Transfusion medicine and hemotherapy : offizielles Organ der Deutschen Gesellschaft fur Transfusionsmedizin und Immunhamatologie最新文献

{"title":"Does Offline Beat Inline Treatment: Investigation into Extracorporeal Photopheresis.","authors":"Wolfgang Helmberg,&nbsp;Sabine Sipurzynski,&nbsp;Andrea Groselje-Strehle,&nbsp;Hildegard Greinix,&nbsp;Peter Schlenke","doi":"10.1159/000506750","DOIUrl":"https://doi.org/10.1159/000506750","url":null,"abstract":"<p><strong>Background: </strong>Extracorporeal photopheresis is a therapy based on the induction of apoptosis to cells harvested from peripheral blood, followed by direct retransfusion. Currently, there are two approaches: inline procedures, where cell harvesting, 8-methoxypsoralen (8-MOP) incubation, and UV irradiation is performed with a single device, and offline procedures, with collection in one device, followed by 8-MOP incubation/UV irradiation using a second device.</p><p><strong>Study design and methods: </strong>In a prospective crossover study, we compared an inline (Cellex, Therakos) with an established offline procedure (Optia, Terumo, and MacoGenic G2, Macopharma) in 6 patients, focusing on cell composition and apoptosis induction after 24 h. In total, 32 photopheresis treatments per device were performed.</p><p><strong>Results: </strong>We observed an overall 2-fold higher number of apoptotic \"target\" cells for each patient with offline treatment. All yields were stratified per patient. Yields were compared as ratio offline/inline for CD3+ (2.5-fold), CD4+ (2-fold), CD8+ (2.8-fold), CD56+ (2.8-fold), CD19+ (1.8-fold), CD15+ (0.5-fold), and CD14+ (2.2-fold) cells. Apoptosis induction was measured after 24 h with Annexin V/7-AAD for early and late apoptosis rates of CD3+ (CD4+, CD8+) and CD56+ cells. CD3+ cells of the inline treatment had an average of 88% (26% early, 62% late) of apoptotic cells compared to 75% (34% early, 41% late) in the offline treatment. Procedure duration ranged from 80 to 100 min inline, with a maximum of 1,500 mL processed blood, and 125-140 min offline, with at least 3,000 mL processed blood, depending on blood flow. Average hematocrit levels of the products were 2.7% inline versus 1.7% offline.</p><p><strong>Conclusions: </strong>The offline procedure, as established in our department, provides more apoptotic cells for treatment. The increased number of mononuclear cells collected outweighs a slightly reduced apoptosis rate after 24 h in comparison to the inline procedure. Besides this, the final decision for one or the other procedure has to take into account additional aspects, such as peripheral white blood cell count, hematocrit, and weight of the patient, required before apheresis, extracorporeal volume, and, last but not least, overall costs. The final criterion, however, has to be the reported clinical efficacy of the system applied.</p>","PeriodicalId":520820,"journal":{"name":"Transfusion medicine and hemotherapy : offizielles Organ der Deutschen Gesellschaft fur Transfusionsmedizin und Immunhamatologie","volume":" ","pages":"198-204"},"PeriodicalIF":2.2,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000506750","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38098619","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":"Extracorporeal Photopheresis in Graft-versus-Host Disease.","authors":"Beatrice Drexler,&nbsp;Andreas Buser,&nbsp;Laura Infanti,&nbsp;Gregor Stehle,&nbsp;Joerg Halter,&nbsp;Andreas Holbro","doi":"10.1159/000508169","DOIUrl":"https://doi.org/10.1159/000508169","url":null,"abstract":"<p><strong>Background and summary: </strong>Extracorporeal photopheresis (ECP) is a leukapheresis-based procedure used in the therapy of acute and chronic graft-versus-host disease (aGvHD, cGvHD) and other diseases. Based on the substantial efficacy and the excellent safety profile in the absence of immunosuppression ECP has established itself as a major treatment form for steroid-refractory GvHD. Here we review the current literature on ECP as a treatment option for patients with aGvHD as well as cGvHD.</p><p><strong>Key messages: </strong>ECP is a well-established second-line therapy for cGvHD. Its role in the treatment of aGvHD is less clear but also points towards an effective second-line therapy option. In the future ECP could play a role in the prevention of GvHD. More experimental and randomized controlled trials are needed to define the best patient selection criteria, settings, and therapy regimens for GvHD.</p>","PeriodicalId":520820,"journal":{"name":"Transfusion medicine and hemotherapy : offizielles Organ der Deutschen Gesellschaft fur Transfusionsmedizin und Immunhamatologie","volume":" ","pages":"214-225"},"PeriodicalIF":2.2,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000508169","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38098621","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":"Extracorporeal Photopheresis: A Case of Immunotherapy Ahead of Its Time.","authors":"Pablo Augusto Vieyra-Garcia,&nbsp;Peter Wolf","doi":"10.1159/000508479","DOIUrl":"https://doi.org/10.1159/000508479","url":null,"abstract":"<p><p>Extracorporeal photopheresis (ECP) is a cell-based immunotherapy that involves the reinfusion of autologous leukocytes after exposure to psoralen and UVA. The treatment has been used for over 30 years, at first on patients with cutaneous T-cell lymphoma (CTCL) and later for the management of patients with graft-versus-host disease (GvHD), sclerosing disorders, atopic dermatitis, and other diseases that may share the common driving factor of a pathogenic T-cell clone or clones in blood circulation. Patients with clinical improvement mount an antigen-specific immune response that may have tolerance traits in the case of GvHD or anticlonal cytotoxic characteristics in the case of CTCL. The exact mechanisms that dictate one response or the other are not fully understood, but the evidence accumulated so far indicates that multiple events occur simultaneously and consequentially contribute to the end result. These include contact of cells with the outside (plastics and tubing of the ECP apparatus), exposure to psoralen and UVA that activates platelets, monocytes, and other myeloid cells, the release of damage-associated molecular patterns, differentiation of monocytes into dendritic cells, and generation and successive presentation of numerous antigens after the phagocytosis of apoptotic cells. Once reintroduced, the ECP product increases the frequency and activity of regulatory T cells (Tregs), shifts the systemic cytokine balance, and promotes extravasation of immune cells that together shape the effects of this treatment. In this review, we summarize the seminal work and most recent literature of the therapeutic mechanisms and reflect on future avenues of improvements and applications of ECP.</p>","PeriodicalId":520820,"journal":{"name":"Transfusion medicine and hemotherapy : offizielles Organ der Deutschen Gesellschaft fur Transfusionsmedizin und Immunhamatologie","volume":" ","pages":"226-235"},"PeriodicalIF":2.2,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000508479","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38098622","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":"Outcome of Extracorporeal Photopheresis as an Add-On Therapy for Antibody-Mediated Rejection in Lung Transplant Recipients.","authors":"Alberto Benazzo,&nbsp;Nina Worel,&nbsp;Stefan Schwarz,&nbsp;Ulrike Just,&nbsp;Anna Nechay,&nbsp;Christoph Lambers,&nbsp;Georg Böhmig,&nbsp;Gottfried Fischer,&nbsp;Daniela Koren,&nbsp;Gabriela Muraközy,&nbsp;Robert Knobler,&nbsp;Walter Klepetko,&nbsp;Konrad Hoetzenecker,&nbsp;Peter Jaksch","doi":"10.1159/000508170","DOIUrl":"https://doi.org/10.1159/000508170","url":null,"abstract":"<p><strong>Introduction: </strong>The diagnosis and treatment of antibody-mediated rejection (AMR) after lung transplantation has recently gained recognition within the transplant community. Extracorporeal photopheresis (ECP), currently used to treat chronic lung allograft dysfunction, modulates various pathways of the immune system known to be involved in AMR. We hypothesize that adding ECP to established AMR treatments could prevent the rebound of donor-specific antibodies (DSA).</p><p><strong>Objectives: </strong>This study aimed to analyze the role of ECP as an add-on therapy to prevent the rebound of DSA.</p><p><strong>Methods: </strong>Lung transplant recipients who received ECP as an add-on therapy for pulmonary AMR between January 2010 and January 2019 were included in this single-center retrospective analysis. Baseline demographics of the patients, as well as their immunological characteristics and long-term transplant outcomes, were analyzed.</p><p><strong>Results: </strong>A total of 41 patients developed clinical AMR during the study period. Sixteen patients received ECP as an add-on therapy after first-line AMR treatment. Among the 16 patients, 2 (13%) had pretransplant DSA, both against human leukocyte antigen (HLA) class I (B38, B13, and C06). Fifteen patients (94%) developed de novo DSA (dnDSA), i.e., 10 (63%) against class I and 14 (88%) against class II. The median time to dnDSA after lung transplantation was 361 days (range 25-2,548). According to the most recent International Society of Heart and Lung Transplantation (ISHLT) consensus report, 2 (13%) patients had definite clinical AMR, 6 (38%) had probable AMR, and 7 (44%) had possible AMR. The median mean fluorescence intensity (MFI) of dnDSA at the time of clinical diagnosis was 4,220 (range 1,319-10,552) for anti-HLA class I and 10,953 (range 1,969-27,501) for anti-HLA class II antibodies. ECP was performed for a median of 14 cycles (range 1-64). MFI values of dnDSA against HLA classes I and II were significantly reduced over the treatment period (for anti-class I: 752; range 70-2,066; for anti-class II: 5,612; range 1,689-21,858). The 1-year survival rate was 55%. No adverse events related to ECP were reported in any of the patients.</p><p><strong>Conclusions: </strong>ECP is associated with a reduction of dnDSA in lung transplant recipients affected by AMR. Prospective studies are warranted to confirm the beneficial effects of ECP in the setting of AMR.</p>","PeriodicalId":520820,"journal":{"name":"Transfusion medicine and hemotherapy : offizielles Organ der Deutschen Gesellschaft fur Transfusionsmedizin und Immunhamatologie","volume":" ","pages":"205-213"},"PeriodicalIF":2.2,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000508170","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38098620","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":"Validation of Spiked Postmortem Blood Samples from Cornea Donors on the Abbott ARCHITECT and m2000 Systems for Viral Infections.","authors":"Ingo Schmack,&nbsp;Seda Ballikaya,&nbsp;Brigitte Erber,&nbsp;Irina Voehringer,&nbsp;Ulrich Burkhardt,&nbsp;Gerd U Auffarth,&nbsp;Paul Schnitzler","doi":"10.1159/000502866","DOIUrl":"https://doi.org/10.1159/000502866","url":null,"abstract":"<p><strong>Background: </strong>Transplantation of human corneal tissue is associated with the potential risk of transmittance of viral infections. In accordance with European directives and federal laws, in Germany each tissue donor has to be tested for infectious diseases such as hepatitis B and C virus (HBV and HCV) and human immunodeficiency virus (HIV) infection. However, most of the currently available CE-marked serologic and nucleic acid screening systems are only validated for antemortem blood.</p><p><strong>Methods: </strong>Twenty related and paired ante- and postmortem blood samples from cornea donors were obtained and subsequently analyzed for hepatitis B surface antigen (HBsAg), hepatitis B antibody (anti-HBc), anti-HCV, HCV RNA, anti-HIV-1/2, and HIV p24 Ag using Abbott test systems. The sera were also spiked with reference materials in concentrations giving low and high positivity for HBV, HCV, and HIV markers.</p><p><strong>Results: </strong>The spiked ante- and postmortem sera from related donors showed similar results for HBsAg, anti-HBc, anti-HCV, HCV RNA, anti-HIV, and HIV p24 Ag, indicating a high stability of viral markers in cadaveric specimens. Three cornea donors had a medical history of HBV infection and revealed anti-HBc at similar levels in the ante- and postmortem sera. In addition, there was a single postmortem sample demonstrating a weak signal of anti-HIV-1 and HIV-1 p24 Ag. False-positive or false-negative results were not detected. The results obtained with the Abbott ARCHITECT analyzer and Abbott RealTime HCV PCR showed no significant differences.</p><p><strong>Conclusion: </strong>The analyzed screening assays are suitable for the detection of infectious markers of HBV, HCV, and HIV at similar levels in spiked ante- and postmortem sera from cornea donors.</p>","PeriodicalId":520820,"journal":{"name":"Transfusion medicine and hemotherapy : offizielles Organ der Deutschen Gesellschaft fur Transfusionsmedizin und Immunhamatologie","volume":" ","pages":"236-242"},"PeriodicalIF":2.2,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000502866","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38098623","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":"Thromboelastography Detects Possible Coagulation Disturbance in Pediatric Patients with Portal Cavernoma.","authors":"Linfeng Wu,&nbsp;Gaofu Zhang,&nbsp;Chunbao Guo","doi":"10.1159/000501229","DOIUrl":"https://doi.org/10.1159/000501229","url":null,"abstract":"<p><strong>Background: </strong>Thromboelastography (TEG) allows a dynamic assessment of clot formation and dissolution that might be useful for assessing the relative contribution of the coagulation components to overall clot formation and dissolution, but it has not been fully defined in patients with portal cavernoma (PC).</p><p><strong>Methods: </strong>We retrospectively recruited consecutive patients with PC between July 2006 and June 2016 who had no abdominal malignancy or liver cirrhosis. Blood samples were drawn on admission and were subjected to coagulation parameter assessment, including conventional coagulation tests, measurement of the circulating levels of procoagulant and anticoagulant factors, and TEG assessment.</p><p><strong>Results: </strong>Compared with controls, patients with PC showed significant reductions in the serum levels of procoagulant factors and anticoagulants factors, whereas factor VIII was slightly elevated. TEG showed clot formation (α-angle), and the maximal clot strength (MA) was higher in patients with PC than in controls, indicating a hypercoagulable state. Thrombocytopenia decreased both clot formation (α-angle) and the maximal clot strength (MA) but was still significantly higher than the control. Furthermore, patients with PC had a higher level of D-dimer and LY30 than did controls, indicating the in vivo activation of coagulation and fibrinolysis.</p><p><strong>Conclusion: </strong>TEG analysis showed that patients with PC were in a hypercoagulable state that could be partially masked by thrombocytopenia secondary to splenomegaly and hypersplenism in these patients, which indicates that our current prophylaxis and therapy regimen could be improved.</p>","PeriodicalId":520820,"journal":{"name":"Transfusion medicine and hemotherapy : offizielles Organ der Deutschen Gesellschaft fur Transfusionsmedizin und Immunhamatologie","volume":" ","pages":"135-143"},"PeriodicalIF":2.2,"publicationDate":"2020-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000501229","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37889917","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":"Human Brucellosis: Risks and Prevalence among Iranian Blood Donors Residing in Endemic Areas.","authors":"Maryam Zadsar,&nbsp;Mohammad Reza Shirzadi,&nbsp;Mohammad Zeynali,&nbsp;Mahboubeh Rasouli,&nbsp;Gharib Karimi","doi":"10.1159/000500248","DOIUrl":"https://doi.org/10.1159/000500248","url":null,"abstract":"<p><strong>Background: </strong>Brucellosis is a common zoonotic infection worldwide. Transmission can be occasionally observed via transfusion or transplantation. This study was designed to survey the seroprevalence of anti-<i>Brucella</i> antibody in blood donors in different endemic provinces.</p><p><strong>Materials and methods: </strong>A total of 14,706 blood donors from the 5 most prevalent provinces were studied by standard tube agglutination (STA) and any positive subjects were further confirmed by 2-mercaptoethanol agglutination test (2-ME). Significant titres were 80 for STA and 40 for 2-ME.</p><p><strong>Result: </strong>A total of 63 (0.43%) serum samples were STA-positive. Of these, the 2-ME test was reactive in 42 samples. The 2-ME test was reactive in 31 samples with a low titre. However, concomitant STA ≥80 and the titre of ≥40 for the 2-ME test were found in 11 subjects (0.075%), mostly resident in urban areas. Exposure to manure products was identified as a significant risk factor (<i>p</i> = 0.0128). <b><i>Conclusion</i></b> : The observed data show a somewhat noticeable prevalence among Iranian blood donors, bringing attention to the importance of pre-donation screening via a questionnaire which supplies answers about occupational history, and any history of exposure or past infections. Further studies to evaluate the frequency and related risk factors in certain populations, in conjunction with implementing stricter regulations in blood donor selection in endemic areas, may be necessary.</p>","PeriodicalId":520820,"journal":{"name":"Transfusion medicine and hemotherapy : offizielles Organ der Deutschen Gesellschaft fur Transfusionsmedizin und Immunhamatologie","volume":" ","pages":"103-109"},"PeriodicalIF":2.2,"publicationDate":"2020-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000500248","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37889915","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":"Validation of Microbiological Testing of Cellular Medicinal Products Containing Antibiotics.","authors":"Ramin Lotfi,&nbsp;Markus Thomas Rojewski,&nbsp;Philip H Zeplin,&nbsp;Wolfgang Funk,&nbsp;Oliver Pullig,&nbsp;Ulrich Nöth,&nbsp;Hubert Schrezenmeier","doi":"10.1159/000501284","DOIUrl":"https://doi.org/10.1159/000501284","url":null,"abstract":"<p><strong>Background: </strong>The risk of microbial contamination of cellular products can be reduced when cultured in the presence of antibiotics. This however, may impact the sensitivity of microbiological tests. Given that the addition of antibiotics to cell/tissue products does not guarantee sterility but may just reduce the proliferation rate of microorganisms, microbiological testing of medicinal products remains obligatory. Thus, an appropriate method to test for microbial contamination of antibiotic-containing products has to be validated.</p><p><strong>Objectives: </strong>In the context of microbiological testing of a cellular advance therapy medicinal product, the method was validated and approved by German competent authorities for four different matrices with three matrices containing antibiotics. The paper shall provide help for establishing test methods for other investigational medicinal products which contain antibiotics.</p><p><strong>Methods: </strong>Matrices were spiked individually with <i>Staphylococcus aureus, Bacillus subtilis, Pseudomonas aeruginosa, Streptococcus pyogenes, Escherichia coli, Clostridium sporogenes, Propionibacterium acnes, Candida albicans,</i> and <i>Aspergillus brasiliensis</i>. Samples were pretreated with penicillinase for 1 h before inoculation and incubation in BacT/ALERT iFA Plus and iFN Plus culture bottles using 3D BacT/ALERT automates. Microorganisms within positive BacT/ALERT bottles were specified. The procedure was performed in two different laboratories to prove robustness of test.</p><p><strong>Results: </strong>All nine tested microorganisms were detected within 14 days of incubation in accordance with requirements of the European Pharmacopoiea in terms of sensitivity, specificity and robustness of the test. Penicillin and streptomycin did not have any influence on specifications defined within the investigational medicinal product dossier.</p><p><strong>Conclusions: </strong>Culturing cellular products in the presence of antibiotics can serve as an effective method to reduce contamination risk but only if the chosen antibiotics neither have any influence on specifications of the investigational medicinal product nor interfere with microbiological tests. Consequently, cells and tissues primarily contaminated with microorganisms, like placenta, may be considered as a source of cellular therapeutics when cultured for a sufficient time with antibiotics and tested with a validated method. The choice of microorganisms for the validation of the microbiological test should always consider all conceivable scenarios and should not be reduced to minimal criteria defined in European Pharmacopoiea, wrongfully believing to thus save time and effort.</p>","PeriodicalId":520820,"journal":{"name":"Transfusion medicine and hemotherapy : offizielles Organ der Deutschen Gesellschaft fur Transfusionsmedizin und Immunhamatologie","volume":" ","pages":"144-151"},"PeriodicalIF":2.2,"publicationDate":"2020-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000501284","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37889776","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":"Beyond Description: The Predictive Role of Affect, Memory, and Context in the Decision to Donate or Not Donate Blood.","authors":"Barbara Masser,&nbsp;Eamonn Ferguson,&nbsp;Eva-Maria Merz,&nbsp;Lisa Williams","doi":"10.1159/000501917","DOIUrl":"https://doi.org/10.1159/000501917","url":null,"abstract":"<p><strong>Background: </strong>Research on the recruitment and retention of blood donors has typically drawn on a homogeneous set of descriptive theories, viewing the decision to become and remain a donor as the outcome of affectively cold, planned, and rational decision-making by the individual. While this approach provides insight into how our donors think about blood donation, it is limited and has not translated into a suite of effective interventions. In this review, we set out to explore how a broader consideration of the influences on donor decision-making, in terms of affect, memory, and the context in which donation takes place, may yield benefit in the way we approach donor recruitment and retention.</p><p><strong>Summary: </strong>Drawing on emerging research, we argue for the importance of considering the implications of both the positive and the negative emotions that donors experience and we argue for the importance of directly targeting affect in interventions to recruit nondonors. Next, we focus on the reconstructed nature of memory and the factors that influence what we remember about an event. We discuss how these processes may impact the retention of donors and the potential to intervene to enhance donors' recollections of their experiences. Finally, we discuss how our focus on the individual has led us to neglect the influence of the context in which donation takes place on donor behavior. We argue that the amassing of comprehensive large data sets detailing both the characteristics of the individuals and the context of their giving will ultimately allow for the more effective deployment of resources to improve recruitment and retention.</p><p><strong>Key messages: </strong>In suggesting these directions for future research, our want is to move beyond the ways in which we have traditionally described blood donation behavior with the aim of improving our theorizing about donors while improving the translational value of our research.</p>","PeriodicalId":520820,"journal":{"name":"Transfusion medicine and hemotherapy : offizielles Organ der Deutschen Gesellschaft fur Transfusionsmedizin und Immunhamatologie","volume":" ","pages":"175-185"},"PeriodicalIF":2.2,"publicationDate":"2020-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000501917","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37889778","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":"Molecular Basis of ABO Variants Including Identification of 16 Novel <i>ABO</i> Subgroup Alleles in Chinese Han Population.","authors":"Yan-Ling Ying,&nbsp;Xiao-Zhen Hong,&nbsp;Xian-Guo Xu,&nbsp;Shu Chen,&nbsp;Ji He,&nbsp;Fa-Ming Zhu,&nbsp;Xin-You Xie","doi":"10.1159/000501862","DOIUrl":"https://doi.org/10.1159/000501862","url":null,"abstract":"<p><strong>Introduction: </strong>The characteristic of ABO blood subgroup is crucial for elucidating the mechanisms of such variant phenotypes and offering useful information in blood transfusion.</p><p><strong>Methods: </strong>In total, 211 ABO variants including part of available family members were investigated in this study. The phenotypes of these individuals were typed with serologic methods. The full coding regions of <i>ABO</i> gene and the erythroid cell-specific regulatory elements in intron 1 of them were amplified with polymerase chain reaction and then directly sequenced. The novel alleles were confirmed by cloning and sequencing. Phylogenetic tree was made using CLUSTAL W software. 3D structural analyses of the glycosyltransferases (GTs) with some typical mutations were performed by PyMOL software.</p><p><strong>Results: </strong>Forty-eight distinctly rare <i>ABO</i> alleles were identified in 211 Chinese variant individuals, including 16 novel <i>ABO</i> alleles. All of the alleles were categorized as 5 groups: 16 <i>ABO</i>*<i>A</i> alleles, 23 <i>ABO</i>*<i>B</i> alleles, 4 <i>ABO</i>*<i>BA</i> alleles, 4 <i>ABO</i>*<i>cisAB</i> alleles, and 1 <i>ABO</i>*<i>O</i> alleles. <i>ABO</i>*<i>A2.08</i> and <i>ABO</i>*<i>BA.02</i> were the relatively predominant <i>A</i> and <i>B</i> subgroup alleles, respectively. According to the phylogenetic tree, 28 alleles (5 common alleles and 23 alleles identified in our laboratory) were classified into 3 major allelic lineages. The structural analysis of 3D homology modeling predicted reduced protein stability of the mutant GTs and may explain the reduced ABO antigen expression.</p><p><strong>Conclusions: </strong>The molecular basis of ABO variants was analyzed, and 16 novel <i>ABO</i> alleles were identified. The results extended the information of ABO variants and provided a basis for better transfusion strategies and helped to improve blood transfusion safety.</p>","PeriodicalId":520820,"journal":{"name":"Transfusion medicine and hemotherapy : offizielles Organ der Deutschen Gesellschaft fur Transfusionsmedizin und Immunhamatologie","volume":" ","pages":"160-166"},"PeriodicalIF":2.2,"publicationDate":"2020-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000501862","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37889777","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}