Transfusion Medicine Reviews最新文献

{"title":"The Research of a Large-Scale Analysis Platform for MNS Blood Group Identification Based on Long-Read Sequencing","authors":"Hua Xu,&nbsp;Xiaomin Su,&nbsp;Qinqin Zuo,&nbsp;Liangzi Zhang,&nbsp;Xiaoyue Chu","doi":"10.1016/j.tmrv.2024.150836","DOIUrl":"10.1016/j.tmrv.2024.150836","url":null,"abstract":"<div><div><span>The objective of this study was to devise a novel approach for determining MNS blood group utilizing long-read sequencing (LRS) and to identify intricate genome variations associated with this blood group system. In this study, a total of 60 blood samples were collected from randomly selected Chinese Han blood donors. The amplification of the full-length sequences of </span><em>GYPA</em> exon 2-7 (11 kb) and <em>GYPB</em> exon 2-6 (7 kb) was conducted on the blood samples obtained from these 60 donors. Subsequently, the sequencing of these amplified sequences was performed using the PacBio platform. The obtained sequencing data were then compared with the reference sequence of the human genome (GRCh38) utilizing the pbmm2 software, resulting in the acquisition of the haploid sequences of <em>GYPA</em> and <em>GYPB</em>. The serological typing prediction was conducted using the International Society of Blood Transfusion (ISBT) database, while the analysis of SNVs sites was performed using deepvariant v1.2.0 software and reference sequence alignment. A total of 60 samples yielded unambiguous high-quality haplotypes, which can serve as a standardized reference sequence for molecular biology typing of MNSs in the Chinese population. In a total of 60 serological samples, the LRS method successfully identified the M, N, S, and s blood group antigens by analyzing specific genetic variations (c.59, c.71, c.72 for <em>GYPA</em>, and c.143 for <em>GYPB</em>), which aligned with the results obtained through conventional serological techniques. 4 Mur samples that had been previously validated through serology and molecular biology were successfully confirmed, and complete haploid sequences were obtained. Notably, one of the Mur samples exhibited a novel breakpoint, <em>GYP</em> (<em>B1-136-B ψ 137-212-A213-229-B230-366</em>), thereby representing a newly identified subtype. Single molecule sequencing, which eliminates the necessity for PCR amplification, effectively encompasses GC and high repeat regions, enhancing accuracy in quantifying mutations with low abundance or frequency. By employing LRS analysis of the core region of <em>GYPA</em> and <em>GYPB</em>, diverse genotypes of MNS can be precisely and reliably identified in a single assay. This approach presents a comprehensive, expeditious, and precise novel method for the categorization and investigation of MNS blood group system.</div></div>","PeriodicalId":56081,"journal":{"name":"Transfusion Medicine Reviews","volume":"38 4","pages":"Article 150836"},"PeriodicalIF":2.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141136309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Whole Blood Donor Iron Management Across Europe: Experiences and Challenges in Four Blood Establishments","authors":"K. van den Hurk ,&nbsp;M. Arvas ,&nbsp;D.J. Roberts ,&nbsp;J. Castrén ,&nbsp;C. Erikstrup","doi":"10.1016/j.tmrv.2024.150860","DOIUrl":"10.1016/j.tmrv.2024.150860","url":null,"abstract":"<div><div>Whole blood donors lose iron while donating and frequent blood donation is therefore known to induce a risk of iron deficiency and/or anemia. In this review we present, compare and discuss the pros and cons of 4 distinctive donor iron management strategies in England, Finland, the Netherlands, and Denmark. Donor iron management policies in the countries concerned are described for the year 2021, and data on donor and donation numbers, low hemoglobin (Hb) deferral rates and Hb levels are presented. In England Hb levels were only measured in donors failing a copper sulphate test, while in the other 3 countries Hb is measured at every donation. In Finland, donors considered at risk of iron deficiency receive iron supplements, while in the Netherlands, ferritin-guided donation intervals without iron supplementation are in place. In Denmark, iron supplementation is provided to donors with low ferritin levels. Low-Hb deferral rates and average Hb levels are quite similar across the included countries, with the exception of higher deferral rates in England. To conclude, despite significant diversity in donor iron management approaches, low Hb deferral rates and average Hb levels are similar among the included countries except for England, where higher deferral rates were observed that are likely attributed to the absence of iron supplementation or ferritin-guided deferral. Achieving an optimal, more tailored iron management strategy requires further research and a nuanced understanding of both donor demographics and physiological responses to optimize the effectiveness and safety of blood donation practices.</div></div>","PeriodicalId":56081,"journal":{"name":"Transfusion Medicine Reviews","volume":"38 4","pages":"Article 150860"},"PeriodicalIF":2.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142382478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beta-Amyloid Related Neurodegenerative and Neurovascular Diseases: Potential Implications for Transfusion Medicine","authors":"Ryan T. Muir ,&nbsp;Jeannie L. Callum ,&nbsp;Amy Y.X. Yu ,&nbsp;Moira K. Kapral ,&nbsp;Richard H. Swartz ,&nbsp;Sandra E. Black ,&nbsp;Bradley J. MacIntosh ,&nbsp;Dean A. Fergusson ,&nbsp;Steven Kleinman ,&nbsp;Andrew D. Demchuk ,&nbsp;Peter K. Stys ,&nbsp;Eric E. Smith ,&nbsp;Michael D. Hill","doi":"10.1016/j.tmrv.2024.150858","DOIUrl":"10.1016/j.tmrv.2024.150858","url":null,"abstract":"<div><div>Cerebral amyloid angiopathy (CAA) is a progressive cerebrovascular and neurodegenerative disorder that is caused by the aberrant accumulation of soluble beta-amyloid isoforms in the small vessel walls of the cerebral and cerebellar cortices and the leptomeninges. Vascular beta-amyloid deposition increases vulnerability to intracerebral hemorrhage (ICH). Clinically, CAA can be the underlying cause of up to half of spontaneous lobar ICHs and can also present with convexity subarachnoid hemorrhage, transient focal neurologic episodes and progressive cognitive decline leading to dementia. The majority of CAA is sporadic, with increasing prevalence with age and often coexists with Alzheimer's Disease (AD). Genetic and iatrogenic etiologies are rare. Cases of CAA and AD have been linked to the use of cadaveric pituitary hormone and later life iatrogenic CAA has also been described following early-life neurosurgical procedures with cadaveric dura grafts. Together these data suggest a capacity of beta-amyloid transmissibility. A recent study found that in over 1 million transfusion recipients from donors who later developed (i) &gt;1 ICH or (ii) one ICH event and dementia, had an elevated risk of developing future ICH. Considering prior reports of transfusion associated variant-Creutzfeldt Jakob Disease in humans and <em>in vivo</em> evidence in sheep, coupled with emerging data supporting beta-amyloid's <em>prion-like</em> properties, raises the question of whether CAA could be transmissible by blood transfusion. This would also have implications for screening, especially in an era of emerging plasma biomarkers of cerebral amyloidosis. Given the public health concerns raised by this biologically plausible question, there is a need for future studies with well-characterized definitions – and temporal ascertainment – of CAA <em>exposure</em> and <em>outcomes</em> to examine whether CAA is transfusion-transmissible, and, if so, with what frequency and timing of onset.</div></div>","PeriodicalId":56081,"journal":{"name":"Transfusion Medicine Reviews","volume":"38 4","pages":"Article 150858"},"PeriodicalIF":2.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142442075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Universal irradiation of platelets: Does irradiation affect the quality, effectiveness, and safety of platelets for transfusion?","authors":"Lorna Cain ,&nbsp;Louise J. Geneen ,&nbsp;Michael Wiltshire ,&nbsp;Catherine Kimber ,&nbsp;Sue Proffitt ,&nbsp;Josie Sandercock ,&nbsp;Carolyn Dorée ,&nbsp;Susan J. Brunskill ,&nbsp;Lise J. Estcourt","doi":"10.1016/j.tmrv.2024.150840","DOIUrl":"10.1016/j.tmrv.2024.150840","url":null,"abstract":"<div><div>We aimed to identify any detrimental effects on platelet quality and clinical effectiveness, of irradiated platelets compared to non-irradiated platelets for transfusion. The review was conducted in accordance with PRISMA guidelines. The protocol was prospectively registered on PROSPERO [CRD42023441930]. Our search identified 3002 references, of which we included 44 studies. Forty-one were <em>in vitro</em> only studies, two studies were in healthy volunteers, and one study reported clinical outcomes in thrombocytopenic patients. X-ray was used exclusively in three studies, and alongside gamma irradiation in one study. Two studies did not report the source of irradiation. The remaining 38 studies used gamma irradiation only. We assessed risk of bias (ROB) for studies reporting clinical and <em>in vivo</em> outcomes using ROB 2.0 (3 studies). We adapted a ROB tool designed for animal studies to assess ROB for the studies reporting <em>in vitro</em> outcomes (43 studies). We assessed the certainty of the evidence for the eight outcomes deemed most important to assess platelet quality and clinical effectiveness (where day 0 is the day of the blood draw).<ul><li><span>•</span><span><div>High certainty of a small decrease in pH (day 7) with irradiation: mean difference (MD) 0.04 lower (95% CI, −0.07 to −0.00).</div></span></li><li><span>•</span><span><div>Moderate certainty of an increase in P-selectin (day 5) with irradiation: MD 1.58 % higher (95% CI, 0.72-2.45).</div></span></li><li><span>•</span><span><div>Moderate certainty of no difference in supernatant glucose (days 5 and 7) and P-selectin (day 7).</div></span></li><li><span>•</span><span><div>Very low certainty of any difference in pH (day 5), post-transfusion bleeding risk (WHO 2+), and post-transfusion platelet survival time.</div></span></li></ul></div><div>Overall, gamma irradiation has little to no effect on most markers of platelet quality and effectiveness. Where there is evidence of detriment from irradiation, differences are small <em>in vitro</em>, and are unlikely to affect clinical outcomes following transfusion. However, the evidence base is limited. Only half the studies could be included in any analysis. There is very limited evidence for x-ray as a source of irradiation and, given the potential benefits of using x-ray over gamma irradiation (ease of use and safety requirements), we would welcome further research comparing x-ray to gamma, and x-ray to a non-irradiated control.</div></div>","PeriodicalId":56081,"journal":{"name":"Transfusion Medicine Reviews","volume":"38 4","pages":"Article 150840"},"PeriodicalIF":2.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141635962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expression Alterations of Blood Group Genes During Plasmodium Falciparum Infection in Orthochromatic Erythroblasts","authors":"Fang-Fang Liu ,&nbsp;Ke Li","doi":"10.1016/j.tmrv.2024.150837","DOIUrl":"10.1016/j.tmrv.2024.150837","url":null,"abstract":"","PeriodicalId":56081,"journal":{"name":"Transfusion Medicine Reviews","volume":"38 4","pages":"Article 150837"},"PeriodicalIF":2.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141389393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultra-Massive Transfusion: Predictors of Occurrence and In-Hospital mortality From the Australian and New Zealand Massive Transfusion Registry (ANZ-MTR)","authors":"Marsali Maclean ,&nbsp;Cameron Wellard ,&nbsp;Elham Ashrafi ,&nbsp;Helen E. Haysom ,&nbsp;Rosemary L. Sparrow ,&nbsp;Erica M. Wood ,&nbsp;Zoe K. McQuilten","doi":"10.1016/j.tmrv.2024.150857","DOIUrl":"10.1016/j.tmrv.2024.150857","url":null,"abstract":"<div><div>Few data exist on patient clinical characteristics, predictors of occurrence and short- and long-term outcomes of ultra-massive transfusion (UMT), defined as receiving 20 units or more of red blood cells (RBCs) within 48h. This study analyses UMT events from the Australian and New Zealand Massive Transfusion Registry (ANZ-MTR)<strong>.</strong> The ANZ-MTR captured all patients at 29 participating sites receiving a massive transfusion (MT), defined as ≥5 units of RBCs within 4h. Of 9028 patients, 803 (8.9%) received an UMT. UMT patients were younger than other MT patients (median age 57y vs 62y; <em>P &lt; .</em>001). In UMT and MT, males predominated (66.3% and 62.9%, respectively); and context was predominantly trauma (28.8% and 23%) and cardiothoracic surgery (CTS) (21.7% and 20.3%). Median RBC units received within 4h were 16 (UMT) and 6 (MT). In UMT, 4h FFP:RBC ratio (0.6 vs 0.4, <em>P &lt; .</em>001), and 4h cryoprecipitate use (72.9% vs 39.9%, <em>P &lt; .</em>001) were higher. Independent predictors of UMT (Odds Ratio; 95% CI) were age &lt;60y (1.52; 1.28-1.79), baseline Hb &gt;100g/L (1.31; 1.08-1.59), INR &gt;1.5 (1.56; 1.24-1.96), and APTT &gt;60s (4.49; 3.40-5.61). Predictors of in-hospital mortality in UMT included Charlson Comorbidity Index score ≥3 (11.20, 0.60 - 25.00) and bleeding context, with mortality less likely in liver transplant (0.07, 0.01-0.41) and more likely in vascular surgery (8.27, 1.54-72.85), compared with CTS. In-hospital mortality was higher in the UMT group compared with MT group (20.5% vs 44.2%, <em>P &lt; .</em>001), however 5y survival following discharge was not significantly different between the groups (HR=0.87 [95%CI 0.64-1.18], <em>P</em> = .38). UMT patients are more commonly younger, with baseline coagulopathy, and have higher in-hospital mortality compared with MT. However, UMT is not futile: 55.8% survived to discharge, without significant difference in survival postdischarge between the groups.</div></div>","PeriodicalId":56081,"journal":{"name":"Transfusion Medicine Reviews","volume":"38 4","pages":"Article 150857"},"PeriodicalIF":2.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142395608","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Balancing Donor Health and Plasma Collection: A Systematic Review of the Impact of Plasmapheresis Frequency","authors":"Tine D'aes ,&nbsp;Katja van den Hurk ,&nbsp;Natalie Schroyens ,&nbsp;Susan Mikkelsen ,&nbsp;Pieter Severijns ,&nbsp;Emmy De Buck ,&nbsp;Peter O'Leary ,&nbsp;Pierre Tiberghien ,&nbsp;Veerle Compernolle ,&nbsp;Christian Erikstrup ,&nbsp;Hans Van Remoortel","doi":"10.1016/j.tmrv.2024.150851","DOIUrl":"10.1016/j.tmrv.2024.150851","url":null,"abstract":"<div><div>Most plasma used for manufacturing plasma-derived medicinal products (PDMPs) such as albumin, immunoglobulin (Ig), and clotting factors is obtained from source plasma collected via plasmapheresis, the majority of which is contributed by the United States (US). While the demand for PDMPs continues to rise, it remains unclear whether high-frequency plasmapheresis, such as the twice-weekly plasma donation allowed in the US, may have any (long-term) adverse health effects on the donor. To investigate the frequency at which plasma can be donated without harm to the donor, the current systematic review explores the impact of plasma donation frequency on cardiovascular health, protein depletion, and adverse events in healthy plasma donors. We asked the following research question: What is the impact of plasmapheresis frequency (Intervention) on the safety or health (Outcome) of healthy donors (Population)? Six databases (PubMed, Embase, Web of Science, CINAHL, the Cochrane Library, and Transfusion Evidence Library), 2 clinical trial registries (ICTRP and clinicaltrials.gov), and the PROSPERO database were searched. Four observational and 2 experimental studies were included. The results showed that very high-frequency donation (twice per week) may result in a clinically relevant decrease in ferritin and bring IgG levels below the lower threshold of 6 g/l. However, the evidence is of low to very low certainty, and solid conclusions are hindered by the <em>healthy donor effect</em> and methodological limitations of the included studies. To determine a safe threshold donation frequency that minimizes any possible harmful effect on the donor, more high-quality prospective cohort studies and experimental studies are needed. We should expedite such studies to support recommendations, as conclusive evidence confirming or refuting the safety of maximum allowed donation frequencies is lacking. Donor protection is essential, given that healthy donors receive no direct medical benefit from donating plasma.</div></div>","PeriodicalId":56081,"journal":{"name":"Transfusion Medicine Reviews","volume":"38 4","pages":"Article 150851"},"PeriodicalIF":2.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142146993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Towards Safer Transfusion Therapies: The Role of Non-Inflammatory Fcy Receptor 1 Blockade","authors":"Yaima Tundidor Cabado","doi":"10.1016/j.tmrv.2024.150856","DOIUrl":"10.1016/j.tmrv.2024.150856","url":null,"abstract":"<div><h3>Introduction</h3><div>The ongoing need to reduce reliance on intravenous immunoglobulin (IVIg) in treating autoimmune and inflammatory diseases calls for novel, targeted therapeutic strategies. Given the adverse events linked with Fcγ receptor (FcγR) III blockade, this study investigates the therapeutic potential of targeting FcγRI, demonstrated herein to be non-inflammatory, offering a more specific and safer alternative to the generalized action of IVIg.</div></div><div><h3>Objective</h3><div>This work aims to develop an in vivo anti-FcγRI therapy as a more focused and safer alternative to both IVIg therapy and FcγRIII blockade, with potential implications for improving patient outcomes and quality of life.</div></div><div><h3>Design and Methods</h3><div>From a phage display library, novel anti-human FcγRI antibodies were selected based on their high affinity and specificity for FcγRI. These antibodies were characterized for their ability to block Fc-FcγRI interactions using a human macrophage cell line and to prevent macrophage-mediated phagocytosis of sensitized red blood cells. The inflammatory nature of anti-FcγRI antibodies, compared to those engaging FcγRIII, was assessed through temperature changes and cytokine responses in FcγR-humanized mice, as well as in C57BL/6 and BALB/c mice, providing a comprehensive safety profile.</div></div><div><h3>Results</h3><div>We developed five novel anti-human FcγRI antibodies, each demonstrating a significant ability to inhibit FcγRI-mediated phagocytosis in vitro, without eliciting adverse inflammatory responses in vivo. Notably, anti-FcγRI administration did not result in the temperature changes or inflammatory responses observed with anti-FcγRIII, highlighting the non-inflammatory benefits of FcγRI targeting.</div></div><div><h3>Conclusions</h3><div>Our findings support the development of anti-FcγRI antibodies as a promising, non-inflammatory therapeutic approach for transfusion medicine. This strategy not only has the potential to reduce the dependency on IVIg but also offers a safer and more specific method for modulating the immune response in patients.</div></div>","PeriodicalId":56081,"journal":{"name":"Transfusion Medicine Reviews","volume":"38 4","pages":"Article 150856"},"PeriodicalIF":2.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142721270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Isohemagglutinin titres: A comparison of pathogen reduced pooled platelets manufactured with platelet additive solution versus untreated pooled platelets","authors":"Melanie Bodnar,&nbsp;Dora Lopes-Carvalho,&nbsp;Tammy Ison,&nbsp;Behr Ehsani-Moghaddam,&nbsp;Cindy Lever,&nbsp;Ilona Resz,&nbsp;Mei Yiep,&nbsp;Shuoyan Ning,&nbsp;Michelle Zeller,&nbsp;Charles Musuka","doi":"10.1016/j.tmrv.2024.150853","DOIUrl":"10.1016/j.tmrv.2024.150853","url":null,"abstract":"<div><h3>Introduction</h3><div>Limitations in platelet inventory necessitate the use of ABO-incompatible (ABOi) platelets for transfusion with possible risk of an acute hemolytic transfusion reaction due to the presence of high titre (HT) isohemagglutinins (ISO). Pooled platelets psoralen-treated (PPPT) are manufactured following the division of 7 donor buffy coats in a platelet additive solution (PAS). The PAS:plasma ratio of 60:40 provides a dilutional effect on ISO levels. The purpose of this study is to compare the proportion of PPPT that test ISO HT positive versus untreated 4 donor platelet pools without PAS (UPP).</div></div><div><h3>Methods</h3><div>Component-based ISO titration was performed on 1001 UPP (November 8 2022-February 8 2023) and 1019 PPPT (June 1 2023-August 31 2023) followed by testing of 834 additional group O PPPT (September 1 2023-January 19 2024) to refine the HT rate estimate. All testing was performed at a single laboratory by a manual immediate spin tube method using an aliquot of platelet supernatant diluted 1:50 with saline tested separately against A1 and B cells. Agglutination with either/both A1 and B cell(s) constituted a positive HT result. The proportion of components with HT results were compared for PPPT vs UPP. Statistical analysis was performed using SAS with <em>P</em>-values calculated using the chi-square method.</div></div><div><h3>Results</h3><div>Of 1019 PPPT in PAS, 3 (0.29%) tested HT positive and all were group O. By comparison, 64/1001 (6.4%) UPP were HT positive (<em>P</em>-value &lt;.0001). The rate of HT positivity by ABO blood group for PPPT vs UPP: Group O 3/559 (0.54%) vs 53/496 (10.6%) (<em>P</em>-value &lt;.0001); Group A 0/439 (0%) vs 9/468 (1.9%); Group B 0/21 (0%) vs 2/37 (5.4%). For group A and B platelets, the relatively low rate of HT positive events in both UPP and PPPT precluded meaningful statistical comparison. Testing of 834 additional group O PPPT yielded 6 HT positive components for a total of 9/1393 (0.65%) HT positive group O PPPT (99% CI 0.23-1.43%).</div></div><div><h3>Conclusions</h3><div>Greater than 99% of pathogen reduced pooled platelets in PAS have low isohemagglutinin titres using a common component-based testing assay. For PPPT, none of the group A or B tested HT positive with 0.65% positivity in group O. The significant reduction in HT positive pooled platelet components with this new manufacturing method confers a greater safety profile when ABO incompatible platelet transfusion cannot be avoided. These findings may impact hospital decisions around inventory management, platelet selection and titre testing.</div></div>","PeriodicalId":56081,"journal":{"name":"Transfusion Medicine Reviews","volume":"38 4","pages":"Article 150853"},"PeriodicalIF":2.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142721551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"RhD-Alloimmunization in Adult and Pediatric Trauma Patients","authors":"Richard R. Gammon ,&nbsp;Nour Almozain ,&nbsp;Daniela Hermelin ,&nbsp;Norma Klein ,&nbsp;Sadhana Mangwana ,&nbsp;Amita Radhakrishnan Nair ,&nbsp;Jennifer J. O'Brien ,&nbsp;Aaron Daniel Shmookler ,&nbsp;Laura Stephens ,&nbsp;Christopher Bocquet","doi":"10.1016/j.tmrv.2024.150842","DOIUrl":"10.1016/j.tmrv.2024.150842","url":null,"abstract":"<div><p>The actual risk of providing RhD-positive units to RhD-negative recipients remains debatable. There is no standard of care in the United States (US) to guide transfusion decisions regarding RhD type for patients with an unknown blood type, except for women of childbearing age and neonates. The risk of alloantibody formation by an RhD-negative patient exposed to RhD-positive blood is reported to be from 3% to 70%. Due to such wide variations, this review was undertaken to determine the prevalence of anti-D alloimmunization in trauma patients who are RhD-negative and were transfused RhD-positive blood products. This study used the “Preferred Reporting Items for Systematic Reviews and Meta-Analyses” (PRISMA) approach to answer the question, “In trauma patients who were transfused blood, what is the prevalence of alloimmunization to the D-antigen?” The review included all published articles through April 3, 2022 in databases. Articles published after the search period found by the authors were added to the manuscript if they addressed the primary question and there was unanimous consensus. There were 1683 full-text articles that met the search criteria, with 19 studies meeting eligibility criteria. In addition, 57 references were added after the search period had closed. The incidence of anti-D alloimmunization in adult trauma patients receiving whole blood varied from 7.8% to 42.7%. In contrast, incidence varied in patients receiving red blood cells (RBCs), from 0 to 94%, depending on number of categories analyzed. Anti-D alloimmunization with platelet transfusions varied from 0% to 19%. The alloimmunization rate increased with age and was detected only in children older than 5 years. Recent guidelines recommend the administration of Rh immune globulin (RhIG) to all traumatically injured patients who are both RhD-negative and pregnant. However, there is no specific guidance focused on the RhD-negative patient, pregnant or nonpregnant, and who have received RhD-positive red blood cells (RBC) and platelets. While numerous studies have attempted to evaluate the frequency of RhD alloimmunization rate in trauma settings, emerging data suggests that many factors affect this phenomenon. Additionally, the role of RhIG administration in cases of RhD-incompatible transfusions within the trauma setting adds complexity. As our trajectory propels us towards precision medicine and tailored transfusion practices, gaining a big data approach becomes indispensable.</p></div>","PeriodicalId":56081,"journal":{"name":"Transfusion Medicine Reviews","volume":"38 4","pages":"Article 150842"},"PeriodicalIF":2.7,"publicationDate":"2024-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141714009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}