Blood Transfusion Organization Research Articles

Comparing the Prevalence of Hepatitis B Virus Infection in Stationary and Mobile Blood Donation Centers: A Cross-Sectional Descriptive Study

Background and Aim: Blood transfusion can save a million lives. Nonetheless, every recipient is at risk for transfusion-transmissible infection, chiefly hepatitis B infection. The aim of this study was to compare stationary and mobile blood donation centers respecting the prevalence of hepatitis B in 2007 - 2016. Methods: This cross-sectional descriptive study compared hepatitis B prevalence in stationary and mobile blood donation centers in Southern Khorasan in a ten-year period from 2007 to 2016. Data were retrieved from data sheets available from Iranian blood transfusion organization. Results: A total of 157063 blood units had been collected in 2007 - 2016. The number of blood units collected by stationary and mobile centers was 129,899 (82.7%) and 27,164 (17.3%), respectively. Total hepatitis B prevalence rate was 0.22% (348 cases). This rate in stationary and mobile centers was 0.18% (232 cases) and 0.40% (116 cases), respectively. Hepatitis B prevalence was significantly greater in mobile centers than in stationary centers (P < 0.001). Moreover, hepatitis B prevalence in the second five years, i.e. 2012 - 2016, was significantly lower than that in the first five years, i.e. 2007 - 2011 (P < 0.001). Conclusions: Hepatitis B prevalence in mobile blood donation centers is significantly higher than that in stationary centers. This problem can be due to the limited health-related knowledge of blood donors in rural areas where mainly mobile centers collect blood units. Therefore, restricting blood collection by mobile centers may be indicated until necessary health- and donation-related educations are provided to all people in high-risk areas.

Toxoplasma Gondii Infection and Related Risk Factors Among Blood Donors in Northwest Iran

Background: Toxoplasmosis, a worldwide parasitic infection, is considered as a transfusion-transmitted disease. Objectives: Due to ignorance about Toxoplasma infection in blood donors monitoring and its important role in provision of safe blood and blood products and also poor information about the seroprevalence of T. gondii infection in blood donors, this study was conducted to assess anti-Toxoplasma gondii antibodies and associated risk factors among blood donors in northwest of Iran. Methods: In this cross- sectional study, 194 serum samples were collected from healthy blood donors who referred to Tabriz Blood transfusion organization (East Azerbaijan, Iran) during April and June 2014 and tested for anti-T. gondii IgM and IgG antibodies using chemiluminescence immunoassay. The questionnaire consisting of demographic and risk factors were filled for all the participants. Results: From 194 donors, 75 (38.66%) and 2 (1.03%) individuals were seropositive for anti-T. gondii IgG and IgM antibodies, respectively. In the present study, anti-T. gondii antibodies in first-time donors was significantly higher than those in regular blood donors (P < 0.05). A significant correlation was observed between T. gondii infection and age (P < 0.05); however, there were no relationship between Toxoplasma infection and other factors. Conclusions: Considering the medical importance of blood transfusion and high rate of anti- T. gondii antibodies in healthy blood donors, it seems that effective monitoring of infection is required to prevent transfusion- transmitted toxoplasmosis.

Prevalence and Characteristics of Precore Mutation in Iran and Its Correlation with Genotypes of Hepatitis B.

IntroductionMutation of the HBV precore gene prevents the production of HBeAg, which is an important target for immune responses. Distribution of this mutation varies along with frequency of HBV genotypes in accordance with geographic and ethnic variations. The general objective of this study was to evaluate the prevalence and characteristics of precore mutation in Iran and its correlation with genotypes of hepatitis B.MethodsIn this cross-sectional study, viral DNA of 182 Iranian hepatitis B surface antigen positive patients who were admitted to Bandar Abbas Blood Transfusion Organization in 2012 and 2013 was retrieved from their serum samples. HBeAg, anti-HBe, and anti-HBc IgM diagnostic tests were performed using ELISA kits. Precore and Pre-S regions were amplified using specific primers and PCR thereafter to determine the genotypes; precore mutation, PCR, and restriction fragment length polymorphism (RFLP) methods also were applied. SPSS version 12 was used for data analysis by Mann–Whitney U test, Fisher’s exact probability test, and t-test.ResultsA total of 62 patients (34.1%) had precore mutation (A1896G), and genotype D was the predominant genotype in these patients, which was followed by an unknown genotype that was suspected for genotype B. Interestingly, the relationships between precore mutation and HBeAg (p=0.037) and genotype D (p=0.005) were significant; however, no correlation was observed between this mutation and acute or chronic hepatitis and sex of patients.ConclusionThis study found high prevalence of precore mutations in southern Iran, which was significantly associated with HBeAg and genotype D.

Trends in Sero-Epidemiology of Human Immunodeficiency Virus in Voluntary Blood Donations in Iran, 2008-2013.

Various strategies are implemented to increase blood safety. However, there is always a small amount of residual risk. The amount of risk is associated with the incidence and prevalence of infection in the community. Since increases in the prevalence and changing the pattern of HIV transmission have been observed in the community, monitoring of HIV prevalence among general population and blood donors is necessary. This study aimed to determine the prevalence of HIV in Iranian blood donations. Demographic status and donation type were also investigated in HIV positive blood donors. In the time frame of this study (2008 - 2013), the records of 11,504,231 donations were analyzed and all relevant data were extracted from the central database of the Iranian Blood Transfusion Organization. Demographic characteristics and type of donations were investigated. Descriptive and analytical statistics were used to summarize the obtained data. A total of 421 blood donations were HIV sero-positive. Trends in HIV prevalence from 2008 to 2013 per 100000 donations were found as follows: 3.8, 4.3, 3.8, 3.8, 3, and 2.9, respectively. The average prevalence was 3.6 per 100000. The prevalence rate showed a fluctuation from 3.8 to 2.9 per 100000. Gradual reduction has occurred in HIV sero-prevalence but the difference is not statistically significant. The risk of HIV sero-positivity was higher in single and female blood donors. The prevalence of HIV was much higher among donations from first-time than from regular and lapsed donors. The low prevalence rate of HIV in Iranian blood donations suggests the effectiveness of current safety strategies. However, implementing new strategies or improving the existing ones are advisable.

Seroprevalence and geographical distribution of human T-lymphotropic virus type 1 among volunteer blood donors in endemic areas of Iran

BackgroundHuman T-cell lymphotrophic virus type 1 (HTLV-1) has a worldwide distribution and it is endemic in some regions of Iran. One of the most important routes of HTLV-1 transmission is via transfusion of contaminated blood components. The risk of transmission through asymptomatic blood donors, particularly in endemic areas should be considered and appropriately managed. The main objective of this study was to determine the seroprevalence and description the geographic distribution of HTLV-1 among voluntary blood donors in Iran.MethodsThis retrospective study carried out using the data obtained from the main database of the seven blood transfusion centers of Iranian Blood Transfusion Organization between 2009 and 2013. The presence of anti-HTLV-1/2 antibodies were primarily assessed using Enzyme-linked Immunosorbent Assay. The Ab Kit assay, contain antigens for the screening of antibodies to HTLV type 1 and 2. So, it is expressed as HTLV 1/2 assay. Samples that were positive by the western blot confirmatory test were considered as definite positive HTLV-1 or HTLV-2 cases. The main socio-demographic variables were; age, gender, donation history and marital status. Descriptive and analytical statistics were used to summarize the gathered data. The chi-Square Statistical test was used to test the association between groups, P-value of less than 0.05 was considered significant.ResultsA total of 1864489 blood donations were evaluated. There were 1840 confirmed HTLV-1 positive donations (0.098%). None were positive for anti-HTLV-2. The overall HTLV-1 prevalence was 98.7 per 100,000 donations during the 5 year period. Seroprevalence was higher among females, married and older blood donors. The overall seropositivity among first time, regular and lapsed donors was, 0.29% (290/100000), 0.001% (1/100000) and 0.02% (20/100000) respectively. A significant difference was observed between regular and the first time (p <0.0001) and also between lapsed and regular blood donors (p <0.0001). Most of the HTLV-1 seropositive blood donors (175 per 100,000) were from northeastern regions. We observed a gradual decline in overall HTLV-1 prevalence during the course of the study, the prevalence rate decreased from 0.13% (130/100000) in 2009 to 0.07% (70/100000) in 2013.ConclusionsThe Seroprevalence of HTLV-1 among Iranian blood donors in the regions of our study still is considerable, but there is an obvious declining prevalence over the course of present study. Blood transfusion centers should continually evaluate the residual risk of infection in the country, especially in endemic areas.

Keys to move to self‐sufficiency in safe blood components based on voluntary blood donation

One of the oldest resolutions of WHO urges member states to promote the blood services based on voluntary non‐remunerated blood donation (VNRBD). Consequently, achieving self‐sufficiency in six driver products has been focused on by the WHO and other international agencies in 2010. However, both VNRBD and self‐sufficiency are not a reality in many countries. In this article, proposed ways to achieve self‐sufficiency in blood products and plasma‐derived medicines are discussed. The main proposed ways included are as follows: (i) Donor management: attention to public awareness, donors’ expectations, selection criteria and donor care are so important to maintain a sustainable base for voluntary blood donors. (ii) Wastage blood management: a focused programme can reduce evitable blood product wastage. (iii) Patient blood management plays an important role in avoiding unnecessary exposure to blood and components. In Iran, more than 2 100 000 units of whole blood are being collected annually, all of them from voluntary blood donors. These units are processed to RBC, Plt and FFP that cover all the needs of hospitals generally. Based on formal agreements between Iranian Blood Transfusion Organization (IBTO) and the fractionators, redundant FFP is sent to be processed, which covers most albumin and IVIG demand. IBTO has achieved 100% of VNRBD all over the country since 2007 as well as a good start in self‐sufficiency in PDM by improving donor management, wastage management and patient blood management as well as developing quality systems in the blood transfusion establishment. The experience of Iran has shown that self‐sufficiency in PDM based on VNRBD is an achievable goal that needs a multidisciplinary programme and effort.

Investigating the prevalence of HTLV and HCV infection in blood donors (for the first time) in blood transfusion organization of Kermanshah, Iran

Investigating the prevalence of HTLV and HCV infection in blood donors (for the first time) in blood transfusion organization of Kermanshah, Iran

Alloimmunization in Thalassemia Patients: New Insight for Healthcare.

Background:Development of alloantibodies against the foreign red blood cell (RBC) (alloimmunization) is a well-known complication in thalassemia patients when performing multiple transfusions. The study was conducted to know the prevalence of alloimmunization in thalassemia patients, in the Caspian Sea coastline.Methods:This study is a descriptive, retrospective analysis of transfusion records of 190 patients with β-thalassemia major who received regular transfusions. To detect the type of alloantibodies, two cells panel tests (kits; Iranian Blood Transfusion Organization [IBTO], 3 RBC cells and IBTO, 11 RBC cells) were used. Results:Forty-seven patients were positive for alloantibodies (24.7%). Of them, 18.4% (35 cases) had only one alloantibody, and 6.3% (12 cases) had at least two or more of alloantibodies. The vast majority of alloantibodies were anti-Kell followed by anti-E, and anti-D, respectively.Conclusions:Blood matching for Rh and K antigens in patients with transfusion-dependent thalassemia could reduce the rate of RBC alloinununization.

Seroepidemiological Study of Hepatitis B, C and HIV among Blood Donors in Kerman

Background:Infections transmitted through blood transfusions are the most important issue associated with blood donation. We aimed to provide an assessment of the prevalence of hepatitis B virus (HBV), hepatitis C virus (HCV) and human immunodeficiency virus (HIV) among blood donors in Kerman province of Iran.Methods:Between 2014-2016, 99,187 samples were examined in a retrospective study in five blood transfusion centers in Kerman province. Serologic screening for HBsAg, anti-HCV and anti-HIV1/2 was conducted for all samples and positive cases were confirmed.Result:The positives with the initial serological screening tests for HBsAg , anti-HCV and HIV 1/2 numbered 524, 409 and 285, respectively, and based on confirmation tests, final results were 196 , 72 and 1. The highest prevalences of HBV and HCV were reported as 0.36% in Jiroft city and 0.1% in Rafsanjan city. Co- infection with HBV and HCV was observed in the city of Sirjan.Conclusion:Blood-borne viral infections in people with low education levels were more common. The prevalence in Kerman province was low as compared to previous studies carried out in other regions of Iran. Application of standard operating procedures, with updated equipment, as well as planning for the use of molecular methods are necessary for the Iranian Blood Transfusion Organization, to monitor blood-transmitted infections.

Prevalence and Characteristics of Basal Core Promoter Mutations in Iran and its Correlation with Acute and Chronic Hepatitis B Infection.

IntroductionManifestations of HBV infection differ in chronic and acute phases. Therefore, identifying the determinants such as mutations has a vital role in the treatment of the disease. A dual transversion in the basal core promoter (BCP) region is common among HBV patients. Thus, the present study was conducted with the objective of determining the prevalence of basal core promoter (BCP) mutations and its correlation with the outcome of HBV infection.MethodIn this cross-sectional study, samples were obtained from 182 Iranian HBsAg positive patients who were admitted to the Bandar Abbas Blood Transfusion Organization in 2012 and 2013. They were screened by ELISA test using commercial kits to detect serological marker anti-HBc IgM for distinct chronic hepatitis from acute infection. Thereafter, the extracted DNA was used for determination of the BCP mutations by PCR-RFLP technique. Data analyses were performed with SPSS 12 by Mann–Whitney U test, Fisher’s exact probability test, and t-test.ResultsBCP mutations were observed in 15 samples (8.24%) of the study population, and serological tests determined that, among the BCP mutants, one sample (6.67%) was HBeAg positive, 14 samples (93.33%) were HBeAg negative, and four samples (2.2%) were positive for anti-HBc IgM test. Data analysis indicated a statistically significant association between BCP mutations and acute hepatitis (p=0.002). However, no relationship was detected between the prevalences of the BCP mutations and gender of subjects (p>0.567).ConclusionsThe prevalence of BCP variants was low in the south of Iran, and this mutation can lead to acute phase of viral hepatitis.

Legal Principles Governing the Production and Distribution of Blood

&lt;p&gt;Use of blood and its derivatives has a special place in ensuring the health of citizens. In recent years, due to risk of transfusion-transmitted infections, followed by risk of serious and incurable diseases such as for people in need AIDS, hepatitis B, C and etc., consumers have been prompted to refer to the courts for litigation and justice. It should be noted that the state, as an exercise of sovereignty and trustee of the exclusive production and distribution of blood products, produce commodities with inevitable insecurity. In this regard, it must observe safety obligations and provide information and warnings to the public in relation to the delayed complications of transfusion medicine. According to existing laws, law doctrine, and judicial procedures, Blood Transfusion Organization and the Center for Blood Research and Fractionation are working under the supervision of the Ministry of Health and Medical Education. In the case of failure tocompliance with the obligations, the state is obliged to compensate the physical, moral, and material damages to victims despite the governmental nature of action, article 11 of the law of civil liability, and in relation to the State Immunity to compensate for the loss of the exercise of sovereignty. Thus, it is possible to execute justice for these people through the legal courts based on the inherent competence of the courts in form of complaint according to additional and exceptional competence of criminal authorities.&lt;/p&gt;

Risk factor analysis of hepatitis C virus seropositivity in Iranian blood donors: a case‐control study

Due to blood screening and blood donor selection, the prevalence of hepatitis C virus (HCV) is expected to be lower among blood donors compared to the general population. The effective control of blood-transmitted infectious diseases should be one of the goals of public health. Thus, this case-control study was conducted to evaluate the risk factors of HCV in a representative sample of blood donors in Iran. A case-control study was conducted on HCV-negative and on serologically confirmed HCV-positive donors across the country from 2009 to 2013. Univariate logistic regression, multiple logistic regression, and subgroup analyses were performed to assess the risk factors in first-time blood donors (FTs) and repeat blood donors (RDs) independently. A total of 970 cases and 1542 controls were selected from the cohort of Iranian blood donors registered in the Iran Blood Transfusion Organization. Intravenous (IV) drug abuse (ORFT , 6.42; 95% CI, 3.34-12.34; and ORRD , 27.62; 95% CI, 12.58-60.62), living with an IV drug abuser (ORFT , 3.47; 95% CI, 1.26-9.55; and ORRD , 6.95; 95% CI, 1.54-31.34), prison history (ORFT , 2.4; 95% CI, 1.48-3.88; and ORRD , 2.42; 95% CI, 1.38-4.27), sharing personal razors (ORFT , 2.00; 95% CI, 1.01-3.96; and ORRD , 5.62; 95% CI, 2.65-11.89), and medical exposure (ORFT , 1.97; 95% CI, 1.15-3.37; and ORRD , 2.19; 95% CI, 1.27-3.76) were significant independent risk factors in both types of blood donation. The findings of this analytic study on HCV exposure in Iranian blood donors conforms to those of international studies. Behavioral and medical factors should be examined in the donor health screening process.

Detection of Hepatitis E Virus Genotype 1 Among Blood Donors From Southwest of Iran.

BackgroundInfection with hepatitis E virus (HEV) is endemic in developing countries and reveals significant regional differences. Several studies have reported virus transmission via blood transfusion. To date, however, no cases of HEV RNA detection in blood donors have been reported from Iran.ObjectivesThe aim of this study was to determine the presence of HEV RNA in plasma samples of blood donors referred to a blood transfusion center in Shiraz in the southwest of Iran. The HEV genotypes were also investigated using nucleotide sequencing.Patients and MethodsBlood samples were collected from 700 blood donors who were referred to Fars blood transfusion organization from January to March 2014. Plasma samples were screened for the presence of HEV IgG and IgM antibodies by standard enzyme immunoassay. Samples seroreactive to anti-HEV were further tested for the presence of HEV RNA using nested polymerase chain reaction (PCR) with universal primers for detection of all four HEV genotypes. Positive PCR samples were then subjected to DNA sequencing for further analysis.ResultsFifty (50, 7.1%) out of 700 plasma samples tested positive for anti-HEV antibodies. HEV RNA was detected in 7/50 (12%) of the antibody-positive samples, the majority of which were IgM positive. Sequence analysis of seven isolates of the HEV RNA ORF 2 gene region revealed > 80% similarity with genotype 1.ConclusionsThe analysis indicates that the HEV isolated from blood donors in the southwest of Iran belongs to genotype 1. However, more samples from other geographic regions of Iran are needed to confirm these findings. Because transmission of HEV by administration of blood or blood components is likely to occur, it may be sensible to screen donor blood for HEV to eliminate transfusion-transmitted HEV infection when the recipient is immunocompromised.

Blood collection, components preparation and distribution in Iran, 2008–2012

BackgroundThe information about the dynamics of blood collection, components preparation and distribution in Iran was measured and compared during 2008–2012. Study designs and methodsThe survey instruments were based on collecting data from all 220 blood collections and blood processing centers over the country, registering them in the validated data base and reporting them to headquarter of Iranian Blood Transfusion Organization. ResultsTotal blood collection increased during this period, and in 2012 represented a 12.6 percent increase compared to that in 2008. On average, red blood cells, fresh frozen plasma and platelet concentrate were prepared from 95.5 ± 2.4, 81 ± 3.8 and 47 ± 8.8 percent of all whole blood collection. From 2008 to 2011, the distribution of whole blood and fresh frozen plasma revealed different patterns. For whole blood, declines were noted, while for fresh frozen plasma increases were reported. In addition the distribution of red blood cells and platelet concentrate did not change considerably. Also between 2008 and 2012, the mean percentage of outdated and discarded units was 3.6 ± 1 and 5.2 ± 4.6. ConclusionThis study as a first national survey provides comprehensive information about the blood supply, components preparation and distribution, and helps to define strategy for the future.

Discrepancies in ABO and Rh Grouping in Southeast Iran, an Analysis of 3 Years' Experience

Background: ABO and Rh blood grouping discrepancies are significant causes of transfusion-related morbidity and mortality. Most of these errors occur when blood grouping standards are unavailable or misinterpreted. This study determined the rate of such errors among hospitals in Zahedan, a city in southeast Iran. We also assessed the prevalence of ABO and Rh grouping errors in the Iranian Blood Transfusion Organization (IBTO) in Zahedan. Method: During the study, 30,254 blood bags were sent to five of Zahedan's hospitals. Pre-transfusion ABO and Rh blood grouping was carried out by slide method. Any sample showing a discrepancy between IBTO and hospital laboratory was returned to IBTO for identification of the error by the American Association of Blood Banking (AABB) standards protocol. Results: We observed 420 discrepancies in the pre-transfusion ABO and Rh blood grouping of 30,254 units, a 1.4 percent error, among Zahedan hospitals. The most common error was misidentification of group A as O (62 cases), while group B was misidentified as O in 41 cases. We discovered critical errors, such as misdiagnosis of A as B and vice versa, which could endanger the patient’s life. We also noted 20 misidentifications in routine IBTO laboratory testing, a 0.02 percent error. Conclusion: The high incidence of pre-transfusion blood grouping errors emphasizes the necessity of always using standard forward and reverse grouping tests in hospitals.

Distribution of blood groups in the Iranian general population

Abstract We report the first study of antigen and phenotype prevalence within various blood group systems in the Iranian general population. In this retrospective study, samples from 3475 individuals referred to the Immunohematology Reference Laboratory of the Iranian Blood Transfusion Organization, Tehran, Iran, for paternity testing from 1998 to 2008 were additionally tested for red blood cell (RBC) antigens in the Rh, Kell, Kidd, Duffy, MNS, Lutheran, P1PK, and Xg blood group systems. The antigen testing was performed by the tube method, and the phenotype prevalences were expressed as percentages. Of 3475 (1857 male and 1618 female) blood samples, 1268 samples were typed as group O (36.49%), 1115 as group A (32.09%), 823 as group B (23.68%), and 269 as group AB (7.74%). In our sample population, 3152 (90.71%) samples were D+ and 323 (9.29%) were D–. Analysis of Rh antigen typing results showed e (3359; 96.66%) to be most prevalent in the Iranian population, followed by D (3152; 90.71%), C (2677; 77.04%), c (2557; 73.58%), and E (1059; 30.47%). In the Kell blood group system, 3293 (94.76%) samples were typed as K–k+. For the Kidd and Duffy blood group systems, the following were the most common phenotypes: Jk(a+b+) (1703; 49%), Jk(a+b–) (1006; 28.95%), Fy(a+b+) (1495; 43.02%), and Fy(a+b–) (1005; 28.92%). In the MNS blood group system, the following were the most common phenotypes: M+N+ (1668; 48%), M+N– (1310; 37.70%), S+s+ (1564; 45%), and S–s+ (1392; 40.06%). In the Lutheran and P1PK blood group systems, Lu(a–b+) and P1+ phenotypes were observed in 3292 (94.73%) and 1966 (56.58%) samples, respectively. The Xg antigen was present in 1953 (56.20%) samples versus 1522 (43.80%) samples identified as Xg(a–). Knowledge of the prevalence of RBC antigen phenotypes in a population can be useful in databank creation for providing antigen-negative compatible blood to patients with multiple alloantibodies. Immunohematology 2016;32: 135–139.

Elevated factor VIII activity and venous thromboembolism in patients referred to the Iranian Blood Transfusion Organization: A case control study

ObjectiveA high plasma level of factor eight (FVIII) is a risk factor for venous thromboembolism (VTE). Since, there was no report about the association of elevated FVIII and VTE in Iranian population, the incidence of elevated FVIII and its association to VTE was evaluated. Materials and methods152 consecutive idiopathic VTE patients referred to the Iranian Blood Transfusion Organization (IBTO) and 130 healthy matched blood donors were studied. At least one confirmed idiopathic deep vein thrombosis (DVT) or pulmonary embolism (PE) was found among all cases. The blood samples were collected at least 3 months after DVT/PE diagnosis. The normal reference range was determined by using the Control samples of the donors. FVIII levels were measured using PTT based one-staged assay. ResultsThe FVIII levels in the cases and controls were 157.3±53.4 and 111.8±29.7, respectively. In cases, the lowest and the highest levels of FVIII were 66IU/dl and 364IU/dl, while they were 42IU/dl and 195IU/dl for the controls.There was no relation between gender, age and FVIII level in either group. The normal reference range for the controls was 52–171IU/dl. Considering the cut-off point as 180IU/dl, the elevated values were seen in 28.9% of the case group vs. 3.1% of the control group. ConclusionElevated factor VIII is likely to be a risk factor for VTE. Moreover, a new normal reference range for the Iranian population was defined.

Improving the neuronal differentiation efficiency of umbilical cord blood-derived mesenchymal stem cells cultivated under appropriate conditions.

Umbilical cord blood-derived mesenchymal stromal cells (UCB-MSCs) are ideally suited for use in various cell-based therapies. We investigated a novel induction protocol (NIP) to improve the neuronal differentiation of human UCB-MSCs under appropriate conditions. This experimental study was performed in Iranian Blood Transfusion Organization (IBTO), Tehran, Iran. UCB-MSCs were cultured in DMEM medium supplemented with 10% FBS in a humidified incubator in equilibration with 5% CO2 at 37°C. For neuronal differentiation of UCB-MSCs, DMEM was removed and replaced with pre-induction medium containing RA, bFGF, EGF, and basal medium for two days. Then, NGF, IBMX, AsA, and Neurobasal medium were used for six days for this purpose. Real-time PCR was performed to analyze the neuronal differentiation of UCB-MSCs for the first time in Iran. We found that the maximum and minimum levels of gene expression were related to GFAP and nestin, respectively. In addition, our study showed that compared to other neuronal inducers, RA might play the main role in neuronal differentiation and fate of MSCs compared to other neuronal inducers. Our data showed that the combination of chemical (RA, IBMX, AsA) and growth factors (NGF, EGF, bFGF) in NIP may improve the efficiency of neuronal differentiation of UCB-MSCs and may provide a new method for easy and quick application of UCB-MSCs in regenerative medicine in the future. However, the functionality of neuron-like cells must be carefully assessed in animal experiments prior to use in clinical applications.

Profile of side Effects in Patients Receiving Blood Transfusion from the Perspective of Management Unit

Background: In spite of being vital to save the patients' life, blood transition may be dangerous and even fatal, too the aim of this study was to investigate the side effects (complications) of blood transfusion in the educational hospitals of Qazvin. M aterials and Methods: This is a descriptive cross sectional and practical study that was carried out in 2010. In this study, all the patients of four health training centers in Qazvin, that have had blood transfusion and complications, were considered as a part of the statistical community. The instrument for data collection was checklist which was filled through an interview with blood bank manager and some other responsible individuals and scrutinizing files of patients who had blood injection among the blood products consumption, request for the packed cells was the most and for fresh frozen plasma was the least. R es ults: 75% of these people had only one blood injection and the maximum injection volume was 100cc which was done mostly in the evening. Most of the transfusion history belonged to 21-30 year olds in our statistical community. 56% of all Patients that had transfusion, possessed background of some disease such as heart problems (21.9%). More than half of them (2.56%) had a chill feeling complication transfusion and there was a significant relationship between the blood transfusion volume and itching complication. Conclusion : Existence of a continuous association between blood transfusion organization and hospitals is indispensable. Therefore, it seems that Hemovigilance system or computer connected network to send reports, between hospital centers and blood transfusion organization of Iran, can be an appropriate solution .

Prevalence of Hepatitis B, Hepatitis C and HIV and Related Risk Factors in Contact Sportsmen in Zanjan: A Letter to Editor.

Prevalence of Hepatitis B, Hepatitis C and HIV and Related Risk Factors in Contact Sportsmen in Zanjan: A Letter to Editor.