storage lesion was evaluated by erythrocyte morphology, hemolysis rate, microvesicle formation, phosphatidylserine exposure, lactate dehydrogenase release, osmotic fragility, and Band 3. Ferrostatin-1 was used to verify the involvement of ferroptosis.</p><p><strong>Results: </strong>The results demonstrated a time-dependent escalation of both storage lesion and ferroptosis, evidenced by biochemical changes such as increased hemolysis, phosphatidylserine exposure, ROS accumulation, 4-HNE and MDA, as well as a reduction in antioxidant capacity and protein level of GPX4. Ferrostatin-1 treatment effectively mitigated pathological changes, suggesting that ferroptosis-associated pathways may contribute to storage lesion. Notably, Sal B supplementation correlated with reduced ferroptosis markers and mitigation of storage lesion, as evidenced by preserved GPX4 levels and reduced lipid peroxidation.</p><p><strong>Discussion: </strong>This study demonstrates that a ferroptosis-like process of lipid peroxidation contributes to RBC storage lesion, with GPX4 regulating erythrocyte stability. Sal B alleviates storage lesion in parallel with preservation of GPX4 and reduced lipid peroxidation, providing a potential strategy to improve the quality of stored blood.</p>","PeriodicalId":520572,"journal":{"name":"Blood transfusion = Trasfusione del sangue","volume":" ","pages":"379-389"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13614870/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148538044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of protease resistant synthetic antimicrobial peptides as a new approach methodology to mitigate bacterial growth in ex vivo human platelet concentrates.","authors":"Joseph Jackson, Supaksorn Chattagul, Nazli Azodi, Nijah Simmons, William Wimley, Chintamani Atreya","doi":"10.2450/BloodTransfus.1342","DOIUrl":"10.2450/BloodTransfus.1342","url":null,"abstract":"","PeriodicalId":520572,"journal":{"name":"Blood transfusion = Trasfusione del sangue","volume":" ","pages":"373-378"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13614863/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148538018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The RHCE*CeRN allele: molecular junction characterization and frequency distribution in Sub-Saharan African populations.","authors":"Assia Hadjkali, Caroline Izard, Laurine Laget, Lugdivine De Boisgrollier, Nelly Bichel, Marie-Laurence Deligny, Stéphane Mazières, Mélissa Galloux, Julien Paganini, Jacques Chiaroni, Julie Di Cristofaro","doi":"10.2450/BloodTransfus.1264","DOIUrl":"10.2450/BloodTransfus.1264","url":null,"abstract":"<p><strong>Background: </strong>The CeRN (RHCE*02.10) allele was described as resulting from hybrid RHCE-D-CE genes, involving either exon 4 alone or exon 4 and part of exon 3. No solution allows to distinguish between the two reported CeRN alleles. The objectives of this study were to determine the existence of both alleles, their genetic sequence and their frequencies.</p><p><strong>Materials and methods: </strong>We investigated 17 heterozygous CeRN samples and 10 homozygous CeRN samples, and described the junction between the RHCE and RHD genes. Analysis combined classical PCR associated with Sanger sequencing, and Oxford Nanopore NGS applied to long-range PCR.We also explored CeRN allelic frequency in sub-Saharan populations from the 1000 Genomes Project and the International Genome Sample Resource.</p><p><strong>Results: </strong>One CeRN allele sequence was observed, involving exon 4 alone with an RHCE-RHD junction approximately 400 base-pairs upstream of exon 4.We observed the CeRN allele in Gambian ethnic groups, with a maximum allelic frequency of 6.0% in the Fula group.</p><p><strong>Discussion: </strong>The CeRN allele involving exon 4 and part of exon 3 was not observed here, supporting at least a low frequency, as our sample size limited the power to investigate this putative second CeRN variant.The homogeneity of the CeRN sequence observed in DNA samples and the high allelic frequency are consistent with a single genetic founder event in the Fula ancestral group.Nearly 20% of individuals in The Gambia have abnormal hemoglobin. Knowledge of CeRN genetic architecture and frequency may have significant implications for more precise molecular diagnostics and transfusion therapy.The probabilistic pipeline developed here, based on subset of samples for which both DNA and WGS data were available, showed that WGS low-coverage data can be used to investigate complex genetic variants in population studies.</p>","PeriodicalId":520572,"journal":{"name":"Blood transfusion = Trasfusione del sangue","volume":" ","pages":"356-365"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13614866/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148261303","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Frequency of type 2N von Willebrand disease among patients with mild or moderate factor VIII deficiency in an 18-month period in Iran.","authors":"Behnam Azari, Mojgan Mirakhorli, Minoo Ahmadinejad","doi":"10.2450/BloodTransfus.1124","DOIUrl":"10.2450/BloodTransfus.1124","url":null,"abstract":"<p><strong>Background: </strong>Type 2N von Willebrand disease (VWD) increases the clearance rate of factor VIII (FVIII) in patient's plasma, leading to clinical symptoms and laboratory findings similar to those of mild or moderate hemophilia A. Differentiating between these conditions is crucial for genetic counseling and treatment. This research aims to use genetic analysis to distinguish type 2N VWD from mild or moderate FVIII deficiency.</p><p><strong>Materials and methods: </strong>During 18 months, suspected type 2N patients with mild or moderate FVIII deficiency, were selected from those referred to the Iranian Blood Transfusion Organization (IBTO) coagulation laboratory. Exons 18, 19, and 20 of the VWF gene were sequenced using Sanger's method. Subsequently, sequenced data were analyzed using NCBI's BLAST database and Chromas Pro.</p><p><strong>Results: </strong>In the current study of 35 participants with mild or moderate FVIII deficiency, 5 were found to have type 2N VWD mutations. The mutations detected were p.Arg816Gln (No.=3) and p.Thr789Pro (No.=2), which are common in Iran. Three patients were misdiagnosed with hemophilia A at a young age, while 2 were not diagnosed until later in life.</p><p><strong>Discussion: </strong>The current study discovered that 14.2% of the participants carried known type 2N VWD mutations, a higher prevalence compared to previous studies using a similar approach. Additionally, the study indicated that the limited availability of accurate diagnostic tests for type 2N VWD in our country could lead to a high probability of misdiagnosing or underdiagnosing patients with this condition.</p>","PeriodicalId":520572,"journal":{"name":"Blood transfusion = Trasfusione del sangue","volume":" ","pages":"400-406"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13614868/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148261269","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Blood donor deferral patterns in Iran: six-year national analysis (2016-2021).","authors":"Leila Kasraian, Erfan Sadeghi, Zahra Khakrah, Mahtab Farahangiz, Nima Naderi","doi":"10.2450/BloodTransfus.1206","DOIUrl":"10.2450/BloodTransfus.1206","url":null,"abstract":"<p><strong>Background: </strong>Blood donor deferral has a significant impact on the adequacy of blood supply and donor retention globally. Understanding deferral patterns is crucial for optimizing donation services and ensuring a sustainable blood supply in middle-income countries with established voluntary donation systems. The aim of this study was to analyze the prevalence, temporal trends, and causes of blood donor deferrals across Iran using a comprehensive 6-year national dataset (2016-2021).</p><p><strong>Material and methods: </strong>We conducted a retrospective analysis of all voluntary blood donation attempts recorded in Iran's \"Negareh\" database (2016-2021). Data included demographics, donation history, deferral status, and provincial variations. Non-parametric tests and chi-square analyses were performed (p<0.05).</p><p><strong>Results: </strong>Among 12,966,574 donation attempts, 2,161,808 individuals (16.67%) were deferred: 14.37% temporarily and 2.30% permanently. Deferral rates varied significantly by experience: 32.19% for first-time donors, 18.18% for repeat donors, and 8.98% for regular donors (η²=0.24, p<0.001). Female donors had higher deferral rates than males (30.68 vs 14.08%; odds ratio=2.70, p<0.001). Provincial rates ranged from 11.60% to 26.90%, inversely correlating with the Human Development Index (r=-0.67, p<0.001). Primary deferral reasons were high-risk behaviors (27.80%), general health unfitness (21.60%), and donor record issues (16.89%).</p><p><strong>Discussion: </strong>Iran's 16.67% deferral rate falls within global ranges but shows potential for optimization. The predominance of temporary deferrals (86.2%) and their association with modifiable factors suggest that targeted interventions could reduce deferrals by 2-3% while maintaining safety. Gender-specific prevention of anemia, enhanced preparation of first-time donor, and province-specific approaches could improve the donor experience and blood supply sustainability.</p>","PeriodicalId":520572,"journal":{"name":"Blood transfusion = Trasfusione del sangue","volume":" ","pages":"390-399"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13614871/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148261314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}