Donor Blood Components Research Articles

Proteomic Characterization of Transfusable Blood Components: Fresh Frozen Plasma, Cryoprecipitate, and Derived Extracellular Vesicles via Data-Independent Mass Spectrometry.

Extracellular vesicles (EVs) are a heterogeneous collection of particles that play a crucial role in cell-to-cell communication, primarily due to their ability to transport molecules, such as proteins. Thus, profiling EV-associated proteins offers insight into their biological effects. EVs can be isolated from various biological fluids, including donor blood components such as cryoprecipitate and fresh frozen plasma (FFP). In this study, we conducted a proteomic analysis of five single donor units of cryoprecipitate, FFP, and EVs derived from these blood components using a quantitative mass spectrometry approach. EVs were successfully isolated from both cryoprecipitate and FFP based on community guidelines. We identified and quantified approximately 360 proteins across all sample groups. Principal component analysis and heatmaps revealed that both cryoprecipitate and FFP are similar. Similarly, EVs derived from cryoprecipitate and FFP are comparable. However, they differ between the originating fluids and their derived EVs. Using the R-package MS-DAP, differentially expressed proteins (DEPs) were identified. The DEPs for all comparisons, when submitted for gene enrichment analysis, are involved in the complement and coagulation pathways. The protein profile generated from this study will have important clinical implications in increasing our knowledge of the proteins that are associated with EVs derived from blood components.

Implementing pathogen reduction technology while discontinuing blood donor deferral criteria for sexual risk behaviors: A simulation study.

Combining pathogen reduction technology (PRT) with blood screening may alleviate concerns over the risk of transfusion-transmitted infections (TTI) and support changes in blood donor selection to potentially increase blood availability. This study aimed to estimate the residual risk of human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV) transfusion-transmission in Canada after implementing PRT, while eliminating deferrals for sexual risk behaviors. A probabilistic approach that combined Bayesian networks with Monte Carlo simulations was used to estimate the risk of transfusing HIV-, HBV-, or HCV-contaminated blood components. Different scenarios were considered to compare the current residual risk after PRT implementation, with and without donor deferral criteria for sexual risk behaviors. Donor profiles and blood component outcomes were simulated based on a literature review including the prevalence and incidence of HIV, HBV, and HCV in the Canadian blood donor population; the use of current blood screening assays; and HIV, HBV, and HCV blood donor viral loads. In the universal PRT scenario (i.e., with PRT/without deferral criteria), the estimated risks of HIV, HBV, and HCV transmission were significantly lower than those in the currently observed scenario (i.e., without PRT/with deferral criteria). This risk model suggests that PRT for platelets and plasma (and eventually for RBCs when available) significantly reduces the residual risks of HIV, HBV and HCV transfusion-transmission and could enable the removal of blood donor deferral criteria for sexual risk behaviors.

Surgical Safety Checklist as an optimal organizational model in ensuring the maximum degree of preparedness for intraoperative incidents (case report)

Objective. The use of checklists for quality and safety control of medical care is an effective tool for reducing the frequency of errors, dangers and complications in any section of medical practice.The aim is to demonstrate the possibilities of minimizing and leveling the potential risks accompanying surgical intervention using the example of routine application of the surgical safety checklist.Object and methods. Patient A., 55 years old, was admitted to the emergency department of Samara City Clinical Hospital №1 named after N.I. Pirogov on 24.04.2023. with complaints of pain in the right upper abdomen, nausea, vomiting, general weakness. The diagnosis was Cholelithiasis, acute calculous cholecystitis with the formation of a perivesical abscess. It required laparoscopic cholecystectomy operation. While filling in the surgical safety checklist (SSC) and analyzing possible intraoperative incidents, the attending physician executed an informed voluntary consent for transfusion of donor blood components. The corresponding components were ordered. Having weighted up the potential intraoperative risks specified in the part "Before anesthesia" of SSC, the anesthesiologist installed a catheter into one of the central veins and performed the urine bladder catheterization. Surgical intervention was complicated by bleeding, which required conversion of surgical approach. Upper median laparotomy, cholecystectomy, surgical hemostasis were performed. Total blood loss was 1000 ml, plasma and red blood cell were donated to the patient. The operation was completed by drainage of the subhepatic space and suturing of surgical wounds.Results. The clinical case describes the importance of a team approach at the stage before the operation, as well as the role of all specialists provided life support and medical care for the patient. It results from attentive work with the checklist which shows a clear liability for each member of the operating team at different stages of preparation and treatment of a surgical patient.Conclusions. The development of a culture of surgical safety is an important way to minimize the risks associated with surgical intervention for each individual patient and for the institution by optimizing the work of operating units.

Frequency and causes of blood chimera in combat trauma victims

The frequency and causes of blood chimeras in victims of combat trauma who arrived from special military operations were analyzed. Data from immunohematological studies of patients admitted to the clinics of the Military Medical Academy named after S. M. Kirov in the period from February to December 2022 were analyzed. All patients were assessed for blood group membership by AV0 systems and Rh factor with phenotyping of erythrocytes and the presence of antierythrocyte antibodies. Chimerism was found in 21% of the patients. According to the AB0 system, general chimerism was detected in 3. 1% of cases, whereas blood chimerisms for antigens A and B were found in 81. 8% and 36. 4% of the cases, respectively. Moreover, blood chimerism for antigens C, c, E, and e was detected in 100% of the cases, and for antigen D, the rate of chimerism was 7. 6%. The identified chimerism in the patients was caused by the use of “universal” doses of erythrocyte blood components by advanced medical service units. In general, the frequency of blood chimerism in victims of combat trauma in the clinics of the Military Medical Academy named after S. M. Kirov was 21%. Blood chimerism in combat trauma victims did not lead to significant immunization. Despite the absence of detected immunization, blood chimerism was a favorable background for possible hemolytic posttransfusion complications during treatment. Possible options for the prevention of blood chimerism include the introduction into practice of advanced use of artificial oxygen carriers, active use of hardware support for reinfusion of blood spilled into the cavity, and preparation of autokrovi for certain patients. These measures are aimed at reducing the number of transfusions of donor blood components, thereby preventing the formation of antierythrocyte antibodies and blood chimeras.

Концепция «Менеджмент крови пациенток» в практике акушера-гинеколога: на что обратить внимание?

Aim. To present literature and own data on the implementation of the concept of patient blood management (PBM) in obstetrics and gynecology. Key points. PBM involves “the timely, interdisciplinary application of evidence-based, multimodal medical and surgical concepts aimed at screening, diagnosing and appropriately treating anemia, minimizing surgical, procedural, iatrogenic blood loss, and managing coagulopathy bleeding to improve health outcomes through patient-centered care”. As part of the PBM, it is important for the obstetrician-gynecologist to first screen for iron deficiency (ID) and identify iron deficiency anemia (IDA), prescribe treatment with modern iron preparations. A new generation of ferrous iron preparation with prolonged release is proposed, which minimizes the side effects of therapy. The second aspect is to screen and treat identified coagulation disorders using treatment algorithms based on thromboelastometry data, the third is in the postpartum/postoperative period, screen for and treat iron deficiency and anemia, control coagulation, monitor blood loss and rational use of allogeneic blood components. The results of the introduction of PBM into clinical practice of the National Medical Research Center for Obsterics, Gynecology and Perinatology named after Academician V.I. Kulakov, which allows for timely diagnosis of ID and IDA at the “Anemia-STOP!” Center, rational transfusion of allogeneic blood components, which contributed to a reduction in the volume of procured and transfused donor blood components. Conclusion. The implementation of the PBM concept helps to improve the effectiveness and safety of treatment, while promoting the best use of economic resources. Keywords: patient blood management, obstetrics, gynecology, iron deficiency anemia, new generation ferrous sulfate, coagulation control, efficiency, safety.

Safety of plasma-derived blood products transfusions harvested from anti-SARS-CoV-2 positive and negative donors

Introduction. Testing for antibodies to the causative agent COVID-19 is not mandatory for donor blood or its components. It is unknown whether transfusion of plasma-containing blood components from seropositive donors is a safe procedure especially for immunocompromised hematological patients. Aim. To assess the frequency of adverse reactions and complications in hematological patients after transfusions of plasma-derived blood products harvested from anti-SARS-CoV-2 positive and negative donors. Material and Methods. 9152 transfusions of components harvested from anti-SARS-CoV-2 positive and negative donors were carried out from April 29, 2020 to January 21, 2022 at the NMRC for Hematology. Post-transfusion reactions and complications were analyzed in 576 hematological patients. 2059 plasma units, 327 cryosupernatant plasma units and 6766 cryoprecipitate doses were assessed. The occurrence of adverse reactions (hyperthermia) and complications within two hours after transfusion were evaluated. Results. Among 9152 blood units, anti-SARS-CoV-2 were detected in 2660 (29 %) cases and 6492 (71 %) were antibodies free. The analysis of adverse reactions and complications showed no significant differences in the incidence of adverse reactions in recipients after anti-SARS-CoV-2 positive and negative blood unit transfusions. Conclusion. There were no significant differences in the number of post-transfusion reactions when using donor blood components (fresh frozen plasma, cryosupernatant plasma, cryoprecipitate) obtained from donors in whose blood antibodies to SARS-CoV-2 were detected or not detected. Plasma-derived blood products from seropositive donors with a high degree of probability can be used to correct the plasma hemostasis path in hematological patients along with components prepared from seronegative donors.

Is your blood bag safe for transfusion? Bacterial screening of donor blood and its components: An essential infection control tool for safe transfusion practice

Introduction: Transfusion-associated bacterial sepsis is still a major public health concern that has received little attention. Data on bacterial contamination of blood are scarce, despite rising demand for blood transfusions. Blood bags intended for transfusion should be free of microorganisms. Aim: The aim of the study was to assess the prevalence, identify the microorganisms involved in bacterial contamination of donor blood and blood components and determine blood products most likely to be contaminated, received in microbiology laboratory for sterility testing. Settings and Design: The study was carried out in the department of microbiology in association with the transfusion medicine department of tertiary care hospital in Western Uttar Pradesh from January 2023 to June 2023. Methodology: A total of 87 cellular blood components were tested aerobically for bacterial contamination using the BD BACTEC™ FX 40 automated culture system. For incubation, culture vials that showed positive signals were subcultured onto a set of solid media followed by bacterial identification and antimicrobial susceptibility testing. Results: The overall prevalence rate was 14.9% (whole blood 18.75%, platelets 14.2%, packed cells 13.3% and fresh frozen plasma 10.5%). The contaminants were Aeromonas hydrophila, Sphingomonas paucimobilis, Escherichia coli, Coagulase-negative Staphylococcus spp., Pseudomonas aeruginosa, Delftia acidovorans, and Candida albicans. Discussion: The bacterial contamination in blood products suggests the patient who receives blood products is at risk of developing infection. Implementing proper blood transfusion policies, donor screening and technical staff training will all help to reduce the contamination rate of blood and blood components. Conclusion: Bacterial contamination of blood bags indicates a potential risk of healthcare-associated infection. Microbiological Sterility testing for donor blood bags in blood banks should be used as mandatory infection control Tool for Quality assurance.

Совершенствование системы донорства крови в России (на примере Белгородской и Курской областей)

The development of donation of blood and its components is a strategic direction of the healthcare system. Active work on attracting donors and forming a base of regular donors serves as an important factor in the system of providing the population with donor blood components. The research question is to identify motives, incentives and barriers to blood donation in Russia. This issue is considered on the example of Belgorod and Kursk regions, where the number of blood donors and its components per 1000 population is lower than the national average. The aim of the article is to develop recommendations for the development of blood donation and its components in the Russian Federation. The study uses sociological, statistical, and econometric research methods. The article is based on the analysis of annual reports prepared for FMBA of Russia by blood service organizations of Belgorod and Kursk regions from 2019 to 2021. The method of collecting primary information is a survey of blood donors and its components and the population of Belgorod and Kursk regions, conducted in March-May 2022. Based on the results of the survey it is shown that the effectiveness of advertising campaigns to promote voluntary and non-remunerated blood donation and its components is not high enough, donor traffic light is not currently an effective tool to inform the population about the current status of blood stocks and need for individual components of donor blood. A social portrait of a donor, which is reasonable to use for the adjustment of marketing activities in terms of increasing the coverage of the target audience, has been compiled. The article formulates recommendations for the development of donation of blood and its components.

Intraoperative transfusion is a risk factor for cerebral injury after cardiac surgery in children: a prospective observational study

INTRODUCTION: Donor blood components are able to initiate a systemic inflammatory response syndrome (SIRS) and potentiate neuroinflammation with subsequent cerebral damage. OBJECTIVE: To study the effect of transfusion on the development of cerebral damage during the surgical correction of congenital heart defects in children. MATERIALS AND METHODS: 78 patients aged from 1 to 78 months, weighing from 3.3 to 21.5 kg, were studied. All patients underwent correction of a septal defect under cardiopulmonary bypass. All patients were divided to group 1 — without the use of transfusion and group 2 — with the use of red blood cell transfusion. Cerebral damage markers (S-100-β protein, neuron-specific enolase (NSE) and glial fibrillar acidic protein (GFAP)) and SIRS (interleukins 1 (ILb-1), 6 (IL-6), 10 (IL-10) and tumor necrosis factor alpha (TNF-α) were studied. Markers ware studied at three control points: 1 — before the start of surgery, 2 — immediately after end of cardiopulmonary bypass, 3 — 16 hours after the end of the operation. RESULTS: The peak concentration of most markers in the blood in both groups of patients was noted at the 2nd control point. The concentration of all markers of cerebral damage was significantly higher in the transfusion group at the 2nd control point: S-100-β protein (ng/ml) — 509.90 [379.30–871.70] and 717.10 [517.90–1195.33] (р = 0.024); NSE (ng/ml) — 17.55 [11.19–26.41] and 34.05 [17.06–44.90] (р = 0,023); GFAP (ng/ml) — 0.1190 [0.1135–0.1245] and 0.1231 [0.1138–0.1493]. Correlations were found between markers of cerebral damage and SIRS, the strongest of which was the relationship between NSE and TNF-α at the 3rd control point — Rho = 0.43 (p = 0.0001). A correlation of S-100-β protein with transfusion volume was observed at the 2nd (Rho = 0.48, p = 0.00065) and 3rd control points (Rho = 0.36, p = 0.01330). CONCLUSIONS: The influence of the fact of transfusion and the dose of red blood cell on the development of cerebral damage during cardiac surgery in children has been proven.

Changes of Lipid Peroxidation after Administration of Nanomodified Resuspending Solution into Donor Red Blood Cells

The problem of increasing the functional activity preservation of red blood cells is priority for the Blood Service and clinical transfusiology. Taking into account the previously discovered unique properties of magnetite nanoparticles, namely: nonspecific modulation of metabolic processes, strengthening of adaptive mechanisms of cellular organelles, acceleration of reparative processes at the level of membranes and macromolecules, for the first time an attempt was made to use the upgraded saline solution of sodium chloride (nanotechnologically upgraded solution - NUS) as a resuspending of erythrocyte-containing components (ECC). Objective: to improve the preservation of red blood cells containing donor blood components using NUS for resuspending. To achieve this goal, the first stage of the study examined the effect of a new resuspending solution (NUS) on lipoperoxidation, catalase activity, and red blood cell peroxidation resistance in donor blood components containing red blood cells. Object of Research: red blood cells from preservation blood of donors, which are intended for component transfusion therapy. As a result of the study, the advantages of using NUS were established, namely: a significant decrease in the levels of primary and secondary lipid peroxidation products in the first 15 days of observation, an increase in catalase activity and resistance of red blood cells to peroxidation in the first stages of the study, inhibition of the shear reaction with neutral lipid peroxidation in the late stages of observation.

The Effect of Erythrocyte-Containing Donor Blood Components in the Priming of the Cardiopulmonary Bypass Circuit on the Development of Systemic Inflammation During Correction of Congenital Heart Defects in Children

Various pathological factors accompanying any cardiac surgery can cause intraoperative systemic inflammatory responses (SIR). As the number of cardiac surgical interventions grows worldwide, the issue of SIR prevention appears highly relevant.Aim of the study. To determine the effect of not using donor blood components in the priming of the cardiopulmonary bypass circuit in children with septal congenital heart defects, operated under cardiopulmonary bypass, on the severity of SIR.Material and methods. A prospective, randomized study included 40 children with a median age of 14 [12–22.5] months and weight of 8.8 [7.25–11] kg. All patients underwent radical correction of septal defect under cardiopulmonary bypass. The patients were divided into two groups depending on the use of donor blood components for priming the CPB. The severity of SIR was assessed using four specific serum biomarkers such as interleukin 1b (IL-1b), interleukin 6 (IL-6), interleukin 10 (IL-10), and tumor necrosis factor alpha (TNF-α), measured before the operation, after the CPB and 16 hours after the surgery. In addition, the intra- and postoperative periods were evaluated.Results. The safety of the proposed strategy of skipping the donor blood was confirmed by lack of any organ dysfunction in all patients, as well as a significant difference in the balance of oxygen delivery and consumption. In addition, the levels of systemic inflammation markers after CPB were significantly higher in patients who had transfusion: IL-1b was 3.3 [3.2–3.48] pg/mL vs 2.86 [2.7–3.11] pg/mL (P=0.003) and TNF-α reached 1.81 [1.37–3.3] pg/mL vs 1.33 [1.26–1.76] pg/mL (P=0.034). Meanwhile, 16 hours post surgery, IL-6 and IL-10 levels were significantly higher in the group using donor blood components with IL-6 being 48.91 [33.89–57.6] pg/mL vs 31.56 [26.83–48.89] pg/mL (P=0.087) and IL-10 reaching 0.8 [0.76–1.43] pg/mL vs 0.69 [0.6–0.83] pg/mL (P=0.005).Conclusion. The study demonstrates and confirms the safety and efficacy of cardiopulmonary bypass without using donor blood components to reduce the severity of the systemic inflammatory response in children undergoing correction of septal congenital heart defects.

Итоги работы учреждений службы крови Дальневосточного федерального округа в 2021 году

During the scientific and practical conference "Actual issues of transfusiology", held in Khabarovsk in February 2022, the results of the work of blood service institutions of the Far Eastern Federal District (FEFD) for 2021 were summed up, tasks and activities aimed at improving the quality of work of blood service institutions were identified , increasing the procurement of modern and highly effective donor blood components and their rational use, ensuring the safety of transfusion therapy in the context of a pandemic of a new coronavirus infection in 2022

Prospects for the use of donor blood components in the treatment of COVID-19 patients

INTRODUCTION. The significance of all components of donor plasma on the process of inflammation in patients with COVID-19 is currently a little-studied problem. The OBJECTIVE was to determine the effect of components of donor plasma on the inflammatory process in COVID-19. METHODS AND MATERIALS. The study included 50 patients with coronavirus infection (COVID-19), bilateral polysegmental pneumonia, who received standard therapy. Anticovid plasma transfusions were performed in 38 patients. Quarantine fresh frozen plasma was transfused to 12 patients. Before and after transfusion, changes in biochemical, immune, clinical and instrumental parameters of patients were evaluated in dynamics. Separately, the intensity of humoral immunity to SARS-CoV-2 was evaluated in donors of anticovid plasma and in all patients in dynamics. The dynamics of changes in the parameters of components of donor plasma was studied with an assessment of their correlation relationships between biochemical and immune blood parameters before and after transfusion. The most significant component of donor plasma affecting the inflammatory process in COVID-19 was identified. RESULTS. After transfusion of any type of donor plasma, the parameter of the intensity of humoral immunity to SARS-CoV-2 increased with normalization of clinical and instrumental parameters and a decrease in the parameters of acute phase inflammatory reactants. The value of the alpha2-macroglobulin index was reduced, and it increased after transfusion. Correlations between acute phase inflammatory reactants and donor plasma components before and after transfusion with any type of donor plasma were consistently studied. As a result, the interrelations of varying degrees of severity with the alpha2-macroglobulin index were revealed. CONCLUSION. After transfusion of any type of donor plasma, there is an increase in the intensity of humoral immunity to SARS-CoV-2 in the form of the appearance of specific antibodies, the parameters of acute phase inflammatory reactants decrease. One of the significant components of donor plasma affecting the inflammatory process in COVID-19 is alpha2-macroglobulin. The study of the possibility of using alpha2-macroglobulin isolated from donor plasma is one of the promising directions in the complex treatment of COVID-19 patients.

STORAGE OF ERYTHROCYTE MASS OF HORSES AND CONTROL OF ITS STERILITY

Currently, blood transfusion should be considered as a tissue transplantation operation with all the consequences - possible rejection of cellular and plasma components of blood, development of allosensitization to antigens of blood cells and plasma proteins, as well as, in the case of an immunodeficient patient, the possible development of a life-threatening reaction "Transplant against host". Erythrocyte mass is a transfusion medium containing at least 70% erythrocytes, which is optimal in the treatment of anemic syndrome. At equal volumes compared to whole blood, the erythrocyte mass contains a larger number of erythrocytes, but significantly less citrate, products of cell decay, cellular and protein antigens, and antibodies. Transfusions of erythrocyte mass occupy a prominent place in transfusion therapy, which aims to fill the deficiency of erythrocytes in anemic conditions. We studied 5 samples of preserved erythrocyte mass from clinically healthy horses. Blood was collected by a closed method followed by separation of the erythrocyte mass by centrifugation. The mass was stored in a refrigerator at a temperature of 2-6°C for 30 days. Sowing of each sample was carried out in the thickness of the nutrient medium. Cultures in a thioglycol medium and control tubes were incubated in a thermostat at a temperature of 20-25°C and at a temperature of 30-35°C, with a Sabouraud medium at a temperature of 20-25°C. The term of incubation of crops in a thermostat in both nutrient media was 14 days. According to the results of bacteriological examination of samples of erythrocyte mass of horses after their storage, not a single non-sterile sample was found. Therefore, the method of blood collection using closed systems is reliable and makes it possible to receive donor blood and blood components without loss of sterility during a long storage period.

Study of Effects a New Resuspending Solution on Lipoperoxidation, Catalase Activity and Red Blood Cell Peroxidation Resistance in Donor Blood Components

Study of Effects a New Resuspending Solution on Lipoperoxidation, Catalase Activity and Red Blood Cell Peroxidation Resistance in Donor Blood Components

"Study of Effects a New Resuspending Solution Which Was Nanotechnologically Upgraded on Lipoperoxidation, Catalase Activity and Red Blood Cell Peroxidation Resistance in Donor Blood Components"

The problem of increasing the functional activity preservation of red blood cells is priority for the Blood Service and clinical transfusiology. Taking into account the previously discovered unique properties of magnetite nanoparticles, namely: non-specific modulation of metabolic processes, strengthening of adaptive mechanisms of cellular organelles, acceleration of reparative processes at the level of membranes and macromolecules, for the first time an attempt was made to use the upgraded saline solution of sodium chloride (nanotechnologically upgraded solution - NUS) as a resuspending of erythrocyte-containing components (ECC).

Cardiopulmonary bypass strategy without donor blood components as a method for preventing brain damage in children

Aim. To establish the role of donor blood components which are used in the intraoperative period in children with septal congenital heart disease (CHD) who need surgical interventions with cardiopulmonary bypass (CPB) for the prevention of cerebral injury in the postoperative period.Methods. 40 children of 14 months old on average and 8.8 kg of weight were under the study. All patients underwent radical correction of the septal CHD with the use of CPB. The patients were divided into 2 groups according to the donated blood components used. Cerebral damage was assessed with the help of three specific markers: protein S-100-ß, neuron-specific enolase (NSE) and glial fibrillar acidic protein (GFAP). The severity of the systemic inflammatory response was defined by the level of the following markers: interleukin 1, 6 and 10 in serum before operations, after the completion of IC and 16 hours after surgery. The clinical analysis of cerebral injury was performed via the Cornell Assessment for Pediatric Delirium.Results. Statistically the concentration of all three markers of cerebral injury was significantly higher in the transfusion group after the end of CPB. Similar dynamics was observed in the concentrations of interleukins. In addition, the values for GFAP were higher in the transfusion group and 16 hours after surgery.Conclusion. The safety and effectiveness of the strategy on refusal of intraoperative transfusion in order to prevent cerebral injury in children during the correction of septal CHD has been demonstrated.

Modeling global transfusion medicine education.

Modeling global transfusion medicine education.

STERILITY MONITORING OF CANINE PACKED RED BLOOD CELLS

Transfusing of whole blood and blood components has a constant risk factor – a microbial contamination. Because using of contaminated blood products can cause sepsis and high risks to the health of recipients. Violation of the rules of asepsis during blood donation, during the manufacture of blood products, damage to blood collection systems or their tightness, etc. can lead to microbial contamination. We examined 5 samples of preserved canine packed red blood cells, which were taken in closed systems, using CPDA anticoagulant and following storage at a temperature of + 2-6 ° C for 30 days. According to the results of bacteriological examination of samples of canine packed red blood cells (pRBC) after their storage, no non-sterile sample was found. Thereby, the method of blood collection using closed systems with CPDA anticoagulant is reliable and allows to obtain donor blood and blood components without loss of sterility during long-term storage. Keywords: canine packed red blood cells, microbial contamination, donor blood sterility

Transfusion Strategies in Patients with Mitral Valve Replacement

The aim. To carry out research of liberal, restrictive and blood-saving transfusion strategies in patients with mitral valve replacement (MVR) in the conditions of artificial blood circulation during operation, in intensive care unit, and in the postoperative period.
 Material and methods. Retrograde examinations were performed in 70 patients who underwent surgery for ac-quired mitral valve disease. Our research consisted of three stages: stage 1 involved the study of the volume of transfu-sions of donor blood components during MVR, stage 2 involved the study of the volume of transfusion of donor blood components in the emergency room, stage 3 involved the study of the volume of transfusions of donor blood components in the intensive care unit. All the patients were divided into 3 groups. Group A included 14 patients in whom (arbitrary) liberal transfusion strategy (LTS) with transfusion of donor blood components was applied during the operation. Group B included 19 patients in whom (economical) restrictive transfusion strategy (RTS) during surgery with transfusion of donor blood components was applied. Group C included 37 patients in whom the patient’s autologous blood-saving tech-nology (BST) was applied during the operation.
 Results and discussion. At stage 1 of the study, the volume of packed RBCs per 1 transfusion in group A exceeded the volume of packed RBCs per 1 transfusion in group B by 68.0%. The volume of transfusions of native fresh-frozen plasma (FFP) in group A exceeded that in group B by 73.5%. The volume of platelet transfusions (PT) in group A at stage 1 was 75.0%. At stage 2 of the study, the total volume of PT in patients of group A was still 3.0 times higher and FFP was 2.7 times higher than that in group B. At this stage of the study, there was also a 2.6-fold decrease in the volume of PT per 1 transfusion in group B compared with group A. In total, during 3 stages of the study, the volume of PT use in group A was 5.7 times higher, and in group B it was 3.9 times higher than that in group C. The volume of FFP use in group A was 4.4 times higher, and in group B it was 3.8 times higher than that in group C.
 Conclusions. The use of LTS in group A and RTS in group B resulted in 5.2-fold and 3.8-fold increase in the total volume of transfused donor blood components, repsectively, compared to group C.