Blood Transfusion Service Research Articles

Resolving Genotype-Phenotype Discrepancies of the Kidd Blood Group System Using Long-Read Nanopore Sequencing.

Due to substantial improvements in read accuracy, third-generation long-read sequencing holds great potential in blood group diagnostics, particularly in cases where traditional genotyping or sequencing techniques, primarily targeting exons, fail to explain serological phenotypes. In this study, we employed Oxford Nanopore sequencing to resolve all genotype-phenotype discrepancies in the Kidd blood group system (JK, encoded by SLC14A1) observed over seven years of routine high-throughput donor genotyping using a mass spectrometry-based platform at the Blood Transfusion Service, Zurich. Discrepant results from standard serological typing and donor genotyping were confirmed using commercial PCR-SSP kits. To resolve discrepancies, we amplified the entire coding region of SLC14A1 (~24 kb, exons 3 to 10) in two overlapping long-range PCRs in all samples. Amplicons were barcoded and sequenced on a MinION flow cell. Sanger sequencing and bridge-PCRs were used to confirm findings. Among 11,972 donors with both serological and genotype data available for the Kidd system, we identified 10 cases with unexplained conflicting results. Five were linked to known weak and null alleles caused by variants not included in the routine donor genotyping. In two cases, we identified novel null alleles on the JK*01 (Gly40Asp; c.119G>A) and JK*02 (Gly242Glu; c.725G>A) haplotypes, respectively. Remarkably, the remaining three cases were associated with a yet unknown deletion of ~5 kb spanning exons 9-10 of the JK*01 allele, which other molecular methods had failed to detect. Overall, nanopore sequencing demonstrated reliable and accurate performance for detecting both single-nucleotide and structural variants. It possesses the potential to become a robust tool in the molecular diagnostic portfolio, particularly for addressing challenging structural variants such as hybrid genes, deletions and duplications.

Analysing lapsing rates among first-time blood donors at a blood centre in Zimbabwe using survival analysis.

blood centres are often faced with the problem of donor lapsing resulting in loss of donors from the already strained donor pool. In Zimbabwe, 70% of the donated blood comes from younger donors aged 40 years and below, who at the same time, have high attrition rates. This study seeks to apply the concept of survival analysis in analysing blood donor lapsing rates. in analysing the donor lapsing and retention rates, data on 450 first-time blood donors at the National Blood Service Zimbabwe, in Harare´s blood bank for the period 2014 to 2017 was extracted from the donors´ database. The Cox proportional hazards (Cox PH) and Kaplan-Meier methods were applied in the analysis. Donor demographic characteristics suspected of having effect on donor lapsing and retention were identified and analysed. the study findings show that 56.9% of the donors had lapsed by the end of the four-year study period. Results from the multiple Cox PH model indicate that donor age had a significant effect on blood donor retention time (p = 0.000918 < 0.05). The hazard ratio (HR) = 0.615 with 95% CI: (0.461; 0.820) shows that the relatively older donors had a lower hazard (38.5% lower) of lapsing compared to the hazard for younger donors. The effect of gender, blood donor group and donation time interval on donor retention and attrition were not statistically significant. Male donors had HR = 1.03; 95% CI (0.537; 1.99) with (p = 0.922 > 0.05) and donors with a 4-month interval between donations had HR = 1.31; 95% CI (0.667; 2.59) with (p = 0.430 > 0.05). the study confirmed the problem of donor attrition faced by blood centres. The age of the donor had a significant effect on the retention time of blood donors before lapsing. The older the blood donor, the lower the risk of lapsing. The Zimbabwe National Blood Service (NBSZ) Blood Centre authorities should have a critical mass of individuals above 40 years as potential blood donors because of their reliability in blood donation according to the study findings.

Assessment of knowledge, attitude, and practice of blood donation among paramedical students of a medical college in Chennai, Tamil Nadu

Abstract: BACKGROUND: Blood donation is an essential global need far outweighs the available supply, rendering it a scarce and valuable resource. Within India, blood transfusion services hold significant importance and constitute a crucial aspect of the national health-care framework. Voluntary Non-Remunerated Blood Donation (VNRBD) is deemed the safest among the various ways of donating blood. The student population of educational institutions across the country, particularly those who are young and physically fit, represents one of the most promising sources of blood donations. The aim of the study was to evaluate the knowledge, attitudes, and donation practices of medical college students and motivate them to embrace voluntary blood donation as a regular habit. MATERIAL AND METHODS: The Department of Allied Health Science at Dr MGR Educational and Research Institute in Chennai, Tamil Nadu, India, conducted a questionnaire survey from March 2023 to October 2023. Two thousand and two hundred forty students were invited to participate, with 2331 ultimately willing to partake. The gathered data underwent analysis using the SPSS Statistics software, version 20, with a significance level fixed at a P = 5%. RESULTS: The study included 2331 participants, comprising 840 males (36%) and 1491 females (64%). The age range of the participants was between 17 and 25 years, with a mean age of 18.9 ± 1.3 years. Out of 2331 participants, the majority (66.7%) showed sufficient knowledge with 9 or more correct answers, while the rest (33.2%) showed below-average knowledge. CONCLUSION: The Tamil Nadu Health Professions Colleges possess the potential to make a noteworthy impact on the promotion of blood donation. According to a recent survey, students express a keen interest in donating blood if a camp is organized on the campus. By organizing awareness campaigns and conducting informative sessions, the colleges can inspire and motivate more students to donate blood, thereby playing a vital role in saving lives.

Analysis of Blood Donor Deferral Pattern during COVID-19 Pandemic at a Tertiary Care Hospital-based Blood Centre, Jammu and Kashmir, India: A Cross-sectional Study

Introduction: Blood donor deferral is vital for ensuring safe blood transfusion. However, with the unfolding Coronavirus Disease-2019 (COVID-19) pandemic, significant changes were made in donor screening and blood donation criteria, resulting in a shift in the pattern of donor deferrals. Aim: To estimate the blood donor deferral patterns during the COVID-19 pandemic. Materials and Methods: A retrospective cross-sectional study was conducted in the Department of Transfusion Medicine at SMHS Hospital/GMC Srinagar, Jammu and Kashmir, India. The study spanned two years, from March 2020 to February 2022. All blood donors were screened in accordance with the Ministry of Health and Family Welfare (MOHFW), National Acquired Immune Deficiency Syndrome (AIDS) control organisation (National blood transfusion services) 2017 guidelines. The data was analysed in Microsoft Excel, considering factors such as age, gender, type of deferral, and reasons for deferral. Results: Deferred blood donors were most common in the age group of 18-33 years. During the study period, a total of 19,895 blood donors (19493 males and 402 females) were registered for blood donation. Out of these, 3441 donors (17.30%) were deferred, with a male donor deferral rate of 3258/19493 (16.71%) and a female donor deferral rate of 183/402 (45.52%). Temporary blood donor deferrals accounted for 3272 (95.09%) cases, while permanent deferrals were 169 (4.91%). The most common cause of deferral was low haemoglobin, accounting for 991/3441 (28.80%) cases, followed by deferrals due to reasons attributable to the COVID-19 pandemic (786/3441, 22.84%) and hypertension (653/3441, 18.98%). Conclusion: The study observed a substantial increase in the total donor deferral rate, as well as a change in the donor deferral pattern during the COVID-19 pandemic.

Effects of Tariff on the Management of Blood Products in Fars Province Hospitals

Background In Iran, blood products were being delivered to healthcare centers without charge. For optimum usage and reducing wastage, the tariff was set on October 23, 2015. Thus, hospitals must pay for blood products to blood transfusion services and then the expenses are paid to healthcare centers by the insurance. Objectives This study aimed to explore the effects of the tariff policy on utilization pattern of blood products in healthcare centers of Fars province, Iran. Design This is a retrospective study which analyzes the recorded data. Methods Throughout this retrospective study, the number of units requested, delivered, returned, and return/delivery ratio of RBC, FFP, cryoprecipitate, and platelet were examined before and after the tariff in different cities of Fars province of Iran. Results After the tariff, return/delivery ratios of FFP, cryoprecipitate, and platelet increased in comparison with before tariff but were not statistically significant which means the return of unused units was increased after imposing tariff. Conclusion The results of this investigation showed that tariff may lead to more return of FFP, cryoprecipitate, and platelet units to the transfusion services of Fars province. More research must be performed to further approve it.

Blood Transfusion Service Challenges and Patterns at Kampala International University Teaching Hospital, Ishaka-Bushenyi, Western Uganda: Insights from a Comprehensive Prospective Study

Uganda, a developing East African nation with nearly 20% of its populace living below the poverty line, faces significant constraints in its national blood transfusion service. Despite serving over 3 million individuals in Regional Referral Hospitals, a chronic scarcity of blood persists, impacting critical healthcare provisions, notably at Mulago, Uganda’s National Referral Hospital. This study conducted a meticulous assessment of the indications and influential factors shaping blood transfusion services at Kampala International University Teaching Hospital, Ishaka-Bushenyi, adopting a prospective descriptive cross-sectional design encompassing a 100% review of the target patient population receiving blood transfusions. Employing a pretested questionnaire as the data collection instrument, the gathered information underwent meticulous coding, sorting, entry, and analysis utilizing statistical software. Results were systematically presented through tables and charts. The findings revealed that a considerable proportion (42.3%) of transfused individuals fell within the age range of 20-39 years, with infants and young children (&lt;5 years) comprising 22.4% of the recipients. Males accounted for 58.7% of the transfused population. Predominant indications for blood transfusions included anemia (30.4%), obstetric and gynecological conditions (23.4%), surgical operations (19.0%), infections (14.2%), and incidents involving road traffic accidents or assault (13.0%). The study identified the availability of a blood storage facility as a significant factor motivating the utilization of blood transfusion services, with an 87.4% availability rate reported. Notably, the demand for transfusions was notably high among females (56.1%) compared to males (43.9%), with anemia (53.3%) and blood group O (48.6%) constituting the majority of cases. Blood group distributions varied across different indications, with group O being predominant in most categories. Additionally, the Rh factor played a role, with Rh+ constituting 90.5% of cases and Rh- comprising 9.5%. Blood Group O had the highest occurrence of Rh+, while Blood Group A had the highest occurrence of Rh-. In summary, the study outlined several prominent factors influencing blood transfusion indications at KIUTH, notably anemia, obstetric and gynecological conditions such as postpartum hemorrhage and cesarean sections, surgical procedures (e.g., abdominal obstructions), infections (e.g., malaria), and incidents involving road traffic accidents or assault. These indicators are influenced by factors such as blood availability, age, gender, medical conditions, and blood type, with Blood Group O Rh+ being the most prevalent. Keywords: Blood transfusion, Gynaecology, Anaemia, Blood Group O.

Blood transfusion service in Poland in 2022

Blood transfusion service in Poland in 2022

Blood Donor’s Knowledge, Attitude and Practice Towards Blood Donation among Voluntary Blood Donors at Nepal Red Cross Society Central Blood Transfusion Service Centre

Introduction: Blood donation is the major source of blood as well as components of blood worldwide. Even though there are lots of promising components to substitute blood, a true component for blood and blood components is not available. Donated blood is an essential component in the management of many diseases. It is the core lifesaving component for an individual with loss of large volumes of blood from accidents, hemorrhages, or surgery.&#x0D; Aims: To evaluate the knowledge, attitude and practices of blood donors who visit blood bank.&#x0D; Methods: A cross-sectional study was done among 227 voluntary donors during six different Blood Donation Campaigns from March to October 2023.&#x0D; Results: A total of 227 blood donors participated in this research, with ages ranging from 19 to 60 years, and an average age of 34.7 years with a standard deviation of 8.77. Among all donors, the majority were male (71.4%), with females representing 28.6%. 1.3% of the donors were illiterate, while 26 % were literate. Additionally, 33% hold a secondary-level degree, 31.3 percent have a bachelor's degree, and 8.4 percent possess a master's degree or higher. The majority (46.7%) of the voluntary blood donors were from the service sector, 11% were students, 5.3% in business, 3.5%. were engaged in agriculture and 1.8% working in foreign employment. The remaining 31.7% were involved in various other occupations.&#x0D; Conclusion: Almost 1/10th, 5% had adequate knowledge and 72% showed positive attitude related to blood donation in our study the level of blood donation practice was in majority of donor about 89%.

Unnecessary blood and blood products transfusion: Single institute study of the expected harmful effect of unneeded transfusion

Background. Blood and blood products such as packed RBCs, whole blood or other types of blood transfusions are some of the most common daily medical procedures performed all over the world. However, the doctor decisions to transfuse blood are not easy in clinical practice. Method. It was used a descriptive prospective study including 136 children who received blood and blood products transfusions in Al-Diwanyah Maternity and Children Teaching Hospital, Iraq, from 15 January to 15 November 2023. Result. The gender distribution among patients was of 56 males (41.17%) and 80 females (58.82%), all of them exposed to unnecessary blood transfusion. There was no significant difference in gender between high and low level of the hemoglobin groups. Presence of underlying chronic disease was higher in the group with Hb level less than 8 compared to the group with Hb level above 8 (55.65% vs.44.11 %), and the difference was significant (p = 0.042). Provisional diagnosis before transfusion was more effective in lower hemoglobin level subjects than in those with higher hemoglobin level (p = 0.019). About 70 % of these unneeded transfusions were performed due to lack of doctor awareness regarding the indications and the time when the blood and blood products transfusions were necessary. Conclusion and recommendations. All the new strategies of the hospital should be focused on avoiding the harmful effect of any procedure like blood transfusions, weighting their balance of benefits and harms. It is no need to perform a blood transfusion as an initial treatment if the affection can be treated by other means, excepting the life saving emergency situations after trauma or life threating hemorrhage. In some patients who are asymptomatic and/or where specific therapy is available, lower threshold levels may be acceptable. Continuous medical educational and increased doctor’s knowledge might help decrease unnecessary transfusions. Prior to surgery, multidisciplinary teams and discussions about transfusion should be engaged between pediatrician and surgeon. Safe blood and blood products as well as the cost of blood transfusion services should be considered before any decision.

Performance of Enzyme Linked Immunosorbent Assay and Rapid Screening Techniques for detection Of Transfusion Transmitted Infections among blood donors

Introduction: Blood transfusion is associated with many risks, especially exposure to a transfusion-transmitted infections (TTIs). Lack of effective diagnostic techniques that can identifying the infection at window period contributes to the major health problem in most developing countries. The aim of this study was to compare diagnostic performance of enzyme linked immunosorbent assay (ELISA) and rapid screening techniques for detection of transfusion-transmitted infections (TTIs) among blood donors Methodology: This study was conducted in the Department of Haematology and Blood Transfusion Services Federal Teaching Hospital, Ido-Ekiti, Nigeria from February 2021 to July 2023. A total of 3150 eligible blood donors that were screened fit for blood donation using rapid kits were subjected to ELISA screening technique. Questionnaire was used to inquire about risk factors for transfusion transmissible infection among blood donors and to sort the consent of all the blood donors before collecting their blood sample for study Result: A total of 3150 blood donors that were screened negative for TTIs (HbsAg, HCV, HIV and syphilis) by rapid test kits were recruited for the study. Out of 3150 blood donors that were re-screened for TTIs by ELISA techniques, 34 (1.08%), 50 (1.59%), 07 (0.22%) and 13 (0.41%) were sero-positive for HbsAg, HCV, HIV and syphilis respectively. In general, the percentage seroprevalence of TTIs in our study was 104/3150 (3.3%), HCV had the highest prevalence of TTIs and Blood group O Rh D positive has the highest frequency among the study population Conclusion: This study concluded that rapid test did not show any promising results when compared to ELISA. This study suggested that rapid test kits should not be recommended in transfusion center solely for screening blood donors for TTIs. There is need for combination of rapid test kits along with ELISA technique in the diagnosis of TTIs for blood donors. We advocate for legislation to make screening with ELISA mandatory for TTIs in all blood transfusion center and other health facilities in the country

Unravelling the complexities of compatibility testing in multiple alloantibodies: A case report exploring challenges and solutions

Multiple transfusions pose a risk of alloimmunization resulting in delayed hemolysis in recipients. This makes it difficult for blood transfusion services to find cross match compatible red cell units especially when antibodies against Kidd antigens are present in recipients which are clinically significant and known to cause evanescence. We present a case of a 43 years.

Prevalence and Distribution of ABO and Rh (D) Factor among Blood Donors in the United Arab of Emirates

Abstract Introduction/Objective Karl Landsteiner discovered the ABO blood group system in 1900, which was the first human blood group system. The Rh blood group system was found forty years later. The antigens on the surface of red blood cells are used to classify people into ABO blood groups. In the ABO system, there are four types: A, B, AB, and O; in the rhesus system, there are two types: Rh-positive and Rh-negative. Blood group identification is critical for efficiently managing blood banks and blood transfusion services to avoid serious transfusion reactions. Methods/Case Report The study was performed on a total of 5996 healthy blood donors in the United Arab of Emirates (UAE). ABO and Rh (D) groupings were performed on all donors' samples by the gel electrophoresis technique. Data on the frequency of ABO and Rh(D) blood groups were reported in numbers and percentages. Results (if a Case Study enter NA) The study revealed that type O is the most prevalent blood group in the United Arab Emirates (43.83%), followed by A at 26.68% and B at 23.90%, with AB having the lowest prevalence at 5.58%; O &amp;gt; A &amp;gt; B &amp;gt; AB. Our study found that 92.57% of the donor population was Rh-positive, whereas 7.43% was Rh- negative. The IA, IB, and IO allele frequencies were determined using the Hardy-Weinberg rule of equilibrium. The gene frequencies are calculated to be 0.1942 for IA (p), 0.1438 for IB (q), and 0.6620 for IO (r). O (r) has the most value in UAE, followed by A (p) and B (q); O &amp;gt; A &amp;gt; B. OO constituted 43.83% of the homozygous types, AA 3.77%, and BB 2.06%. The heterozygous types were 25.71% for AO, 19.03% for BO, and 5.58% for AB. Conclusion The study gives reliable ABO gene frequency statistics and information on the distribution of ABO blood group Rh groups of various alleles in the United Arab Emirates. This knowledge aids in the efficient management of the blood bank's inventory. It will aid transfusion services in anticipating future health issues and improving blood transfusion practice. The study is the first to give reliable ABO gene frequency statistics and information on the distribution of ABO blood group Rh groups of various alleles in the United Arab Emirates. This knowledge aids in the efficient management of the blood bank's inventory. It will aid transfusion services in anticipating future health issues and improving blood transfusion practice.

The UK Impact Transplant Trials Network: An Effective National Strategy to Accelerate the Delivery of Randomized Trials in Stem Cell Transplantation

Introduction: Stem cell transplantation (SCT) is an important curative modality in patients with blood cancer whose outcome with chemotherapy is predicted to be poor and is an increasingly important therapy in non-malignant disease. However, even in 2023, 50% of patients are still destined to die after either allogeneic or autologous transplantation, either of relapsed disease or treatment toxicity. In response the transplant community continue to develop innovative strategies designed to improve patient outcome. However, despite the fact that the adoption of new therapies in haemato-oncology is, almost without exception, based on evidence generated by randomized studies fewer than 5% of transplant patients are currently recruited to prospective practice informing trials. Thus, much current transplant practice is based on retrospective registry analyses whose results can often be misleading. There is therefore an urgent need for innovative trial models with the ability to accelerate transplant trial delivery if patient outcomes after SCT are to be improved. Methodology: We reasoned that limited trials capacity at busy centres coupled with the absence of a fit-for-purpose clinical trials network represented potentially tractable barriers to transplant trial recruitment. In 2018 a $5 million grant was secured from UK blood cancer charities in order to directly fund the salaries of research nurses within the IMPACT network covering 11 major UK transplant centres and a linked clinical trials hub. Critically, up-front investment into research nurses at major transplant centres created a catchment region in excess of 20 million. The pre-stated aim of the IMPACT pilot was to recruit 400 patients to 7 new transplant trials over a 4 year period. Results Opened in 2018 the IMPACT network has now randomized 1344 patients to 7 prospective transplant trials over a 5 year period. Trials delivered include COSI, a randomized trial examining the benefit of the addition of Thiotepa to a Fludarabine/Busulphan based conditioning regimen in patients allografted for acute myeloid leukemia (AML) (n=333) and AMADEUS a randomized comparison of the benefit of post-transplant CC486 maintenance (n-326). In conjunction with recruitment to the Pro-DLI trial- a randomized study of prophylactic DLI in patients allografted for high risk AML (n=150)- the IMPACT initiative has resulted in more than 900 patients being recruited to practice informing AML transplant trials over a 5 year period. Importantly, AMADEUS has been designed and delivered in order to generate registration enabling data. Additional trials delivered by the IMPACT network include ALL-RIC the first randomized comparison of reduced intensity conditioning regimens in acute lymphoblastic leukemia (n=102, now in follow-up) and the ongoing MoTD trial a randomized comparison of post-transplant cyclophosphamide GVHD prophylaxis (n=139 to date). Sample return for bolt-on scientific studies has been in excess of 85% allowing prospective analysis of the prognostic significance of pre and post-transplant MRD, molecular determinants of transplant outcome and the biology of disease relapse in patients allografted for AML and ALL. Of note the IMPACT research nurse network demonstrated impressive resilience during the COVID-19 pandemic permitting continued trial delivery despite faltering recruitment to other cancer trials. Conclusions: The funding of a national transplant trials network has transformed recruitment to prospective randomized transplant trials in the UK. The success of the IMPACT pilot, which-out-performed its recruitment metrics by 300%, confirms the importance of innovative trial delivery models in accelerating recruitment to practice informing transplant studies and is a scalable model internationally. At the same time, IMPACT has proved a highly effective mechanism to generate linked translational data with the ability to inform future trial design. Building on similar models in Europe, such as LYSARC, the IMPACT network is now funded by a not-for-profit trials delivery vehicle Accelerating Clinical Trials Ltd (www.act4patients.com) creating a financially sustainable model within the UK for the delivery of a mixed portfolio of industry sponsored and investigator initiated transplant and cell therapy trials.

An external validation of the Kidney Donor Risk Index in the UK transplant population in the presence of semi-competing events

BackgroundTransplantation represents the optimal treatment for many patients with end-stage kidney disease. When a donor kidney is available to a waitlisted patient, clinicians responsible for the care of the potential recipient must make the decision to accept or decline the offer based upon complex and variable information about the donor, the recipient and the transplant process. A clinical prediction model may be able to support clinicians in their decision-making. The Kidney Donor Risk Index (KDRI) was developed in the United States to predict graft failure following kidney transplantation. The survival process following transplantation consists of semi-competing events where death precludes graft failure, but not vice-versa.MethodsWe externally validated the KDRI in the UK kidney transplant population and assessed whether validation under a semi-competing risks framework impacted predictive performance. Additionally, we explored whether the KDRI requires updating. We included 20,035 adult recipients of first, deceased donor, single, kidney-only transplants between January 1, 2004, and December 31, 2018, collected by the UK Transplant Registry and held by NHS Blood and Transplant. The outcomes of interest were 1- and 5-year graft failure following transplantation. In light of the semi-competing events, recipient death was handled in two ways: censoring patients at the time of death and modelling death as a competing event. Cox proportional hazard models were used to validate the KDRI when censoring graft failure by death, and cause-specific Cox models were used to account for death as a competing event.ResultsThe KDRI underestimated event probabilities for those at higher risk of graft failure. For 5-year graft failure, discrimination was poorer in the semi-competing risks model (0.625, 95% CI 0.611 to 0.640;0.611, 95% CI 0.597 to 0.625), but predictions were more accurate (Brier score 0.117, 95% CI 0.112 to 0.121; 0.114, 95% CI 0.109 to 0.118). Calibration plots were similar regardless of whether the death was modelled as a competing event or not. Updating the KDRI worsened calibration, but marginally improved discrimination.ConclusionsPredictive performance for 1-year graft failure was similar between death-censored and competing event graft failure, but differences appeared when predicting 5-year graft failure. The updated index did not have superior performance and we conclude that updating the KDRI in the present form is not required.

Changing Strategies for the Detection of Bacteria in Platelet Components in Ireland: From Primary and Secondary Culture (2010-2020) to Large Volume Delayed Sampling (2020-2023).

Bacterial contamination of platelet components (PC) poses the greatest microbial risk to recipients, as bacteria can multiply over the course of PC storage at room temperature. Between 2010 and 2020, the Irish Blood Transfusion Service (IBTS) screened over 170,000 buffy coat-derived pooled (BCDP) and single-donor apheresis platelets (SDAPs) with the BACT/ALERT 3D microbial detection system (Biomerieux, L'Etoile, France), using a two-step screening protocol which incorporated primary and secondary cultures. Although the protocol was successful in averting septic transfusion reactions (STRs), testing large sample volumes at later time points was reported to improve detection of bacterial contamination. A modified large-volume delayed sampling (LVDS)-type protocol was adopted in 2020, which in the case of SDAP was applied to collections rather than individual splits (2020-2023, 44,642 PC screened). Rates of bacterial contamination for BCDP were 0.125% on Day-2, 0.043% on Day-4 vs. 0.191% in the post-LVDS period. SDAP contamination rates in the pre-LVDS period were 0.065% on Day-1, 0.017% on Day-4 vs. 0.072% in the post-LVDS period. Confirmed STRs were absent, and the interdiction rate for possibly contaminated SDAP was over 70%. In the post-LVDS period, BCDPs had a higher total positivity rate than SDAPs, 0.191% (1:525) versus 0.072% (1:1385), respectively, (chi-squared 12.124, 1 df, p = 0.0005). The majority of organisms detected were skin-flora-type, low pathogenicity organisms, including coagulase-negative staphylococci and Cutibacterium acnes, with little change in the frequency of clinically significant organisms identified over time. Both protocols prevented the issue of potentially harmful components contaminated (rarely) with a range of pathogenic bacteria, including Escherichia coli, Serratia marcesens, Staphylococcus aureus, and streptococci. Culture positivity of outdates post-LVDS whereby 100% of expired platelets are retested provides a residual risk estimate of 0.06% (95% CI 0.016-0.150). However, bacterial contamination rates in expired platelets did not demonstrate a statistically significant difference between the pre-LVDS 0.100% (CI 0.033-0.234) and post-LVDS 0.059% (0.016-0.150) periods (chi-squared = 0.651, 1 df, p = 0.42).

Association Between Concerns About COVID-19 Infection and Blood Donation Intention: Cross-Sectional Survey Study Through a Mobile Communication Platform.

The ongoing COVID-19 pandemic has had an unprecedented impact on blood transfusion and collection. At the beginning of the pandemic, most blood transfusion services had a tough challenge in maintaining an optimal blood inventory. This study aims to understand the public's psychological cognition and intention toward blood donation as well as the factors influencing their worries. We aimed to find a solution for increasing blood donations and provide a scientific reference for policy formulation regarding blood donation during the COVID-19 pandemic and in the future. A random survey with a 14-item scale on worries related to blood donation was conducted from December 31, 2022, to January 3, 2023, among residents aged 18-60 years in Zhejiang province via SMS text messaging. The results of 8 worry items in this study were compared with the survey results of March 2022, during which COVID-19 was not considered as an epidemic in Zhejiang province. Chi-square test and logistic regression analysis were performed to analyze the factors affecting respondents' blood donation intention and concerns. The degree of worry about blood donation was assigned from 1 (completely disagree) to 5 (completely agree), and 2-sided t tests were performed to analyze the differences in blood donation intention and worries about blood donation. In total, 1254 valid questionnaire responses were obtained. Males accounted for 62.36% (782/1254) of the sample, 78.39% (983/1254) were 18-45 years old, 60.61% (760/1254) had a university education, and 69.06% (866/1254) had no previous blood donation experience. Approximately 36.52% (458/1254) of the public clearly expressed that they had blood donation worries regarding COVID-19. The main concerns of the respondents were temporary physical weakness caused by blood donation, their own physical conditions not meeting the requirements of blood donation, inconvenient location and working hours for blood donation, and family (or friends) worrying about blood donation. Compared with the results in 2022, the results in 2023 regarding the harmful effects of blood donation on health, temporary physical weakness, infection in donated blood, and family (friends) worrying increased significantly (P<.001). The factors influencing blood donation worries regarding COVID-19 were COVID-19 infection status, adverse reactions to the donated blood, family (or friends) worrying, and unsatisfactory blood donation experience. The factors influencing blood donation intention were gender, age, previous blood donation times, blood donation worries regarding COVID-19, harmful effects of blood donation on health, and blood donation anxiety. Blood transfusion services should make full use of the recovery phase of COVID-19 infection as an important time point, publicize the blood donation process and operation standardization, reduce the public's concerns about blood donation, correct negative evaluations, and increase perceived behavioral control and subjective norms.

O-negative blood shortage management in a university hospital: Impact of transfusing RhD-positive red blood cells to RhD-negative patients.

Shortages of O-negative red blood cells are becoming increasingly common, forcing hospitals' blood transfusion services to find solutions to conserve this blood group for patients who need it most. The present study aimed to retrospectively evaluate the practice of transfusing selected RhD-negative patients with RhD-positive red blood cells and to assess the impact of this measure on patients and blood transfusion service management. Transfusion data of 1199 RhD-negative patients hospitalised at Cliniques Universitaires Saint-Luc between 2019 and 2022 were analysed. For patients who received RhD-positive red blood cells, age, gender, reason for hospital admission, indication for transfusion, and immunohematology analyses were recorded. These data enabled an assessment of transfusion practices over the years, characterisation of patients who received RhD-mismatched transfusions, determination of the alloimmunisation rate, and calculation of the total number of RhD-negative red blood cells saved. During the study period, 141 RhD-negative patients received 604 RhD-positive red blood cells. A change in transfusion practices was observed over the years, with a greater proportion of RhD-negative patients being transfused with RhD-positive red blood cells in 2022 (28%) compared to 2019 (2%). The overall alloimmunisation rate was at least 20%, and 416 red blood cells were saved without any consequences. Patients undergoing cardiovascular surgery received the highest number of RhD-positive red blood cells. The transfusion of selected RhD-negative patients with RhD-positive red blood cells is a low-risk practice that helps conserve RhD-negative red blood cells. However, there is a minimum 20% risk of alloimmunisation, which could have clinical and transfusion-related consequences in the future.

Education in blood transfusion: Adequacy of the content in the Kenyan undergraduate curricula and medical doctor's perspectives and perceptions.

Although blood transfusion (BT) service is important in modern health care, blood is scarce, costly, and without risks. Medical education should therefore play a role in equipping medical doctors with the necessary BT knowledge, skills, and attitudes for optimal utilization of blood. This study aimed at determining the adequacy of curriculum content of Kenyan medical schools and the clinicians' perceptions of undergraduate education in BT. A cross-sectional study was conducted among non-specialist medical doctors and the curricula of Kenyan medical schools. Data was collected using questionnaires and data abstraction forms and analyzed using descriptive and inferential statistics. Curricula from six medical schools and 150 clinicians were studied. All six curricula covered topics that are essential in BT and had the content integrated into the haematology course taught during the third year. The majority (62%) of the doctors perceived their knowledge of BT as being either fair or poor, and 96% reported that knowledge of BT was important to their clinical practice. The rating of perceived knowledge in BT was significant between the different cadres of clinicians (H (2)=7.891, p=0.019), and all participants (100%) acknowledged the usefulness of additional training in BT. The Kenyan medical schools' curricula covered topics that are essential for safe BT practice. However, the clinicians felt that their knowledge of BT was not good enough and that they needed more training in the subject.

A91Integrating Simulation Based Education to Trauma &amp;amp; Orthopaedic Training: A Regional Experience

In recent years we have seen an exponential increase in the use of simulation-based education (SBE) within surgical training. Early evidence supported initial integration of simulation to Trauma &amp; Orthopaedic (T&amp;O) training [1] with more contemporary evidence focused on refining training methods and technology usage [2,3]. We aim to assess the integration of established as well as novel SBE components within our T&amp;O training programme in Northern Ireland. Simulation sessions were introduced to the Northern Ireland (NI) T&amp;O Core Curriculum in academic year 2022/23: Trauma Simulation Scenario Training: Pelvic trauma scenarios were delivered to all T&amp;O specialist trainees as part of Core Curriculum teaching in a regional simulation centre. Multi-professional input was sought and delivered by Blood Transfusion Service (Major Haemorrhage Protocol training) and Urological micro-teaching session (traumatic urological injuries in setting of pelvic trauma). Arthroscopy Simulation Course: A knee arthroscopy course was developed in conjunction with industry for all T&amp;O trainees in NI utilizing passive haptic feedback arthroscopy simulators. Pre + post simulation surveys were completed assessing educational value, engagement with SBE as method of teaching, desire for further SBE content and suggestions for topics of same. Focus groups of lead educators were set up to plan development of further SBE training within T&amp;O curriculum. Trainees reported increased confidence in management of pelvic trauma. Overwhelmingly positive response to integration of SBE sessions to core curriculum with 89% in favour of further multi-specialty simulation training sessions. There was a preference seen within feedback for a variety of SBE iterations with in-situ and operative/ procedural simulation being slightly preferred to scenario-based training. With majority of trainees requesting procedural SBE training as topic for future sessions, Knee Arthroscopy Simulation Course was subsequently developed (to be delivered as part of Core Curriculum in May 2023). From lead educator focus groups further simulation-based training sessions are planned for development in 2023/24 including shoulder arthroscopy simulation course, rare approaches simulation and advanced supracondylar simulation sessions. Feedback will be sought throughout to ensure training is tailored to needs of trainees as well as curriculum requirements. Recognition of benefits and scope of SBE training within T&amp;O has prompted development of formal simulation trainee role as result of initial regional experience. Our experience of integrating SBE training methods to T&amp;O core curriculum has been hugely positive with demand amongst trainees high for a wide range of further sessions and courses. Authors confirm that all relevant ethical standards for research conduct and dissemination have been met. The submitting author confirms that relevant ethical approval was granted, if applicable.

Distribution of ABO and Rh (D) Blood Groups and their Genotypes in Amran Governorate, Yemen

Background: The ABO and Rh blood group system is essential for blood bank inventory, blood transfusion services, and organ transplants. Relatively very little data is available about ABO and Rh (D) blood groups distributions in the Amran governorate. Therefore, this study aimed to determine the distribution of ABO and Rh (D) blood group and their genotypes in the Amran governorate, Yemen. Methods: A cross-sectional prospective and retrospective study was carried out from January 2020 to December 2021, on 1949 volunteer blood donors; 414 medical students were obtained from Amran University and 1535 from clinical records in the blood bank of Maternity and childhood hospital at Amran Governorate. The ABO and RhD grouping was done by using commercially available monoclonal antibodies (anti-A, anti-B, and anti-D) by slide methods. The allele and genotype frequency of the donors was determined by the Hardy-Weinberg equilibrium assumption. Descriptive statistics were analyzed using the SPSS program. The difference between the observed and expected frequency was tested by an online Chi-square calculator. A P-value of &lt;0.05 was considered statistically significant. Results: Out of 1949 participants; were 78.8% of hospital donors, 92.2% of males, and 63.5% of rural areas. Blood group O was the most prevalent (51.2%), followed by A (31.5%), B (13.9%), and AB (3.5%) with statistically significant differences (P= 0.002). The Rh (D) positive was present in 86.8% of participants and 13.2% were Rh (D) negative. Moreover, the allele frequencies were in the order of (IO &gt; IA &gt; IB &gt; AB), where (IO i = 0.513, IA = 0.313, IB = 0.138, and AB= 0.035). While the Rh(D) and d allelic frequencies were 0.868 and 0.132, respectively. Also, there was no statistically significant difference between observed and expected allele and genotype frequency (P-value &gt;0.05). Conclusion: The frequency of distribution of ABO and Rh (D) blood group and their genotypes among the study population was found to be similar to those reported from most Asian populations. This crucial information may be helpful in planning for future health challenges, particularly planning with regard to blood transfusion services.