Blood Services Research Articles

Successful Collaboration of a Hospital Based Blood Center and Blood Bank during the Pandemic and Blood Shortage

Abstract Introduction/Objective At the beginning of the SARS-Co-V2 pandemic, many hospitals implemented mitigating strategies to preserve their blood supply in anticipation of a blood shortage. Our health system, Inova (IHS), which includes 5 hospitals supported by our hospital based blood services, was no different. During the pandemic we experienced a decline in donations and available blood products. In anticipation of this shortage, our institution mobilized the Patient Blood Management (PBM) initiative. A multidisciplinary review of transfusion criteria was performed across the system. This included enforcing single unit red blood cell (RBC) transfusions, partial RBC exchanges for sickle-cell disease, and reduction in plasma replacement volume during plasma exchanges for patients with thrombotic thrombocytopenic purpura (TTP). By implementing these strategies, patient outcomes were not impacted despite the constraints to our blood supply. Methods/Case Report IHS Executive leaders were identified to participate along with key stakeholders in the PBM committee meetings to ensure proper blood utilization for our patients. Clinical guidelines were updated within the physician order sets. Data was compiled with a focus on hemoglobin metrics along with the percentage of single unit transfusions. Collaborating with IHS Apheresis Services and our providers, we developed a strategy to reduce the number of blood products transfused. Results (if a Case Study enter NA) Although there was decline in donor blood collections during the pandemic due to significant concerns of SARS-CO-V2 exposure, the implementation of Patient Blood Management strategies at our institution proved to be beneficial for product management and resource allocation. Although there was a decline in the number of donations (6.5%) we were able to transfuse more patients. Conclusion The SARS-Co-V2 pandemic significantly reduced the blood inventory nationwide. By implementing a robust Patient Blood Management program, we were able to successfully utilize our blood inventory while maintaining transfusion practices that aligned with standards of care. The collaborative efforts between our hospital based blood center and the blood bank led to the optimal use of a reduced blood supply during the pandemic. Incorporating Patient Blood Management principles and safe implementation of novel treatment plans for certain apheresis patient population during the pandemic enabled our system to have more available blood products and care for more patients with improved patient outcomes.

Management of blood transfusion services in low-resource countries.

Enabling universal access to safe blood components should be a key component of every country's national healthcare strategy. This study aimed to assess the current status of infrastructure and resources of blood transfusion services (BTS) in low- and middle-income countries. A cross-sectional survey was designed to gather information on blood donations, components, redistribution, testing resources and quality management systems (QMSs). The survey was distributed to the International Society of Blood Transfusion members between October 2021 and November 2021. A total of 54 respondents from 20 countries responded to the survey. This included hospital-based BTS/blood centres (46%), national blood centres (11%)and national and regional blood services (11%). Voluntary non-remunerated, replacement and paid donors accounted for 94.2%, 84.6% and 21.1% of donations, respectively. Apheresis donation was available in 59.6% of institutions. National/regional criteria for redistribution of blood components were reported by 75.9% of respondents. Blood components incurred payment charges in 81.5% of respondents' institutions, and payments were borne by patients in 50% of them. Testing methods, such as manual (83%), semi-automated (68%) or fully automated (36.2%), were used either alone or in combination. QMSs were reported in 17 institutions, while accreditation and haemovigilance were reported in 12 and 8 countries, respectively. QMS was implemented in most of the countries despite the common use of paid donations and the lack of advanced testing. Efforts to overcome persistent challenges and wider implementation of patient blood management programmes are required.

SCREENING AND PHYSIOTHERAPY SERVICES FOR MUSCULOSKELETAL COMPLAINTS IN THE ELDERLY DURING THE COVID-19 PANDEMIC AT TRESNA WERDHA WANA SOCIAL ORIGINAL SERAYA

The number of elderly people in Indonesia from year to year continues to increase. With the increasing amount of elderly, it is followed by an increase in musculoskeletal complaints. The outbreak of Covid-19 has resulted in limited and disrupted physical activity and health services for the elderly. The elderly are a group at risk of death if infected with Covid-19 because there is a degenerative process and there are co-morbidities. Community service activities carried out at the Tresna Werdha Wana Seraya Social Home in Ketalanggu Village aims to provide health services so that during the Covid-19 pandemic the quality of life for the elderly will be better. Activities carried out using blood pressure screening methods and examination of musculoskeletal complaints as well as providing physiotherapy services related to musculoskeletal complaints such as exercise and infrared therapy for free to the elderly. The participation in this community service activity was 34 people with the most aged 66-70 years. The results of this activity are the presence of the elderly, and the results of blood pressure screening and services for musculoskeletal complaints in the elderly at the Tresna Werdha Wana Seraya Social Institution during the Covid-19 pandemic.

The potential for eye donation from hospice and palliative care clinical settings in England: a retrospective case note review of deceased patients' records

There is a need to identify additional routes of supply for ophthalmic tissue in the UK. This paper reports the findings from a national study exploring the potential for eye donation (ED) from three Hospice Care (HC) and three Hospital Palliative Care Services (HPC) in England. The objectives addressed in this paper are i.) to establish the size and describe the clinical characteristics of the potential eye donor population across six clinical sites; ii.) to identify challenges for clinicians in applying the standard ED criteria for assessing patient eligibility. Retrospective assessment of 1199 deceased patient case notes, 601 Hospice Care and 598 Hospital Palliative Care services, against current eye donation criteria. Clinicians’ assessments were then evaluated against the same criteria. by specialists based at the National Health Service Blood and Transplant Tissue Services division (NHSBT-TS). Results of the assessment and evaluation are reported as descriptive statistics (numerical data). Free-text comment boxes facilitated clarification and/or justification of review and evaluation decisions. 46% (n = 553) of 1199 deceased patients’ notes were agreed as eligible for eye donation (Hospice care settings = 56% (n = 337); Palliative care settings = 36% (n = 216). For all eligible cases (n = 553) the option of ED was recorded as being raised with family members in only 14 cases (3%). Significant potential exists for eye donation from the clinical sites in this study. This potential is not currently being realised.

Validation of new, gender-neutral questions on recent sexual behaviors among plasma donors and men who have sex with men.

Several blood services might eventually interview donors with gender-neutral questions on sexual behaviors to improve the inclusivity of blood donation. We tested two ways (i.e., "scenarios") of asking donors about their recent sexual behaviors. The study comprised 126 regular source plasma donors and 102 gay, bisexual, and other men who have sex with men (gbMSM), including 73 cis-gbMSM (i.e., the "cis-gbMSM subgroup," which excluded nonbinary, genderqueer, and trans individuals). In Scenario 1, participants were asked if, in the last 3months, they "have […] had a new sexual partner or more than one sexual partner." In Scenario 2, they were asked "Have you had a new sexual partner?" and "have you had more than one sexual partner?". Validation questions included more specific questions on the type of partners and sexual activity. Among plasma donors, sensitivity was 100.0% for both scenarios; specificity was 100.0% and 99.1% for Scenarios 1 and 2, respectively. Among gbMSM, sensitivity was 74.5% and 82.9% for Scenarios 1 and 2, respectively; specificity was 100.0% for both scenarios. Among cis-gbMSM, sensitivity was 88.6% and 100.0% for Scenarios 1 and 2, respectively; specificity was 100.0% for both scenarios. The area under the receiver operating characteristic curve of Scenario 2 was significantly higher than that of Scenario 1 among gbMSM and in the cis-gbMSM subgroup (all p< .05). Scenario 2 questions performed well among plasma donors and cis-gbMSM, but less so in the broader gbMSM population.

Blood Center Testing Allows the Detection and Rapid Treatment of Acute and Recent HIV Infection.

Blood donations in South Africa are tested for HIV RNA using individual donation NAT (ID-NAT), allowing detection and rapid antiretroviral therapy (ART) of acute HIV infections. We enrolled a cohort of acute and recent HIV-infected blood donation candidates in South Africa in 2015-2018, measured HIV antibody, ID-NAT, and recency of infection <195 days (Sedia LAg) at enrollment and initiated early ART. A small cohort of HIV elite controllers was followed without treatment. HIV reservoir measurements included ultrasensitive plasma RNA, cell-associated HIV RNA, and total DNA. Enrollment of 18 Fiebig I-III and 45 Fiebig IV-VI HIV clade C subjects occurred a median of 18 days after index blood donation. ART was administered successfully and compliance with follow-up visits was excellent. There were only minimal differences in HIV reservoir between ART initiation in Fiebig stages I-III vs. IV-VI, but ART noncompliance increased HIV reservoir. In 11 untreated HIV elite controllers, HIV reservoir levels were similar to or higher than those seen in our early treated cohort. National blood services can identify acute HIV cohorts for subsequent HIV cure research studies. Among HIV clade C-infected donors, HIV reservoir differed little by Fiebig stage at treatment initiation, but was smaller than in chronically treated HIV and those with ART noncompliance.

Characteristics and trends in the work of the Blood Service of the Russian Federation in 2016–2020

Introduction. Ensuring a sustainable supply of safe donor blood is crucial for strategic issues and challenges. The evaluation of donor characteristics as well as the volume of components harvested and issued to medical organizations in the Russian Federation is a topical task for the national blood service.Aim — to analyze the performance indicators of the national blood service for the procurement and provision of donated blood and its components to medical organizations from 2016–2020.Methods. Data on over 6.5 million donors who donated blood in Russia during 2016–2020 were analyzed. Data were obtained from Blood Service report form No. 39 “Blood products and derivatives”. Descriptive statistics were used during analysis.Results. A decrease of the number of blood donors per thousand population was shown (from 9.68 to 8.26, р &lt; 0.0001). There was a decrease of the number of first-time donors and of the number of repeat donors (by 23 and 9.3 %, respectively) within studied period. Regular donor quantum increased from 71 to 76 %. The share of volunteer blood donors from 2016 to 2020 throughout the Russian Federation remained stable and amounted to 97.7–98.0 %. The total number of donations decreased by 6.0 % due to a significant decrease in the number of donations of automatic apheresis plasma (from 507,396 in 2016 to 388,742 in 2020, p &lt; 0.001), at the same time, a significant increase in the number of donations platelets was noted (from 83,285 donations in 2016 to 126,574 in 2020, p &lt; 0.001). During the follow-up period, there was an increase from 2.0 in 2016 to 2.21 in 2020 (10 %) in the average number of donations of blood components made by donors per year. Despite the decrease in the total number of donations in the analyzed period, the volume of blood components transferred for clinical use increased. The largest increase in blood components transferred at the request of medical organizations was noted for the concentrate of donor platelets (from 702,732 units in 2016 to 1,072,830 in 2020, by 34.5 %) and erythrocyte- containing blood components (from 491,791 liters in 2016 to 555,909 liters in 2020, by 13.5 %). A general trend was noted both towards a decrease in the frequency of detection of markers of bloodborne infections (from 16.8 to 7.7 %), and in individual infections. When analyzing the frequency of detection of infection markers, a significant difference was obtained in the group of newly registered and repeated donors (50,114 and 25,814, р &lt; 0,001).Conclusion. The decrease of the number of cases of detection of infection markers and the redistribution of blood collection in accordance with the changing demands of medical organizations demonstrates a targeted strategy for improving the safety of transfusions, improving the quality of recruiting activities, and improving the principles of lean production of blood components.

Retaining blood donors

Strong organisation-stakeholder relationships contribute to the former attaining its goals.This is also the case with blood services, such as the South African National Blood Service(SANBS). Blood services are dependent on people donating blood to unknown recipients, withoutremuneration. This paper reports the approach of the SANBS to relationship management with itsdonors, as well as the perceptions of blood givers of the quality of this relationship. The SANBS’srelationship management approach and activities are analysed from a qualitative approach,using mixed method research, namely qualitative semi-structured interviews and quantitativequestionnaires to answer the research questions.The SANBS’s relationship with blood givers is strong, especially regarding relationship satisfactionas outcome. The blood service staff’s behaviour and communication are the main contributors todonor satisfaction, since they provide education and comfort during the donation process. Twowaycommunication focusing on enhancing the outcomes of relationships, can therefore assistthe SANBS in recruiting and retaining donors.

Blood donor biobank and HLA imputation as a resource for HLA homozygous cells for therapeutic and research use

BackgroundAllogeneic therapeutic cells may be rejected if they express HLA alleles not found in the recipient. As finding cell donors with a full HLA match to a recipient requires vast donor pools, the use of HLA homozygous cells has been suggested as an alternative. HLA homozygous cells should be well tolerated by those who carry at least one copy of donor HLA alleles. HLA-A-B homozygotes could be valuable for HLA-matched thrombocyte products. We evaluated the feasibility of blood donor biobank and HLA imputation for the identification of potential cell donors homozygous for HLA alleles.MethodsWe imputed HLA-A, -B, -C, -DRB1, -DQA1, -DQB1 and -DPB1 alleles from genotypes of 20,737 Finnish blood donors in the Blood Service Biobank. We confirmed homozygosity by sequencing HLA alleles in 30 samples and by examining 36,161 MHC-located polymorphic DNA markers.ResultsThree hundred and seventeen individuals (1.5%), representing 41 different haplotypes, were found to be homozygous for HLA-A, -B, -C, -DRB1, -DQA1 and -DQB1 alleles. Ten most frequent haplotypes homozygous for HLA-A to -DQB1 were HLA-compatible with 49.5%, and three most frequent homozygotes to 30.4% of the Finnish population. Ten most frequent HLA-A-B homozygotes were compatible with 75.3%, and three most frequent haplotypes to 42.6% of the Finnish population. HLA homozygotes had a low level of heterozygosity in MHC-located DNA markers, in particular in HLA haplotypes enriched in Finland.ConclusionsThe present study shows that HLA imputation in a blood donor biobank of reasonable size can be used to identify HLA homozygous blood donors suitable for cell therapy, HLA-typed thrombocytes and research. The homozygotes were HLA-compatible with a large fraction of the Finnish population. Regular blood donors reported to have positive attitude to research donation appear a good option for these purposes. Differences in population frequencies of HLA haplotypes emphasize the need for population-specific collections of HLA homozygous samples.

A Markov jump process approach to modeling blood donor status: Donor retention and attrition rates at a blood service center in Zimbabwe.

BackgroundBlood service agencies depend upon the availability of regular blood donors for sustainability. The knowledge and understanding of the stochastic behavior of donors is the first step toward sustaining the blood supply. Analyzing the changes in the donor status within the donor pool will help the blood service authorities to manage the blood donation process.ObjectivesThe study presents a multistate Markov jump model in analyzing the changes in blood donor status during their blood donation career. Relevant covariates are used to aid in explaining the transitions.Materials and MethodsThe status of a blood donor i that can be in one of four states S = {1; 2; 3; 4}. A new donor (s = 1), repeat/regular donor (s = 2), occasional donor (s = 3), and lapsed donor (s = 4). A Continuous‐time Markov model was used to estimate blood donor progression during their blood donation career. Frequencies of blood donations made in a given time interval determines the state occupied.ResultsIn the early years of blood donation career, first‐time donors have a higher likelihood of becoming regular donors. Donor attrition increases with time whilst donor retention decreases with time. The results show that when the jump process is currently in an occasional state, the probability that it moves into lapsed state when it leaves the occasional state is given as 69.06%. Similarly, donors are forecasted to spend 21.193 months (1.8 years) in the occasional state before lapsing. Repeat donors can spend 39.342 months (3.3 years) in the regular state before the transition to other states. The study established that donor‐specific demographic factors such as age and gender are critical in donor status transitions.ConclusionsWith the passage of time, donor status evolves, with trend inclined towards reduction in the frequency of blood donations as more donors become inactive or lapsed. The transition of donors in various states can be described by a time homogeneous Markov model.

WITHDRAWN: Payment and profit in Canada’s plasma collection system: a process evaluation of Canadian Blood Services effort to meet sufficiency

This article has been withdrawn at the request of the author(s) and/or editor. The Publisher apologizes for any inconvenience this may cause. The full Elsevier Policy on Article Withdrawal can be found at https://www.elsevier.com/about/our-business/policies/article-withdrawal

National Blood Foundation 2021 Research and Development summit: Discovery, innovation, and challenges in advancing blood and biotherapies.

National Blood Foundation 2021 Research and Development summit: Discovery, innovation, and challenges in advancing blood and biotherapies.

Modelling the outcomes of different red blood cell transfusion strategies for the treatment of traumatic haemorrhage in the prehospital setting in the United Kingdom.

The limited supply and increasing demand of group O RhD-negative red blood cells (RBCs) have resulted in other transfusion strategies being explored by blood services that carry potential risks but may still provide an overall benefit to patients. Our aim was to analyse the potential economic benefits of prehospital transfusion (PHT) against no PHT. The impact of three PHT strategies (RhD-negative RBC, RhD-positive RBC and no transfusion) on quality-adjusted-life-years (QALYs) of all United Kingdom trauma patients in a given year and the subset of patients considered most at risk (RhD-negative females <50 years old), was modelled. For the entire cohort and the subset of patients, transfusing RhD-negative RBCs generated the most QALYs (141,899 and 2977, respectively), followed by the RhD-positive RBCs (141,879.8 and 2958.8 respectively), and no prehospital RBCs (119,285 and 2503 respectively). The QALY difference between RhD-negative and RhD-positive policies was smaller (19.2, both cohorts) than RhD-positive and no RBCs policies in QALYs term (22,600 all cohort, 470 for a subset), indicating that harms from transfusing RhD-positive RBCs are lower than harms associated with no RBC transfusion. A survival increase from PHT of 0.02% (entire cohort) and 0.7% (subset cohort) would still make the RhD-positive strategy better in QALYs terms than no PHT. While the use of RhD-positive RBCs carries risks, the benefits measured in QALYs are higher than if no PHT are administered, even for women of childbearing potential. Group O RhD-positive RBCs could be considered when there is a national shortage of RhD-negative RBCs.

The Use of Web Technology and IoT to Contribute to the Management of Blood Banks in Developing Countries

Health-care-sector-related activities are more accessible and faster as a result of technological development. Technology such as the Internet of Things (IoT) can work with blood bank services to manage and provide healthy blood in emergencies. However, there are many problems in blood bank management and inventory monitoring, especially in developing countries as compared to developed ones. The lack of an adequate and safe blood supply is a major limitation to health care in the developing world. The instability of the electric power in developing countries may lead to a temperature departure from the recommended for keeping blood inventory, and the use of manual systems, which are characterized by time and resource exhaustion and human mistakes, augments the management problems. This study aims to introduce a reliable, practical application to manage and organize the blood bank, manage donor information, monitor inventory, and obtain matching blood types as quickly as possible. The proposed system was designed and implemented in two parts: using Web technology for enhanced data management and using an IoT sensor for blood inventory temperature monitoring in real time. The test stage helped us to measure the Web application’s functionality with sensors, and the results were encouraging. Obtaining and monitoring blood bank data were made easier in real time by using the black box method for functionalities testing. The evaluation step was performed using a questionnaire instrument based on three parameters: Satisfaction, Effectiveness, and Efficiency. The questionnaire was answered by 22 participants working in the blood bank management field. The results indicated that end users generally responded positively to the system which improved blood bank administration and services. This indicated efficiency of the application and the desire to adopt it. Integrating the two technologies can enhance usability and applicability in the health care sector.

EP06.01-002 Cancer Care in a Time of COVID: Lung Cancer Patient’s Experience of Telehealth and Connectedness.

As health care systems have raced to prepare for, and manage, the SARS-CoV-2 (COVID19) pandemic, we have seen a reorganization of how health care is delivered. Delivery of cancer care has been affected globally. New Zealand (NZ) entered their highest restriction level in March 2020, essentially locking down the country for all but essential services for a period of five weeks. Reprioritization of healthcare services began. Auckland Regional Cancer and Blood Service, which provides oncology services for a population of approximately 1.72 million quickly implemented pathways to protect vulnerable patients.

A brief history of Canadian freeze-dried blood products: Ingenuity, collaboration, and leadership

LAY SUMMARY During the Second World War, Canada became a leader in the development and production of products used to treat shock, particularly shock caused by massive bleeds. Canada started the first blood service in response to the need for blood products overseas. This was done in the form of freeze-dried serum, which is made up of fluid-based proteins extracted from blood. Freeze-dried serum could be stored indefinitely and was lightweight, hardy, and easy to deliver both to the battlefield and to the patient. Freeze-dried serum could be provided to patients in shock as a result of losing a large volume of blood. Unfortunately, after the war, freeze-dried blood products fell out of favour over concerns about viral hepatitis. Recently, freeze-dried blood products have enjoyed a renaissance, and Canada is currently developing a new product to meet the challenges of remote resuscitation.

413.3: Towards a National System of Living Donor Follow-up in Canada

Introduction: Despite the provision of universal health care, there are several real or potential gaps in the post-donation care of living kidney donors in Canada. Health services are administrated by provincial governments and there is no national standard for living donor follow-up. In the absence of a national standard, transplant programs lack dedicated funding to ensure appropriate long-term follow-up of living donors and there is no mechanism to obtain national information about the health outcomes of living donors including death or kidney failure. Methods: We describe our ongoing work-plan to establish national consensus on the follow-up of living kidney donors in Canada and to establish funding for a new national system of living donor follow-up. This work was financially supported by Canadian Blood Services. The results of completed activities will be presented. Results: The work-plan includes: 1) An environmental scan of the current practice of living donor follow-up. This showed significant clinical practice variation between the 28 adult and pediatric kidney transplant programs. 2) A literature search to determine international models of living donor follow-up, which revealed significant international variation in practice and failed to identify a preferred model for implementation in Canada. 3) A survey of 685 living donors, which was undertaken to determine donors’ experience, needs, satisfaction and preferences for follow-up. The survey revealed that most (72%) of donors receive follow-up from a primary care physician, a minority (30%) of donors were dissatisfied with their follow-up, and two thirds endorsed life-long follow-up after donation. 4) A stakeholder conference including past donors, transplant professionals and researchers will be held in October 2022. This conference will include presentation of background information, breakout discussions led by facilitators and a plenary session in order to establish consensus recommendations on living donor follow-up including donor consent, essential data capture, and implementation recommendations. The workshop recommendations will also be used to produce a report. Finally, we plan to advance a business plan to implementation in all 28 kidney transplant programs. Conclusions: The presentation will summarize our workplan and findings to date. The information may be useful in other countries or regions considering establishment of living donor follow-up programs. This work was financially supported by Canadian Blood Services.

341.4: Uncovering Work-Related Problems Among Organ Donation Coordinators: The BRiC Research Program

Introduction: Organ Donation Coordinators (OTDCs) play a fundamental role in deceased organ donation processes. However, due to the emotionally challenging and stressful scenarios faced daily, they are commonly affected by work-related issues (e.g., burnout and compassion fatigue), which can lead to increased turnover, reduced quality of healthcare services and negative impact in Organ Donation Organizations performance. Therefore, Canadian Blood Services has partnered with CHEO Research Institute and the organ and tissue donation community to create a research program to study Burnout and Resilience in OTDCs (The BRiC Research Program). The main objectives of the BRiC Research Program are to investigate the incidence and potential causes of work-related issues among OTDCs and to propose innovative ways of dealing with these issues to support teams and decrease turnover of experienced and exceptional OTDCs. Method: The BRiC Research Program was built using a participatory approach that provides the best evidence possible to help address the specific needs of knowledge users (Organ Donation Organizations and OTDCs). The BRiC started with the development of a core three-phased study: phase 1, we published a scoping review to investigate the available literature on burnout and compassion fatigue among OTDCs; in phase 2, we are using a mixed-methods approach to explore work-related issues among Canadian OTDCs; and in phase 3, informed by phases 1 and 2, we will develop, implement and measurethe impact of interventions designed to address work-related issues among OTDCs. In addition to the core three-phased study, we also completedfour related projects: (1) a working meeting with representatives from Canadian Organ Donation Organizations; (2) a reflective narrative paper co-authored by Canadian OTDCs discussing their views and experiences with work-related issues; (3) a qualitative study that investigated experiences of OTDCs about compassion fatigue, burnout and resilience; and (4) a qualitative study that explored the perceptions of OTDCs related to their experiences in a Relationship Centred Care workshop. Results: An overview of the BRiC Research Program can be found in Figure 1. The outputs of this research program since its launching in 2019 include: a scoping review protocol and a final manuscript publication; three publications regarding the additional projects (reflective narrative, and results from both qualitative studies); 2 poster presentations, 4 invited speaker presentations; and 9 grant applications, 2 granted. Conclusion: The findings from this research program will inform clinical practice through knowledge dissemination activities. As this study has been designed in collaboration with national knowledge disseminators (Canadian Blood Services) and provincial end users (Organ Donation Organizations) it will yield meaningful results that can be readily integrated into strategies to decrease OTDC turnover. We would like to thank Canadian Blood Services and the Children’s Hospital of Eastern Ontario for their support funding this work. We thank all Canadian Organ Donation Organizations and the Organ and Tissue Donation Coordinators for their support and participation in this work.

Changes of Lipid Peroxidation after Administration of Nanomodified Resuspending Solution into Donor Red Blood Cells

The problem of increasing the functional activity preservation of red blood cells is priority for the Blood Service and clinical transfusiology. Taking into account the previously discovered unique properties of magnetite nanoparticles, namely: nonspecific modulation of metabolic processes, strengthening of adaptive mechanisms of cellular organelles, acceleration of reparative processes at the level of membranes and macromolecules, for the first time an attempt was made to use the upgraded saline solution of sodium chloride (nanotechnologically upgraded solution - NUS) as a resuspending of erythrocyte-containing components (ECC). Objective: to improve the preservation of red blood cells containing donor blood components using NUS for resuspending. To achieve this goal, the first stage of the study examined the effect of a new resuspending solution (NUS) on lipoperoxidation, catalase activity, and red blood cell peroxidation resistance in donor blood components containing red blood cells. Object of Research: red blood cells from preservation blood of donors, which are intended for component transfusion therapy. As a result of the study, the advantages of using NUS were established, namely: a significant decrease in the levels of primary and secondary lipid peroxidation products in the first 15 days of observation, an increase in catalase activity and resistance of red blood cells to peroxidation in the first stages of the study, inhibition of the shear reaction with neutral lipid peroxidation in the late stages of observation.

Utilisation of immunoglobulin in New Zealand.

Immunoglobulin is an expensive and scarce resource and usage is increasing worldwide. Immunoglobulin is used to treat a variety of clinical conditions, particularly primary and acquired immunodeficiencies and immune-mediated neurological disorders. As immunoglobulin usage continues to increase, plasma collection must increase accordingly in order to sustain immunoglobulin production. The New Zealand Blood Service (NZBS) is the provider of immunoglobulin in New Zealand (NZ). Information regarding national immunoglobulin usage warrants analysis given the rise in usage. To review immunoglobulin usage in NZ with a focus on the trend in the amount used, number of patients, clinical indications and compliance with international guidelines. A comparison with international immunoglobulin usage was performed. The impact on national plasma collection was reviewed. Data on immunoglobulin usage, number of patients and plasma collection over the past decade were obtained from the NZBS Tableau database. Data from international literature were reviewed. Immunoglobulin usage in NZ has been increasing over the past decade, with an annual growth rate of 6.4%. The three main indications for immunoglobulin are primary immunodeficiency disorders, chronic inflammatory demyelinating polyneuropathy (CIDP) and acquired hypogammaglobulinaemia secondary to haematological malignancies. Prominent growth in usage is evident for CIDP and acquired hypogammaglobulinaemia. Immunoglobulin usage in NZ is low compared with other countries, such as Australia and the United States. There has been a marked increase in plasma donations in order to keep up with immunoglobulin demand. Immunoglobulin is a strategic resource and appropriate usage is critical to regulate demand.