Blood transfusion = Trasfusione del sangue最新文献

{"title":"Transfusion risk assessment for cesarean delivery: a preoperative tool to guide blood utilization.","authors":"Rosa F Drummond, Jane Quackenbush, Lauren Bernard, Yasmin Hasbini, Katharine Zhu, Michael Plazak, Allison Lankford","doi":"10.2450/BloodTransfus.1368","DOIUrl":"10.2450/BloodTransfus.1368","url":null,"abstract":"<p><strong>Background: </strong>Cesarean delivery is performed in approximately one-third of pregnancies in the United States and is associated with an increased risk of intrapartum and postpartum hemorrhage. Routine crossmatching of blood for all cesarean deliveries requires substantial resources and may not be necessary for every patient. We aimed to identify preoperative and intrapartum predictors of intraoperative blood transfusion and develop a practical risk stratification tool to support perioperative blood preparation.</p><p><strong>Materials and methods: </strong>We conducted a retrospective cohort study including 3,033 cesarean deliveries performed at a university medical center between 2018 and 2022. Multivariable logistic regression with bootstrap internal validation (10,000 replicates) was used to derive a weighted transfusion risk score. Model performance was assessed by discrimination and calibration across predefined risk groups.</p><p><strong>Results: </strong>Intraoperative transfusion occurred in 114 cases (3.8%). Independent predictors were placenta previa (aOR 5.14), prior blood transfusion (aOR 4.18), preoperative hemoglobin <11 g/dL (aOR 3.06), suspected intraamniotic infection (aOR 2.43), cervical dilation ≥6 cm (aOR 2.33), uterine fibroids (aOR 2.23), vaginal bleeding (aOR 2.04), and multifetal gestation (aOR 1.83) (all p<0.05). The model demonstrated good discrimination (AUC 0.75). The risk score stratified patients into low-, medium-, and high-risk groups with observed transfusion rates of 2.1%, 5.4%, and 15.1%, closely matching predicted probabilities of 2.1%, 5.8%, and 15.0%, respectively. Using a cut-off score of 4, specificity (91.7%) and negative predictive value (97.4%) were high, whereas sensitivity (37.7%) and positive predictive value (15.4%) were low.</p><p><strong>Discussion: </strong>This simple risk score, based on routinely available preoperative and intrapartum factors, may help identify patients at low risk for intraoperative transfusion, allowing more selective blood preparation, improved resource allocation, and more efficient utilization of blood products during cesarean delivery while supporting individualized clinical decision-making.</p>","PeriodicalId":520572,"journal":{"name":"Blood transfusion = Trasfusione del sangue","volume":" ","pages":"417-424"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13614862/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148972930","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":"Erratum: Rh_null phenotype caused by a novel RHAG allele, RHAG*c.640+1G>C, in a Chinese individual.","authors":"Min Wang, Shuangshuang Jia, Shanshan Zhou, Shihui Li, Qian Liu","doi":"10.2450/BloodTransfus.1509","DOIUrl":"10.2450/BloodTransfus.1509","url":null,"abstract":"","PeriodicalId":520572,"journal":{"name":"Blood transfusion = Trasfusione del sangue","volume":"24 5","pages":"432"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13614867/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149067028","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":"Characterization of growth factors in platelet-poor plasma for eye drop applications from umbilical cord blood and from allogeneic adult donor serum.","authors":"Larysa Mykhailova, Dinara Samarkanova, Jesus Fernandez-Sojo, Stefania Villa, Manuela Brasca, Paolo Rebulla, Daniele Prati, Tiziana Montemurro","doi":"10.2450/BloodTransfus.1330","DOIUrl":"10.2450/BloodTransfus.1330","url":null,"abstract":"","PeriodicalId":520572,"journal":{"name":"Blood transfusion = Trasfusione del sangue","volume":" ","pages":"425-429"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13614869/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148538065","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":"Statistical quality control practices in a sample of Spanish Blood Establishments: a mixed-methods exploratory study.","authors":"Héctor Sarmiento Palao, María I Ortiz de Salazar Martín, Luis R Larrea González, Ana M Arruga Manzano, María L Ayape Puyales, Aida I Azcarate Gonzalez, Teresa Díaz Rueda, Marta López Melchor, Pascual Marco Vera, María Del Carmen Martín Alonso, María Mercadillo González, Ana I Perez Aliaga, Magdalena Prohens-Batle","doi":"10.2450/BloodTransfus.1300","DOIUrl":"10.2450/BloodTransfus.1300","url":null,"abstract":"<p><strong>Background: </strong>The European Directorate for the Quality of Medicines & HealthCare (EDQM) provides guidance for statistical quality control in blood component manufacturing, including recommendations for sampling and statistical process control. However, the extent to which these recommendations are implemented in routine practice remains unclear.</p><p><strong>Materials and methods: </strong>We conducted a sequential explanatory mixed-methods study among professionals working in blood establishments, recruited through the Spanish Society of Blood Transfusion blood processing working group. Phase 1 was a cross-sectional survey (10 responding centers across 10 autonomous communities; response rate 77%). Phase 2 comprised semi-structured interviews with a purposive sample of survey respondents (No.=7). Survey findings informed the interview topic guide. Thematic analysis followed the Braun and Clarke approach. Findings from both phases were integrated using a joint display.</p><p><strong>Results: </strong>Respondents represented centers with varied production volumes, and most had more than 6 years of experience (80%). Use of statistical quality control methods was limited: 90% reported using descriptive statistics only and 10% used control charts. For sample size determination, 80% applied fixed production percentages without formal statistical justification. Spreadsheet-based workflows with custom formulas predominated (90%). Key challenges included determining sample size and laborious report generation (both 80%). Interviews highlighted uncertainty about sampling adequacy, potential for earlier trend detection, perceived complexity of guidance, and the need for interpretive decision support. All participants expressed interest in automated approaches.</p><p><strong>Discussion: </strong>Among participating centers, variation in the implementation of statistical quality control practices relative to EDQM recommendations suggests opportunities for improved harmonization. Automated tools that embed recommended sampling and monitoring methods may support implementation, although larger studies are needed to estimate prevalence at national level.</p>","PeriodicalId":520572,"journal":{"name":"Blood transfusion = Trasfusione del sangue","volume":"24 5","pages":"407-416"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13614872/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149067064","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":"Variation in eluate volume during DNA extraction does not affect eluate concentration of plasma-derived DNA.","authors":"Frederik Banch Clausen, Victoria Bølling Jensen, Caroline Lai Kjar, Steffen Ullitz Thorsen, Leif Kofoed Nielsen, Grethe Risum Krog","doi":"10.2450/BloodTransfus.1347","DOIUrl":"10.2450/BloodTransfus.1347","url":null,"abstract":"","PeriodicalId":520572,"journal":{"name":"Blood transfusion = Trasfusione del sangue","volume":" ","pages":"366-369"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13614864/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148537998","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 2 breakpoint regions of an RHCE-D(2-9)-CE allele causing a D phenotype and its RhAG antigen density.","authors":"Kshitij Srivastava, Caroline Ballard Dixon, Marina Ursula Bueno, Katharina Schallmoser, Lydia Gruener, Willy Albert Flegel","doi":"10.2450/BloodTransfus.1365","DOIUrl":"https://doi.org/10.2450/BloodTransfus.1365","url":null,"abstract":"<p><strong>Background: </strong>Among 195 known RHCE alleles, 10 have evolved to form hybrid RHCE-D-CE alleles encoding aberrant RhCE proteins lacking CE antigen expression. The resulting D-- phenotype predisposes to anti-Hr_o alloimmunization (anti-Rh17). Although hybrid alleles may appear identical at the mRNA level, distinct breakpoint configurations can result in diverse D phenotypes or Rh antigens. We determined the molecular structure of a D-- phenotype. An unrelated RHD allele, DMA had been observed once without serology. We tested Rh antigen densities.</p><p><strong>Materials and methods: </strong>Genomic DNA and cDNA were analyzed using a combination of molecular techniques and commercial red cell genotyping assays targeting the RHD and RHCE genes. A flow cytometric method was developed to quantify RhAG antigen expression. Red cell antigen densities were determined for RhAG and RhD in the D-- and DMA/DAU3 samples serologically.</p><p><strong>Results: </strong>Nucleotide sequencing of the RHCE gene and its cDNA identified a homozygous CE-D(2-9)-CE hybrid allele in an individual of Afghan origin. The 5' and 3' breakpoint regions included 131 and 4,287 nucleotides. The new allele was linked in a haplotype to the normal RHD allele (RHD*01). Quantitative flow cytometry demonstrated antigen densities of 92,297 RhD and 52,907 RhAG molecules per red cell for the D-- sample (12,465 RhD and 117,871 RhAG for DMA/DAU3).</p><p><strong>Discussion: </strong>We describe the breakpoint regions of a Ce-D(2-9)-Ce allele that encoded a D-- phenotype. Our results underscore the importance of breakpoint characterization for identifying clinically relevant RH variants and advancing personalized transfusion medicine. The second DMA observation, in trans to a DAU3 allele, aligned with a weak D phenotype for DMA.</p>","PeriodicalId":520572,"journal":{"name":"Blood transfusion = Trasfusione del sangue","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148972939","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":"Patient Blood Management in the Emergency Department: reducing transfusions and anemia-related admissions at 6 months.","authors":"Giacomo Marchi, Fabio Chesini, Alice Vianello, Ciro Paolillo, Antonio Maccagnani, Domenico Girelli","doi":"10.2450/BloodTransfus.1392","DOIUrl":"https://doi.org/10.2450/BloodTransfus.1392","url":null,"abstract":"","PeriodicalId":520572,"journal":{"name":"Blood transfusion = Trasfusione del sangue","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148972943","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":"Distribution of human platelet antigen genotypes in Lithuanian blood donors.","authors":"Asta Semėnė, Astra Vitkauskienė, Diana Remeikienė, Erika Skrodenienė","doi":"10.2450/BloodTransfus.1385","DOIUrl":"https://doi.org/10.2450/BloodTransfus.1385","url":null,"abstract":"<p><strong>Background: </strong>Human platelet antigens (HPAs) are polymorphic structures on platelet membrane glycoproteins that may induce alloimmune responses after transfusion or pregnancy. Knowledge of HPA distribution in different populations is essential for improving transfusion practice and managing platelet transfusion refractoriness.</p><p><strong>Materials and methods: </strong>A total of 200 unrelated voluntary blood donors were included. Genomic DNA was extracted from EDTA-anticoagulated whole blood, and HPA genotyping was performed using polymerase chain reaction with sequence-specific primers. Genotype and allele frequencies were calculated, and Hardy-Weinberg equilibrium was assessed using the χ² test.</p><p><strong>Results: </strong>The most frequent genotypes were HPA-1aa, HPA-2aa, HPA-3ab, HPA-5aa, and HPA-15ab. Allele frequencies were 0.833 (HPA-1a), 0.925 (HPA-2a), 0.578 (HPA-3a), 0.923 (HPA-5a), and 0.525 (HPA-15a). The HPA-6 and HPA-9 systems were monomorphic. No significant deviations from Hardy-Weinberg equilibrium or sex-related differences were observed.</p><p><strong>Discussion: </strong>The distribution of HPA alleles in Lithuanian donors is comparable to other European populations. These findings are clinically relevant for improving donor-recipient compatibility and may support the development of HPA-typed donor registries, contributing to better management of platelet transfusion refractoriness.</p>","PeriodicalId":520572,"journal":{"name":"Blood transfusion = Trasfusione del sangue","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148538042","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":"Standardized diagnostic approach for cold agglutinin disease: results from a Delphi-Based Expert Consensus.","authors":"Gianluca Ubezio, Wilma Barcellini, Serelina Coluzzi, Bruno Fattizzo, Antonella Matteocci, Andrea Patriarca, Sebastiano S Pergolizzi, Daniele Prati, Nicoletta Revelli, Francesco Fiorin","doi":"10.2450/BloodTransfus.1314","DOIUrl":"https://doi.org/10.2450/BloodTransfus.1314","url":null,"abstract":"<p><strong>Background: </strong>Cold agglutinin disease (CAD) is a rare autoimmune hemolytic anemia characterized by clonal immunoglobulin M (IgM) autoantibodies that activate complement at low temperatures, leading to hemolysis. Diagnostic practices remain inconsistent, with considerable interlaboratory variability and no established guidelines. Objective - To develop a consensus-based diagnostic framework for CAD through a structured Delphi methodology, with the goal of harmonizing laboratory practices across medical centers.</p><p><strong>Materials and methods: </strong>A total of 30 experts in classic hematology and transfusion medicine were invited to participate in a two-round, web-based modified Delphi survey; 27 (90%) completed both rounds. A scientific board developed 37 diagnostic statements covering five domains: CAD definition, clinical evaluation, immunohematological testing, and pre-analytical and analytical procedures. Statements were rated on a 5-point Likert scale, with consensus defined a priori as a score of 4 or 5 by ≥80% of respondents.</p><p><strong>Results: </strong>All 37 statements achieved consensus, with 36 (97.3%) doing so in Round 1 and the remaining one in Round 2 after re-evaluation. The panel provided recommendations on when to suspect CAD and specified necessary diagnostic tests, including C3d positivity on direct antiglobulin test (DAT) with monospecific antisera and the detection of cold agglutinins in serum. They heavily emphasized the importance of sample handling at 37°C, alongside issuing recommendations on cold agglutinin titration, transfusion management, and immune-hematologic follow-up.</p><p><strong>Discussion: </strong>This expert consensus provides a standardized diagnostic approach for CAD, addressing current gaps in clinical and laboratory evaluation. Implementing these recommendations is expected to improve diagnostic accuracy and consistency, facilitating better patient outcomes and national harmonization of practices.</p>","PeriodicalId":520572,"journal":{"name":"Blood transfusion = Trasfusione del sangue","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148538055","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":"International Haemovigilance Seminar 2026, Rome, 18-20 March 2026.","authors":"Simon Benson, Shruthi Naryan, Barbee Whitaker, Barbora Jacobsen, Gratia Muru, Marjatta Okkonen, Christina Mikkelsen","doi":"10.2450/BloodTransfus.2026.Suppl3","DOIUrl":"https://doi.org/10.2450/BloodTransfus.2026.Suppl3","url":null,"abstract":"","PeriodicalId":520572,"journal":{"name":"Blood transfusion = Trasfusione del sangue","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148538025","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}