Blood Collection Centers Research Articles

Developing an integrated blood supply chain network in disaster conditions considering multi-purpose capabilities

PurposeThis study aims to minimize the cost and time of blood delivery in the whole blood supply chain network (BSCN) in disaster conditions. In other words, integrating all strategic, tactical and operational decisions of three levels of blood collection, processing and distribution leads to satisfying the demand at the right time.Design/methodology/approachThis paper proposes an integrated BSCN in disaster conditions to consider four categories of facilities, including temporary blood collection centers, field hospitals, main blood processing centers and medical centers, to optimize demand response time appropriately. The proposed model applies the location of all permanent and emergency facilities in three levels: blood collection, processing and distribution. Other essential decisions, including multipurpose facilities, emergency transportation, inventory and allocation, were also used in the model. The LP metric method is applied to solve the proposed bi-objective mathematical model for the BSCN.FindingsThe findings show that this model clarifies its efficiency in the total cost and blood delivery time reduction, which results in a low carbon transmission of the blood supply chain.Originality/valueThe researchers proposed an integrated BSCN in disaster conditions to minimize the cost and time of blood delivery. They considered multipurpose capabilities for facilities (e.g. field hospitals are responsible for the three purposes of blood collection, processing and distribution), and so locating permanent and emergency facilities at three levels of blood collection, processing and distribution, support facilities, emergency transportation and traffic on the route with pollution were used to present a new model.

The development, evaluation, performance, and validation of micro-PCR and extractor for the quantification of HIV-1 &-2 RNA

HIV infection has been a global public health threat and overall reported ~ 40 million deaths. Acquired immunodeficiency syndrome (AIDS) is attributed to the retroviruses (HIV-1/2), disseminated through various body fluids. The temporal progression of AIDS is in context to the rate of HIV-1 infection, which is twice as protracted in HIV-2 transmission. Q-PCR is the only available method that requires a well-developed lab infrastructure and trained personnel. Micro-PCR, a portable Q-PCR device, was developed by Bigtec Labs, Bangalore, India. It is simple, accurate, fast, and operationalised in remote places where diagnostic services are inaccessible in developing countries. This novel micro-PCR determines HIV-1 and HIV-2 viral load using a TruePrep™ extractor device for RNA isolation. Five ml blood samples were collected at the blood collection centre at AIIMS, New Delhi, India. Samples were screened for serology, and a comparison of HIV-1/2 RNA was done between qPCR and micro-PCR in the samples. The micro-PCR assay of HIV-RNA has compared well with those from real-time PCR (r = 0.99, i < 0.002). Micro-PCR has good inter and intra-assay reproducibility over a wide dynamic range (1.0 × 102–1.0 × 108 IU/ml). The linear dynamic range was 102–108 IU/ml. The clinical and analytical specificity of the assay was comparable, i.e., 100%. Intra-assay and inter-assay coefficients of variation ranged from 1.17% to 3.15% and from 0.02% to 0.46%, respectively. Moreover, due to the robust, simple, and empirical method, the Probit analysis has also been done for qPCR LODs to avoid uncertainties in target recoveries. The micro-PCR is reliable, accurate, and reproducible for early detection of HIV-1 and HIV-2 viral loads simultaneously. Thus, it can easily be used in the field and in remote places where quantification of both HIV-1/2 is not reachable.

A Multiobjective Model for a Multilevel Blood Supply Chain to Improve the Attractiveness of Blood Centers during the COVID-19 Pandemic

Failure to control crisis conditions leads to irreparable damage to many supply chains around the world, including blood supply chains (BSCs) as critical networks in the health system. Consequently, it significantly reduces the supply of blood and its products, as vital materials, and exerts detrimental effects on the activities of blood organizations and facilities as well as the health of individuals in society. In the present study, the proposed model seeks to simultaneously minimize the operating costs and the shortage of blood products with the aim of improving the attractiveness of blood centers during the COVID-19 pandemic. Accordingly, by optimizing the overall cost and the attractiveness of blood donation centers, an attractive efficient environment is provided. It can help to remove barriers to blood donation and improve blood health. To this end, the model takes certain strategies into account for the proper establishment of new local blood collection centers (BCCs) and mobile BCCs. It also arranges suitable transportation vehicles for the efficient transfer of blood products to the provincial centers of the candidate country and sets various incentive policies for blood donation. In order to minimize the costs of the entire supply chain network and maximize the attractiveness of the BCCs, a two-objective mathematical model is developed. It produces Pareto solutions using the ε-constraint method. Finally, the efficiency of the proposed approach and the sensitivity of the corresponding parameters are analyzed through a practical case study. The obtained results represent that a growth in the attractiveness of blood centers induces a raise in the number of donors, and, consequently, the amount of the donated blood grows. This depends on more investment at all levels of the supply chain, including collection, production, storage, and transportation. Moreover, the performance and attractiveness of a BSC can be enhanced significantly if the number of collection centers and the amount of blood sent from the receiving centers to the demand nodes are increased.

Serological screening in a large-scale municipal survey in Cascais, Portugal, during the first waves of the COVID-19 pandemic: lessons for future pandemic preparedness efforts.

Serological surveys for SARS-CoV-2 were used early in the COVID-19 pandemic to assess epidemiological scenarios. In the municipality of Cascais (Portugal), serological testing combined with a comprehensive socio-demographic, clinical and behavioral questionnaire was offered to residents between May 2020 and beginning of 2021. In this study, we analyze the factors associated with adherence to this municipal initiative, as well as the sociodemographic profile and chronic diseases clinical correlates associated to seropositivity. We aim to contribute with relevant information for future pandemic preparedness efforts. This was a cross-sectional study with non-probabilistic sampling. Citizens residing in Cascais Municipality went voluntarily to blood collection centers to participate in the serological survey. The proportion of participants, stratified by socio-demographic variables, was compared to the census proportions to identify the groups with lower levels of adherence to the survey. Univariate and multivariate logistic regression were used to identify socio-demographic, clinical and behavioral factors associated with seropositivity. From May 2020 to February 2021, 19,608 participants (9.2% of the residents of Cascais) were included in the study. Based on the comparison to census data, groups with lower adherence to this survey were men, the youngest and the oldest age groups, individuals with lower levels of education and unemployed/inactive. Significant predictors of a reactive (positive) serological test were younger age, being employed or a student, and living in larger households. Individuals with chronic diseases generally showed lower seroprevalence. The groups with low adherence to this voluntary study, as well as the socio-economic contexts identified as more at risk of viral transmission, may be targeted in future pandemic situations. We also found that the individuals with chronic diseases, perceiving higher risk of serious illness, adopted protective behaviors that limited infection rates, revealing that health education on preventive measures was effective for these patients.

Mixed-methods exploration of the knowledge of young adults about blood donation processes; a one-center cross-sectional study in a tertiary institution.

Ghana is a majority youthful population, but is only able to meet 60% of its annual blood donation requirements. Although tertiary students in Ghana may serve as important blood donor resource by virtue of their higher educational attainment, data about their blood donation processes-specific knowledge are scarce. This study therefore explored the perspectives, and experiences of young adults regarding blood donation processes. This exploratory study employed mixed-methods approach (semi-structured questionnaire and focus group discussion, [FGD]). Data collection was sequential; the questionnaire distribution was completed before FGD commenced; themes that emerged from the questionnaire responses guided FGDs. Convenience sampling technique was used to recruit 382 young adults (15-49 years). All statistical analyses were undertaken using the two-tail assumptions; p<0.05 was considered statistically significant. Majority (79.3%) of the participants were in their twenties, with only 1.3% being 40-49 years old. Although two-thirds of participants expressed willingness to donate blood, less than a-third (31.7%; 127/382) had previously donated blood. Overall, less than one-third of participants could correctly identify the minimum weight (26.4%), or the inter-donation interval (14.7%); 37.4% and 58.1% could respectively indicate the required donor age or ≥3 infectious agents screened for prior to blood collection. Among previous donors, 37.2%, 28.1% and 43.0% could identify the required weight, acceptable inter-donation period, and donor age respectively. Two-thirds and a-third of participants preferred voluntary unrelated, and paid donations respectively. Whereas 42.4% of participants indicated intrinsic health benefits of blood donation, 17.0% suggested that blood donation was associated with disease risks. Both previous donors and non-donor groups considered lack of education, fear of post-donation health issues and lack of privacy at blood collection centers as main hindrances to donor recruitment. Targeted intentional blood donation-specific educational campaigns are warranted to address the blood donation processes knowledge gap among the study population.

Predicting donations and profiling donors in a blood collection center: a Bayesian approach

AbstractDonor profiling and donation prediction are two key tasks that any blood collection center must face. Profiling is important to target promotion campaigns, recruiting donors who will guarantee a high production of blood units over time. Predicting the future arrivals of donors allows to size the collection center properly and to provide reliable information on the future production of blood units. Both tasks can be addressed through a statistical prediction model for the intensity function of the donation event. We propose a Bayesian model, which describes this intensity as a function of individual donor’s random frailties and their fixed-time and time-dependent covariates. Our model explains donors’ behaviors from their first donation based on their individual characteristics. We apply it to data of recurrent donors provided by the Milan department of the Associazione Volontari Italiani del Sangue in Italy. Our method proved to fit those data, but it can also be easily applied to other blood collection centers. The method also allows general indications to be drawn, supported by quantitative analyses, to be provided to staff.

Towards SDG30: Fighting HCV with a screening program in Lombardy

Abstract Background The third Sustainable Development Goal, specifically in target 3.3, identifies fighting HCV as a priority. It is estimated that in Italy more than 200.000 patients eligible for HCV treatment are not being treated and 20% are not aware of the infection. Lombardy region to promptly identify and treat patients affected, developed a screening program to be offered to all patients born between 1969 and 1989. Healthcare facilities were divided into first and second-level centers and the campaign was designed in 2 phases: at the first level centres patients were screened with blood tests, if positive they were contacted by second level structures to get a diagnostic test and if confirmed positive to start the therapeutic approach. Methods The screening program started in June 2022 and consisted of an opportunistic offer of free testing for serum anti-HCV antibodies in the context of any healthcare performance offered to eligible patients. Data were uploaded and collected on a web database from which second-level centers could obtain data of positive patients to contact them and set appointment for confirmation tests. Results As of 31st December 2022 120,193 individuals underwent HCV screening in 75 screening centers in Lombardy. The mean age was 44 years, 65.2% were females, and 83.7% were tested at outpatient blood collection centers. 604 (0.50%) patients tested positive with mean age 47 (±5). HCV-RNA was detectable in 125 out of 441 (28.3%) anti-HCV positive subjects with available HCV-RNA. Patients with active HCV infection were aged 46 (±6) and were mostly males (56.8%). Overall, the prevalence of active infection in the general population was 0.10% and was higher in elderly. Conclusions The prevalence of active HCV infection in the general population born between 1969 and 1989 in Lombardy was low. Considering the higher prevalence of active infection in the elderly population, an extension of the screening offer to patients born between 1949-70 could be evaluated. Key messages • Prevalence of active HCV infection in screened population is low. • Extending the screening offer may result in higher number of positive results and more people directed towards treatment.

Increasing the time-to-freezing for clinical apheresis plasma meets quality specifications.

In Australia, the vast distances between blood collection centres and processing facilities make it challenging to align supply with demand. Increasing the time to freezing for clinical plasma beyond 6 h would alleviate supply issues. This study aimed to determine the quality of clinical apheresis plasma frozen within 12 h of collection. Apheresis plasma (n = 20) collected at donor centres was immediately transported to a blood processing facility, stored at 26°C and sampled aseptically at 6, 8 and 12 h post collection. Frozen samples were thawed, and coagulation factors (F) II, V, VII, VIII and XIII, von Willebrand factor (vWF) and fibrinogen were measured using a coagulation analyser. FVIII concentrations declined in plasma frozen at 6, 8 and 12 h post collection (1.22 ± 0.27, 1.21 ± 0.25 and 1.16 ± 0.24 IU/mL, respectively) but not significantly (p = 0.3338). Importantly, all components met the FVIII specification (>0.7 IU/mL) for clinical plasma. Fibrinogen concentrations were stable from 6 to 12 h (p = 0.3100), as were vWF concentrations (p = 0.1281). Coagulation factors II, V, VII and XIII were not significantly different (p > 0.05 for all factors). Clinical apheresis plasma can be frozen within 12 h of collection, allowing collections from donor centres further from processing centres and increasing supply.

A hierarchical model for strategic and operational planning in blood transportation with drones.

Blood transportation is a critical aspect of the healthcare systems, ensuring whole blood and blood products are delivered to patients in a timely and efficient manner. However, transportation of blood and other medical supplies can be challenging, especially in urban areas with limited infrastructure and heavy traffic. Drones have become increasingly important in recent years as a means of delivering medical supplies, including blood, due to their ability to provide fast, reliable, and cost-effective transportation. This study proposes two mathematical programming models in the hierarchical structure to improve decision-making for strategic and operational planning in the blood supply chain network. The limited information available in strategic planning presents risks to the blood supply chain, making it imperative to address uncertainties. To tackle this challenge, a novel approach called Scenario-based Robust Bi-objective Optimization has been proposed. The first model employs this approach to efficiently handle demand uncertainty by simultaneously maximizing the covered demand and minimizing costs. The model is subsequently solved using the augmented ε-constraint method. The second model is a routing-scheduling operational model that aims to minimize the sum of operations time, taking into account time windows for blood collection centers and hospitals. The developed hierarchical model is implemented in a three-level supply chain of Tehran province under three crisis scenarios in different parts. The findings and analysis of this implementation suggest that it is beneficial to set up drone stations in cost-effective and central locations to avoid costly network design. Furthermore, utilizing the minimum number of feasible drones enhances operational time and results in cost savings and increased efficiency. Overall, this study highlights the potential of using drones for blood transportation in urban settings, which can have significant implications for improving the quality of healthcare delivery.

Quality assessment of red blood cell concentrates from blood donors at the extremes of the age spectrum: The BEST collaborative study.

Blood donors at the extremes of the age spectrum (16-19 years vs. ≥75 years) are characterized by increased risks of iron deficiency and anemia, and are often underrepresented in studies evaluating the effects of donor characteristics on red blood cells (RBC) transfusion effectiveness. The aim of this study was to conduct quality assessments of RBC concentrates from these unique age groups. We characterized 150 leukocyte-reduced (LR)-RBCs units from 75 teenage donors, who were matched by sex, and ethnicity with 75 older donors. LR-RBC units were manufactured at three large blood collection centers in the USA and Canada. Quality assessments included storage hemolysis, osmotic hemolysis, oxidative hemolysis, osmotic gradient ektacytometry, hematological indices, and RBC bioactivity. RBC concentrates from teenage donors had smaller (9%) mean corpuscular volume and higher (5%) RBC concentration compared with older donors counterparts. Stored RBCs from teenage donors exhibited increased susceptibility to oxidative hemolysis (>2-fold) compared with RBCs from older donors. This was observed at all testing centers independent of sex, storage duration, or the type of additive solution. RBCs from teenage male donors had increased cytoplasmatic viscosity and lower hydration compared with older donor RBCs. Evaluations of RBC supernatant bioactivity suggested that donor age was not associated with altered expression of inflammatory markers (CD31, CD54, and IL-6) on endothelial cells. The reported findings are likely intrinsic to RBCs and reflect age-specific changes in RBC antioxidant capacity and physical characteristics that may impact RBC survival during cold storage and after transfusion.

Improving Blood Donor Care in a Collection Center Through Advanced Data Exploitation.

Blood collection centers can take advantage of the huge amount of data collected on donors over the years to predict and detect early the onset of several diseases, However, dedicated tools are needed to carry out these analyses. This work develops a tool that combines available data with predictive tools to provide alerts to physicians and enable them to effectively visualize the history of critical donors in terms of the parameters that led to the alert. The developed tool consists of data exchanging functions, interfaces to raise alerts and visualize donor history, and predictive algorithms. It was designed to be simple, modular and flexible. A prototype was applied to the Milan department of the Associazione Volontari Italiani Sangue, and was deemed suitable for prevention and early diagnosis objectives by the physicians of the center. The included Machine Learning predictive algorithms provided good estimates for the variables considered in the prototype. Prevention and early diagnosis activities in blood collection centers can be effectively supported by properly using and displaying donor clinical data through a dedicated software tool.

Association of ABO and RhD blood groups with the risk of HIV infection.

Naturally occurring antibodies against ABO antigens present in human sera have been shown to neutralize ABO-expressing HIV in vitro. We investigated associations between ABO and RhD blood groups and HIV infection among blood donors from all blood collection centers in eight of South Africa's nine provinces. Whole blood donations collected from first time donors between January 2012 and September 2016 were tested for HIV RNA by nucleic acid testing and HIV antibody using third generation serology assays. ABO and RhD blood types were determined using automated technology. Odds ratios for the association between HIV positivity and ABO and RhD phenotypes were calculated using multivariable logistic regression analysis. We analyzed 515,945 first time blood donors and the overall HIV prevalence was 1.12% (n = 5790). After multivariable adjustment, HIV infection was weakly associated with RhD positive phenotype (OR = 1.15, 95% CI 1.00-1.33) but not with ABO blood group. The observed association with RhD positive phenotype was marginal and likely due to residual confounding by racial group but could serve to generate hypotheses for further studies.

Continued stabilization of blood collections and transfusions in the United States: Findings from the 2021 National Blood Collection and Utilization Survey.

National Blood Collection and Utilization Surveys (NBCUS) have reported decreases in U.S. blood collections and transfusions since 2008. The declines began to stabilize in 2015-2017, with a subsequent increase in transfusions in 2019. Data from the 2021 NBCUS were analyzed to understand the current dynamics of blood collection and use in the United States. In March 2022, all community-based (53) and hospital-based (83) blood collection centers, a randomly selected 40% of transfusing hospitals performing 100-999 annual inpatient surgeries, and all transfusing hospitals performing ≥1000 annual inpatient surgeries were sent a 2021 NBCUS survey to ascertain blood collection and transfusion data. Responses were compiled, and national estimates were calculated for the number of units of blood and blood components collected, distributed, transfused, and outdated in 2021. Weighting and imputation were applied to account for non-responses and missing data, respectively. Survey response rates were 92.5% (49/53) for community-based blood centers, 74.7% (62/83) for hospital-based blood centers, and 76.3% (2102/2754) for transfusing hospitals. Overall, 11,784,000 (95% confidence interval [CI], 11,392,000-12,177,000) whole blood and apheresis red blood cell (RBC) units were collected in 2021, a 1.7% increase from 2019; 10,764,000 (95% CI, 10,357,000-11,171,000) whole blood-derived and apheresis RBC units were transfused, a 0.8% decrease. Total platelet units distributed increased by 0.8%; platelet units transfused decreased by 3.0%; plasma units distributed increased by 16.2%; and plasma units transfused increased by 1.4%. The 2021 NBCUS findings demonstrate a stabilization in U.S. blood collections and transfusions, suggesting a plateau has been reached for both.

Impact of the COVID-19 pandemic on blood donation and transfusions in the United States in 2020.

Reports have suggested the COVID-19 pandemic resulted in blood donation shortages and adverse impacts on the blood supply. Using data from the National Blood Collection and Utilization Survey (NBCUS), we quantified the pandemic's impact on red blood cell (RBC) and apheresis platelet collections and transfusions in the United States during year 2020. The 2021 NBCUS survey instrument was modified to include certain blood collection and utilization variables for 2020. The survey was distributed to all US blood collection centers, all US hospitals performing ≥1000 surgeries annually, and a 40% random sample of hospitals performing 100-999 surgeries annually. Weighting and imputation were used to generate national estimates for whole blood and apheresis platelet donation; RBC and platelet transfusion; and convalescent plasma distribution. Whole blood collections were stable from 2019 (9,790,000 units; 95% CI: 9,320,000-10,261,000) to 2020 (9,738,000 units; 95% CI: 9,365,000-10,110,000). RBC transfusions decreased by 6.0%, from 10,852,000 units (95% CI: 10,444,000-11,259,000) in 2019 to 10,202,000 units (95% CI: 9,811,000-10,593,000) in 2020. Declines were steepest during March-April 2020, with transfusions subsequently rebounding. Apheresis platelet collections increased from 2,359,000 units (95% CI: 2,240,000-2,477,000) in 2019 to 2,408,000 units (95% CI: 2,288,000-2,528,000) in 2020. Apheresis platelet transfusions increased from 1,996,000 units (95% CI: 1,846,000-2,147,000) in 2019 to 2,057,000 units (95% CI: 1,902,000-2,211,000) in 2020. The COVID-19 pandemic resulted in reduced blood donations and transfusions in some months during 2020 but only a minimal annualized decline compared with 2019.

Prevalence of Weak D Antigen in Rh Negative Blood Group: An Experience at a Tertiary Blood Centre in Bengaluru, Southern India

Introduction: The Rh blood group system, consisting of more than 50 different antigens, is the most polymorphic among human blood types. Among them, D is the most important antigen. The incidence of weak (Du) antigens ranges from 0.2 to 1%. Routine screening for RhD does not cause agglutination with anti-RhD serum; therefore, it must be detected using anti- human globulin serum. Due to the potential immunological reaction of Du-positive cells in RhD-negative individuals, it is crucial to emphasise the therapeutic implications of this finding and its relation to the risk of alloimmunisation. Aim: To determine the frequency of the Du antigen among RhD- negative individuals. Materials and Methods: This five-year hospital-based cross- sectional study was conducted from January 2017 to January 2022 in the Department of Transfusion Medicine at ESIC MC and PGIMSR, Bengaluru, Karnataka, India. ABO and Rh blood group samples were collected in EDTA vacutainers from the blood collection centre and sent to the Department of Transfusion Medicine. Data analysis was performed using Microsoft Excel. Results were presented as numbers and percentages. ABO and Rh blood group typing were carried out using the tube method (immediate spin tube technique), and negative samples were further tested for weak D (Du) using the Gel card system. The Rh-negative cases with Du testing were recorded, and the frequency of the Du antigen in Rh-negative blood group types was determined. Results: A total of 69,282 blood samples were analysed, of which 66,442 (95.90%) were Rh positive, and 2,840 (4.10%) were Rh negative. The male-to-female ratio was 1:1.79. Out of the total 2,840 Rh-D negative samples, 31 samples were weak D positive. Among them, 06 (0.85%) belonged to the A blood group, 12 (1.63%) to the B blood group, 12 (1.01%) to the O blood group, and 1 (0.47%) to the AB blood group. The Du positivity noted among the Rh-negative cases was 1.09%. The overall Du positivity noted among all the samples was 0.045%. Conclusion: To prevent RhD mismatches, which can lead to life-threatening complications, it is advised to retype all Rh- negative blood samples using a Du test during routine grouping. This is because weak D antigen is immunogenic and capable of producing alloimmunisation if transfused to RhD-negative individuals.

Assessment of Lab request forms: How do our clinicians communicate with Laboratory?

Central clinical laboratory is an important division in the health care setup. Laboratory results help clinical decisions, follow up care and ensure patient safety. Laboratory request Form [LRF] is an important medium between the patient, a treating clinician and Laboratory. A meticulously filled LRF is important for patient care. Providing accurate and complete information in LRF is the doctor's responsibility. Erroneous LRF will have an impact on the quality of laboratory results. Present study evaluates the degree of completeness and correctness of quality indicators on laboratory request forms [LRF] to examine preanalytical standards of laboratory services.This study is a single center, prospective, cross sectional, descriptive type conducted at a 650 bed teaching hospital from Gujarat. In the span of a six months study period, 3735 [20% of total] LRFs were selected by simple random sampling method from the total LRF received at OPD blood collection center. They were analyzed for patient, clinician and sample identifier quality indicators along with completeness and correctness. Qualitative information was converted to quantitative by using two point scale, 0 score for incomplete information and 1 score for complete information.Among patient identifier quality indicators name, age, gender and location were filled in more than 75% forms whereas, very poorly filled 2% provisional diagnosis and 42% MRD number. Clinician identifier quality indicator was attended to in less than 50% forms. Time and date of request were absent on 100% forms. Sample identifier quality indicator shows 97% forms with the nature of the sample and 92% having investigation requests. Test requests on one third forms were invalid and inappropriate. 38% forms were incomplete and inappropriate whereas 46% forms had error in filling one or other data indicators.Appropriately filled LRF communicates well with the Central clinical laboratory. It will help in providing quality reports in time and benefit clinicians to manage quality care for patients. Hand written, poorly legible, inappropriately abbreviated, erroneous LRF are misleading and may compromise laboratory service and patient safety. Training and change in attitude towards LRF writing is required to maintain the standard of the health care system.

Prep@Gref: Software Streamlining for the Search for Donors for Hematopoietic Stem Cell Transplantation

Introduction: Donor recruitment in allogeneic hematopoietic stem cell transplantation (HSCT) is a multi-step process involving several stakeholders: patients, donors, coordinators, clinicians, HLA typing lab and blood collection center. With few, if any software existing on the market to perform these steps securely and efficiently, we aimed at developing an in-house academic software to streamline this process. Our objectives were: to reduce delays, facilitate interactions between stakeholders through secure real-time sharing of information and documents and limit the workload at each step. Methods: We set off by listing the steps involved in donor recruitment, analyzing their outputs and time required to accomplish them, documenting the delays between them and establishing key performance indicators. We then created the Prep@gref software that includes an interactive list of patients awaiting an allogenic HSCT, with work lists specific to each of the previously-listed steps (updated in real time), documents and information necessary for proceeding (or not) with donor recruitment and automated alerts for deadlines to accomplishing the individual tasks by each stakeholder. Training stakeholders and optimizing the software preceded its introduction into routine practices. Measurable outcomes were: median time to donor identification (related and unrelated donors), non-quantifiable variables include: stakeholder feedback and ease-of-use of the software. Results: Tracking key performance indicators shows that the time for matched related donor (MRD) identification has reduced by a median of 29% over the past 5 years: 34 days pre-Prep@gref to 24 days since the introduction of Prep@gref into routine use. Time for mismatch related donor (MMRD) has reduced by a median of 32% (36 days pre-Prep@gref versus 25 days post). Unrelated donor search reduced by 21% (67 days versus 53 days, respectively). Time for adoption of the software by stakeholders could explain the slow amelioration of indicators over time. Increase in activity of the transplant program (21% since the introduction of Prep@gref into routine use) and the COVID-19 pandemic did not significantly affect the time for donor identification. Positive feedback from clinicians and coordinators favor its positive impact on practices. Conclusion: Prep@gref software represents a prototype of complex care process modeling, evolving from the traditional organizational set up in many hospitals for donor recruitment. Saving times and being able to delegate tasks is key in addressing shortage of human resource that periodically happen in our activities, while absorbing the growing workload and increasing complexities of these tasks.

Study on Urban North Indians Incidence of Dyslipidemia among Different Age Groups

Background: Coronary artery disease is a known entity of morbidity and mortality in industrialised countries. It is a major public health problem around the world. Coronary artery disease increase incidence in Indian population at least 10 years before in age than other ethnic groups. There are a numbers of factors associated with atherosclerosis the most important one is dyslipidemia. Recent studies suggest that over the span of 20 years, the total amount of triglycerides, cholesterol and Low Density Lipoproteins (LDL) `levels is usually increased in young urban populations. So, a study was performed out to know the prevalence of dyslipidemia in urban North Indians among different set of age groups. Methods: This is a descriptive cross-sectional study which was carried out on patients visiting to the blood collection centre of the Department of Pathology. Patients were divided into 3 groups with age 18 year to 40 year, 41 year to 60 year and &gt;60 year by involving 1989 subjects of whom 532 were between 18 year to 40 year, 522 were between 41year to 60 year and 935 were &gt; 60 year of age. This study included measurement of fasting serum lipid profile comprising of, Low Density Lipoprotein (LDL), High Density Lipoproteins (HDL), Triglycerides and total cholesterol. Results: Number of subjects studied, the prevalence of dyslipidemia was higher in &lt;60 years age population. A remarkable difference in mean was observed statistically with the levels of triglycerides, LDL and total cholesterol of this age group ranging from 18- 40 years and for those who are &gt;60 years. A remarkable difference for the levels of HDL was not found in age group between 18 – 40 years and &gt; 40 years to 60 years. Mean cholesterol level was observed to be elevated between the age group 18 – 40 years. The mean peak triglycerides were observed in age group between 41-60 years. This elevated mean HDL levels were noticed in the age group who are &gt; 60 years of age. Conclusions: Elevated percentage of dyslipidemia was observed in less than 60yrs age groups. Large population study is required to substantiate the results of this study. It is necessary to plan out comprehensive strategies for the screening and awareness in all ages on periodic basis.

How to increase first-time donors' returns? The postdonation letter's content can make a difference.

BackgroundRetention of first‐time donors is pivotal for blood collection centers. The present study built on research showing the importance of donor identity among regular donors and sought to compare the effectiveness of various communication strategies on return rate.Study Design and MethodsPostal letters were sent to a large sample of first‐time whole blood donors (N = 1219) a few weeks following their first donation. Four versions of this letter were differently constructed in a way to boost the acquisition of donor identity (i.e., by including information about their ABO and Rh(D) blood group, emphasizing the salience of donor identity, offering a keyring with personalized information, or specifying the percentage of those sharing the same ABO and Rh(D) blood group). One version with no identity‐related information served as a control condition. Participants' subsequent blood donations were tracked for 5–22 months after receiving the letter.ResultsSurvival analysis showed that the return rate was significantly higher among those who had received information about the percentage of the country's population with the same ABO and Rh(D) blood group (in comparison with the four other versions). There was no significant effect on the blood type rarity.ConclusionBlood collection centers could orient the strategy employed to communicate with first‐time donors to improve donors' retention. Arousing a sense of social identification with others with the same blood type may reveal a promising avenue.

A Systematic Review on Effect of Whole Blood Donation on Iron Profile in Blood Donors

Regular whole blood donations sometimes may result in iron (Fe) inadequacy in the blood donors, which can lead to increased deferral rate among the donors. Blood collection centers must keep a track record of Fe status of regular whole blood donors, as well the impact it has on donor health. The blood centers must also counsel the donors regarding measures to improve the low Fe stores. Serum ferritin levels have been a better indicator of low Fe stores in the body as compared to hemoglobin. There is presently no international agreement on an acceptable approach for Fe monitoring. There are several ways to check the Fe levels in blood of whole blood donors. Hemoglobin- or ferritin-levels and Fe supplementation could be accessed to check the impact of regular blood donations. However, employing an Fe assessment method may provide new confrontations in management and accessibility of blood donors. We present an overview of parameters monitored for Fe stores in regular whole blood donors.