Annals of blood最新文献

{"title":"Molecular genetic narrative review of the novel blood group systems KANNO, SID, CTL2, PEL, and MAM","authors":"G. Denomme","doi":"10.21037/aob-21-25","DOIUrl":"https://doi.org/10.21037/aob-21-25","url":null,"abstract":"","PeriodicalId":72211,"journal":{"name":"Annals of blood","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41346848","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":"Transfusion of blood products during extracorporeal membrane oxygenation: a narrative review of rationale, indications, impact on immune function and outcome","authors":"Antonio Siragusa, C. Forlini, Benedetta Fumagalli, S. Redaelli, Dario Winterton, G. Foti, M. Giani","doi":"10.21037/aob-21-32","DOIUrl":"https://doi.org/10.21037/aob-21-32","url":null,"abstract":"The use of extracorporeal membrane oxygenation (ECMO) support poses several risks, particularly thrombosis and bleeding. As a result, transfusion of blood components is frequent during extracorporeal support. In this review we aim to describe the rationale and indications of blood products transfusions, and their impact on the immune function and outcome. The red blood cells (RBC) transfusion threshold is very debated, because of awareness of transfusion-associated adverse events due to liberal strategies. To date, no specific recommendations exist but a comprehensive physiologic approach appears feasible to evaluate the need for RBC transfusion. For patients without bleeding, the guidelines of the Extracorporeal Life Support Organization (ELSO) suggest fresh frozen plasma (FFP) administration if the prothrombin time (PT) ratio is higher than 1.5–2.0 and/or there is significant bleeding. Conversely, for bleeding patient indications often refer to trauma guidelines, where it is recommended to use a 1:1 ratio of RBC and FFP in massive transfusion situations. The indications for antithrombin supplementation are unknown and large inhomogeneity exists between different ECMO centers and between pediatric and adult patients. Supplementation of fibrinogen is considered only for bleeding patients and/or with fibrinogen level below 100 or 150 mg/dL. ELSO guidelines suggest 25–50 IU/kg of prothrombin complex concentrate as an alternative to FFP for patients with active bleeding and a prolonged PT. Recombinant activated factor VII might be a potential therapeutic option for intractable bleeding despite conventional treatment but may cause life-threatening thrombotic complications. Platelet transfusions might be limited to cases of severe thrombocytopenia accompanied by bleeding. ELSO guidelines recommend a target of at least 80×10/L platelets. Liberal platelets transfusion thresholds may be reasonable in case of intracranial hemorrhage. Albeit rare, multiple adverse events of blood products transfusion are described. There is no evidence of transfusion-related acute lung injury during ECMO support, likely because of the difficulty to distinguish the cause of clinical worsening in patients with severe respiratory failure. Infections represent a major contributor on morbidity and mortality in ECMO patients. However, as of today, no literature has explored the impact of transfusions on immune function of ECMO patients. Currently, there are no specific guidelines for transfusions in ECMO patients and the management is highly variable among centers. Further research is warranted on this topic.","PeriodicalId":72211,"journal":{"name":"Annals of blood","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43277449","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":"Acquired hemophilia A and deep vein thrombosis attributable to the Pfizer-BioNTech SARS-CoV-2 mRNA vaccine—case report","authors":"P. Rani, O. Ogunleye, S. Ramineni, Uma Medapati, Dmitriy Berenzon","doi":"10.21037/aob-21-66","DOIUrl":"https://doi.org/10.21037/aob-21-66","url":null,"abstract":"Background: Acquired hemophilia A (AHA) is a rare autoimmune bleeding disorder that occurs in a sporadic, nonhereditary pattern. It is caused by circulating autoantibodies against clotting factor VIII that are triggered by several conditions. Moreover, AHA is clinically distinct from the inherited form of hemophilia A, with a different natural history and management approach, necessitating a high-index of suspicion in at-risk patients. Coronavirus disease 2019 (COVID-19) has emerged as a multisystemic disease whose manifestations are continuously being evaluated. There are few case reports of AHA associated with COVID-19 infection, while one case of AHA has been associated with COVID-19 vaccination. Similarly, deep venous thrombosis (DVT) frequently complicates COVID-19 infection, but two cases of DVT have been reported following COVID-19 vaccination. We report the occurrence of both AHA and DVT in a 63-year-old male patient within one week of receiving his first dose of the Pfizer-BioNTech SARS-CoV-2 mRNA vaccine. Case Description: Patient is a 63-year-old male who presented with a 3-day history of left lower extremity (LLE) swelling and pain. He was hemodynamically stable, but examination showed exquisite tenderness, ecchymosis, and pitting edema at the calf of the LLE. He had normal platelet counts at presentation but had mild anemia (11.9 g/dL) and elevated activated partial thromboplastin time (APTT) of 68.0 seconds. Venous Doppler ultrasound showed acute DVT in the left popliteal vein, necessitating commencement on heparin drip. He developed progressively worsening hematomas, symptomatic anemia that required red cell transfusions, and persistently elevated APTT despite stopping the heparin drip. Work up for pulmonary embolism, malignancy, and disseminated intravascular coagulopathy (DIC) were negative. Antiphospholipid antibodies and lupus anticoagulant were also negative. He had low factor VIII levels, tested positive for factor VIII inhibitor, and PTT mixing studies were consistent with acquired factor inhibitor. Treatment involved administration of Factor Eight Inhibitor Bypassing Activity (FEIBA) as well as intravenous methylprednisolone and cyclophosphamide. Following resolution of active bleeding with evidence of stable hemoglobin concentration, he was discharged home on oral prednisone and cyclophosphamide. Conclusion(s): This case report highlights the possibility of AHA and DVT as rare, potentially life-threatening adverse events that could occur following COVID-19 vaccination, which is currently the most effective tool employed in controlling the COVID-19 pandemic.Copyright © Annals of Blood. All rights reserved.","PeriodicalId":72211,"journal":{"name":"Annals of blood","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41344440","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":"Blood product transfusions on extracorporeal membrane oxygenation: a narrative review","authors":"Ewa Olek, M. Pasierski, Artur Słomka, G. Raffa, Steven Lebowitz, M. Pilato, K. Szułdrzyński, P. Suwalski, R. Lorusso, M. Kowalewski","doi":"10.21037/aob-21-30","DOIUrl":"https://doi.org/10.21037/aob-21-30","url":null,"abstract":"","PeriodicalId":72211,"journal":{"name":"Annals of blood","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42341364","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":"The use of blood components prior to bedside procedures","authors":"A. Menard, A. Mujoomdar, L. Tapley, Nicole Relke, Joey Zheng, A. Shih, J. Callum","doi":"10.21037/aob-21-69","DOIUrl":"https://doi.org/10.21037/aob-21-69","url":null,"abstract":"A transition from liberal use of transfusions prior to invasive procedures to a thoughtful, restrictive approach to transfusion is underway. This shift is being driven by the publication of very large observational studies showing a very low incidence of bleeding complication from most common procedures (even in the presence of severe thrombocytopenia and abnormal tests of coagulation) in conjunction with an evidence-based 2019 guideline from the Society for Interventional Radiology recommending restrictive use of pre-procedure transfusion. Many common invasive procedures have a major bleeding risk well less than 1% with image-guided techniques. This is excellent for patient care, however prospective randomized trials of transfusion vs. no transfusion before invasive procedures are unattainable, given the studies would require an impracticable sample size due to low event rates and would expose the transfusion group to the harms of transfusion. Indeed, a recent pilot randomized trial not only found challenges with recruitment but high rates of transfusion complications suggesting that transfusion risks currently exceed bleeding risks. Utilization studies find approximately 25% of plasma and 10% of platelets are transfused to patients as prophylaxis for bleeding prevention prior to procedures. This suggests that adherence to restrictive practices could substantially reduce adverse reactions from transfusion, minimize blood product shortages, and minimize delays in procedures for transfusion. In addition to unnecessary transfusions, the unselected use of preprocedure laboratory testing is unwarranted for all procedures. This testing is expensive, has a low positive predictive value for bleeding complications, and delays procedures unnecessarily. Numerous studies have also shown that the infusion of plasma for mildly elevated international normalized ratio (INR) test results (INR of 1.5–1.9) does not alter the INR and therefore is very unlikely to reduce the bleeding risk. Lastly, the INR does not predict the risk of bleeding and the coagulation status of patients with liver cirrhosis. Many large centers have successfully transitioned to a restrictive use of blood before procedures and published the safety of this approach. This review will provide the evidence to convince others to follow suit.","PeriodicalId":72211,"journal":{"name":"Annals of blood","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45244482","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":"Special series on thrombocytopenia due to immunization against CD36","authors":"B. Curtis","doi":"10.21037/aob-2021-03","DOIUrl":"https://doi.org/10.21037/aob-2021-03","url":null,"abstract":"","PeriodicalId":72211,"journal":{"name":"Annals of blood","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47717414","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":"Molecular genetics and genomics of blood group systems","authors":"Y. Fichou","doi":"10.21037/aob-21-71","DOIUrl":"https://doi.org/10.21037/aob-21-71","url":null,"abstract":"","PeriodicalId":72211,"journal":{"name":"Annals of blood","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47770034","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":"Intrauterine, neonatal and pediatric transfusion therapy","authors":"Y. Mo, B. Bahar, C. Jacquot","doi":"10.21037/aob-21-59","DOIUrl":"https://doi.org/10.21037/aob-21-59","url":null,"abstract":"","PeriodicalId":72211,"journal":{"name":"Annals of blood","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46362240","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":"Anemia and red blood cell transfusion in the adult non-bleeding patient","authors":"C. D. Burns","doi":"10.21037/aob-21-51","DOIUrl":"https://doi.org/10.21037/aob-21-51","url":null,"abstract":"Anemia is a global health issue. It is associated with a wide variety of disease states in both medical and surgical patients. Increased morbidity and mortality are notable in patients with even mild anemia. Clinicians often consider red blood cell (RBC) transfusions as first-line therapy for patients with anemia to raise the hemoglobin (Hgb) level and increase oxygen delivery. RBC transfusion in the hemorrhaging patient can be lifeor limb-saving. However, RBC transfusion may result in serious adverse events, both acute and delayed, and thus, the medical decision to transfuse in the non-bleeding, anemic patient must be carefully considered. Recent literature identifies RBC transfusion practice, in a multitude of patient populations, can be readily avoided with attention placed on proper assessment of patient symptoms, optimal diagnosis of the etiology of the anemia, and appropriate treatment thereof. This review seeks to collate the current state of the science regarding RBC transfusions in the adult non-bleeding patient. Evidence-based alternatives to transfusion will also be briefly presented.","PeriodicalId":72211,"journal":{"name":"Annals of blood","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45772290","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":"Bacterial contamination and sepsis associated with transfusion: current status in Latin America","authors":"Michel-Andrés García-Otálora, María-Antonieta Núñez-Ahumada, Silvina Kuperman, Leonardo Oliveira-Leitão, F. Silveira, Rita Martins, Mónica Pesántez-Pesántez, Jorge Gutiérrez, Romi-Edenilse Alcaráz-Paredes, Eddy Renzo Manrique Castagnola, A. Bravo-Lindoro, E. Vinelli, Marta Lilian González, Keydi Juárez, M. Bermúdez-Forero","doi":"10.21037/AOB-20-92","DOIUrl":"https://doi.org/10.21037/AOB-20-92","url":null,"abstract":"In 2016 and 2017, eighteen Latin American countries transfused 21,808,541 blood components, 55.9% corresponded to red blood cells and 20.1% to platelet concentrates. In the same period, only Brazil reported to the Pan American Health Organization (PAHO) six cases of sepsis due to bacterial contamination (BC; four in 2016 and two in 2017). These data represent a frequency of one case per 3,634,756 transfused blood components. These results contrast with those notified by the haemovigilance reports from North America, Europe, Africa, and Oceania, where transmitted-transfusion bacterial infection (TTBI) frequency range 1:14,515 to 1:384,903 in transfused platelets, and 1:96,850 to 1:3,448,275 in transfused erythrocytes. Today’s frequency of TTBI is higher than viral infections. Although strategies such as diversion of the first aliquot, bacterial detection during storage, and pathogen reduction technologies (PRT) reduce the risk of TTBI, they do not eliminate it. This review aims to establish the strategies implemented to reduce TTBI in Latin American countries and know the number of cases recorded. Likewise, we determined the limitations that prevent TTBI notification. Finally, we estimated the number of events that should be presented based on more experienced haemovigilance programs. TTBI mitigation strategies vary within each country and throughout the Latin American region. There are blood banks that have not yet implemented the diversion 18 ^ ORCID: 0000-0001-9637-8937. Annals of Blood, 2021 Page 2 of 18 © Annals of Blood. All rights reserved. Ann Blood 2021 | http://dx.doi.org/10.21037/aob-20-92 Introduction Blood transfusion is one of the therapeutic strategies employed in clinical practice (1). However, its use carries not only benefits but also potential risks. Transfusiontransmitted infections (TTIs) comprise several biological agents (viruses, parasites, bacteria, fungi, and prions) transmitted during the administration of whole blood or blood components (2). To date, there are more than 68 potentially causative agents of TTI (3,4). However, currently, the spread of viruses transmitted by transfusion has been substantia l ly reduced, so that bacteria l contamination (BC) of blood components is today the most frequent cause of TTI (5). Sepsis associated with red blood cell transfusion has decreased rapidly in the last twenty years, possibly due to the more widespread application of leukoreduction filters (6). Therefore, most cases of posttransfusion sepsis today involve platelet components stored at room temperature. With the introduction of better skin disinfection, first aliquot diversion techniques, and bacterial detection in platelets, the rate of clinically significant septic reactions has decreased but not eliminated. Today it is known that the severity of a septic reaction will depend on various factors related to bacteria (gram-positive or gramnegative, the type of strain) and receptors (comorbidities, immune status, use of antibi","PeriodicalId":72211,"journal":{"name":"Annals of blood","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45943025","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}