Blood Services Research Articles

Acquired haemophilia A in Finland: A nationwide study of incidence, treatment and outcomes.

Acquired haemophilia A (AHA) is a bleeding disorder caused by autoantibody development against factor VIII (FVIII). Studies on AHA have mainly focused on patients treated at specialist centres. To determine the incidence, clinical characteristics and outcomes of AHA in an unselected population-based patient cohort from Finland. This retrospective observational cohort comprised all cases diagnosed with AHA in Finland between 2006 and 2019. Patients were identified by the two central laboratories performing FVIII antibody testing in Finland, the Finnish Red Cross Blood Service and HUSLAB. Clinical details were collected from all hospitals and healthcare units where patients were treated. This study was performed in conjunction with the AHA in the Nordics study. The median incidence of AHA was 0.65 per million per year (range 0.19-1.27). Fifty-five patients were identified, with a median age of 76 years and an even sex ratio (51% women). When diagnosed, all had bleeding symptoms with severe bleeds in 92%. First-line immunosuppressive treatment regimens included steroid monotherapy in 31% of cases, steroids and a cytotoxic agent in 51% and a rituximab-based regimen in 16%. Clinical remission was achieved in 71% of cases, and 15% had relapses. Mortality was 13% for bleeds and 9% for treatment-related infections. Overall survival was 64% for 1 year and 56% for 2 years after diagnosis. In a nationwide population-based cohort study, we discovered a lower incidence of AHA than previously reported. Mortality among patients with AHA was high, calling for the consideration of updated treatment strategies.

Word-of-mouth among blood service employees who also donate blood: a qualitative investigation of advantages and challenges for dual-role donors

BackgroundDespite word-of-mouth (WOM) and electronic WOM (eWOM) influencing people’s willingness to donate blood, no research has explored this behavior among blood service employees who are also donors. This underexplored segment is highly important, as they are generally committed to both the organization and the cause and are likely more informed on the topic of blood donation than the average donor.MethodsThis study comprised six online focus groups with 26 Australian Red Cross Lifeblood employees who are also donors. Questions covered a range of blood donation and WOM topics, including when they became blood donors, if they had engaged in WOM about blood donation, what they had talked about and with whom, and what were audience reactions. Thematic analysis was then used to explore how responses related to the employees’ motivations, opportunities, and abilities to engage in WOM and eWOM about blood donation.ResultsWhile most employee-donors saw alignment in their employee and donor roles, advocating for blood donation was not considered a necessary part of either role. Educating others about blood donation was a common goal of employee-donor WOM and eWOM, and almost all employees engaged in reactive WOM, triggered by events (e.g., recent donations) or questions about their work. Employee-donors in donor-facing roles (e.g., communications and collections staff) felt more aware of the importance of encouraging others to donate blood and were also more likely to be proactive in their WOM activity. Along with these perceived advantages of having a dual role, employee-donors also identified some disadvantages, such as unrealistic expertise expectations and negative audience responses that can be difficult to navigate.ConclusionsBeing an employee-donor is a double-edged sword. For example, increased opportunities to talk about blood donation and access to more information can be offset by having to respond to more challenging questions/comments and expectations, while appropriately representing their employer. More research is needed among those in employee-donor roles within the healthcare and/or non-profit sectors, to determine whether these are issues faced more broadly, and how those in dual roles can be most effectively supported to engage in positive WOM and eWOM.

Deferral of blood donors who have ever stayed in a Trypanosoma cruzi endemic area: An international survey.

Trypanosoma cruzi is the etiologic agent of Chagas disease (CD), an anthropozoonosis from the American continent that progresses from an acute phase to an indeterminate phase, followed by a chronic symptomatic phase in around 30% of patients. In countries where T. cruzi is not endemic, many blood transfusion services test blood donors who have stayed in an endemic country ('at-risk stay')-even if they do not present with other risk factors. However, the efficiency of this approach has been questioned. On 18 September 2023, a worldwide survey was distributed among employees of blood transfusion services. The questions mainly pertained to CD's endemicity in the blood services' region, the current testing policy for T. cruzi and the number of confirmed positive results among donors with a prior at-risk stay alone (i.e., without other risk factors for T. cruzi infection). Twenty-six recipients completed the survey. Of the 22 (84.6%) blood services that operated in a non-endemic region, 9 (42.9%) tested donors for T. cruzi, including 8 (88.9%) that considered the travel history or the duration of the stay (alone) in their testing algorithm ('study blood services'). Over 93 years of observation among all study blood services, 2 donations from donors with an at-risk stay alone and 299 from those with other risk factors were confirmed positive for T. cruzi. The study findings question the utility of testing blood donors who have stayed in an endemic country without other risk factors.

'Yeah, this is my donation': An application of psychological ownership in blood donation.

To meet the priority healthcare needs of any population there must be a consistently available blood supply donated by willing donors. Due to this universal need for blood, retaining blood donors remains an ongoing challenge for blood services internationally. Encouraging psychological ownership, or the feeling of ownership one experiences over a possession, provides a potential novel solution to donor retention. This study, based on semi-structured interviews with blood donors, investigates how donors perceive and develop psychological ownership in the context of blood donation. Interviews were conducted in Australia with 20 current blood donors (10 men, 10 women; Mage = 41.95). Through thematic analysis, six themes were identified based primarily on the theoretical framework of psychological ownership. This research offers a novel perspective on donor retention, suggesting that donors' ownership over their individual donation practices, and not the blood service, may contribute to maintaining a stable blood supply.

Menstrual blood loss is an independent determinant of hemoglobin and ferritin levels in premenopausal blood donors.

To prevent blood donors from developing iron deficiency (ferritin <15 μg/L) and subsequent anemia (hemoglobin <120 g/L), blood services rely on information about known risk factors, including the donor's sex and age. For example, while Finnish women are able to donate whole blood with a minimum donation interval of 91 days, women in the 18 to 25-year-old age group are recommended to donate no more than once per year. Menstrual blood loss is not accounted for in blood donation interval recommendations, despite being a known risk factor of iron deficiency. We aim to investigate to what extent menstrual bleeding is associated with ferritin and hemoglobin levels in female blood donors, and quantify the association of other menstruation-related variables not currently accounted for by blood services (i.e., use of hormonal contraception, heavy menstrual bleeding) with iron deficiency or anemia. The study population consisted of 473 premenopausal and 491 postmenopausal Dutch whole blood donors. Exclusion criteria were current pregnancy, BMI ≥50, ferritin ≥200, pictorial blood assessment chart (PBAC) ≥400, and age <18 or ≥70 years. Menstrual blood loss was quantified using a PBAC, a semiquantitative method to evaluate the number of used menstrual products and the degree of staining. We identified predictors of log(ferritin)/hemoglobin and iron deficiency/anemia using Bayesian linear and logistic regression models and quantified the average percentage of variance in log(ferritin) and hemoglobin explained by the covariates. Menstrual blood loss accounted for most of the explained variance in hemoglobin (8%) and second only to the number of days since last donation for ferritin (8%). Heavy menstrual bleeding (PBAC ≥150, OR = 3.56 [1.45-8.85], prevalence 13%) was associated with anemia, and use of levonorgestrel-releasing intrauterine device was negatively associated with iron deficiency (OR = 0.06 [0.01-0.44]). After statistical control for menstrual blood loss, age was not associated with iron status. Menstrual blood loss and blood donation were the most important determinants of iron status in premenopausal women. Thus, results suggest that accounting for menstrual blood loss in donation interval guidelines may benefit blood donors.

Discursive History of Screening Criteria for Blood Donation Affecting Gay, Bi, and Other Men Who Have Sex with Men in Canada: 1983–2013

Background: In September 2022, Canadian Blood Services (CBS) implemented a sexual behaviour–based screening (SBBS) approach for all donors, putting an end to Canada’s “gay blood ban.” Analysis: To better understand the discursive history leading up to this change, this article analyzes articles in major newspapers and 2SLGBTQIA+ periodicals in Canada from 1983 to 2013 related to the ban. Conclusions and implications: The move to SBBS came about due not only to advancements in epidemiological knowledge and testing technologies, but also to significant shifts in how the issues were framed in public discourse.

Prevalence and Residual Risk of HIV in Volunteer Blood Donors of Zhejiang Province, China, from 2018 to 2022.

Blood safety levels have been significantly improved since the implementation of nucleic acid amplification technology (NAT) testing for blood donors. However, there remains a residual risk of transfusion transmission infections. This study aimed to evaluate the prevalence of HIV and its residual risk transmission among volunteer blood donors of Zhejiang Province, China, for five years after NAT implementation. All specimens and information were collected from voluntary unpaid donors at all blood services in Zhejiang Province, China, from January 2018 to December 2022. The HIV antibody or antigen and HIV RNA were detected using enzyme-linked immunosorbent assay and NAT, respectively. The HIV residual risk transmission was calculated using the incidence or window period model. A total of 3,375,678 voluntary blood donors were detected, revealing an HIV prevalence of 9.92/100000. The HIV prevalence of blood donors in 12 blood services in Zhejiang Province was 6.11, 6.98, 7.45, 8.21, 8.36, 8.94, 9.04, 9.66, 9.73, 10.22, 11.80, and 12.47 per 100000 donors, without statistically significant difference observed among the services (p > 0.05). The HIV prevalence of males (15.49/100000) was significantly higher compared to females (1.95/100000; p < 0.05). There was an insignificant difference in HIV prevalence among blood donors of all different age groups (p > 0.05), but the HIV prevalence in the 26-35 age group and 18-25 age group was significantly higher compared to the 36-45 age group (p < 0.05). The difference in HIV prevalence between first-time blood donors (13.65/100,000) and repeat blood donors (6.78/100,000) was statistically significant (p < 0.05). From 2018 to 2022, the HIV residual risk in blood transfusion transmission was 0.266/100000. The prevalence of HIV among blood donors in Zhejiang Province, China, is associated with age, gender, and times of blood donation. The HIV residual risk in blood transfusion transmission remains low in the province, and increasing the rate of repeat blood donors is beneficial to improve blood safety.

Pemberdayaan Lansia untuk Mencegah Kolesterol dan Hipertensi dengan Optimalisasi Teh Sahdu (Saffron, Telang Biru, dan Madu)

&lt;p&gt;&lt;em&gt;Donor recruitment services are the components of blood services. This donor recruitment activity aims to obtain voluntary blood donors and sustainable blood donors who are healthy and safe. Age is an indicator of the determination to recruit donors. The elderly are the age group that is still the target for recruiting sustainable blood donors. It can be said that donations from elderly donors also contribute to the safety and availability of blood products. These elderly donors come from new blood donors or repeat blood donors. Elderly people who will donate blood are guaranteed to be healthy and have no health problems.&lt;/em&gt;&lt;/p&gt;&lt;p&gt;&lt;em&gt;Elderly people are prone to experiencing high blood pressure and cholesterol levels that are above normal. This can be prevented with preventive measures, one of which is providing alternative drinks that can be used to control cholesterol and blood pressure in the elderly.&lt;/em&gt;&lt;/p&gt;&lt;p&gt;&lt;em&gt;This Community Service aims to screen health and empower cadres to optimize the use of sahdu tea.&lt;/em&gt;&lt;/p&gt;&lt;em&gt;The results of this Community Service are health checks for the elderly with results based on blood pressure levels, the largest percentage is stage 2 hypertension (37.84%) and cholesterol levels, the largest percentage experiences hypercholesterolemia (64.86%). The socialization and simulation of making sahdu tea was attended by 37 elderly and enthusiastic respondents. Sahdu tea is distributed for 3 weeks and monitored by cadres for routine consumption&lt;/em&gt;

Opportunities to improve feedback to reduce blood component wastage: Results of a national scheme evaluation.

Blood components are costly and scarce. The Blood Stocks Management Scheme (BSMS) was established in the United Kingdom (UK) to support hospital transfusion services and national blood services through collection, analysis, and monthly feedback of data on blood component inventory and wastage management. There is a growing evidence base on how best to deliver feedback for quality improvement. We assessed the quality and utility of the monthly BSMS component reports. We assessed the content of BSMS reports issued in March 2023 against established criteria for effective feedback. Two researchers independently rated whether criteria spanning the five domains of goal setting, data collection, feedback content, feedback display and feedback delivery were fully, partially or not met. Disagreements were resolved through discussion. We conducted an online questionnaire survey of recipients of BSMS reports during March 2023 to assess their use of reports and seek suggestions for improvement. Five out of 20 criteria for effective feedback were fully met. Areas for improvement included placing more emphasis in the feedback on positive change, linking data and summary messages, and including specific suggestions for action. Respondents highlighted the value of benchmarked comparisons with other hospital transfusion services. There is scope for enhancing the effectiveness and utility of BSMS feedback reports and hence reducing wastage of blood components. This methodology for evaluation of feedback could be utilized to improve other areas of transfusion practice.

The effect of COVID‐19 lockdown periods and societal restrictions on blood product usage in adult trauma patients: A retrospective observational study

Background. Blood products, though potentially lifesaving, are a scarce and costly resource. Trauma injuries, which contribute to the demand for these resources, increase in proportion to alcohol consumption. South Africa’s COVID-19 lockdown measures included a ban on alcohol sales and curfews.Objective. To investigate the effect of these societal measures on blood product usage. Methods. We retrospectively compared medical patient data from the South African National Blood Service database of red cell concentrate (RCC) usage in four disciplines during the COVID-19 period with data from the 3 years preceding the pandemic. We also examined trauma case patterns using an institutional database from the Harry Gwala Regional Hospital (HGRH) Emergency Department during the same periods. Results. In total, 16 922 RCCs at HGRH and 528 734 RCCs in KwaZulu-Natal were issued across the four disciplines, from March 2017 - March 2021. RCC usage significantly decreased among trauma patients at institutional and provincial levels during the COVID-19 period (provincial pre-lockdown mean 10.99 units per day; SD 6.89, 95% CI 10.63 - 11.35 v. lockdown 7.46 units per day; SD 5.42, 95% CI 6.14 - 8.79; p&lt;0.01). Further, RCC usage significantly increased during the weekend immediately following the lifting of the first alcohol ban, along with a significant decrease in the number of trauma patients seen during hard lockdown periods. Conclusions. Societal restrictions, including curfews and banning alcohol consumption, decreased the use of RCCs in trauma patients. Government policies aimed at reducing alcohol-related traumatic injuries would likely have a significant impact on RCC usage.

Implementation of sexual risk behavior donor screening in Canada.

The two Canadian blood suppliers, Canadian Blood Services and Héma-Québec, removed the time-based deferral for men who have sex with men and adopted criteria assessing sexual risk behaviors. We report the impact of these changes on the safety and adequacy of the Canadian blood supply. Since 2022, all donors are asked if (1) they have had a new partner and (2) more than one sexual partner in the last 3 months. Donors answering yes to either question are asked if they had anal sex in the last 3 months; if yes, they are deferred for 3 months. We followed HIV rates for the 18 months before and 14 (Héma-Québec) or 18 months (Canadian Blood Services) post-implementation and interviewed HIV-positive whole blood donors. We assessed the number and characteristics of whole blood donors answering yes to the two first questions with or without deferral. There were four HIV-positive donations out of 1,492,355 donations pre-implementation and four out of 1,447,772 post-implementation (0.27/100,000 vs. 0.28/100,000, p = 1.00). Post-implementation, one HIV-positive donor was non-compliant with multiple criteria, no risk factors were identified in the others. 3.2% of donors answered yes to questions (1) and/or (2); 0.17% were deferred for a new partner and/or more than one partner and anal sex. Deferral rates were highest in first time, younger donors, and similar in males and females. Implementation of sexual risk behavior donor screening resulted in unchanged HIV rates to date and a manageable deferral rate.

Kasus Reaksi Transfusi pada Pasien Penerima Donor Darah di RSUD Sayang Kabupaten Cianjur Periode 2020-2022

Blood transfusions must be performed based on appropriate indications, selecting the correct volume and type of component, and administered at the right time. The risk of transfusion reactions is inherent in nearly every transfusion process and can manifest clinical symptoms in patients. Hospitals must conduct oversight of the blood transfusion process, known as hemovigilance, to prevent transfusion reactions and enhance the safety of blood services. This study aims to determine the number of transfusion reaction cases in blood donor recipients at RSUD Sayang, Cianjur Regency, during the period from 2020 to 2022. This qualitative research utilizes a total sampling technique. The population comprises all blood donor recipients at RSUD Sayang, Cianjur Regency, from 2020 to 2022. The sample includes medical records data of transfusion reaction cases in blood donor recipients at RSUD Sayang, Cianjur Regency, from 2020 to 2022. The results indicate 35 cases of transfusion reactions. The majority of transfusion reaction cases in blood donor recipients were acute category I (mild) reactions, totaling 21 cases (60%). Patients with a history of previous transfusions predominantly experienced category I (mild) and category II (moderate) reactions, each with 12 cases (57.1%). Most acute reaction cases were category I (mild), with 20 cases (57.1%), occurring during transfusions with Packed Red Cells (PRC). The majority of acute transfusion reactions occurred after the administration of the first blood bag, with 17 cases (48.6%), and these reactions were primarily category I (mild).

A scoping review of sociology of voluntary blood donation.

Maintaining stable blood supplies presents an increasing challenge for blood collection agencies (BCAs). Novel and multidisciplinary approaches and research have been called for to understand the mechanisms underlying the trends. The current body of sociological research on blood donation is a potentially valuable resource, but it is dispersed over different publications and theoretical frameworks. We conducted a scoping review of sociological research on voluntary, non-remunerated blood donation to identify insights and practical applications for researchers and BCAs. Four organizing themes were identified: donated blood, blood donors, organizations and blood service systems. Key challenges associated with the organization of voluntary blood donation exist at the institutional and systems levels, and they may not be readily resolved by interventions focussed solely on the individual donor level. We identified opportunities for organizations to build trust with donors and the public through communications and working with communities to promote inclusion in blood donation. The results support a multidisciplinary approach and research for BCAs to move forward and find novel ways to ensure safe, resilient blood service systems.

Demand forecasting for platelet usage: From univariate time series to multivariable models.

Platelet products are both expensive and have very short shelf lives. As usage rates for platelets are highly variable, the effective management of platelet demand and supply is very important yet challenging. The primary goal of this paper is to present an efficient forecasting model for platelet demand at Canadian Blood Services (CBS). To accomplish this goal, five different demand forecasting methods, ARIMA (Auto Regressive Integrated Moving Average), Prophet, lasso regression (least absolute shrinkage and selection operator), random forest, and LSTM (Long Short-Term Memory) networks are utilized and evaluated via a rolling window method. We use a large clinical dataset for a centralized blood distribution centre for four hospitals in Hamilton, Ontario, spanning from 2010 to 2018 and consisting of daily platelet transfusions along with information such as the product specifications, the recipients' characteristics, and the recipients' laboratory test results. This study is the first to utilize different methods from statistical time series models to data-driven regression and machine learning techniques for platelet transfusion using clinical predictors and with different amounts of data. We find that the multivariable approaches have the highest accuracy in general, however, if sufficient data are available, a simpler time series approach appears to be sufficient. We also comment on the approach to choose predictors for the multivariable models.

Iron status in Dutch and Finnish blood donor and general populations: A cross-cohort comparison study.

Blood donors are at risk of developing iron deficiency (ID) (ferritin <15 μg/L, World Health Organization definition). Blood services implement different strategies to mitigate this risk. Although in Finland risk group-based iron supplementation is in place, no iron supplementation is provided in the Netherlands. We aim to describe differences in ferritin levels and ID prevalence in donor and general populations in these countries. Six cohorts, stratified based on sex, and for women age, in the Netherlands and Finland were used to evaluate differences in ferritin levels and ID between donor populations (Donor InSight-III and FinDonor 10,000) and general populations (Prevention of Renal and Vascular End-Stage Disease [PREVEND], FinRisk 1997 and Health 2000) and newly registered Dutch donors. Multivariable logistic regression was used to quantify associations of various explanatory factors with ID. In total, 13,443 Dutch and 13,933 Finnish subjects were included. Donors, except for women aged ≤50 years old in Finland, had lower median ferritin levels compared with the general population and new donors. Dutch regular blood donors had higher or similar prevalence of ID as compared with the Dutch general population, including new donors. In contrast, Finnish donors showed similar prevalence of ID compared with the general population, except for a markedly lower prevalence in ≤50-year-old women who routinely receive iron supplements when donating. Iron status in blood donors differs from that in the general population. The Finnish blood service donor management policy, for example, iron supplementation for risk groups, seemingly protects young female blood donors from developing ID.

State of affairs: the US platelet supply and the role of whole blood–derived platelets

PurposeThe US platelet supply is almost exclusively dependent on apheresis donors who are “aging out.” As a result, blood centers and hospitals have been experiencing spot shortages and have resorted to transfusing low-dose platelets. This paper explores using whole blood–derived platelets (WB-PLTs) to supplement the apheresis platelet (APH-PLT) supply.Design/methodology/approachThis paper reviews the history leading to the current state of the US platelet supply and includes the impact of recent events such as the COVID-19 pandemic and the implementation of the US Food and Drug Administration (FDA)-mandated bacterial mitigation strategies.FindingsWB-PLTs represent a viable source of platelets that can be used to supplement the APH-PLT supply. Whole blood automation represents a new methodology to more easily prepare WB-PLTs. Advances in donor testing and screening as well as pre-storage leukoreduction have improved the safety of WB-PLTs to the same level as APH-PLTs. Blood services in the US and abroad transfuse WB-PLTs interchangeably in all patient populations.Originality/valueThis paper highlights how the US blood industry is essentially “sole-sourced” in terms of APH-PLTs. In this post-COVID-19 period, when most industries are building redundancies in their supply chains, blood centers should consider WB-PLTs as an additional source of platelets to bolster the US platelet supply.

Impact of Shelf-Life Extension on Platelet Availability: Results from an Inventory Management Modeling Study

&lt;b&gt;&lt;i&gt;Introduction:&lt;/i&gt;&lt;/b&gt; In Germany, demand for platelet transfusion is maintained or even increasing, despite a decrease in whole blood donations observed in the last decade. The shelf-life of platelet concentrates (PCs) in Germany is 4 days, which can be extended to 5 days if appropriate safety measures are used. This short shelf-life leads to decreased PC availability. &lt;b&gt;&lt;i&gt;Methods:&lt;/i&gt;&lt;/b&gt; We investigated the impact of PC shelf-life extension on PC shortage, using a mathematical simulation model based on the PC production and delivery statistics of the Frankfurt Institute of the German Red Cross Transfusion Service of Baden-Württemberg-Hessen. We used a 2.2-year dataset for PC production and delivery as input data for a Monte Carlo inventory management simulation, focusing on PC shortage. The model generated the daily stock (expressed as mean number of PC units ± standard deviation), mean PC age at release, mean number of expired PC units, and shortage rates (i.e., requiring the release of more PCs than available), overall and by PC blood group. &lt;b&gt;&lt;i&gt;Results:&lt;/i&gt;&lt;/b&gt; Over 2.2 years, a total of 74,322 PC units were produced and 62,178 units were released at the Frankfurt Institute; the overall overproduction rate was 19.5%. Shortage rates decrease with an increase in PC shelf-life and/or increase in overproduction rates. At an overproduction rate of 20%, shortage rates would be reduced from 2.8% for a 4-day shelf-life to 0.7%, 0.3%, and 0.2%, for shelf-life lengths of 5, 6, and 7 days, respectively. Extending the PC shelf-life to 6 or 7 days would eliminate shortages almost entirely, including for rare bloods. &lt;b&gt;&lt;i&gt;Conclusion:&lt;/i&gt;&lt;/b&gt; These results can inform blood services and regulatory authorities on the potential medical and economic impact of extending PC shelf-life to 6 or 7 days.

Marketing management in blood service enterprises

In blood service, the volume of collected blood components depends on availability of donors. High demands require high product quality (safety, etc.). Blood component quality depends on the state of donors health. Storage periods of blood components are limited and require certain conditions. Blood service enterprises should be located within the reach of patients, and mostly in big cities with a large population. The quality and quantity of collected blood are affected by the level of morbidity, which leads to the withdrawal of donors and losses to blood service enterprises. Consequently, the blood centre performance largely depends on success of marketing activities: number of donors and recruitment campaigns. Simultaneously, blood donation by volunteers is possible only thanks to successful and systematic advertising about the benefits of donation for health. Maintenance of a suitable health state depends on retention campaigns and establishment of long-term relations between blood centres and donors via direct marketing. Sales promotion measures force people to donate blood for the first time and make it a stable habit to visit a blood centre every month. The safest blood is from a regular donor, and retention marketing helps convert a primary donor into a regular one. The article carries out a bibliometric analysis of Web of Science works for 1991-2023 that are devoted to marketing at blood service enterprises. The analysis proved some facts. Firstly, the blood service topic requires studing further (there are only 304 works). Secondly, we see a growth of research interest (32.5% of all works for 2019-2023) and an almost double increase in annual citations from 2019. Thirdly, scientists from the United States, Germany, Australia, England, France, and Spain lead in such studies. The article summarises problems of the Ukrainian blood service. They can be solved with marketing management (safety, managerial, informational, economic). The paper defines goals and objectives, main stages and principles of marketing management for blood service enterprises. A system of 20 criteria for evaluating the efficiency of marketing management measures at blood service enterprises has been developed. The research results form a basis for the general idea of marketing management in blood service enterprises.

A machine-learning method for biobank-scale genetic prediction of blood group antigens.

A key element for successful blood transfusion is compatibility of the patient and donor red blood cell (RBC) antigens. Precise antigen matching reduces the risk for immunization and other adverse transfusion outcomes. RBC antigens are encoded by specific genes, which allows developing computational methods for determining antigens from genomic data. We describe here a classification method for determining RBC antigens from genotyping array data. Random forest models for 39 RBC antigens in 14 blood group systems and for human platelet antigen (HPA)-1 were trained and tested using genotype and RBC antigen and HPA-1 typing data available for 1,192 blood donors in the Finnish Blood Service Biobank. The algorithm and models were further evaluated using a validation cohort of 111,667 Danish blood donors. In the Finnish test data set, the median (interquartile range [IQR]) balanced accuracy for 39 models was 99.9 (98.9-100)%. We were able to replicate 34 out of 39 Finnish models in the Danish cohort and the median (IQR) balanced accuracy for classifications was 97.1 (90.1-99.4)%. When applying models trained with the Danish cohort, the median (IQR) balanced accuracy for the 40 Danish models in the Danish test data set was 99.3 (95.1-99.8)%. The RBC antigen and HPA-1 prediction models demonstrated high overall accuracies suitable for probabilistic determination of blood groups and HPA-1 at biobank-scale. Furthermore, population-specific training cohort increased the accuracies of the models. This stand-alone and freely available method is applicable for research and screening for antigen-negative blood donors.

What is the environmental impact of a blood transfusion? A life cycle assessment of transfusion services across England.

Healthcare activities significantly contribute to greenhouse gas (GHG) emissions. Blood transfusions require complex, interlinked processes to collect, manufacture, and supply. Their contribution to healthcare emissions and avenues for mitigation is unknown. We performed a life cycle assessment (LCA) for red blood cell (RBC) transfusions across England where 1.36 million units are transfused annually. We defined the process flow with seven categories: donation, transportation, manufacturing, testing, stockholding, hospital transfusion, and disposal. We used direct measurements, manufacturer data, bioengineering databases, and surveys to assess electrical power usage, embodied carbon in disposable materials and reagents, and direct emissions through transportation, refrigerant leakage, and disposal. The central estimate of carbon footprint per unit of RBC transfused was 7.56 kg CO2 equivalent (CO2eq). The largest contribution was from transportation (2.8 kg CO2eq, 36% of total). The second largest was from hospital transfusion processes (1.9 kg CO2eq, 26%), driven mostly by refrigeration. The third largest was donation (1.3 kg CO2eq, 17%) due to the plastic blood packs. Total emissions from RBC transfusion are ~10.3 million kg CO2eq/year. This is the first study to estimate GHG emissions attributable to RBC transfusion, quantifying the contributions of each stage of the process. Primary areas for mitigation may include electric vehicles for the blood service fleet, improving the energy efficiency of refrigeration, using renewable sources of electricity, changing the plastic of blood packs, and using methods of disposal other than incineration.