Blood Transfusion Organization Research Articles

The Effects of Glutathione Monoethyl Ester on Different Biochemical, Oxidant, and Antioxidant Levels During Storage in Leukoreduced Red Blood Cells

Background: It is essential to maintain the quality of the stored blood, because various factors affect the stored red blood cells (RBCs) over time, some red blood cell storage lesions (RCSL) develop during storage, and it could reduce the function of the RBCs. The present study aimed to evaluate the effects of glutathione monoethyl ester on different biochemical changes, oxidant, and antioxidant levels in the leukoreduced RBCs (LR-RBCs) during storage. Materials and Methods: About 10 units of LR-RBC were collected, processed and stored according to the standard operating procedures (SOPs) of the Iranian Blood Transfusion Organization. Each unit divided into 2 equal parts; LR-RBC treated with glutathione monoethyl ester and a control group. Exposure of phosphatidylserine (PS), reactive oxygen species (ROS) and microvesicle derived from the RBCs (RBC-MVs), were measured by the flow cytometry method. ELISA was used to measure the level of glutathione, and 2, 3-diphosphoglycerate (2,3-DPG). Glucose-6-phosphate dehydrogenase (G6PD) enzyme activity was measured with a chemistry autoanalyzer. Results: The levels of glutathione reduced the initial value in the treated group (80%), and the control group (60%), respectively. Exposure of surface PS, ROS and RBC-MVs increased significantly during storage time for consecutive weeks to the amount of GSH. The levels of 2,3-DPG decreased with increasing storage time. Conclusions: Overall, The study suggest that glutathione monoethyl ester is effective to reduce the oxidative stress and the quality of RBCs can be improved.

Frequency of Blood Components Wastages and Related Factors in Fars Blood Transfusion Centers, Iran

Introduction: Blood component waste is an important issue in all blood transfusion centers. Therefore, reducing and managing these wastages are a major concern in blood transfusion centers. The present study examined the causes and frequency of blood product wastage in blood transfusion centers of Fars Province from 2015 to 2020. Materials and Methods: This is a descriptive and retrospective study, and the cause and frequency of red blood cell, platelet, plasma and cryoprecipitate wastage from 2015 to 2020 were evaluated. The data related to the blood product wastage were extracted from the comprehensive software of the Blood Transfusion Organization (Negareh). Then, it was analyzed using SPSS software version 25. Results: The total amount of waste was equal to 164981 units. The highest percentage of wastage of products was in 2015 (8.12%), 2016 (7.15 %) and 2017 (6.75 %), respectively. The most discarded products were whole blood, cryoprecipitate and platelet, respectively. Also, the leading causes of waste included positive screening test results, expiration date, contamination, blood group incompatibility, and abnormal and bloody color, respectively. Conclusion: The authors concluded that blood component wastage has a dropping pattern in this period. Proper management and continuous training of technical staff are important in reducing blood product wastage.

The Comparative Effect of Plasma Exosomes of Young and Old People on the Expression of BCL-2 and BAX Genes in Hematopoietic Stem Cells.

Apoptosis may disrupt differentiation of hematopoietic stem cells (HSCs), which can affect aging. Thus, the main goal of this study was to compare the effect of plasma exosomes from young and old people on the expression of Bcl-2-associated X (BAX) and B-cell lymphoma 2 (BCL-2) genes in the HSCs. Plasma samples were acquired from four elderly adults and four younger adults, referring to Blood Transfusion Organization of Tehran-Iran during August 2022- September 2022.Then, the exosomes of the samples were extracted and analyzed using DLS, TEM, and CD63 surface marker. HSCs were isolated from umbilical cord blood cells. The MTT test was used to assess the viability of exosomes-treated HSCs at doses of 5 and 10 μg/ml. The expression of BAX and BCL-2 genes in the cells was examined using real-time PCR. A one-way analysis of variance (ANOVA) was performed to examine the distinctions among five groups. The viability of HSCs was not affected by the exosomes from young and old people than the control group (P = 0.453). Exosomes from young people (doses 5 and 10 µg/ml) did not have any significant impacts on BAX (P = 0.746, and P = 0.345, respectively) and BCL-2 (P = 0.773, and P = 0.461, respectively) expression in the HSCs compared to the control group. The BAX gene was significantly upregulated and the BCL-2 gene was significantly downregulated after utilizing the exosomes derived from the plasma of elderly individuals (dose 10 µg/ml) compared to the control (P = 0.001, P = 0.002, respectively). The current research shows that aged people's exosomes can increase BAX/ BCL-2 ratio in umbilical cord blood-derived HSCs compared to control and young groups.

Frequency, clinical, and laboratory findings of platelet secretion disorders in patients referred to the specialized coagulation laboratory of the Iranian Blood Transfusion Organization.

Platelet secretion disorders (PSDs) are a subgroup of platelet function disorders (PFDs) caused by defects in the content or release of platelet granules. These patients have a variable degree of mucocutaneous bleeding tendency. The diagnostic facilities of PSDs are imitated in Iran, even in specialized coagulation laboratories. The present study aims to estimate the frequency of PSDs among patients referred to the Iranian Blood Transfusion Organization (IBTO). The research population includes all patients referred to the specialized coagulation laboratory of IBTO and requested platelet function and von Willebrand testing by their physicians. They were recruited between May 2022 and October 2022 if they were not diagnosed as having procoagulant defects, von Willebrand disease (VWD), Glanzmann thrombasthenia (GT), Bernard-Soulier syndrome (BSS), and platelet count <100 × 10 9 (except in the syndromic forms). Patients with a defect in response to at least two agonists in Light transmission aggregometry (LTA), one agonist in the ATP-secretion study, and/or impairment in the expression of CD62P are considered PSDs. Among 121 cases referred to our center over 6 months, 40 patients fulfilled the inclusion and exclusion criteria. Ten patients were diagnosed with PSDs. Six were classified as δ-platelet secretion disorders (δ-PSD), two α-platelet secretion disorders (α-PSD), and two αδ-platelet secretion disorders (αδ-PSD). The prevalence of PSDs in our population study was 25% (10/40), which seems highly prevalent. Therefore, expanding laboratory approaches to platelet function defects is necessary as a routine in our country.

Impact of Implementing a Standard Operating Procedure to Reduce Blood Wastage in Blood Centers of Iran.

Blood wastage leads to additional costs and reduced blood availability to patients. Above all is the moral issue of wasting donor gifts. This study aimed to determine the rate of blood wastage before and after implementing a new standard operating procedure (SOP) in Iran. In this interventional study, a SOP for wastage management was prepared and implemented in all blood centers throughout the country. Data were extracted from the integrated software of the Iranian Blood Transfusion Organization (IBTO). The wastage rate of blood components in the post-intervention years (2016-2017) was then compared with that in the pre-intervention years (2013-2015) using the Z test. The overall wastage rate decreased by 36.86% (P<0.001, 95% CI [36.84-36.88]) after the intervention. Red blood cell (RBC) wastage decreased from 2.6% to 2.5%, platelet wastage from 19.5% to 10.6% and plasma wastage from 15.5% to 7.3% (P<0.001). The highest percentage of waste reduction pertained to plasma components, which decreased by 52.90% (P<0.001, 95% CI [52.86-52.94]). Expiration was the most common cause of RBC and platelet wastage. The most common causes of plasma wastage were RBC contamination and rupture or leakage of the bags. The intervention resulted in a drop of over 250000 discarded components each year, equal to approximately thirty-six million dollars in savings. This intervention effectively reduced waste and increased efficiency. Ongoing blood wastage reviews, auditing, and receiving feedback from the central headquarters were powerful tools in following the compliance of blood centers. Further studies are recommended, especially concerning blood wastage in hospital blood banks and various wards.

Estimating the Adverse Reaction Among Iranian Blood Donors: The First National Report

Background: The aim of this study was to estimate the incidence of reactions caused by blood donations in Iran as well as exploring three potential scenarios of the worst, moderate, and the best situations for adverse reactions among Iranian blood donations by specifying the under-reporting rate.&#x0D; Methods: There are two different designs; first, the ecological study was coducted to estimate the blood donation adverse effects by using the data registered in the donor vigilance part of Iranian Blood Transfusion Organization (IBTO). Second, the cross-sectional study was conducted to estimate under-reporting in the data. For the cross-sectional study, 2408 donors were selected randomly in three cities.&#x0D; Results: In general, based on the estimations of this study, adverse reactions to blood donation in Iran is 2%(CI 95%, 1.4-2.6%). Local and systemic reactions estimated are 1.7%(CI 95%, 1.2-2.2) and 0.3%(0.1-0.5), respectively. Based on the national report, in general, adverse reactions to blood donation in Iran is 0.5(CI 95% 0.4-0.6). Local and systemic reactions estimated are 0.38%(CI 95% 0.28-0.48) and 0.03%(0.0.02-0.04), respectively.&#x0D; Conclusion: Adverse reactions may vary from region to region in Iran, but in total, there is a lot of under-reporting in the incidence of adverse reactions to blood donation in Iran, most of which are related to local reactions.

PB1387 Frequency of Inherited Platelet Secretion Disorders in Patients Referred to the Special Coagulation Laboratory of the Iranian Blood Transfusion Organization (IBTO)

PB1387 Frequency of Inherited Platelet Secretion Disorders in Patients Referred to the Special Coagulation Laboratory of the Iranian Blood Transfusion Organization (IBTO)

ABO/Rh Blood Groups and the Temperament (Mizaj) Based on Traditional Persian Medicine Perspective: A Cross-sectional Study.

Mizaj is a fundamental concept in traditional Persian medicine (TPM) that explains the physiological and psychological traits of human beings. This study aimed to investigate the association between the ABO/Rh blood groups and the Mizaj. This cross-sectional study was conducted on 18-60 years old individuals who visited the Iranian Blood Transfusion Organization, Shiraz Branch. We used Mojahedi's Mizaj questionnaire to determine the Mizaj of the participants. The participants' blood group and Rh were determined based on the antibodies against types A, B, and Rh antigens of their blood. We assessed 308 individuals consisting of 174 (56.49%) male and 134 (43.51%) female. The results of our study showed a significant relationship between the AB blood group and the cold Mizaj in both simple and compound Mizaj categories (P=0.012, P=0.014, respectively). Logistic regression analysis revealed that people with the AB blood group were 2.88 times more likely to have cold Mizaj than people with the O blood group (OR=2.88, 95% CI: 1.16 to 7.15). In addition, those with the A blood group were found to be 54% less likely to have a dry Mizaj than those with the O blood group (OR=0.46, 95% CI: 0.23 to 0.92). There was no significant association between the participants' Mizaj and their Rh blood group (P0.05). It seems that there was a significant relation between the AB blood group and cold Mizaj, as well as the A blood group and dry Mizaj. However, further studies are recommended with controlling the probable confounding factors.

Cost of Blood Products in Iran: A Case Study of the Shiraz Blood Transfusion Organization Using Activity-based Costing

Background: Although blood is donated rather than purchased, collecting, storing, and testing it for viral markers is expensive. During the Cost of Blood Consensus Conference (COBCON), activity-based costing (ABC) was proposed as a standard way to figure out the cost of preparing a unit of blood. Objectives: The ABC can be used by any organization that pays for blood or blood products. It was used to determine how much each unit of allogeneic blood costs in Iran, considering the limited blood sources and the importance of cost evaluation studies. Methods: This cross-sectional, descriptive-analytical study was conducted at Shiraz Blood Transfusion Organization in 2020-2021 (Shiraz, Iran). We used the ABC method to determine how much each unit of allogeneic blood costs in Iran. In this study, activity centers were divided into high-level, intermediate, and final activity centers. The resources of each activity center were made up of human resources, consumables, buildings, equipment, and energy. Results: Direct and indirect costs of producing blood were separately investigated in the studied sub-units. The final estimated cost of preparing one blood unit was almost 13 million IRR (≈308 USD). According to our findings, indirect costs comprised a significant portion (86.45%) of the cost of producing a unit of blood, while direct costs accounted for only 13.55%. Conclusion: As evidenced by the obtained results, the cost of one blood unit was far more than the national average estimated by the Iran Blood Transfusion Organization. There is a need for additional research on the cost of other blood products and indirect cost reduction strategies.

Survey in Iranian Malaria Blood Donation Deferral: Laboratory Evaluation in Malaria Blood Donation Deferral in the Iranian Blood Centers

Introduction: Transfusion-transmitted malaria (TTM), from a malaria infected donor, is an accidental Plasmodium infection, which is one of the concerns of blood transfusion issue in the world. Countries have adopted different strategies for donor selection and improving criteria to overcome these concerns, In the Iranian Blood Transfusion Organization (IBTO), donors who refer to blood transfusion centers after registration are screened by the physicians based on interview and examination. This prevention due to the possibility of malaria infection is called malaria donor deferral strategy.&#x0D; Methods: In this study 248 malaria blood donation deferral samples were selected and evaluated by microscopic, serological and molecular methods, after completing the questionnaire.&#x0D; Results: The results of the survey of the questionnaires showed that 30 cases were deferred from donating blood due to having a history of malaria infection. In microscopic examination, Plasmodium ring was observed in 2 samples and 2 samples were also reported as suspicious. In serological examination, 23 cases (9.27%) were reported positive. All cases were reported negative for the presence of malaria parasite DNA.&#x0D; Conclusions: The adoption of TTM prevention strategies depends on the malaria endemicity of the geographical area. According to the IBTO instructions, donors are examined and interviewed by a blood transfusion physician’s and owning to traveling or residency in endemic area or malaria infection, deferred temporary or permanently.&#x0D; Recent study reveal that the strategy of donor selection and deferral in the IBTO, with little residual risk of malaria transmitting, is sufficient to prevent the occurrence of TTM in Iran.

Leukocyte Reduction Filters Are Reliable and Economic Source for Natural Killer Cell Preparation.

An issue that hinders researchers' access to Natural Killer (NK) cells is their low proportion in peripheral blood leukocytes. This issue is currently addressed by methods involving a series of differentiation and expansions that are time-consuming and expensive. We have investigated whether the used leukocyte reduction filters, a by-product in the blood transfusion practice that currently is considered waste, can be utilized as a source of the NK cells. Following the blood donation of 46 donors based on the Iranian Blood Transfusion Organization's protocols, a sample of peripheral blood of each donor and the leukocyte reduction filter used in their donation procedure have been obtained. The entrapped cells were flushed back from the leukocyte reduction filters. Both groups of samples were analyzed using an automatic hematological analyzer. NK cell isolation was done by the MACS negative selection method. The samples have been comparatively analyzed utilizing flow cytometry data of NK cells' subpopulation compositions, viability, degranulation patterns, and cytotoxic capacity against the K562 cell line. Every major leukocyte population was abundant in the samples extracted from the used leukocyte reduction filters. The NK cells extracted from leukocyte reduction filters did not show any statistically meaningful differences (P<0.5) from peripheral blood samples in terms of subpopulation composition, viability, degranulation potency, and cytotoxic capacity. Used leukocyte reduction filters can be considered an economic, easy to obtain, and robust source of abundant research-grade NK cells.

Effect of Convalescent Plasma Therapy on COVID-19 Patients: A Retrospective Study

Background: Coronavirus disease 2019 (COVID-19) was first detected in December 2019 in Wuhan, China. Different treatments have been used to fight against the virus; however, one of the most effective and accessible is convalescent plasma therapy (CPT). Objectives: The present study investigated the effect of CPT on improving the clinical conditions of COVID-19 patients. Methods: This study was conducted on 440 individuals, including 220 COVID-19-recovered individuals as plasma donors and 220 plasma recipients, in Shiraz, Fars province, Iran, from May 2020 to February 2021 using random sampling. After complete recovery from COVID-19, patients were recalled for apheresis and plasma isolation for convalescent plasma (CP) preparation; they were referred to the blood donation centers of Shiraz. According to the hospital request, compatible and related plasma was sent for COVID-19-hospitalized patients. At the same time, hospitals were asked to send the clinical condition documents of the patients based on the medical records and the outcomes after CPT. The Iranian Blood Transfusion Organization evaluated the results. Results: The median antibody titer was 1300. Titers higher and lower than 1300 were considered high and low, respectively. Blood group O had 54 times higher antibody titers above 1300 than other blood groups (odds ratio (OR) = 54, confidence interval (CI): 19.5 - 205.3, P &lt; 0.001). Additionally, most deceased cases received plasma with antibody titers less than 1300 (OR = 0.08, CI: 0.009 - 0.36, P &lt; 0.001). Nevertheless, most discharged patients received plasma with antibody titers higher than 1300 (OR = 1.5, CI: 1.06 - 2.3, P = 0.01). Moreover, when donors’ antibody titer was higher than 1300, the chance of survival increased by 50%. In addition, the results of this study showed higher mortality in patients whose volume of received plasma was less than 387 mL (OR = 0.3, CI: 0.10 - 0.91, P = 0.018). However, patients who received more than 387 mL CP were more likely to discharge (OR = 5.7, CI: 3.7 - 8.8, P &lt; 0.001). Conclusions: Using blood group O plasma with a minimum volume of 387 mL can be very effective in improving the clinical symptoms of patients with COVID-19 and increasing the chances of survival for these patients.

Resveratrol; a Double-Edged Sword Antioxidant Agent for Preserving Platelet Cell Functions During Storage; Molecular Insights.

In the current study we have aimed to find the effects of Resveratrol treatment on platelet concentrates (PCs) at the dose dependent manner. We have also attempted to find the molecular mechanism of the effects. The PCs, have received from Iranian blood transfusion organization (IBTO). Totally 10 PCs were studied. The PCs divided into 4 groups including untreated (control) and treated by different dose of Resveratrol; 10, 30 and 50 µM. Platelet aggregation and total reactive oxygen species (ROS) levels were evaluated at day 3 of PCs storage. In silico analysis was carried out to find out the potential involved mechanisms. The aggregation against collagen has fallen dramatically in all studied groups but at the same time, aggregation was significantly higher in the control versus treated groups (p<0.05). The inhibitory effect was dose dependent. The aggregation against Ristocetin did not significantly affect by Resveratrol treatment. The mean of total ROS significantly increased in all studied groups except those PCs treated with 10 µM of Resveratrol (P=0.9). The ROS level significantly increased with increasing Resveratrol concentration even more than control group (slope=11.6, P=0.0034). Resveratrol could potently interact with more than 15 different genes which, 10 of them enrolled in cellular regulation of the oxidative stress. Our findings indicated that the Resveratrol affect the platelet aggregation at the dose dependent manner. Moreover, we have also found that the Resveratrol play as double-edged sword in the controlling oxidative state of the cells. Therefore, Using the optimal dose of Resveratrol is the great of importance.

Paid Plasma versus Voluntary Nonremunerated Plasma Collection for Plasma-Derived Medicine

Iranian Blood Transfusion Organization (IBTO) established in 1975 has been the sole responsible entity for blood adequacy and safety in Iran. It has been the same in case of providing recovered plasma. At the same time, the first commercial plasma center was authorized by IBTO to operate in the capital Tehran to contribute to the main purpose that was the investment of the private sector in fulfilling fractionation purposes and the construction of a fractionation plant. The goal that unfortunately did not materialize. To make remedies based on a well-calculated plasma document, in 2015, a plasma program developed in Iran by IBTO by which new donor centers were opened or already blood center were equipped to allow for the collection of voluntary nonremunerated source plasma. It had in it capacities of plasma collection for IBTO recovered, commercial source, and IBTO voluntary source. The latter third was a gradually growing program that lasted just 3 years and showed progress but the managerial changes and invalid arbitrary and sudden decisions brought it to the end. Whilst the paid private centers grew and ruined the voluntary nonremunerated sense that IBTO always pursued and was against the Ministry of Health requirements for what the commercial private sectors should have abided by. Safe voluntary nonremunerated source plasma collection that almost all countries pursue to grow along with existing recovered plasma share was terminated with consequences that are detailed in the present article.

Forecasting blood demand for different blood groups in Shiraz using auto regressive integrated moving average (ARIMA) and artificial neural network (ANN) and a hybrid approaches

Providing fresh blood to keep people in need of blood alive, has always been a main issues of health systems. Right policy-making in this area requires accurate forecasting of blood demand. The current study aimed at predicting demand for different blood groups in Shiraz using Auto Regressive Integrated Moving Average (ARIMA), Artificial Neural Network (ANN) and a hybrid approaches. In the current time series analysis, monthly data of the Shiraz hospitals and medical centers demand for 8 blood groups during 2012–2019 were gathered from Shiraz branch of Iranian Blood Transfusion Organization. ARIMA, ANN and a hybrid model of them was used for prediction. To validate and comprise ARIMA and ANN models, Mean Square Error (MSE) and Mean Absolute Error (MAE) criteria were used. Finally, ARIMA, ANN and hybrid model estimates were compared to actual data for the last 12 months. R3.6.3 were used for statistical analysis. Based on the MSE and MAE of models, ARIMA had the best prediction for demand of all blood groups except O+ and O−. Moreover, for most blood groups, ARIMA had closer prediction to actual data. The demand for four blood groups (mostly negative groups) was increasing and the demand for other four blood groups (mostly positive ones) was decreasing. All three approaches including ARIMA, ANN and the hybrid of them predicted an almost downward trend for the total blood demand. Differences in the performance of various models could be due to the reasons such as different forecast horizons, daily/month/annual data, different sample sizes, types of demand variables and the transformation applied on them, and finally different blood demand behaviors in communities. Advances in surgical techniques, fetal screening, reduction of accidents leading to heavy bleeding, and the modified pattern of blood request for surgeries appeared to have been effective in reducing the demand trend in the current study. However, a longer time period would certainly provide more accurate estimates.

The impact of COVID-19 on blood safety and availability in the Islamic Republic of Iran.

The COVID-19 pandemic has affected blood inventory and donation worldwide. The Islamic Republic of Iran was among the first countries to report the COVID-19 pandemic and it faced a significant blood shortage during the first weeks of the pandemic. We aimed to evaluate the impact of COVID-19 pandemic on the number, type, and safety of blood donations, comparing the periods before and during the pandemic. This retrospective study evaluated data from all volunteers who attended the blood transfusion centres in the Islamic Republic of Iran from March to December 2020 (during the COVID-19 pandemic) and during the same period in 2019, i.e. pre-pandemic. Data on the number of blood collections, confirmed transfusion transmissible infection marker test results, and donor demographic information were collected from the Iranian Blood Transfusion Organization integrated donor database. Total blood donations decreased by 8.38%. The number of first-time, lapsed, and female blood donors increased by 4.41%, 0.17%, and 0.90% respectively. Regular blood donation decreased by 4.58%. The distribution of the 3 main blood products, red cell concentrate, frozen fresh plasma and platelets, decreased by 7.86%. All changes were statistically significant. The prevalence rates of hepatitis C virus and hepatitis B surface antigen increased significantly during the pandemic. COVID-19 had a negative effect on blood safety and availability in the Islamic Republic of Iran. To improve blood supply and enhance regular blood donation, the Iranian Blood Transfusion Organization needs to reassure blood donors of the safety and hygiene measures being observed at blood collection sites.

Rationale for supporting stepwise access to safe plasma proteins through local production in low- and middle-income countries: A commentary of an international workshop

This document provides a commentary and further elaboration on the conclusions reached during a recent international workshop on plasma protein therapies organized by the Working Party for Global Safety of the International Society of Blood Transfusion (ISBT). The workshop addressed the profound deficiency in access to safe plasma protein therapies that persists in low- and middle-income countries (LMICs). We provide additional factual economic and technological information that highlights why local production of small-scale virus-inactivated concentrates of clotting factors and immune globulins from domestic recovered plasma through stepwise introduction of available validated technologies is a pragmatic approach to gradually improve the care of patients with bleeding disorders and immune deficiencies in LMIC while supporting progress toward fractionation of plasma. This strategy is in line with a recent WHO guidance. We stress that the active involvement of international blood donor and blood transfusion organizations, patient organizations, governments and industry will be essential in supporting stepwise and sustainable improvements in access to safe, effective, and quality assured plasma protein therapies.

Comparing RT-qPCR and Hepatitis C Virus Antigen Detection Assay for Detecting Active Infection in Blood Donors in Fars Province, Iran

Background: Immunoassay is still used to detect hepatitis C virus (HCV) antibodies in donated blood in many developing countries. However, an immunoblotting confirmation test is needed to confirm positive results. Objectives: We compared the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of nucleic acid testing and HCV core antigen (HCVcAg) detection in the serum samples of blood donors with HCV antibodies to determine active infection. Methods: Overall, 90 serum samples from blood donors referred to Fars Blood Transfusion Organization, Iran during March 2017-March 2019 and initially tested for HCV antibodies were included in the study. Enzyme immunoassays were used to detect the HCV antigen and anti-HCV antibody. A commercial reverse transcription-polymerase chain reaction (RT-PCR) kit was used to quantify HCV RNA. The HCV genotypes were also determined by DNA sequencing. In order to compare the HCVcAg detection method with the RT-qPCR reference method, sensitivity, specificity, performance, PPV, and NPV were calculated. Results: Out of 90 serum samples, 73 were positive for anti-HCV antibody, and 17 sera were negative. The HCV RNA was detected in 60 (82%) of anti-HCV antibody-positive samples, whereas the HCVcAg test detected HCV antigen in 54 (74%) of the samples, indicating a significant correlation between the two assays (r = 0.86). The overall sensitivity and specificity for HCVcAg detection method were 93.85% [95% confidence interval (CI): 84.99 - 98.3%] and 100% (95% CI: 94.64 - 100%), respectively. Based on the statistical analysis, the accuracy of the antigen detection test was 94.83% (95% CI: 87.26 - 98.58%). Moreover, the agreement between HCV RNA detection using RT-qPCR and HCVcAg detection was 97.78% (kappa value: 0.94). Conclusions: The sensitivity and specificity of HCVcAg detection in blood donors were ideal compared to the RT-qPCR reference method. However, the method should be tested on more HCV antibody-positive and -negative samples. Furthermore, our study revealed a significant association between the number of RT-qPCR-positive cases and the cases diagnosed by the HCVcAg detection method for screening and detecting active HCV infection in blood donors.

Source Plasma Donation: The Experience of the Iranian Blood Transfusion Organization.

Background: A declining need for red blood cells coupled with strengthening demand for plasma-derived medicines has led to a strong focus on moving whole blood donors to plasmapheresis. The purpose of this study was to evaluate the four-year policies of the Iranian Blood Transfusion Organization (IBTO) in terms of plasmapheresis recruitment of first-time donors and its effect on plasmapheresis outcome. Materials and Methods: Plasmapheresis data related to 16 centers from 2016 to 2019 was obtained from IBTO software. This information includes; (1) blood donation number, (2) plasmapheresis donation number, (3) number of plasmapheresis donors, (4) plasmapheresis donor demographic data, (5) plasmapheresis donor status, (6) frequency of plasma donation for each donor, (7) volume of plasma and (8) the prevalence of transfusion-transmissible infections (TTIs) in plasmapheresis donors. Results:The result of this study demonstrated thatplasmapheresis collection centers have recruited 85,515 (91%) first-time and 8,595(9%) regular and repeated donors from 2016 to 2019 years. Plasmapheresis to blood donation index was increased from 0.2% in 2016 to 4.9% in 2019. The mean donation number was 2 times per year. The trend of the yearly Whole Blood Donation (WBD) Index decreased from 26.69 to 24.11/1000 for the general population. The total volume of collected source plasma was 49,203 liters during this period. However, 46,000 liters of recovered plasma were decreased due to less WBD. Furthermore, the results indicated that the prevalence of HCV was significantly higher in first-time donors compared to repeated and regular donors (P = 0.000). Conclusion: It is concluded that during four years, the net volume of plasma did not increase and plasmapheresis led to reducing WBD in our country. Moreover, first-time plasmapheresis donors can be associated with challenges such as increasing screening costs and compromising the safety of plasma resources. Therefore IBTO decided to stop the project and focus on its main role to prepare safe and sufficient blood components through WB collection and also single donor platelet and concurrent plasma by plateletpheresis.

Seroprevalence of West Nile Virus in Regular Blood Donors Referred to the Blood Bank of Kurdistan Province, Iran

Background: West Nile virus is an infection that is most commonly caused by infected mosquito bites, however, blood transfusions, organ transplants, breast feeding, pregnant mother-to-the-fetus transmission, and occupational transmission among laboratory and medical staff are also the less common routes of infection. Given the endemic nature of this virus in the Middle East, the aim of this study was to investigate the presence of this virus in regular blood donors, as the reliable source of blood supply needed for patients in hospitals. Methods: In this descriptive-analytical study, venous blood samples were collected from 259 regular blood donors referred to the Blood Transfusion Organization of Kurdistan. After separating blood serum, the amount of IgM and IgG antibodies against West Nile virus was measured via ELISA test. Results: Concerning antibodies, IgG and IgM against West Nile virus were positive in 14 patients (5.4%) and 3 patients (1.2%), respectively. Seropositive IgG levels were observed in 11 patients over the age of 40 (12.5%) but only in 3 patients under 40 years of age (1.8%). The difference was statistically significant (OR = 7.95; 95% CI: 2.16–29.32; p &lt; 0.01). Conclusion: Given the value of blood and blood products obtained from regular blood donors for therapeutic purposes and the significant prevalence of the virus and considering the presence of cases with positive IgM, it seems necessary to screen blood donors in blood transfusion centers in the western parts of Iran.