American Red Cross Blood Services Research Articles

Predictors of Donor/Host (D/H) Lineage Specific Chimerism Trends in Pediatric Patients Following Allogeneic Hematopoietic Cell Transplantation

The outcome of allogeneic HCT is dependent on several pre-transplant variables. We hypothesize that these pre-transplant factors may influence the donor/host chimerism post HCT, which in its turn may affect the outcome. We performed an analysis to study lineage specific D/H chimerism patterns of total blood leukocytes, myeloid cells/neutrophils, B-cells, NK-cells and T-cells. All consecutive patients who underwent an allogeneic HCT between 01/2010 to 06/2015 on the Pediatric BMT Service at MSKCC were reviewed. Chimerism analyses were performed by short tandem repeat (STR) polymorphism analysis at the American Red Cross Blood Services (Philadelphia, PA). Lineage specific donor chimerism post HCT was studied including donor chimerism trend, and factors with potential impact on chimerism including: age, disease, graft source, and T-cell depletion (TCD). Preliminary analyzes performed on this cohort included Wilcoxon Rank Test and cox proportional hazard analyses. 140 patients with a median age of 11.5 years were included. They included 97 patients with hematologic malignancies, 27 patients with non-malignant hematologic disorders and 16 patients with immunologic disorders. Cytoreduction included TBI in 48 patients or chemotherapy only in 98 patients. 105 patients received T-cell depleted grafts, 28 patients unmodified marrow or peripheral blood grafts, and 7 patients unrelated cord blood grafts. No patients received donor leukocyte infusions (DLI). Observational studies revealed that full donor chimerism of myeloid cells, B-cells and NK-cells, but not T-cells occurred early post-transplant. In Wilcoxon Rank Test, there was no difference in the percentage of total donor leukocytes at 3 months vs 12 months post HSCT (n=30), while the median of donor T-cell chimerism was 51% at 3 months and 91% at 12 months post HSCT (p The studies of the impact of different factors on chimerism were performed, including age, disease, and type of graft. Loss of donor total leukocytes chimerism between 3 and 12 months post-transplant was significantly more pronounced for patients This preliminary analysis of lineage specific chimerism post-transplant showed that donor T-cells may take one year to fully recover post-transplant, mostly following T-cell depleted grafts, without intervention. Cord blood grafts were associated with high donor chimerism throughout the post-transplant period. Lastly, factors associated with loss of donor chimerism post-transplant were younger age and non-malignant disorders. More in-depth analyses are being performed.

International Society of Blood Transfusion Working Party on red cell immunogenetics and blood group terminology: Berlin report

The International Society of Blood Transfusion Working Party on red cell immunogenetics and blood group terminology convened during the International congress in Cancun, July 2012. This report details the newly identified antigens in existing blood group systems and presents three new blood group systems.

The legacy of Charles R. Drew, MD, CM, MDSc

Abstract April 2011 marked the 70th anniversary of the establishment of the American Red Cross Blood Services (ARCBS). In this report, we present a biography of Dr. Charles Drew, the first medical director of the ARCBS. Although many may recognize Dr. Charles Drew for this position, the research and training that led him to be uniquely qualified to take this position may not be as well known. We present his professional training, his research on blood preservation and distribution, and his service to the larger medical community and country. Lastly, we address the many myths that have arisen over the years since his untimely death at the age of 45 on April 1, 1950, and present the legacy of Dr. Charles Drew that has largely been unknown to the greater medical and scientific community. Immunohematology 2011;27:94–100.

Tibor Jack Greenwalt: Father of Transfusion Medicine

Tibor J. Greenwalt (1914-2005) was, as much as anyone, the Father of Transfusion Medicine. He was founder of the Blood Center of Wisconsin, the first member of the American Association of Blood Banks, founding editor of Transfusion, chair of the National Research Council's Committee on Blood and Transfusion, national medical director of the American Red Cross Blood Services, and president of the International Society of Blood Transfusion. He wrote 200 papers and 25 books, describing erythroblastosis fetalis as an immune hemolytic anemia, new blood groups and antigens, the effects of hepatitis testing on blood safety, better ways to store red cell, and much more. He worked until days before his death at age 91, ending a 63-year career with 5 papers in press.

Prevalence, incidence, and residual risk of major blood‐borne infections among apheresis collections to the American Red Cross Blood Services, 2004 through 2008

The number of apheresis collections increased significantly in recent years; however, data on viral marker rates among these collections are lacking. Apheresis collection data for 2004 to 2008 were analyzed. All collections were tested for antibodies and viral RNA for human immunodeficiency virus (HIV) and hepatitis C virus (HCV), hepatitis B surface antigen (HBsAg), antibody to hepatitis B core antigen (anti-HBc), antibody to human T-lymphotropic virus (anti-HTLV), and other markers. HBsAg-confirmed-positive but anti-HBc-nonreactive units were further verified by HBV DNA testing. From 2004 to 2008, apheresis collections for double red blood cells (R2) increased by 294% to a total of 37% of all apheresis collections. Marker rates (/100,000) among all apheresis collections were 1.41, 7.83, 2.04, and 0.28, for HIV, HCV, HBsAg, and HTLV. Among R2 collections, rates (/100,000) were 6- to 13-fold higher than among non-R2 collections for HIV (3.50 vs. 0.53), HCV (21.84 vs. 1.96), and HBsAg (5.83 vs. 0.44), but not HTLV (0.53 vs. 018). First-time male R2 donors accounted for 25% to 100% of positivity but only 1% to 5% of the total number of apheresis collections. Incidence (/100,000 person-years) and residual risk estimates among repeat apheresis donors between 2007 and 2008 for HIV were 3.82 and 1:1.0 million, for HCV were 1.53 and 1:3.2 million, and for HBsAg were 4.85 and 1:200,000. These estimates were comparable to those among repeat whole blood donors. The risk of major blood-borne infections among current apheresis collections was low; however, an upward trend in the viral marker frequency among apheresis donations was attributable to the contribution of first-time, male R2 donors.

Current value of serologic test for syphilis as a surrogate marker for blood‐borne viral infections among blood donors in the United States

Serologic screening for syphilis has been justified in part as a surrogate marker for infections caused by other pathogens such as human immunodeficiency virus (HIV). This study assessed the current surrogate value of the test. Testing results for blood donors with the American Red Cross Blood Services between January 1, 2006, and December 31, 2007, were analyzed. All donations were tested according to standard procedures for markers of HIV, hepatitis B virus (HBV), hepatitis C virus (HCV), human T-lymphotropic virus (HTLV), syphilis, and other infections. The frequency of window-period (w-p) infections interdicted by syphilis testing was estimated. There were significantly higher frequencies of HIV, HCV, hepatitis B surface antigen (HBsAg), and HTLV confirmed-positive donations among those with positive syphilis test results, although the sensitivity of syphilis test positivity in these groups was low. Among more than 3 million repeat donors with complete testing through reactive donation confirmation for both syphilis and HIV (anti-HIV and HIV RNA), 225 seroconverted for syphilis but not for anti-HIV or HIV RNA and 83 converted for HIV (anti-HIV or HIV RNA) but not for syphilis, with only 1 who converted for both syphilis and HIV, resulting in an incidence ratio of 150 (95% confidence interval, 21-1080) and a sensitivity of 1.2 percent. No syphilis seroconverters converted for HCV, HBsAg, or anti-HTLV. Syphilis testing presents no surrogate value for incident HCV, HBV, and HTLV infections and could only remove approximately 1 HIV w-p unit of every 148 million donations.

Donor deferral and resulting donor loss at the American Red Cross Blood Services, 2001 through 2006

A large number of blood donors are deferred each year and many of the temporarily deferred donors do not return to donate blood. This study analyzed actual deferral and return donation data from the American Red Cross to further assess the impact of donor deferral on donor availability. Voluntary blood donors who presented between 2001 and 2006 were included in this study. Deferred donors were classified into three groups according to their history of presentation during the prior 2 years: Group 1 with no prior donation or deferral, Group 2 with prior donation but no deferral, and Group 3 with prior deferral. Temporarily deferred donors in Groups 1 and 2 who did not return during the next 3 years were considered lost donors. All indefinitely deferred donors were lost donors. A mean of 12.8 percent of a total of 47,814,370 donor presentations between 2001 and 2006 resulted in a deferral. While majority of the deferrals were related to donor safety reasons, deferrals for recipient safety reasons accounted for 22.6 percent of deferrals or 2.9 percent of total presentations. Temporary and indefinite deferrals for recipient safety-related reasons collectively caused an estimated loss of 647,828 donors during the 6 years. An additional 1,042,743 donors were lost due to deferrals for donor safety-related reasons during the same period. The results on donor loss after deferral call attention to the impact of donor deferrals on donor availability and the need to monitor and assess the necessity and effectiveness of such deferrals.

Regional and temporal variation in American Red Cross blood donations, 1995 to 2005

Maintaining a stable blood supply is a critical goal of the American Red Cross Blood Services. Extensive Red Cross data provided the opportunity to assess both long-term and short-term trends in the variation of weekly blood donations. Overall trends and week-to-week variation in donation rates were assessed in volunteer, whole-blood donations from 1995 to 2005 among three Red Cross donor regions: the Connecticut region, the Greater Chesapeake and Potomac (Maryland) region, and the Southern California region, adjusting for population change, calendar time, age, sex, and donor region. Weekly donation rates varied widely by region, ranging from 3.5 donations per 10,000 persons in Southern California to 10.2 donations per 10,000 in Connecticut. Week-to-week variation in donation rates within each region was also quite high. Typical swings in weekly donation rates ranged from 38 percent in Connecticut to 56 percent in Southern California. Week-to-week variation was also 103 percent higher (95% confidence interval [CI], 87%-120%) among 18- to 24-year-old donors, compared to 25- to 44-year-olds, ranging from 32 to 49 percent. By comparison, week-to-week variation among adults 25 and older was more stable, ranging from 16 to 21 percent. This study suggests that there is a great deal of variation in donation rates, particularly among the youngest donors. Improving recruitment and retention among these donors will be critical to maintaining an adequate blood supply as the donor population ages.

Implementation of the Uniform Donor History Questionnaire across the American Red Cross Blood Services: increased deferral among repeat presenters but no measurable impact on blood safety

The Uniform Donor History Questionnaire (UDHQ) was implemented across the American Red Cross Blood Services in 2005. This study assessed the potential impact of changes inherent in UDHQ implementation on deferral and on prevalence of infectious disease markers among donated units. Deferral and donation records were extracted and analyzed for the period of April 1, 2005, to September 30, 2005, after the implementation of the UDHQ and for the same period in the previous year. For comparison, most of the questions in the UDHQ were aligned with corresponding questions in the previous questionnaire, although such alignment could not be exact because of changes in the wording and organization of the questions. From 2004 (1 year previously) to 2005 (UDHQ), significant changes in deferral rate were observed for different groups of deferral questions, with the largest being +99.2 percent for "man who had sex with another man" and +92.0 percent for "receipt of blood, tissue, organ, or clotting factor concentrates or a bleeding condition or a blood disease" among repeat presenters. Changes to the educational material and the wording of questions, elimination of compound questions, and other concurrent changes could have contributed to the changed deferral rates. There was no significant change in prevalence rates of major infectious disease markers. Implementation of the UDHQ impacted on donor deferral, including increased deferral among repeat presenters. No significant impact was observed for infectious disease marker rates. Further monitoring for longer-term trends is recommended.

American Society for Apheresis, Society of Hemapheresis Specialists and Francis S. Morrison, MD, revisited

AbstractThe histories of the American Society for Apheresis (ASFA) and the Society for Hemapheresis Specialists (SHS) are intimately intertwined with Francis S Morrison, MD. Because many of the relevant historical events are not recorded as written documents, it is useful to revisit them via the memory of those who lived‐through the growth and development of ASFA. ASFA began in 1982 as an organization of physicians interested in automated hemapheresis—actually, meetings of ASFA perse were preceded in the late 1970s by apheresis symposia sponsored by the American Red Cross Blood Services in Chicago. Concurrently, SHS formed as an organization of nurses and “operators” performing hemapheresis procedures and held meetings separate from ASFA. Following a number of turbulent years, ASFA and SHS merged. Trusting my memory and a few personal documents, I will touch on many of the notable events of ASFA and SHS history. Because of the leadership of Dr. Fran Morrison during many crucial events in ASFA history, I will make special efforts to remember his contributions to ASFA as an organization and the ways in which he touched the lives of many ASFA members. J. Clin. Apheresis., 2007 © 2007 Wiley‐Liss, Inc.

International Society of Blood Transfusion Committee on Terminology for Red Cell Surface Antigens: Cape Town report

International Society of Blood Transfusion Committee on Terminology for Red Cell Surface Antigens: Cape Town report

Prevalence of selected viral infections among blood donors deferred for potential risk to blood safety

Health history questions identify blood donors believed to pose a higher risk of transmission of infectious diseases. This study assesses the current impact of some of these questions on blood safety as reflected by infectious disease markers. Donors who were deferred from donating blood due to health history question(s) were recruited at four different regions of the American Red Cross Blood Services. A blood sample was tested for serologic markers of blood-borne infections as performed for accepted blood donors. Of 497 deferred donors enrolled, 29 donors were deferred for having had "yellow jaundice, liver disease, or hepatitis since the age of 11" (Question 3), 1 of whom had hepatitis C virus antibodies (anti-HCV) and hepatitis B core antigen antibodies (anti-HBc), 2 had anti-HBc, and 1 had anti-HCV (p < 0.05 for both markers). Among 37 donors deferred for having "ever tested positive for hepatitis" (Question 4), 1 had hepatitis B surface antigen and anti-HBc and 3 had anti-HBc (p < 0.05 for both markers). Of 14 donors deferred for "having ever used a needle, even once, to take any illegal or nonprescription drug" (Question 12), 1 had anti-HCV, human T-lymphotropic virus-I antibodies and anti-HBc, 1 had anti-HCV and anti-HBc, and 2 had anti-HCV (p < 0.05 for all three markers). Blood donors deferred for standard blood donor questions regarding risk of viral hepatitis as well as those with a history of intravenous drug use were more likely to have higher hepatitis marker rates than those who were not deferred. No significant findings were identified for other markers or questions.

Partners for Life: the transfusion program for patients with sickle cell disease offered at the American Red Cross Blood Services, Southern Region, Atlanta, Georgia

Partners for Life: the transfusion program for patients with sickle cell disease offered at the American Red Cross Blood Services, Southern Region, Atlanta, Georgia

Donors who react may not come back: Analysis of repeat donation as a function of phlebotomist ratings of vasovagal reactions

Previous studies using small or restricted samples suggest that vasovagal reactions to blood donation are associated with a decreased likelihood of repeat donation. In the present study, we examined data for all allogeneic whole blood donors ( n = 89,587) in the American Red Cross Blood Services, Central Ohio Region during an entire year. Results of a one-year follow-up revealed that moderate and severe vasovagal reactions reduced the likelihood of repeat donation by 50% or more. Light vasovagal reactions, which represented 97% of all reactions recorded, significantly reduced return rates by 20% for first-time donors and 33% for experienced donors.

Platelets from pooled buffy coats: an update

From the American Red Cross Blood Services, Penn-Jersey Region, Philadelphia, Pennsylvania. Address reprint requests to: Scott Murphy, MD, Chief Medical Officer, American Red Cross Blood Services, 700 Spring Garden Street, Philadelphia, PA 19123; e-mail: smurphy@usa.redcross.org. Received for publication December 3, 2004; revision received December 16, 2004, and accepted December 17, 2004. TRANSFUSION 2005;45:634-639. R E V I E W

Blood group terminology 2004: from the International Society of Blood Transfusion committee on terminology for red cell surface antigens

1 Bristol Institute for Transfusion Sciences, Bristol, UK 2 Growing your Knowledge, Spit Junction, NSW, Australia 3 American Red Cross Blood Services, Los Angeles-Orange Counties Region, Los Angeles, CA, USA 4 Biotechnology Research Centre, Auckland University of Technology, Auckland, New Zealand 5 Regional Blood Transfusion Center, Department of Clinical Immunology, University Hospital, Arhus N, Denmark 6 Department of Pathology, University Hospitals UH-2G332, Ann Arbor, Michigan, USA 7 Reference Laboratory for Immunohematology and Blood Groups, National Blood Services Centre, Tel Hashomer, Israel 8 New York Blood Center, New York, NY, USA 9 Ortho-Clinical Diagnostics, Raritan, NJ, USA 10 Drexel University College of Medicine, Philadelphia, PA, USA 11 Gamma Biologicals Inc (subsidiary of Immunocor Inc), Houston, TX, USA 12 Central Laboratory of the Netherlands Red Cross Blood Transfusion Service, Amsterdam, the Netherlands 13 Centre national de Reference pour les Groupes sanguines (CNTS), Paris, France 14 International Blood Group Reference Laboratory, Bristol, UK 15 Finnish Red Cross Blood Transfusion Service, Helsinki, Finland 16 South African National Blood Service, East Coast Region, Pinetown, South Africa 17 Osaka Red Cross Blood Center, Osaka, Japan 18 Blood Bank, Hospital Sirio-Libanes, Sao Paulo, Brazil 19 Rh Laboratory, University of Manitoba, Winnipeg, Manitoba, Canada

This month in J Lab Clin Med: Issue highlights for February 2000

This month in J Lab Clin Med: Issue highlights for February 2000

Applications of flow cytofluorometry to red blood cell immunology.

CytometryVolume 38, Issue 6 p. 259-267 Review ArticleFree Access Applications of flow cytofluorometry to red blood cell immunology George Garratty, Corresponding Author George Garratty garratty@usa.redcross.org Southern California Region, American Red Cross Blood Services, Los Angeles, CaliforniaSouthern California Region, American Red Cross Blood Services, 1130 S. Vermont Ave., Los Angeles, CA 90006.Search for more papers by this authorPatricia A. Arndt, Patricia A. Arndt Southern California Region, American Red Cross Blood Services, Los Angeles, CaliforniaSearch for more papers by this author George Garratty, Corresponding Author George Garratty garratty@usa.redcross.org Southern California Region, American Red Cross Blood Services, Los Angeles, CaliforniaSouthern California Region, American Red Cross Blood Services, 1130 S. Vermont Ave., Los Angeles, CA 90006.Search for more papers by this authorPatricia A. Arndt, Patricia A. Arndt Southern California Region, American Red Cross Blood Services, Los Angeles, CaliforniaSearch for more papers by this author First published: 26 December 2002 https://doi.org/10.1002/(SICI)1097-0320(19991215)38:6<259::AID-CYTO1>3.0.CO;2-PCitations: 45AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Citing Literature Volume38, Issue615 December 1999Pages 259-267 ReferencesRelatedInformation

Donor attitudes about exporting and importing blood.

The movement of blood among different areas of the United States and the collection of more blood than is needed locally in some areas are increasing. Little is known of donors' attitudes about this blood resource sharing. One thousand donors from five regions of the American Red Cross Blood Services were surveyed by telephone. Demographic information about the donors and the regions was obtained, and the donors were asked to describe their attitudes about blood resource sharing as well as other blood donation-related issues. Donors are not very knowledgeable about whether their community is self-sufficient in its blood supply. In regions that import blood, 29 to 43 percent of donors believed that enough blood was collected to meet all local needs, and, in regions that export blood, only 22 to 24 percent of donors believed that more than enough blood was collected. About three-fourths of the donors believed it acceptable to send their blood to other communities if it is needed there. However, this attitude was based on the premise that all local needs would be met first. Only 4 percent of donors would be less willing to donate if their blood was being sent to another community. Donors are not very aware of blood resource sharing but are willing, under certain circumstances, to donate blood for use outside their local communities.

Quality of blood components filtered before storage and at the beside: Implications for transfusion practice

TransfusionVolume 36, Issue 5 p. 470-474 Quality of blood components filtered before storage and at the beside: Implications for transfusion practice M. A. Popovsky MD, Corresponding Author M. A. Popovsky MD Adjunct Clinical Professor, Department of Pathology and Laboratory Medicine, Boston University School of Medicine, Boston, MAChief Medical Officer and Acting Principal Officer, American Red Cross Blood Services, New England Region, 180 Rustcraft Road, Dedham, MA 02026.Search for more papers by this author M. A. Popovsky MD, Corresponding Author M. A. Popovsky MD Adjunct Clinical Professor, Department of Pathology and Laboratory Medicine, Boston University School of Medicine, Boston, MAChief Medical Officer and Acting Principal Officer, American Red Cross Blood Services, New England Region, 180 Rustcraft Road, Dedham, MA 02026.Search for more papers by this author First published: May 1996 https://doi.org/10.1046/j.1537-2995.1996.36596282594.xCitations: 31Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Citing Literature Volume36, Issue5May 1996Pages 470-474 RelatedInformation