Blood Collection System Research Articles

Development of a Venous Collapse Prevention Device for Blood Draw

Abstract Blood sampling typically involves puncturing a superficial vein with a needle and then creating a vacuum (e. g., with a syringe) to transfer the blood from the venous system to the collection container. In some cases, the venous walls collapse due to excessive vacuum generated. In this work, a device is presented that prevents venous collapse and can be combined with any blood collection system available on the market. The mechanism of preventing venous collapse is based on a tubular segment interconnected between the needle and the syringe, which collapses at a lower vacuum pressure than the vein. The prototype was tested and evaluated using a test rig that simulates venous blood draw. The experiments proved the functionality of the device on a vein phantom.

Serious hazards of transfusion: evaluating the dangers of a wrong patient autologous salvaged blood in cardiac surgery

BackgroundThe past half century has seen the near eradication of transfusion-associated hazards. Intraoperative cell salvage while widely used still poses significant risks and hazards due to human error. We report on a case in which blood collected from a patient with lung cancer was mistakenly administered to a patient undergoing cardiac surgery who should have received his own collected blood. The initial investigation found that the cause of the patient harm was violations of procedures by hospital personnel. A detailed investigation revealed that not only violations were the cause, but also that the underlying causes included haphazard organizational policies, poor communication, workload and staffing deficiencies, human factors and cultural challenges.Case presentationOn August 14, 2019, a 72-year-old male was admitted to our hospital for angina pectoris and multivessel coronary artery disease. Cardiac surgery was performed using an autologous salvage blood collection system, and there were no major problems other than the prolonged operation time. During the night after the surgery, when the patient’s blood pressure dropped, a nurse retrieved a blood bag from the ICU refrigerator that had been collected during the surgery and administered it at the physician's direction, but at this time neither the physician nor the nurse performed the required checking procedures. The blood administered was another patient's blood taken from another surgery the day before; an ABO mismatch transfusion occurred and the patient was diagnosed with DIC. The patient was discharged 65 days later after numerous interventions to support the patient. An accident investigation committee was convened to analyze the root causes and develop countermeasures to prevent a recurrence.ConclusionThis adverse event occurred because the protocol for intraoperative blood salvage management was not clearly defined, and the procedure was different from the standard transfusion practices. We developed a new workflow based on a human factors grounded, systems-wide improvement strategy in which intraoperative blood collection would be administered before the patient leaves the operating room to completely prevent recurrence, instead of simply requiring front-line staff to do a double-check. Implementing strong systems processes can reduce the risk of errors, improve the reliability of the work processes and reduce the likelihood of patient harm occurring in the future.

The multi-trip vehicle routing problem with increasing profits for the blood transportation: An iterated local search metaheuristic

This paper studies a multi-trip routing problem of a shuttle fleet to transport blood units from collection sites to a blood center. In this problem, the blood units intended to produce platelets and cryoprecipitate must be processed within eight hours from their donation and arrive at the blood center at a time less than its closing time to guarantee enough processing time. Since it is assumed that blood units are donated at a collection site following a constant ratio over its operating hours, this problem is modeled as a multi-trip vehicle routing problem with increasing profits for which a mixed-integer linear programming formulation is proposed. A hybrid iterated local search metaheuristic and an extended version are developed as solution methods. The extended version includes a mixed-integer linear programming component into the local search of the hybrid metaheuristic to optimize the decision on the departure times of the trips. The solution methods are tested on a new set of instances based on the blood collection system of Bogota, Colombia.

Using automation to manage donor engagement and fine-tune supply and demand during the first year of the COVID-19 pandemic

BackgroundCOVID-19 disrupted blood center operations starting March 2020 and continues to affect donor presentation and blood availability today. The industry mobilized significant resources to collect COVID-19 convalescent plasma (CCP) to treat COVID-19 patients. At the same time, blood centers continued to collect platelets, plasma, and red blood cells (RBCs) to meet the needs of non-COVID-19 patients. The purpose of this study was to quantify how automation was used to fine-tune supply and demand and increase donor engagement during the first year of the pandemic. MethodsThis was a single-center retrospective study of blood collection and donor presentation at a mid-sized US blood center. Data was evaluated from January 1, 2020 through March 31, 2021. Parameters evaluated included donor presentation, platelets per procedure, concurrent RBC and plasma collections per procedure, operator compliance, total donor appointment count, and donor frequency. ResultsWith the cancelation of mobile blood drives, fixed sites increased total apheresis procedures by 37% and increased turns per bed by 46% whereas less products were collected per donor. By collecting only what was needed, platelet expiration rate decreased from 6.8% (pre-pandemic) to less than 4%. Donor engagement as measured by donor frequency increased from 1.6 in January 2020 to 1.8 in March 2021. ConclusionsUsing technological advances such as automated blood collection and information systems, the blood center improved donor engagement and avoided collecting a surplus of any one type of blood product over the course of the pandemic

Survey of blood centre readiness regarding removal of DEHP from blood bag sets: The BEST Collaborative Study.

Di(2-ethylhexyl) phthalate (DEHP) must be removed from blood bag sets in Europe by 27 May 2025. DEHP is known to interact with the red blood cell (RBC) membrane, resulting in reduced haemolysis and thus prolonging shelf-life. Current non-DEHP alternatives result in increased haemolysis requiring reconsideration of the RBC shelf-life. Although the immediate impact of eliminating DEHP is to the European community, the non-DEHP movement could affect blood bag set availability globally. The purpose of this survey is to understand blood centre readiness regarding the transition to non-DEHP blood collection and storage systems. A 24-question on-line survey was completed by members of the Biomedical Excellence for Safer Transfusion Collaborative research network. Responses were obtained from 16 blood collection or processing institutions. A majority of respondents (12/16) indicated that both shelf-life and haemolysis were equally important in selecting non-DEHP blood bag sets. Six respondents would accept a lower RBC product shelf-life compared to current practice. Respondents were not clear on the best non-DEHP vinyl material or RBC storage solution. Three European blood centres indicated they have developed non-DEHP transition plans. One challenge identified regarding the transition to non-DEHP is the extensive validation testing that will be required. Blood centres in Europe are concerned with meeting the sunset date for DEHP, considering that limited non-DEHP blood bag and RBC storage solutions are currently available. Banning DEHP in Europe, which may have global ramifications, represents a major challenge not yet fully understood by the transfusion medicine community.

English

BACKGROUND In the present era of automation, the quality of laboratory specimens is critical towards the delivery of accurate and useful results. The mode of collection of the sample is one such variable. Proper collection and handling of blood samples prevent erroneous results, reduce turnaround time and ensure safety of healthcare workers and patients. The study purpose is to compare open and closed systems of blood collection and the impact of closed collection system in the reduction of pre analytical errors and promoting health care worker safety. METHODS This is a prospective comparative study and it was conducted on blood samples collected in the Outpatient Department of Government Medical College, Kottayam and preanalytical study variables were assessed at Departments of Haematology and Biochemistry. At the beginning of the study, the quality and the quantity of specimen, result accuracies and healthcare safety parameters were assessed for 4778 samples using open blood collection system. This was followed by training of the phlebotomists for closed system of blood collection. The same parameters were studied for another 2508 blood samples collected via closed collection system by the same phlebotomists. The open blood collection system was carried out using non vacuum tubes (Plain and K3 EDTA), 5 ml syringe and 23G needles and closed blood collection system used BD vacutainer (K2 EDTA and serum gel tubes), Eclipse TM safety 22G needles and pronto TM reusable safety holders. The study was conducted from 01-01-2021 to 31-03-2021. RESULTS The specimen quality errors namely fibrin mass, strands, haemolysis, recentrifugation, and insufficient volume in biochemistry lab were significantly reduced with introduction of closed collection system. In haematology lab, closed collection system reduced incidence of clotted sample, insufficient volume accompanied by significant reduction in platelet and WBC differential flags. Closed collection system also reduced occurrence of blood smeared containers and blood spillage on test requisition forms, hence improving safety of health care personnel. CONCLUSIONS The study establishes a significant reduction in pre-analytical errors with closed blood collection system, prevents test cancellation and improved workflow efficiency. KEY WORDS Accuracy, Blood Collection Systems, Errors, Phlebotomist, Preanalytical, Spillage, Variables.

An insight to the internal quality control of blood components separated using the latest whole blood collection and processing systems: Experience from a tertiary care hospital blood transfusion service in Eastern India.

With blood component therapy becoming the standard of care in transfusion medicine globally, the quality control (QC) of these components has become a routine and mandatory program in all blood centers. Extensive utilization of blood components has been observed in our multidisciplinary tertiary care hospital. We use quadruple bag systems and automated component extraction facilities for collection and processing of whole blood (WB). In this study, we analyzed our data relating to QC of all blood components which we prepare and issue for transfusion. The retrospective 5-year study comprised 47,430 WB collections which were separated into blood components using quadruple bags and automated component extraction machine. A total of 90 units of WB were processed into blood components for the machine calibration and validation. Routine use of the system was started once the calibration and validation results were acceptable. At least 1% of each component prepared was subjected to QC as per departmental standard operating procedures. Statistical analysis was done using the SPSS statistical package. The mean volume, hematocrit (Hct), platelet (PLT), and white blood cell (WBC) in 350 and 450 mL WB units were 394.63 mL, 39.43%, 0.93 × 1011, and 3.12 × 109 and 507.75 mL, 40.72%, 1.13 × 1011, and 3.45 × 109, respectively, with mean recovery of PLT and WBC in buffy coat being 95.54% and 68.63% and 97.87% and 74.51%, respectively. As high as 89.91% RBC recovery was noted in the packed red blood cell units which were subjected to QC. QC of random donor platelets was performed in 979 (2.36%) units with acceptable results. The mean fibrinogen and FVIII values were estimated to be 469.17 mg and 217.34 IU (1.07 IU/mL) and 600.21 mg and 273.39 IU (1.11 IU/mL) in fresh frozen plasma units prepared from 350 and 450 mL WB, respectively. A total of 578 (1.62%) units of cryoprecipitate were investigated for QC with favorable results. We conclude that QC data generated in this study will provide invaluable information about the performance of the latest blood collection systems. QC of all blood components under study complied with both national and international standards. We opine that all blood centers should establish a complete QC program and adhere to departmental protocols and manufacturer's instructions for its execution and effective outcome.

Croatian blood collection system amid the COVID-19 pandemic

BackgroundCroatian blood collection system is based on voluntary donation, according to the recommendations of the World Health Organisation and the Council of Europe. The ongoing COVID-19 pandemic has influenced all the dimensions of human lives and the functional pattern of the health care systems in the whole world. The aim of this study was to investigate the influence of ongoing COVID-19 pandemic on Croatian blood collection system and to evaluate the main factors that influence voluntary blood donation practice in blood donors (BDs).MethodsThis cross-sectional questionnaire study was conducted in convenient sample of voluntary BDs from Split-Dalmatia County during the May 2020 to December 2020.ResultsThe study sample consisted of 479 regular BDs, 88.5% males and 11.5% females, mean age 39.8±10.8 years. Majority of them had high school education and living with the partner (67.4% and 74.5%, respectively). During COVID-19 pandemic 71.0% of them continued with regular donations while 29% of them postponed their donation. According to the BDs knowledge regarding COVID-19 infection there were 88.9% of those with unsatisfactory and only 11.1% of those with satisfactory knowledge regarding this infection. The study revealed that females, BDs living alone and younger BDs (aged 18 to 43 years) had more frequently postponed blood donation during COVID-19 pandemic (P < 0.0001, P = 0.004 and P = 0.017, respectively). The study further showed that there was no correlation between BDs knowledge about COVID-19 infection and their blood donation practice during ongoing pandemic.ConclusionsThe study revealed that ongoing COVID-19 pandemic impacted the Croatian blood collection system via reduction in the practice of voluntary blood donations. Sociodemographic characteristics of BDs were the main factors that influence Croatian BDs voluntary blood donation practice during pandemic while their knowledge about COVID-19 infection was not correlated with their behaviour.Key messages The sustainability of the health care system during a pandemic depends significantly on the blood supply, which is why it is necessary to ensure that blood collection system is continually maintained.The knowledge of blood donors about COVID-19 infection needs to be improved in order to prevent spreading of the infection generally and especially within this highly important population subgroup.

Assessing Phlebotomy Device Preference and Specimen Quality in an Oncology Outpatient Clinic.

Oncology patients have frequent venipunctures, which causes scarring, making subsequent draws difficult and painful. Novel blood collection systems may decrease discomfort in patients experiencing repeat blood draws. Oncology outpatients (n = 101; criteria excluded 12) were recruited to determine their preference for either of two blood collection systems, the 23-gauge standard BD Vacutainer Push Button Blood Collection Set (Standard Push Button system) or the 25-gauge BD Vacutainer UltraTouch Push Button Blood Collection Set (UltraTouch Push Button system). Subjects received two blinded, randomized blood draws, one with each device and just one device for each arm. Subjects subsequently rated their blinded preference for blood collection system. Specimen quality was assessed for each device with measurements for plasma hemoglobin (Shimadzu UV-1800 spectrophotometer, Shimadzu), lactate dehydrogenase, and potassium (Vitros 4600/5600 analyzer, Ortho Diagnostics). Preference for the 25-gauge UltraTouch Push Button system over the 23-gauge Standard Push Button system was significant (UltraTouch, n = 51; Standard n = 30; no preference, n = 8; P = 0.0196). Regarding sample quality, the 25-gauge UltraTouch Push Button system had significantly lower plasma hemoglobin (average 5.34 mg/dL) vs the 23-gauge Standard Push Button system (9.37 mg/dL; P < 0.0001); serum lactate dehydrogenase and potassium differences were not statistically significant. Subjects in an oncology clinic preferred phlebotomy with the 25-gauge UltraTouch Push Button system, and samples using this device had less hemolysis as assessed by plasma hemoglobin.

Multicenter Study of Needle-Free Blood Collection System for Reducing Specimen Error and Intravenous Catheter Replacement.

Inpatient hospital settings require access to high-quality blood specimens and durable peripheral intravenous (IV) catheters for patient care. The most common standard-of-care method for acquiring each blood specimen-venipuncture-often results in a non-negligible preanalytical error rate, patient discomfort, and tissue inflammation. In a 2-year, multicenter (23 hospitals) retrospective study, a novel blood collection system that collects blood specimens through existing inpatient IVs without a needle (PIVO, Velano Vascular) was compared with the current standard of care, in regards to its effect on specimen quality and IV catheter longevity. Using the PIVOTM device for blood collection decreased the rate of preanalytical errors by 56% compared with other collection methods, including venipuncture and conventional line draws. In addition, peripheral IV catheters that were used with PIVOTM for blood draws also had a 19% lower rate of replacement compared with those that did not. This is the largest study to date of PIVO use and demonstrates significant quality improvement outcomes compared with the current standard of care in blood collection, providing an opportunity to innovate inpatient hospital care.

STERILITY MONITORING OF CANINE PACKED RED BLOOD CELLS

Transfusing of whole blood and blood components has a constant risk factor – a microbial contamination. Because using of contaminated blood products can cause sepsis and high risks to the health of recipients. Violation of the rules of asepsis during blood donation, during the manufacture of blood products, damage to blood collection systems or their tightness, etc. can lead to microbial contamination. We examined 5 samples of preserved canine packed red blood cells, which were taken in closed systems, using CPDA anticoagulant and following storage at a temperature of + 2-6 ° C for 30 days. According to the results of bacteriological examination of samples of canine packed red blood cells (pRBC) after their storage, no non-sterile sample was found. Thereby, the method of blood collection using closed systems with CPDA anticoagulant is reliable and allows to obtain donor blood and blood components without loss of sterility during long-term storage. Keywords: canine packed red blood cells, microbial contamination, donor blood sterility

Platelets Feeding Bacteria with Lactate during Room Temperature Storage: Mitigated By Refrigeration

Introduction: Platelet transfusion related sepsis is a serious concern limiting platelet storage time to 5 days. Room temperature (RT) storage of platelets increases the risk of bacterial growth and necessitates implementation of bacterial contamination monitoring. Cold storage of platelets represents an attractive alternative for improving platelet safety. In this study, we assessed bacterial growth in platelets stored either at room temperature (22oC) or refrigerated (4oC).Methods: Apheresis platelets in plasma (PLT) were obtained from healthy donors using the Terumo Trima Accel Automated Blood Collection System (Terumo BCT). Platelet poor plasma (PPP) was obtained from PLT aliquots centrifuged twice at 2,500 x g for 5 min. In some experiments aliquots of PPP were supplemented with 5 to 20 mM lactic acid. Aliquots of PLT or PPP were transferred to pH SAFE minibags (Blood Cell Storage, Inc) and inoculated with Acinetobacter baumannii strains Ci77 or Ci79, Escherichia coli, Pseudomonas aeruginosa, or PBS (uninfected control). Minibag aliquots stored at RT were agitated using an orbital shaker set to 60 rpm while refrigerated aliquots were stored under static conditions. Bacterial growth was monitored daily through dilution plating. Lactate levels in PLT aliquots were assessed by iSTAT (Abbott) using CG4+ test cartridges. Platelet activation and aggregation were assessed on days 0, 1, 3, and 5 by flow cytometry and Multiplate platelet aggregometry respectively.Results: Growth of A. baumannii progressed exponentially over the first 3 days post-collection in PLT aliquots stored at RT. However, growth was significantly (p < 0.05) reduced in PPP units. Growth of E. coli and P. aeruginosa, both of which are capable of utilizing glucose present in the anticoagulant used, grew at significantly faster rates and did not seem to be dependent on metabolically active PLTs. Lactate levels were assessed in PLT units and found to mirror growth of A. baumannii . Furthermore, addition of ≥ 15 mM lactic acid to RT stored PPP restored A. baumannii growth. Although lactate levels did not appear to contribute to growth of E. coli, lactate levels began to decrease in PLT units contaminated with the bacterium at a rapid rate after day 3. Lactate levels in units contaminated with P. aeruginosa increased throughout the observation window. Bacterial growth remained static throughout under all treatment conditions stored refrigerated and lactate levels were reduced. PLT also appeared to retain function throughout cold storage irrespective of bacterial contamination while RT storage resulted in a decrease in aggregation over time which was exacerbated by bacterial contamination.Conclusions: Bacterial growth remained static throughout under cold storage. Additionally, PLT lactate production was increased at RT and correlated with increased growth of A. baumannii . Growth of E. coli and P. aerugionsa appeared to proceed independently of lactate production or metabolically active PLTs. However, E. coli did appear to utilize lactate as a carbon source at later time points. These data demonstrate that bacterial growth can be controlled through refrigeration without loss of function and RT stored platelets may potentiate growth of certain bacterial strains through accelerated metabolism relative to cold storage. DisclosuresNo relevant conflicts of interest to declare.

Order of draw of blood samples affect potassium results without K-EDTA contamination during routine workflow.

IntroductionA specific sequence is recommended for filling blood tubes during blood collection to prevent erroneous test results due to carryover of additives. However, requirement of this procedure is still debatable. This study was aimed to investigate the potassium ethylenediaminetetraacetic acid (K-EDTA) contamination in blood samples taken after a tube containing the additive during routine workflow. The study was also carried out to examine the effect of order of draw on potassium results, regardless of K-EDTA contamination.Materials and methodsIn 388 outpatients, to determine the probability of K-EDTA cross-contamination, blood was drawn sequentially into a serum tube, followed by a tube containing K-EDTA, and by another serum tube. In another 405 outpatients, to evaluate the effect of order of draw blood unrelated to K-EDTA contamination, two serum tube were successively collected. Potassium was measured on Cobas 6000 c501 analyser (Roche Diagnostic GmbH, Mannheim, Germany) by indirect ion selective electrode method.ResultsOf paired samples collected before and after a K-EDTA tube, 24% had a potassium difference of above 0.3 mmol/L. However, no EDTA contamination was detected in these samples as well as 95% confidence intervals (CI) of limits of agreement for calcium were within the allowable error limits based on reference change values. Interestingly, of blood samples drawn successively, 24% had also a difference greater than 0.3 mmol/L for potassium.ConclusionIncorrect order of draw using closed blood collection system does not cause K-EDTA contamination, even in routine workflow. However, regardless of K-EDTA contamination, order of draw has significant influence on the potassium results.

Are all blood-based postal sampling kits the same? A comparative service evaluation of the performance of dried blood spot and mini tube sample collection systems for postal HIV and syphilis testing

ObjectivesWe comparatively evaluated two HIV and syphilis blood sampling kits (dried blood spot (DBS) and mini tube (MT)) as part of an online STI postal sampling service that included tests...

The Order of Draw during Blood Collection: A Systematic Literature Review.

Blood collection is one of the most common nursing procedures and is not devoid of complications. The order of draw during blood collection is a controversial theme. We aimed to define the efficacy of the order of draw during blood collection to guarantee an exact biochemical result. We carried out a systematic literature review on PubMed, Scopus, Web of Science, CINAHL, Embase, Joanna Briggs Institute, Cochrane Library, and Google Scholar. Articles written in English and published from 2000 to 2020 were considered suitable. The analysis of the 11 articles included highlighted different opinions; however, the most recent evidence declares that the cross-contamination caused by the incorrect order of draw is a trait only in the open system of drawing. The most recent evidence affirms the negligible effect of the order of draw during blood collection when using the closed blood collection system, while it is recommended when using the open collection system.

In the era of humanitarian crisis, young women continue to die in childbirth in Mali

Maternal mortality occurs mostly in contexts of poverty and health system collapse. Mali has a very high maternal mortality rate and this extremely high mortality rate is due in part to longstanding constraints in maternal health services. The central region has been particularly affected by the humanitarian crisis in recent years, and maternal health has been aggravated by the conflict. Sominé Dolo Hospital is located in Mopti, central region. In the last decade, a high number of pregnant or delivering women have died in this hospital.We conducted a retrospective and exhaustive study of maternal deaths occurring in Mopti hospital. Between 2007 and 2019, 420 women died, with an average of 32 deaths per year. The years 2014–2015 and the last 2 years have been particularly deadly, with 40 and 50 deaths in 2018 and 2019, respectively. The main causes were hypertensive disorders/eclampsia and haemorrhage. 80% of these women’s deaths were preventable. Two major explanations result in these maternal deaths in Sominé Dolo’s hospital: first, a lack of accessible and safe blood, and second, the absence of a reference and evacuation referral system, all of which are aggravated by security issues in and around Mopti.Access to quality hospital care is in dire need in the Mopti region. There is an urgent need for a safe blood collection system and free of charge for pregnant women. We also strongly recommend that the referral/evacuation system be reinvigorated, and that universal health coverage be strengthened.

Quality validation of platelets obtained from the Haemonetics and Trima Accel automated blood-collection systems.

Platelet transfusion is required to treat haemo-oncology or trauma patients. Platelet apheresis (PA) performed with apheresis equipment has increased rapidly in recent years. Leucocyte-reduced platelet apheresis (LRPA) can reduce the risk of platelet refractoriness and febrile nonhemolytic transfusion reactions (FNHTRs) for transfusion. Accordingly, this study aimed to investigate and compare the platelet metabolic and functional responses between PA performed with Haemonetics and LRPA performed with Trima Accel cell separator. The qualities of platelets collected through PA and LRPA were evaluated in terms of visual appearance, morphology, platelet-aggregation changes, metabolic activities, and bacterium-screening test during 5-day storage. Statistical analyses included two-sample t-test and generalised estimating equation(GEE) method. During 5-day storage in LRPA, residual leucocytes were all <1.0×106, and the parameters of platelet function were as follows: platelet aggregated to agonists such as adenosine 5'-diphosphate (ADP) and collagen, and the extent of shape change and pO2 showed no statistically significant difference between PA and LRPA. The hypotonic shock reaction (HSR) on days 0, 1, and 3 were significantly higher in LRPA than in PA (71.78±6.92 vs. 64.10±7.42; P=0.002; 71.53±8.98 vs. 62.96±9.84; P=0.007; 68.05±7.28 vs. 57.76±6.80; P<0.0001, respectively). Values of mean platelet volume (MPV) were statistically larger in PA than in LRPA on days 0, 1, and 3. On day 5, the swirling score was higher in LRPA than in PA. The mean lactate levels had no statistically significant difference between PA and LRPA. Moreover, no growth was observed through bacterium-screening test conducted on 40 samples. Comparison of LRPA and PA products collected from the Trima Accel and Haemonetics automated blood-collection systems, respectively, revealed that both products possessed good platelet qualities even though additional processes are needed to reduce leucocytes. Furthermore, investigating the outcomes of other apheresis instruments with focus on the safety of donors, products, and recipients is necessary.

Metastatic Breast Cancer and Pre-Diagnostic Blood Gene Expression Profiles-The Norwegian Women and Cancer (NOWAC) Post-Genome Cohort.

Breast cancer patients with metastatic disease have a higher incidence of deaths from breast cancer than patients with early-stage cancers. Recent findings suggest that there are differences in immune cell function between metastatic and non-metastatic cases, even years before diagnosis. We have analyzed whole blood gene expression by Illumina bead chips in blood samples taken using the PAXgene blood collection system up to two years before diagnosis. The final study sample included 197 breast cancer cases and 197 age-matched controls. We defined a causal directed acyclic graph to guide a Bayesian data analysis to estimate the risk of metastasis associated with the expression of all genes and with relevant sets of genes. We ranked genes and gene sets according to the sign probability for excess risk. Among the screening detected cancers, 82% were without metastasis, compared to 53% of between-screening detected cancers. Among the highest ranking genes and gene sets associated with metastasis risk, we identified plasmacytiod dentritic cell function, the SLC22 family of transporters, and glutamine metabolism as potential links between the immune system and metastasis. We conclude that there may be potentially wide-reaching differences in blood gene expression profiles between metastatic and non-metastatic breast cancer cases up to two years before diagnosis, which warrants future study.

Assessment of software-derived predictive algorithms for platelet yield and blood cell count after apheresis.

Algorithms have been developed to predict the platelet yield after apheresis from the donor's data, as well as the effect on the blood cell count, to extract an acceptable platelet number without affecting the donor. However, the evaluation of these algorithms has not been widely reported. This study aimed to assess the accuracy of the predictive algorithms of the Trima Accel v. 6 blood collection system. Platelet concentrates (PCs) obtained by apheresis were analyzed. Platelet count and hematocrit were compared pre- and post-apheresis. Calculated post-apheresis platelet count (CPAPC), hematocrit (CPAH), and platelet yield (CPY), and their actual values were correlated. The bias of the algorithms was assessed with Bland-Altman plots, and the prediction of the extraction of single or double platelet products was evaluated. Two hundred and seventy-nine PCs were analyzed. Post-apheresis platelet count (PAPC) and hematocrit were decreased. A moderate correlation was observed between CPY and the actual yield, with a negative bias, and a trend to increase alongside the magnitude of the measurements. CPAPC and CPAH were strongly correlated with their actual values without bias. Prediction of single or double platelet product extraction showed a significant agreement with the actual outcomes. The predictive algorithm for the platelet yield showed bias, and a trend to underestimate the actual platelet yields when they are higher. The algorithms for the prediction of the PAPC and hematocrit did not show bias, proving their accuracy. Prediction of a single or double platelet product extraction has a strong agreement with the APY.

Comparative analysis of the impact of blood collection systems on the results of the study of indicators hemostasis system

Comparative analysis of the impact of blood collection systems on the results of routine coagulation tests. The aim of this study was to conduct comparative analysis of the effects of blood collection systems on the results of routine coagulation tests. The study involved practically healthy women over 18 years of age female (n=30). Inclusion criteria: practically healthy individuals. Exclusion criteria: taking non-steroidal anti-inflammatory drugs, or oral contraceptives. Blood collection was carried out in the following systems: 1 system-Vacuette Premium,2 system- Improvacuter, 3 system- BD Vacutainer® Plus. Before and after centrifugation, visual assessment of tubes was performed.No signs for the presence of clots, hemolysis, or insufficient filling was observed. In each sample we measured prothrombin time (PV, sec), activated partial thromboplastin time (APTT, sec), and fibrinogen (F, g/l) by clotting method on the automatic coagulometer «Sta Compact» («Diagnostica Stago», France). The results of laboratory analyses were processed using parametric and non - parametric statistics using The Statistica 12.0 software. At the preanalytical laboratory stage, there were no differences when using systems for blood sampling: the clots and hemolysis were not detected in the samples, the level of filling of the sistems was sufficient. Comparative analysis revealed small, though statistically significant, differences for: PT when comparing Improvacuter wiht Vacuette Premium or BD Vacutainer®; APPT when comparing Improvacuter wiht Vacuette Premium. No differences were observed for Fg levels. Our results support the data available in the literature on the effects of blood-taking systems on hemostasis , which should be taken into account when purchasing blood collection systems.