Volunteer Donor Blood Research Articles

Assessment of the effect of hemostatic materials on blood calcium concentration

Purpose of the study. Assessment of the effect of hemostatic materials on concentration of calcium of blood.Materials and methods. The following groups of local hemostatic materials were studied: collagen plate (No. 2), hemostatic sponge from medical gelatin (No. 3), oxidized cellulose material (No. 4), experimental samples of hemostatic sponge developed by the team of authors, based on the sodium salt of carboxymethylcellulose with various modifications (groups No. 5-8). In the control group (No. 1), only blood of volunteer donors was used, without introducing the test materials. Evaluation of the effect of hemostatic materials on blood calcium concentration was carried out according to the described method: «Method for comparative investigation of the effectiveness of local hemostatic agents in an in vitro experiment» Russian patent No. 2709 517. According to the results of the study, median, 25 and 75 percentiles were calculated. The validity of differences between groups was determined using the non-parametric Mann-Whitney test (p<0.05).Results. In groups using various materials, such as group No. 2 (Tachocomb) by 0.24 mmol/L and group № 4 (Surgicel Fibrillar) by 0.7 mmol/L, the serum calcium level was statistically significantly lower than the control group. Significant differences of calcium level values after blood immersion of volunteer donor samples based on cellulose derivatives were revealed, namely in group No. 5 (Na-CMC + Tranexamic acid pressed) value exceeds that in group No. 4 by 0.58 mmol/l. In other cases, comparisons of calcium concentration values in groups using experimental samples (not introduced into clinical practice) with material widely used in abdominal surgery (group No. 4) were found to be greater: in group No. 6 (Na-CMC + Tranexamic acid unsaturated) by 0.61 mmol/l, in group No. 7 (Na-CMC pressed) by 0.75 mmol/l, in group No. 8 (Na-CMC unsaturated) by 0.5 mmol/l.Conclusion. It should be noted that although there are no significant differences in the groups using experimental samples of local hemostatic agents and the control group, the calcium levels in groups No. 5-6 are close to those in the groups using widely known materials such as Tachocomb (No. 2) and Gelita-Spon Standart (No. 3). Also, among the samples developed by the authors, the greatest effectiveness was identified in group No. 8 (Na-CMC, unpressed), in which the serum calcium levels (2.14 mmol/L) are lower than in groups No. 5-7.

PENGARUH KUALITAS PELAYANAN DAN MEDIA SOSIAL TERHADAP MINAT RELAWAN DONOR DARAH DI UNIT DONOR DARAH PMI KABUPATEN GIANYAR

This study aims to determine and analyze how much influence the quality of service and social media to interest of blood donor volunteers at Unit Donor Darah PMI Kabupaten Gianyar. Results of data processing with SPSS For Windows Version 24 obtained the results of multiple linear regression results obtained results of multiple linear regression analysis Y = 4,982 + 0,088X1 + 0,439X2. The result of the analysis of multiple correlation is 0,730, lies between 0.60 to 0.799 which means there is a positive and strong correlation. Based on the result of determination analysis, the value of R2 stated that 55,1% of blood donor volunteer interest is influenced by both variables, service quality and social media, the rest 44,9% volunteer donor blood interest influenced by other variables outside of research. Simultaneously the quality of service and social media influence on the real interest of blood donor at Unit Donor Darah PMI Kabupaten Gianyar. Partially, the service quality (X1) and social media (X2) have positive and significant effect on interest of blood donor volunteer in Unit Donor Darah PMI Kabupaten Gianyar. Thus the quality of service and social media is not only important for the company or profit organization but for non profit organization both of them give a positive effect. Especially for Unit Donor Darah PMI Kabupaten Gianyar engaged in community services, especially blood transfusion.

Operational effectiveness and quality assurance mechanisms with stochastic demand of blood supply: blood bank case study

A general overview of various blood products operational effectiveness and related strategies that can be utilised by service providers (in particular, healthcare providers) is presented in the present study. In terms of the massive volumes of blood products, the North American blood centres collect more than eight million units of whole blood, which represents appropriately 50% of the US and Quebec, Canada?s volunteer donor blood supply. A case study of the quality inspection and inventory control concerns of the Central Blood Bank, located in the metropolitan area of Pittsburgh, PA, is presented. Initially, brief introduction to its general operating environment is followed by sections describing its general situation, quality-service initiatives, and followed by a fairly detailed discussion of the practical applications of lessons learned from the case study.

Platelet‐white blood cell (WBC) interaction, WBC apoptosis, and procoagulant activity in stored red blood cells

Nonleukoreduced units of red blood cells (RBCs) contain activated platelets (PLTs) that interact with white blood cells (WBCs) and may promote inflammation and thrombosis in the recipient. The aim of this study was to characterize PLT-WBC interactions (PLT-WBC aggregates [PLAs]), WBC apoptosis, WBC death, and the development of procoagulant activity in RBCs during storage. RBCs were prepared from volunteer donor blood and stored. Samples were analyzed with flow cytometry between Days 1 and 15 to measure PLT-monocyte aggregate (PMA) and PLT-neutrophil aggregate (PNA) formation, WBC apoptosis (annexin V binding), and cell death (binding of 7-aminoactinomycin D). Procoagulant activity in the supernatant of four RBC preparations was assessed between Days 1 and 39 using a clotting assay with and without the addition of an inhibitory anti-tissue factor (TF) antibody, αTF-5. PLA formation was extensive and maximal on Day 3 of storage (PNA, 23 ± 13%; PMA, 93 ± 4%; n = 6). Apoptosis was progressive throughout storage, with 95 ± 4% of neutrophils and 73 ± 19% of monocytes binding annexin V on Day 15. Cell death became measurable after apoptosis. Procoagulant activity was observed in all RBCs but with varying temporal patterns. It was partially TF dependent and removed with high-speed centrifugation, suggestive of an association with microparticles. The activation of PLTs during the storage of RBCs induces PLA formation that precedes WBC apoptosis and death. Procoagulant activity, likely associated with microparticles derived from apoptotic WBCs, may contribute to adverse effects of stored, nonleukoreduced RBCs.

Methemoglobin Effects on Coagulation: A Dose-Response Study With HBOC-200 (Oxyglobin) in a Thrombelastogram Model

Because oxidation affects platelet and coagulation factors, hemoglobin auto-oxidation in HBOCs results in the transformation to methemoglobin, which may have additive adverse effects on coagulation. The risk of coagulopathy after different dilutions of HBOC-200 with low and high methemoglobin concentrations was studied. A laboratory study on donor blood using thromboelastography (TEG; Haemoscope, Niles, IL). A university laboratory. Volunteer donor blood. Blood samples simulated hemodilution during clinical resuscitation of hemorrhagic shock with varying doses of HBOC-200 (Oxyglobin; Biopure Corp, Cambridge, MA). Coagulopathy related to 1:11, 1:5, 1:2, and 1:1 dilution of whole blood with HBOC-200 high methemoglobin concentrations (65%) and HBOC-200 low methemoglobin concentrations (1%) were analyzed. Analysis of fixed effects of dilution on coagulation showed that the progressive dilution of HBOC-200 (low methemoglobin) and HBOC-200 (high methemoglobin) produced significant prolongation in reaction time (R) and clot propagation (K) and significant decreases in clot kinetics (alpha) and clot strength (MA and G). Analysis of fixed effects of treatment group on coagulation showed that clot propagation (K, alpha) and clot strength (MA and G) are significantly different in HBOC-200 (high methemoglobin) compared with HBOC-200 (low methemoglobin). High methemoglobin concentrations in HBOC-200 cause additive coagulation impairment that likely results from the effects of oxidative substances on platelet function and coagulation proteins. Oxidative products adversely react with coagulation factors and modify redox-sensitive sites in the platelets. Therefore, if methemoglobinemia occurs as a result of HBOC administration and if the levels are significantly elevated (greater than 10%), impairment of coagulation is possible.

Does OxyVita, a New-Generation Hemoglobin-Based Oxygen Carrier, or Oxyglobin Acutely Interfere With Coagulation Compared With Normal Saline or 6% Hetastarch? An Ex Vivo Thromboelastography Study

Because hetastarches have deleterious effects on coagulation that increase with molecular weight (MWt), risk of coagulopathy associated with a high MWt hemoglobin-based oxygen carrier (HBOC) was studied. Preliminary laboratory study of donor blood using thromboelastography (TEG). University laboratory. Volunteer donor blood. Experiments simulated hemodilution during clinical resuscitation of hemorrhagic shock with varying doses of HBOCs. Coagulopathy related to 1:11, 1:5, 1:2, or 1:1 dilution of whole blood with normal saline, 6% hetastarch (670 kilodaltons [kD]), hemoglobin glutamer-200 (HBOC-200, 200 kD), or OxyVita (OXYVITA Inc, New Windsor, NY) (a new-generation, zero-link polymerized bovine hemoglobin-based oxygen carrier, 33 megadaltons) were analyzed. At 2 lower levels of hemodilution, hetastarch, HBOC-200, and OxyVita produced equivalent reductions in maximum clot strength (TEG-MA and TEG-G) that reached statistical significance compared with whole blood and normal saline. At 2 higher dilutions, OxyVita and HBOC-200 impaired maximum clot strength compared with whole blood, normal saline, and hetastarch. Dilution with hetastarch had a greater effect on clot propagation (K and alpha) than either HBOC. OxyVita and HBOC-200, HBOCs with different MWt, had similar effects on coagulation as measured by TEG. The impairment of coagulation by HBOCs and hetastarch occurred at doses corresponding to 12 mL/kg or a blood volume replacement of 17%. The use of HBOCs at doses corresponding to 23 mL/kg or a blood volume replacement of 33% significantly decreased coagulation to levels associated with increased clinical bleeding in this preliminary study. Minimal coagulopathic effects are expected with use of OxyVita at the manufacturer's anticipated effective dose of 10 g or 2 to 3 mL/kg.

Changes in the expression of adhesion molecules as peripheral blood monocytes differentiate into peritoneal macrophages.

Peritoneal macrophages, derived from peripheral blood monocytes, are the chief cellular defenders against invasion of the peritoneal cavity by infectious organisms. Monocyte migration into the peritoneal cavity depends upon a coordinated series of adhesive events, utilizing cell surface receptors known as adhesion molecules. In order to better understand the mechanisms of leucocyte infiltration of the peritoneum during peritonitis, we studied the relative expression of adhesion molecules on monocytes and peritoneal macrophages from patients on continuous ambulatory peritoneal dialysis (CAPD). Peripheral blood and spent peritoneal dialysis fluid were obtained from patients undergoing CAPD, and the level of expression of various adhesion molecules on the monocytes/macrophages analysed by flow cytometry using receptor-specific monoclonal antibodies. Monocytes were also purified from the peripheral blood of volunteer donors, cultured in vitro for varying periods, and analysed in the same manner. Consistent differences in expression of certain adhesion molecules were found between monocytes and peritoneal macrophages, and similar changes occurred on monocytes cultured in vitro. Concurrent infection had no clear effect. Several receptors (integrins alpha 4 beta 1, alpha 6 beta 1, alpha L beta 2 and alpha IIb beta 3, and platelet endothelial cell adhesion molecule-1) were significantly decreased on peritoneal macrophages, while only the integrin alpha v beta 5 increased. It is concluded that monocyte differentiation into peritoneal macrophages is accompanied by characteristic alterations in the adhesion molecule repertoire on the cell surface, emphasizing the different adhesive requirements of these two cell types.

The impact of a patient education program on directed donations

The effect of an informational program in which the benefits and disadvantages of directed donations are discussed directly with the prospective recipient of the blood and/or that patient's family was examined during a 20-month period. Data collected for 27 regional Connecticut hospitals that accept directed donations were compared with similar data for Hartford Hospital, an 885-bed tertiary-care facility. The number of directed-donor units (68) collected by the American Red Cross Blood Services for Hartford Hospital during the study period was comparable to the number (average, 62.3) provided for smaller (301-450 beds) institutions in the state. The percentage that directed-donor units drawn for Hartford Hospital represented of the total number of homologous units provided (0.23%) was less than that for any of the categories of hospitals, by size, in the state. Supplying the patient and/or the patient's family, in a personalized manner, with information concerning the advantages and disadvantages of directed as well as of volunteer donor blood can result in a marked overall reduction in the number of directed donations and also serves to reassure those concerned about blood transfusion.

CLINICAL AND SEROLOGICAL ANALYSIS OF TRANSFUSION-ASSOCIATED HEPATITIS

Of 108 prospectively followed, multiply transfused, open-heart-surgery patients, 12 (11%) developed hepatitis. Patients received only volunteer donor blood tested for hepatitis-B surface antigen (HBsAg) prior to transfusion by counterelec-trophoresis (C.E.P.). 4 of the 12 patients developed hepatitis-B-virus infection. Subsequent testing of donor serums by solid-phase radioimmunoassay (R.I.A.) revealed that an R.I.A.-positive, C.E.P.-negative blood unit was transfused to 3 of the 4 type-B hepatitis cases, but to none of the remaining 104 patients; 3 hepatitis-B cases could probably have been prevented by prescreening of donors by solid-phase R.I.A. 8 hepatitis cases were serologically unrelated to the hepatitis-B virus, the hepatitis-A virus, the cytomegalovirus, or the Epstein-Barr virus. Had R.I.A.-positive donors been excluded, 8 of the 9 residual hepatitis cases (89%) would have represented "non-A, non-B" hepatitis. The existence of previously unrecognised human hepatitis virus(es) is probable.

Can the blood-transmitted hepatitis problem be solved?

Of the approaches presently available for prevention of blood-transmitted hepatitis, most clearly effective is the avoidance of high-risk donor populations, such as most paid commercial donors. It should be emphasized that even after screening for hepatitis B antigen most paid donor blood carries with it a five-ten times higher risk of transmitting hepatitis than volunteer donor blood. Hepatitis B screening is certainly the next most useful approach. However, it has been pointed out that even with the most sensitive of current assays, as much as two-thirds of infective blood may not be eliminated. In part this is due to failure to detect hepatitis B antige, which may be detectable by such currently investigational approaches as selective antibody inhibition or testing for Core antibody. However, a major factor is the inability of hepatitis B screening to eliminate all infectious blood appears to be due to the existence of viruses other than hepatitis B that play a major role in blood-transmitted hepatitis. Tests for detection of carriers of this virus, or viruses, remain to be developed. Improved reporting of hepatitis cases with investigation and registration of implicated donors may provide an additional means for reducing the incidence of hepatitis transmission. The efficiency of additonal approaches, such as transaminase screening of donors and passive or active immunization, remains to be determined.