Preparation Of Blood Components Research Articles

Ways to Ensure Safety in the Preparation, Storage and Transfusion of Blood Components in Blood System Diseases

Ways to Ensure Safety in the Preparation, Storage and Transfusion of Blood Components in Blood System Diseases

Procoagulant activity of red blood cell microparticles in stored packed red blood cell units and its relation to ABO blood grouping

BackgroundThroughout the storage of blood, the red cells undergo alterations known as “storage lesions,” which involve shape changes and the formation of microparticles (MPs). Studies of the formation of red cell microparticles (RMPs) emphasize the prospective application of RMPs as a quality control measure in the preparation and storage of blood components in the future. In the present study, twenty packed RBC units in citrate phosphate dextrose adenine-1 (CPDA1) were collected from volunteers and stored for 35 days. Over 35 days of storage, samples were collected at six distinct time points weekly and evaluated for the presence of RMPs. MPs were separated by the ultracentrifugation method. Electron microscopy was used to characterize the morphology and size of the isolated microparticles, and flow cytometry was performed to determine the percentage of RMPs that expressed glycophorin A (CD235a) and Annexin V antigens. RMPs' procoagulant activity (PCA) was assessed using a plasma recalcification test. RMP concentration in accordance with ABO blood grouping was assessed by using various types of donated blood groups.ResultsRMPs progressively increased over storage. The procoagulant activity (PCA) exhibited a significant increase during storage, as evidenced by a shorter plasma recalcification time (P value = 0.001). A significant negative correlation (P value = 0.001) between plasma recalcification time and Annexin V-positive microparticles, as well as a dual-positive Annexin V/CD235a population, was identified, indicating a strong correlation between the direct quantitative assay by flowcytometry and the functional assay through the PCA.ConclusionRMPs increase on storage with increased PCA. Finding ways to reduce these microparticles in packed RBC units is crucial for reducing the risk of transfusion-related coagulopathy.

Analysis of Allergic Transfusion Reactions at a Children's Tertiary Care Center

Background: Transfusion reaction adverse events are a relatively rare occurrence in the United States. This is due to specific blood safety measures such as appropriate collection, preparation, testing, storage, and distribution of blood components as well as appropriate monitoring of patients receiving these transfusions. Several years of data have been collected by our institution's blood bank. Through our analysis, we have been able to describe the rate of transfusion- associated adverse events in pediatric patients at Children's Hospital of Michigan from 2018-2022. Objectives: The aim of this retrospective chart review was to assess the rate of allergic blood transfusion complications and reactions among pediatric patients at Children's Hospital of Michigan in Detroit, Michigan. Materials and Methods: An institution-based retrospective chart review was conducted for a total of 43,210 transfusions over a span of five years from 2018-2022. Results: There were a total of 43,210 transfusions. A total of 26,669 of these products were red blood cell (RBC) transfusions, 10,447 were platelets, 4,392 were plasma, and 1,702 were cryoprecipitate (combined plasma and cryoprecipitate was 6,094). A reported reaction was encountered in 176 of the 43,210 transfusions. These reported reactions were part of the patients' underlying diseases. A true acute transfusion reaction (ATR) was encountered in 116 of the 43,210 transfusions. Of the 116 transfusions, 66 (56.9%) were classified as allergic reactions. About 61% of those reactions were skin manifestations (urticaria, itching), 9% were respiratory symptoms (dyspnea, tachypnea), and the remaining 30% were both skin and respiratory symptoms. Of the total amount of RBC transfusions, 35 (0.131%) resulted in an allergic reaction. Similarly, 19 (0.182%) platelet and 12 (0.197%) plasma transfusions resulted in ATRs. ATRs were most associated with plasma, followed by platelets and RBC transfusions. Combining all transfusions received, these represented a total of 66 (0.153%) allergic transfusion reactions. These results are demonstrated in Figure 1. Conclusion: ATRs were observed in 0.268% of total transfusions (allergic reactions (0.153%) and other reactions (0.115%)) that occurred over the course of five years at our institution. This is about 1 in 655 blood components transfused that was associated with an allergic reaction (more commonly with plasma > platelets > packed RBCs). The rate of allergic reactions is less than what was reported by National Blood Collection and Utilization Survey 2017 (0.282%). This rate is also less than what is reported for children (0.53%) and adults (0.26%) in a meta-analysis (Wang Y, Sun W, Wang X, et al. Comparison of transfusion reactions in children and adults: A systematic review and meta-analysis. Pediatr Blood Cancer. 2022;69(9):e29842.). These lower rates could be secondary to changes in blood processing and under-reporting.

Blood donation practices, processing and utilisation of blood components in government tertiary hospitals in Nigeria: a multicentre cooperative study.

Timely access to safe blood and blood components is still a challenge in Nigeria. This study aimed to determine blood donation practices, processing and utilization of blood components across government tertiary hospitals (THs) in Nigeria. This was a descriptive cross-sectional study done in Nigeria in June-July 2020. Data were analysed with SPSS version 21.0. Data were collected from 50 THs. The majority (68%) of the THs lack facilities for blood component preparation and only 18% and 32% provide cryoprecipitate and platelet concentrate, respectively. Whole blood was most commonly requested (57.04%). All facilities tested blood for HIV, HBV and HCV, but the majority (23 [46%]) employed rapid screening tests alone and nucleic acid testing was not available in any hospitals. The manual method was the most common method of compatibility testing in 90% (45/50) and none of the THs routinely perform extended red cell typing. The average time to process routine, emergency and uncross-matched requests were a mean of 109.58±79.76min (range 45.00-360.00), 41.62±25.23 (10.00-240.00) and 11.09±4.92 (2.00-20.00), respectively. Facilities for blood component preparation were not widely available. Concerned government authorities should provide facilities for blood component preparation.

Machine-learning prediction models for any blood component transfusion in hospitalized dengue patients

BackgroundBlood component transfusions are a common and often necessary medical practice during the epidemics of dengue. Transfusions are required for patients when they developed severe dengue fever or thrombocytopenia of 10×109/L or less. This study therefore investigated the risk factors, performance and effectiveness of eight different machine-learning algorithms to predict blood component transfusion requirements in confirmed dengue cases admitted to hospital. The objective was to study the risk factors that can help to predict blood component transfusion needs. MethodsEight predictive models were developed based on retrospective data from a private group of hospitals in India. A python package SHAP (SHapley Additive exPlanations) was used to explain the output of the “XGBoost” model. ResultsSixteen vital variables were finally selected as having the most significant effects on blood component transfusion prediction. The XGBoost model presented significantly better predictive performance (area under the curve: 0.793; 95 % confidence interval: 0.699–0.795) than the other models. ConclusionPredictive modelling techniques can be utilized to streamline blood component preparation procedures and can help in the triage of high-risk patients and readiness of caregivers to provide blood component transfusions when required. This study demonstrates the potential of multilayer algorithms to reasonably predict any blood component transfusion needs which may help healthcare providers make more informed decisions regarding patient care.

Development of Prehospital Factors for Predicting Massive Blood Transfusion in Trauma Patients

Background: Massive blood loss is the primary cause of immediate death in trauma patients. In prehospital care, where laboratory and investigation resources are limited, a massive blood transfusion (MBT) scoring system could activate blood bank preparation of blood components and facilitate EMS decision-making regarding the appropriate trauma center destination. This is particularly significant in urban environments where motor vehicle accidents are highly prevalent. Materials and Methods: A retrospective cohort study was conducted using data from prehospital trauma patients. Predictive parameters, including vital signs, mechanism of injury, and serious injury body parts, were analyzed, and the significant parameters identified by a multivariable analysis were used to develop a clinical scoring system. Discrimination was evaluated by the area under the receiver operating characteristic (AuROC) curve, calibration was demonstrated with the Hosmer-Lemeshow goodness of fit test, and internal validation was performed. Results: Among 511 trauma patients, 72 (14.1%) received MBT. The prehospital factors that significantly predicted massive MBT included hypotension with a SBP of less than 90 mmHg, penetrating object injuries, serious injuries to the face, thorax, abdomen, extremities including the pelvis, and the use of life-saving interventions such as advanced airway management and pelvic binding. The AuROC was 0.943 (95% CI 0.914 to 0.972, p<0.001). The probability of receiving massive transfusion was 94.79% in patients with score of 5 or higher. Conclusion: The prehospital MBT score demonstrates good performance and discrimination for predicting MBT using simple and rapidly obtainable parameters in a prehospital setting. Keywords: Massive transfusion; Massive bleeding; Prehospital care

Effect of COVID-19 pandemic on blood transfusion service: an experience from a regional blood transfusion center.

The unforeseen and uncertain life-threatening situation of the COVID-19 pandemic dramatically affected all areas of the human daily work schedule. This study was designed to assess the impact of the COVID-19 pandemic on blood transfusion services and discuss the adopted confrontation measures for uninterrupted blood supply during the pandemic situation. The data on blood donation, blood component preparation, and issue from January 2019 to December 2022 were collected from the inventory registers of the RBTC, Delhi, India. Compared to the non-pandemic year 2019, during the year 2020, all variables decreased gradually. The observed maximum decrease in variables such as blood collection (-79.16%) in the month of October, blood issue (-71.61%) in the month of August, random donor platelets (RDP) preparation (-98.09%) in the month of October, RDP issue (-86.08%) in the month of September, fresh frozen plasma (FFP) preparation (-100%) in the month of October, and FFP issue (-96.08%) in the month of July with an annual decrease of -45.52%, -42.87%, -33.00%, -59.79%, -40.98%, and -54.48%, respectively, as compared to year 2019. Compared to year 2020, in year 2021, the annual increase in blood collection, blood issue, FFP preparation, FFP issue, RDP preparation, and RDP issue was +50.20%, +21.68%, +65.31%, +78.52%, +116.23%, and +213.30%, respectively. Our study results show that the COVID-19 pandemic has significantly affected blood transfusion services at our blood bank. The adopted coping strategies to maintain the safe and uninterrupted blood transfusion chain at our blood bank gave us lessons for future preparedness if faced with a similar situation.

Effectiveness of Preoperative Red Cell Preparation and Intraoperative Massive Transfusion in Brain Tumor Operation

AbstractBackground Excessive requests for preoperative packed red cell (PRC) preparation have been noted, resulting in waste of blood products and higher costs in brain tumor surgery. The objectives of the present study were as follows: (1) the primary objective was to assess the effectiveness index of blood preparation and utilization; (2) the secondary objective was to explore factors associated with intraoperative PRC transfusion; and (3) the third objective was to identify the prevalence and analyze risk factors of massive transfusion.Methods A retrospective cohort study was done on patients who had undergone brain tumor operations. The effectiveness indexes of preoperative PRC preparation and intraoperative utilization were calculated as follows: the crossmatch to transfusion (C/T) ratio, transfusion probability (Tp), and transfusion index (Ti). Additionally, factors associated with intraoperative PRC transfusion and massive transfusion were analyzed.Results There were 1,708 brain tumor patients and overall C/T, Tp, and Ti were 3.27, 45.54%, and 1.10, respectively. Prevalence of intraoperative PRC transfusion was 44.8%, and meningioma, intraosseous/skull-based tumor, and tumor size were linked with massive transfusion.Conclusion Unnecessary preoperative blood component preparation for brain tumor surgery was noticed in routine practice. Exploring intraoperative transfusion variables has been challenged in optimizing crossmatch and actual use.

Blood Transfusion in Obstetrics and Gynecology: A Retrospective Analysis in Government Naseerullah Babar Hospital Peshawar

OBJECTIVES: To evaluate the indications of blood transfusion in the Obstetrics and Gynecology Department of Government NaseerUllah Khan Babar Memorial Hospital. METHODOLOGY: This retrospective observational study was performed on indoor gynecology and obstetrics patients for the period of one year, a total of 100 patients were included in this study that received blood transfusion. Samples were collected by non-random convenience sampling after getting approval from the hospital ethical committee. Data was analyzed by using SPSS version 20. RESULTS: In this study a total of 100 patients who received blood transfusion were analyzed, out of 100 patients 78% of patients received transfusion due to obstetrical causes and 22% patients got transfused for gynecological causes. Most common blood group transfused was B+ and O+ and mean hemoglobin level at which patients received blood transfusion was 9.7g/dl. Blood components preparation can provide components to treat two to three patients from a single donor. The use of packed cell transfusion should be promoted instead of whole blood transfusion that is not even needed in most of the cases. CONCLUSION: Blood transfusion practice has been used aggressively in gynecology and obstetrics in some cases even without proper indications. There is a need to modify this practice by correcting anemia through drugs to avoid the inappropriate use of blood. Use of blood components should be encouraged.

Blood component preparation‐inventory problem with stochastic demand and supply

AbstractBlood component preparation, which is the process of separating whole blood into components that are later used in hematotherapy, plays a significant role in the blood supply chain because it dramatically affects the component inventory levels in blood banks. A dynamic programming model is proposed for jointly optimizing the preparation and inventory management of blood components under uncertainty in both the supply of whole blood and the demand for blood components to better meet demand and manage component inventory levels. The combinations of five common methods for preparing blood components with filtration and centrifugation processes are considered, which generate diverse component varieties and volumes while incurring different costs. Moreover, downward substitution among different types of red blood cells is introduced. Subsequently, an approximate dynamic programming method is proposed to solve the problem of coping with its uncertain characteristics. The results of the computational study show that the proposed model and algorithm lead to superior performance compared to the preparation method combinations currently applied in North America, Europe, and China, thus providing a helpful guide on blood component preparation and inventory management in blood banks.

Application of Autologous Artificial Tears in a Case of an 8-Year-Old Girl with Vernal Keratoconjunctivitis (Spring Catarrh)

IntroductionVernal keratoconjunctivitis is a chronic, recurrent bilateral inflammation of the outer ocular layer. Mostly affected are children and young people and the condition is more common in boys. The disease presents with eye pruritus (itching eye), photophobia (sensitivity to bright light), excessive tearing and foreign eye syndrome. Severe cases manifest themselves with a diffusion of overgrown papillae usually of the upper eyelid, bursting/breaking of the connective tissue barriers and occurrence of giant papillae that press on the cornea. Corneal ulceration is a severe complication of vernal keratoconjunctivitis that may induce scarring, corneal neovascularization and occasionally perforation.Treatment of keratoconjunctivitis mainly relies on steroids, mast cell stabilizers, antihistamines, immunosuppressive drugs (cyclosporine), artificial tears, contact lenses-dressing, cryotherapy and surgical papillae removal.We present the case of an 8-year-old girl with corneal ulceration who was applied artificial tears after traditional methods of treatment proved unsuccessful.AimThe aim was to share our experience on artificial tears therapy applied in ophthalmic disorders.Materials and methodsAutologous blood (20 ml) was collected into disposable, sterile transfer bags used for routine blood component preparation (no anticoagulant) and incubated for 1 hour at 37 °C.The clot was then removed by centrifugation (13 min, 22°C, 3100 x g) and the serum containing erythrocytes was press extracted. Centrifugation was applied again (5 min, 22°C, 2000 x g) to obtain a serum that is free of cellular components. The serum was then divided into 0,3 ml segments (capsules) and the artificial tears were applied to the left eye 8 times per day.ResultsUlcer healing was reported after 4 weeks of therapy with artificial tears. The dosage was reduced to 4 times per day. No recurrence of corneal ulceration was observed after subsequent 8 weeks.Artificial tears are a safe and effective therapy for ophthalmic disorders in children. DisclosuresNo relevant conflicts of interest to declare.

The Features of Antigen Prevalence of Rhesus System in Donor Population

Research materials and methods. 852 voluntary Georgian blood donors have been typed on red blood cells group antigens. The research materials have taken from the diagnostic laboratory of Health Centre of Batumi (Georgia republic). The immunoserological methods with monoclonal anti –AB, -B, -A, A1, -A2 (H), -C, -c, - D, -E, -e (Bio-Rad, cypress diagnostics) antibodies was used for typing blood. The ID cards, such as ABO/D + Reverse Grouping (Bio-Rad) were also used for typing of erythrocyte antigens. Result. Prevalence of Rh system antigens in the studied group is looks like so: e antigens – 94,6%, c antigens -85%, C-68,03, E antigens - 38,07%. The majority (84%) of the studied donors are Rh-positive (n=719), 133 (16%) donors are Rh-negative. C antigen most common is present in the combination with D antigen. 65, 8 % case donors had CD+ combination (n=561). E antigen in most cases is presented with a combination of D antigen. 36, 9% of the studied donors (n=306) had ED+ combination. A miserable number of studied donors had CD - (2,23%; n=19) and ED - (1,17%; n=9) combinations. We have studied the Rh phenotypes prevalence in blood donors. According to RHD, RHC, and RHE gene loci, there are 18 theoretically possible phenotypical groups. Among them half (nine) are Rh-positive and the rest of them are Rh-negative. The Rh-positive phenotypes are: CDE; CDEe; CDe; CcDE; CcDEe; CcDe; ccDE; cDEe and cDe. Rh-negative phenotypes are CdE; CdEe; Cde; CcdE; CcdEe; Ccde; cdE; cdEe; cde. We allocated 17 Rh phenotypes among studied donors. Only one phenotype CdE, which belongs to Rh negative group, was not present in studied donors. Other 17 phenotypes showed different frequencies. Some of them were only in a single case, for example, cdEe, cdE, CdEe phenotypes had only one donor. The majority of the phenotype in he studied donors (27,8±1,53%) was CcDe (n=237). CcDEe -19,3±1,35% (n=165); 125 donors have CDe phenotype (14,6±1,2); The frequency of cde was 13,1±1,5%, which means that 112 studied donors belonged to this phenotype group; 87 studied donors had cDEe phenotype characteristics (10,2%); The frequency of cDe was 4,9% (n=42); 19 donors had CDEe phenotype. Other phenotypes (CDE, Cde, CcdEe, Ccde) frequency was very low. Conclusion. Our studied donors are characterized by rather high polymorphism. The Georgian donor’s population is heterogenic, especially high heterogeneity are shown in Rh positive phenotypes. The obtained data is vital importance for the preparation of whole blood or certain blood components for the purpose of their rational usage in blood transfusion.

What about Platelet Function in Platelet Concentrates?

The characterization of platelet concentrates (PCs) in transfusion medicine has been performed with different analytical methods and platelet lesions (from biochemistry to cell biology) have been documented. In routine quality assessment and validation of manufacturing processes of PCs for transfusion purposes, only basic parameters are monitored and the platelet functions are not included. However, PCs undergo several manipulations during the processing and the basic parameters do not provide sensitive analyses to properly picture out the impact of the blood component preparation and storage on platelets. To improve the transfusion supply chain and the platelet functionalities, additional parameters should be used. The present short review will focus on the different techniques to monitor ex vivo platelet lesions from phenotype characterization to advanced omic analyses. Then, the opportunities to use these methods in quality control, process validation, development, and research will be discussed. Functional markers should be considered because they would be an advantage for the future developments in transfusion medicine.

Vox Sanguinis International Forum on Hospital Transfusion Services' Response to COVID‐19: Responses

Question 1Demographics:a. Beer Yaakov, Israel.b. Large academic medical center.c. 956 beds.d. 9034 RBC units issued in 2019, approximately 9000.e. 4831 confirmed SARS‐CoV‐2 cases and 17 deaths (March 31, 2020, 12:40 pm, data from the Israeli Ministry of Health).f. 9,136,000 inhabitants.g. The spread of SARS‐CoV‐2 in Israel is still increasing, but as of yesterday the rate of increase is declining sharply (from almost 30% of samples tested per day at the peak to 12% yesterday).

Mapping HIV-related figures of risk in Europe’s blood donation regime

Grasping blood donation as contested grounds for enacting notions of belonging, responsibility and citizenship, this article analyses the role of donor deferral policies in the emergence of a European blood donation regime. We demonstrate how shifts in the moral economy of blood donation that followed from the outbreak of the human immunodeficiency virus (HIV) epidemic led to the prioritisation of donor deferral policies in efforts to enhance blood safety across Europe. We propose the notion ‘figures of risk’ – condensed figurations of those understood to pose risks of HIV infection to themselves and to others – to describe the categories of persons implicated in changing European donor restriction policies. We explore how the Council of Europe’s annually revised Guide to the preparation, use and quality assurance of blood components, first published in 1992, came to legitimise and sustain increasingly contested deferral practices, which have produced shifting groups of persons as European ‘figures of risk’. Qualitative analyses of the Guide’s 19 editions reveal 3 dimensions through which these figures have become increasingly stabilised over time: in terms of their ontology, temporality and risk-related exceptionality. We conclude by asking how collectivising figurations of donors, framed through literature on ‘profiling’, shape notions of European citizenship.

Vox Sanguinis International Forum on the selection and preparation of blood components for intrauterine transfusion: Summary.

Vox Sanguinis International Forum on the selection and preparation of blood components for intrauterine transfusion: Summary.

Vox Sanguinis International forum on the selection and preparation of blood components for intrauterine transfusion

Vox Sanguinis International forum on the selection and preparation of blood components for intrauterine transfusion

Procesiranje i skladištenje krvnih komponenti kao preduslov bezbedne transfuzije

The preparation of blood components from whole blood collections must be standardized and compliant with recommendations, EU Directives and Standard Operative Procedures (SOPs). In order to achieve safe and efficient transfusion it is important to have automated separation of whole blood unit producing standardized blood components, good quality control and increased work efficiency. It is also very important that all blood components should be ISBT 128 labelled and properly storaged under the regulated conditions. One of the most important factors that increases transfusion safety is leucoreduction of blood components, which prevents several adverse effects following blood transfusion, as well replacement of plasma as a storage medium in red blood cells and platelet concentrates with preservative solutions, which results in the reduction of isoand HLA-antibodies and plasma proteins. Pathogen inactivation in blood products is the trend of modern blood transfusion practice and acts in the removal or inactivation of all pathogens that can be blood transmitted. It does not replace testing of blood units for transfusion-transmitted diseases, but it reduces the risk of "window phenomenon" and errors in testing, acting on the agents that are not included in routine testing. In circumstances where the pathogen reduction has not been introduced in practice routine bacteriological testing of blood components significantly decreases the occurrence of adverse reactions on contaminated blood. Processing using the most appropriate and effective methodologies and best laboratory practices, efficient inventory management system for optimum blood stocks, and effective blood cold chain for safe storage and distribution of blood and blood products are key requirements to ensure the safety of blood products.

An insight into the encountered challenges and performances of a hospital-based blood transfusion service in Eastern India in the light of COVID-19 pandemic

Background: Every pandemic elaborates its own challenges that should be managed meticulously through proper initiative and planning, following existing guidelines and through population education. We encountered various challenges in our blood center which significantly affected the blood inventory and blood supply. Here, we share our experiences of managing blood donations, blood inventory, staff adequacy, and blood wastages in the light of COVID-19 pandemic. Methods: The retrospective study was performed from January 1, 2020, to June 30, 2020, that included major activities in a blood center. The initial 3 and later 3 months were considered as the pre-COVID and COVID periods, respectively. Data related to various affected parameters were retrieved, analyzed, and compared with the pre-COVID period. Results: The drop in blood donation, blood component preparation, and blood issue in the COVID-period was observed to be 51.2%, 49.1%, and 49.8%, respectively. Mean total blood donation time and turnaround time of blood issue in the COVID period were found to be statistically significant (P

Factors for Blood Transfusions Following Hemi Hip Arthroplasty for Patients With Femoral Neck Fracture.

Background:Hemi hip arthroplasty is one treatment option for femoral neck fractures; however, there has been limited evidence on factors associated with blood transfusions following hemi hip arthroplasty. Hence, the aim of this study was to identify the predictors of blood transfusion after hemi hip arthroplasty, which could lead to the establishment of proper guidelines for management protocols.Materials and Methods:This study was a retrospective cohort study, conducted in a single center of 323 femoral neck fracture patients having undergone hemi hip arthroplasty. Peri-operative factors and demographic data were extracted from the electronic medical records, from 2007 to 2019. A predictive model was developed by logistic regression (LR), and adjusted by multivariate logistic regression.Result:One hundred and twenty-six (39%) patients received blood transfusions. On multivariate analysis, those of a female gender (odds ratio (OR) 2.00, p = 0.037), having a body mass index lower than 18.5 kg/m2 (OR 2.40, p = 0.028), lower preoperative hemoglobin levels (OR 0.52, p < 0.001) and given general anesthesia (OR 2.07, p = 0.028) were shown to be significantly associated with a higher risk of requiring a blood transfusion.Conclusion:The authors recommend that preparation of blood components coupled with the utilization of blood conserving methods for high risk patients, as studies have stated, in addition to the consideration of spinal anesthesia; if patients have no contraindication, should be implemented.