Effect Of Blood Transfusion Research Articles

Investigation of the Frequency of Reactions and Consequences of Blood Transfusion in an Academic Center Guilan-Iran

Background: Blood transfusion is a life-saving procedure, but there are always potential risks, such as blood transfusion reactions. Objectives: Considering the importance of the subject and the lack of a similar study in Guilan province, this research was conducted to analyze blood transfusion reactions. Methods: This retrospective descriptive study was conducted at Al-Zahra Hospital in Guilan, Iran, between 2020 and 2022. The files of all patients who received blood products at this center and experienced a reaction were reviewed. A checklist was completed, which included details such as the hospital ward, age, blood group, underlying disease, type of surgery, type of injected product, history of transfusion, history of reaction and allergy, type of reaction, and treatment intervention. Results: During the study period, 4,887 cases received transfusions. Among them, 18 cases (0.36%) showed reactions during transfusion, of which 14 cases (0.35% of total packed cell injections) were related to packed cell injection. Shivering was the most common reaction, occurring in 8 cases (15.38%). The main interventions included the administration of steroids in 10 cases (25%), antihistamines in 7 cases (17.5%), and oxygen therapy in 7 cases (17.5%). Three cases (7.5%) were transferred to the ICU, and in three cases (7.5%), the blood transfusion was stopped. One mortality was reported, and no cases of incompatible blood transfusion were documented. Conclusions: The incidence of reactions to blood product injections at this center appears to be acceptable. However, it was found that the information recording systems were very inefficient, and forms were incompletely filled, which should be addressed and corrected.

Evaluation of the Effect of Blood Transfusion on Retinopathy of Prematurity at a Tertiary Care Center in Western Saudi Arabia.

IntroductionWe aim to study if there is an association between blood transfusions and the development and severity of retinopathy of prematurity (ROP). We also aim to explore the association with other clinical outcomes.MethodsA cohort of 291 infants admitted to our neonatal intensive care unit (NICU) was retrospectively analyzed. The number and volume of RBC transfusions on Day 7 and Day 30 were recorded. Clinical outcomes including ROP, necrotizing enterocolitis (NEC), bronchopulmonary dysplasia (BPD), and sepsis were noted.ResultsThe mean gestational age (GA) and birth weight (BW) of the evaluated infants were 28 ± 2.2 weeks and 1062 ± 242 g, respectively. One hundred and eighteen infants were transfused at a median of nine days post GA. Compared to non-transfused infants, those who were transfused had a lower GA, a lower BW, a longer stay in the NICU, and received significantly more artificial ventilation. These infants also had a higher number of comorbidities, including sepsis and intraventricular hemorrhage. The number and volume of RBCs at Day 30 were significantly higher in infants with any stage of ROP than in those without ROP.ConclusionA higher frequency and volume of RBC transfusion were associated with an increased risk of ROP development. Whether this is a direct consequence of blood transfusion or the infants being at risk due to prematurity or low BW remains to be determined.

Inhibition of spleen tyrosine kinase decreases donor specific antibody levels in a rat model of sensitization

Antibody mediated rejection is a major cause of renal allograft loss. Circulating preformed donor specific antibodies (DSA) can result as a consequence of blood transfusion, pregnancy or prior transplantation. Current treatment strategies are limited due to partial or transient efficacy, adverse side-effects or patient unsuitability. Previous in vivo studies exploring autoimmune diseases have shown that spleen tyrosine kinase (SYK) signalling is involved in the development of pathogenic autoantibody. The role of SYK in allogenic antibody production is unknown, and we investigated this in a rodent model of sensitization, established by the transfusion of F344 whole blood into LEW rats. Two-week treatment of sensitized rats with selective SYK inhibitor fostamatinib strongly blocked circulating DSA production without affecting overall total immunoglobulin levels, and inhibition was sustained up to 5 weeks post-completion of the treatment regimen. Fostamatinib treatment did not affect mature B cell subset or plasma cell levels, which remained similar between non-treated controls, vehicle treated and fostamatinib treated animals. Our data indicate fostamatinib may provide an alternative therapeutic option for patients who are at risk of sensitization following blood transfusion while awaiting renal transplant.

Patient blood management

Background. Blood transfusions (BT) remain one of the most common medical procedures: about 110,000 doses of whole blood are collected annually and almost as many are transfused. Approximately every 10th patient who undergoes invasive procedures in the hospital needs BT. However, 40-60 % of BT in patients without bleeding are inappropriate.
 Objective. To describe modern views on the BT.
 Materials and methods. Analysis of the literature on this issue.
 Results and discussion. The triad of major risk factors for perioperative complications includes three interrelated factors: blood loss, anemia, and BT. The use of blood products is accompanied by an increase in the number of complications (not directly related to BT) and 30-day mortality. Fatal consequences of blood transfusion are also possible. They include acute lung damage associated with BT, hemolytic and bacterial complications, circulatory overload, anaphylaxis. Patient blood management (PBM) includes early detection and treatment of preoperative anemia, especially in patients at high risk of bleeding; minimization of blood loss and maximally blood-saving tactics; rational and guideline-adequate administration of allogenic blood products. About 39 % of patients scheduled for surgery have preoperative anemia. Absolute iron deficiency (ID) is present in 62 % of patients with preoperative anemia. Ferritin level <30 μg/L is an indicator of such anemia. Preoperative anemia is an independent risk factor for mortality and complications, so in presence of anemia, major emergency surgery should be postponed until hemoglobin returns to normal. The target level of the latter in the treatment of preoperative anemia should be 130 g/L for both sexes. If surgery is scheduled 6-8 weeks after the revealing of ID with or without anemia, oral replacement therapy should be performed. Parenteral forms of iron are used if there are <6 weeks left before the planned operation or the hemoglobin level is <100 g/L. If necessary, BT can be performed according to a liberal (BT is prescribed at a hemoglobin level <90-100 g/L) or restrictive (<70-80 g/L) strategy. According to a large-scale meta-analysis, the latter almost halves the risk of erythromass transfusion compared to the former. As recommended by the National Institute for Health and Care Excellence, it is advisable to apply a single-dose strategy with reassessment of BT requirements after each blood transfusion. Decisions in patients with chronic BT-dependent anemia and cancer should be made individually. The use of intravenous iron supplements before surgery can reduce the number of BT in the postoperative period. Sufer (“Yuria-Pharm”) is a trivalent iron for intravenous use, which effectively, quickly and safely increases hemoglobin levels. As it was mentioned, another element of the PBM is the minimization of blood loss. Tranexamic acid preparations (Sangera, “Yuria-Pharm”) can be prescribed for this purpose. Tranexamic acid is a lysine-like inhibitor of fibrinolysis; it is recommended for the prevention of bleeding with expected moderate and severe blood loss (>500 ml). In patients with trauma with massive blood loss or with a high risk of intracranial hemorrhage, it is also advisable to use tranexamic acid. Its activity is 26 times higher than the activity of aminocaproic acid. Tranexamic acid is highly effective; it reduces the need for BT without increasing the risk of thrombosis.
 Conclusions. 1. The triad of major risk factors for perioperative complications includes three interrelated factors: blood loss, anemia, and BT. 2. PBM includes early detection and treatment of preoperative anemia, minimization of blood loss and adequate administration of allogenic blood products. 3. In conditions of preoperative anemia, it is advisable to correct diabetes with oral or parenteral forms of iron. 4. Tranexamic acid drugs are prescribed to minimize blood loss.

Preoperative renal tumour embolisation revisited

Purpose: Renal artery embolisation prior to surgery for renal tumours has been used for a number of years, however, definitive evidence of its benefits remain elusive. As a result of continued development, the procedure now has minimal morbidity and a high technical success rate. Additionally, there is evidence that decreased immune surveillance as a consequence of blood transfusions is associated with cancer recurrence and progression. We studied the outcomes of the procedure in our institution.

Blood transfusion practices in cancer surgery

Cancer patients are commonly transfused with blood products immediately before, during or after major surgery. Blood loss and haemodilution are the most common causes of red blood cells (RBCs) administration and coagulopathies are the indications for the infusion of fresh-frozen plasma (FFP), cryoprecipitates and platelets. Transfusion-related immune modulation is a complication associated with the administration of blood products. A decreased immune surveillance as a consequence of blood transfusions has been linked to cancer recurrence and progression. Moreover, soluble factors present in packed RBCs, platelets and FFP can directly stimulate tumour growth and spread. Two meta-analyses suggest that the administration of blood products is associated with shorter recurrence-free survival and overall survival after colorectal cancer surgery. More studies are needed to show such association in different cancer patient populations.

Blood transfusions in the surgical patient: A gift of life, but at what cost?

DOI of original article: 10.1016/j.jss.2012.0 * Corresponding author. Department of Surge 2M, New York, NY 10003. Tel.: 212 844 8570; E-mail address: mleitman@chpnet.org (I. 0022-4804/$ e see front matter a 2013 Elsev doi:10.1016/j.jss.2012.02.031 From the discovery of circulation by Dr. William Harvey in 1628, to the first successful human-to-human blood transfusion by Dr. James Blundell in 1818, to the creation of the American Red Cross in 1941, our understanding of blood transfusion has evolved. The so-called hazards of transfusions have been documented since World War II and include infectious complications, hemolytic-related reactions, and, in more recent times, transfusion-related lung injuries and transfusion-induced immunomodulation [1,2]. This immunologic consequence of blood transfusions is not a novel concept. During the 1970s, the immunosuppressive effects of blood transfusion were first recognized when Opelz and Teraski [3] reported improvement in kidney transplant graft survival with an increased number of blood transfusions. This landmark study was the first to highlight the pro-inflammatory and immunosuppressive effects of transfused blood. Despite these

Mechanisms of transfusion-linked parasite infection

Besides bacteriae and viruses, parasite infections can be transmitted by blood as a consequence of blood transfusion. To be transmitted by blood transfusion, parasites must: -i) circulate in the blood stream of donors, -ii) comprise of certain physical characteristics and resist processing steps leading to the preparation of labile blood products (packed red blood cells, therapeutic frozen plasma, or platelet concentrates), -iii) survive conservation; further, to generate infection in the blood receiver, such parasites must retain infectivity. In this Forum, the main characteristics of parasites—with respect to transmissibility by blood exposure—are recalled. This forum will further discuss each of these topics and try to make an issue with possible risks in transfusion, in countries that are either non-endemic for the given parasite or which can afford implementation of preventive measures.

In Vitro Modulation of Cellular Immunity with Antioxidants in Patients with Thalassemia Major.

Immunological disturbances have been reported in thalassemia and the possibility has been raised that these may be consequences of blood transfusion and iron overload. These disturbances are augmentation of the number of supressor T cells (CD8), decreased number and activity of helper T cells (CD4) and impaired activity of NK (natural killer) cells. Iron overload causes toxic tissue changes through the release of free radicals and induces oxidative stress. According to Fenton and Haber-Weiss reactions, iron plays a catalytic role occuring hydroxyl radicals (OH*) which are very reactive free radicals. Antioxidants, like vitamin E, vitamin C and selenium, may modulate oxidative damage.In the present study; firstly, normal lymphocytes mitogen responses and NK activity were investigated by colorimetric MTT test in 26 thalassemia patients and 10 healthy volunteers as control. Secondly, lymphocytes were incubated with vitamin E ( 150, 50, 15 mg/ml), vitamin C (200, 100, 20mg/ml) and selenium (10−5, 10−6, 10−7 M). Finally, lymphocytes mitogen responses and NK activity are investigated. The results were statistically analyzed comparing with controls and healthy volunteers.It was found decreased NK activity of thalassemia patients in comparison with healthy volunteers. The concentration of 10−7 M of selenium enhanced NK activity at the E:T (effector/target) ratio of 50:1 The concentration of 200 mg/ml of vitamin C enhanced NK activity at the E:T ratio of 10:1, 25:1 and 50:1. However, vitamin E decreased NK activity of both thalassemia patients and healhty volunteers. The concentration of 50 mg/ml vitamin E decreased NK activity at the E:T ratio of 5:1 in thalassemia patients and the concentration of 15 mg/ml of vitamin E decreased NK activity at the E:T ratio of 5:1 in healhty volunteers.It was not found any differences between thalassemia patients and healthy volunteers in lymphocytes mitogen responses. The concentration of 200 mg/ml of vitamin C decreased lymphocytes mitogen response against PHA.In conclusion, we suggest that vitamin C and selenium supplementation are required in patients with thalassemia for augmentation of NK cell activity.

Benefits of leukocyte-reduced blood transfusions in surgical patients.

From a surgical point of view, one of the most important consequences of blood transfusion is the immunosuppressive effect and its possible link to postoperative infectious complications and cancer recurrence. The underlying mechanism of transfusion-induced immunosuppression seems to be mediated by transfusion with leukocytes. In prospective randomized trials, therefore, efforts have been made to control the immunosuppressive effect of allogeneic blood transfusion by the use of leukocyte-reduced blood. Only one prospective clinical trial has asserted the effect of leukocyte reduction on cancer recurrence, and no benefit to outcome was found. In four big randomized, prospective clinical trials, allogeneic blood transfusion was associated with significantly increased rates of postoperative infections, and the use of leukocyte reduction was found to have striking benefits in three of the trials, with a several-fold reduction in rates of morbidity and mortality.

HTLV-III antibodies in hemodialysis patients--a consequence of blood transfusions?

An investigation for HTLV-III antibodies in chronic hemodialysis patients revealed in four out of 276 patients a positive result using the ELISA and western blot techniques. All HTLV-III positive patients had received blood transfusions. As it has been shown that a needle stick could transmit the HTLV-III, it is suggested that hemodialysis patients who have received frequent blood transfusions should be screened.