Donor Population Research Articles

Real-world data to improve organ and tissue donation policies: lessons learned from the tissue and organ donor epidemiology study.

The transplantation of human organs, and some human tissues, is often the only life-saving therapy available for serious and life-threatening congenital, inherited or acquired diseases. However, it is associated with a risk of transmission of communicable diseases from donor to recipient. It is imperative to understand the characteristics of the donor population(including both potential and actual donors) to inform policies that protect recipient safety. The Tissue and Organ Donor Epidemiology Study (TODES) was a pilot project designed to identify and collect standardized information on deceased persons referred for organ, tissue and/or eye donation, and to estimate (to the extent possible) infectious disease prevalence and incidence of human immunodeficiency virus (HIV), hepatitis B virus (HBV) and hepatitis C virus (HCV) in this population. TODES is summarized here to shed light on addressable limitations on accessing data needed for transplant recipient safety. Limitations, future research needs and potential pathways to solve the remaining data needs are explored. Retrospective data for all deceased donors during a 5-year period from 2009 to 2013 were obtained from participating organ procurement organizations (OPOs), tissue establishments and eye banks. These decedent data were used to ascertain whether the available real-world data (RWD) could be used to inform donor screening and testing policy. The TODES database contains 291848 records received from nine OPOs and 42451 records received from four eye banks. Data were analysed from deceased donors with at least one organ, tissue or ocular tissue recovered with the intent to transplant. Results for potential donors were not analysed. Available RWD at the time of the TODES study were not fit-for-purpose to help characterize the organ, tissue and eye donor populations and/or to inform donor screening policy. Recent advances in electronic data collection systems make it more realistic to now collect fit-for-purpose RWD that address the research needed to improve transplant safety.

An investigation to improve a nonlinear mixed-effects approach for EC50 estimation based on multi-donor dose–response data

ABSTRACT Dose–response relationships are important in assessing the efficacy and potency of compounds, which can usually be characterized by a 4-parameter logistic (4-PL) model estimating EC50, slope factor, lower asymptote, and upper asymptote. EC50, the concentration of a compound that induces a response halfway between the baseline and maximum, is a key quantity to evaluate compound potency. For multi-donor dose–response data, it is often of interest to estimate the overall EC50 (i.e. the average EC50 of the population of donors) and its 95% confidence interval (CI). A few multi-donor EC50 estimation methods have been proposed in the literature. Jiang and Kopp-Schneider (2014) systematically compared the meta-analysis approach and the nonlinear mixed-effects approach and concluded that the meta-analysis approach is simple and robust to summarize EC50 estimates from multiple experiments, especially suited in the case of a small number of experiments, while the nonlinear mixed-effects approach has the issue of convergence failures probably due to overparameterization. In this article, we propose a modification of the nonlinear mixed-effects approach by using the stochastic approximation expectation-maximization (SAEM) algorithm to estimate model parameters and using multiple starting points to search for globally optimal values, which can substantially alleviate the issue of convergence failures even for small number of donors (e.g. n = 3), and achieve a smaller absolute median bias and better coverage probability of 95% confidence interval than the meta-analysis approach when the number of donors is not too small (e.g. n ≥ 7).

Factors Associated with Increased Risk of Contamination in Bone Marrow Transplants.

Hematopoietic cell transplantation (HCT) remains the definitive therapeutic modality for numerous malignant and non-malignant hematologic disorders. Conventional bone marrow remains a viable donor source for HCT. However, microbial contamination of bone marrow harvests may present a risk to immunocompromised recipients. This analysis sought to identify clinical factors associated with bone marrow contamination. We analyzed a single institution experience comprising 667 unique bone marrow harvests collected between 1999 and 2021. We trended the yearly microbial contamination rate over this time span. Harvest type (autologous vs allogenic), donor age, donor sex, physician experience, total nucleated cell (TNC) count, volume collected, and TNC concentration were included in a univariate (UV) and multivariate (MV) logistic model to assess which factors were associated with contamination. Males comprised 55.8% of the donor population and the median age of the cohort was 35 [IQR: 27-45]. There were 19 autologous, 151 related allogenic, and 497 unrelated allogenic transplants in this cohort. 87 of the 667 (13.0%) harvests were contaminated and essentially all contaminants were common skin flora. The yearly contamination rates displayed substantial variability, ranging from 0% to 42.9%, with no discernible trend. Harvest type did not exhibit a significant association with contamination risk. However, male donor sex was found to be significantly associated with a higher contamination rate (18%) compared to female sex (6.8%, p < 0.001). In both UV and MV logistic models, male sex emerged as the sole factor linked to contamination risk (OR: 2.90, 95% CI: 1.65 - 5.35). This analysis represents the largest single center investigation of bone marrow harvest microbial contamination rates. Notably, it is the first to establish an association between contamination and male donor sex. We propose that this association may be attributed to differences in skin flora composition or innate immune function between sexes, general hygiene practices or possibly the result of the frequent clipping of body hair in males prior to the harvest procedure. Further research is warranted to explore the underlying mechanisms and clinical implications of this novel finding.

Burden of hepatitis B in asymptomatic blood donor population of India: A systematic review & meta-analysis.

Background & objectives India has been classified as an intermediate Hepatitis B Virus (HBV) endemic country, and the transmission is believed to mostly occur horizontally. However, community-based data on HBV prevalence among blood donors in India are limited. The burden of Hepatitis B Virus (HBV) is unknown in the asymptomatic blood donor population. We therefore conducted a meta-analysis to assess the prevalence of the HBV among the blood donor population in India. Methods We searched different databases for research articles on the prevalence of HBV in the blood donor population from India. Following the PRISMA guidelines, forty articles published between January 2013 and October 20, 2023, were selected for meta-analysis after removing duplicates and conducting a two-level screening process. Review Manager Version 5.3 (Rev Man 5.4) was used for statistical meta-analysis. The study has been registered with PROSPERO (number CRD42023487616). Results Forty articles were selected out of the 527 published manuscripts for meta-analysis, and a total of 22,22,736 blood donations were studied. Of these, 24,151 individuals (1.11%) were identified either as chronically infected with HBV or living with HBV infection. A pooled prevalence of approximately 1.11 per cent with a 95% confidence interval (CI) of (0.011; 0.0112) (common effect model) or 95% CI of (0.0079; 0.0116) (random effects model) was estimated. The included studies exhibited a high level of heterogeneity, probably due to different diagnostic approaches followed in different studies. Interpretation & conclusions The burden of hepatitis is profound, impacting public health, economies, and societies in India. The outcome of this study would help address such a burden and develop comprehensive strategies focused on prevention, early diagnosis, treatment, and necessary collaboration to achieve significant reductions in hepatitis-related morbidity and mortality.

Environmental predictors impact microbial-based postmortem interval (PMI) estimation models within human decomposition soils.

Microbial succession has been suggested to supplement established postmortem interval (PMI) estimation methods for human remains. Due to limitations of entomological and morphological PMI methods, microbes are an intriguing target for forensic applications as they are present at all stages of decomposition. Previous machine learning models from soil necrobiome data have produced PMI error rates from two and a half to six days; however, these models are built solely on amplicon sequencing of biomarkers (e.g., 16S, 18S rRNA genes) and do not consider environmental factors that influence the presence and abundance of microbial decomposers. This study builds upon current research by evaluating the inclusion of environmental data on microbial-based PMI estimates from decomposition soil samples. Random forest regression models were built to predict PMI using relative taxon abundances obtained from different biological markers (bacterial 16S, fungal ITS, 16S-ITS combined) and taxonomic levels (phylum, class, order, OTU), both with and without environmental predictors (ambient temperature, soil pH, soil conductivity, and enzyme activities) from 19 deceased human individuals that decomposed on the soil surface (Tennessee, USA). Model performance was evaluated by calculating the mean absolute error (MAE). MAE ranged from 804 to 997 accumulated degree hours (ADH) across all models. 16S models outperformed ITS models (p = 0.006), while combining 16S and ITS did not improve upon 16S models alone (p = 0.47). Inclusion of environmental data in PMI prediction models had varied effects on MAE depending on the biological marker and taxonomic level conserved. Specifically, inclusion of the measured environmental features reduced MAE for all ITS models, but improved 16S models at higher taxonomic levels (phylum and class). Overall, we demonstrated some level of predictability in soil microbial succession during human decomposition, however error rates were high when considering a moderate population of donors.

Successful development of European tree frog (Hyla arborea Linnaeus, 1758) populations in the south-west and west of Luxembourg following reintroduction

In this article, we provide a comprehensive overview of our European tree frog reintroduction, from the sourcing and captive-rearing of donor animals, through reintroduction and population development, to the current status of the project. Before the start of the project, only one isolated population remained in the east of the country. Starting with two initial reintroductions (2012 to 2014), two tree frog populations have developed over the past decade and we have managed to save the species from extinction on the national level. While both populations have been expanding rapidly in recent years, they show noticeable differences regarding initial development and spread. Further reintroductions to reinforce these populations were carried out from 2019 to 2024. In total, more than 7,000 juveniles and tadpoles were released over the entire duration of the project, resulting in ca. 830 calling males at 61 sites in 2024. Our long-term annual monitoring provides detailed data on population development and spread, which are presented and discussed. In addition, comparisons with similar tree frog reintroduction projects in other countries are made and logistical and epidemiological aspects of the reintroduction project are highlighted. Finally, we give an outlook on practical implications for conservation management, upcoming challenges and future focal points of the project.

A cross-sectional pilot study to estimate the frequency of minor blood group alleles and phenotypes in RhD-negative North Indian blood donors by DNA microarray analysis

Abstract: INTRODUCTION: There are scarce data on Indian blood donors with respect to blood group phenotypes using molecular diagnostic modalities. Hence, we planned to estimate frequencies of blood group alleles/phenotypes using DNA microarray analysis in the north Indian RhD-negative blood donor population. With this initial pilot study, we plan to expand it to our entire donor population. METHODOLOGY: The cross-sectional prospective study was conducted on 50 Indian blood donors (O RhD negative), to study the blood group genotype frequency. Genotyping for the most relevant red blood cell antigens (Rh, Kell, Duffy, Kidd, MNS, Lutheran, and Dombrock) was done using Bioarray Precise TypeHM Human Erythrocyte Antigen BeadChip kit containing probes directed to polymorphic sites. RESULTS: In the Rh system, the most common alleles were RHCE*e/RHCE*e (98%) and RHCE*c/RHCE*c (80%). Phenotype K-k+ (genotype- KEL*02/KEL*02) was seen in 98% of samples, Js(a-b+) (KEL*02.07/KEL*02.07) was detected in 98% (49/50) of the samples tested. Jk(a + b+) (JK*01/JK*02) was the most common phenotype (48%) in the Kidd blood group system. In MNSs system, M+N+ (GYPA*01/GYPA*02) 44% and S+s+U+ (GYPB*03/GYPB*04) 34% were the most common phenotypes detected. CONCLUSION: This pilot study shows the feasibility of genotyping a Northern Indian donor population. To the best of our knowledge, it is the first study on molecular blood grouping in Indian blood donors using the Bioarray platform.

Biological Reference Ranges for Healthy Indian Blood Donors: Experience of a Tertiary Care Center Vis-à-Vis International Literature.

Complete blood count is the most common, basic test requisitioned in hematology. The normal reference ranges of hematological parameters are required owing to variable socioeconomic, environmental, and genetic factors in populations. The current study determines the reference ranges of the healthy Indian donor population of a high socioeconomic group. The study was conducted in the Department of Transfusion Medicine at a tertiary care hospital in India and included 4098 individuals, aged 18-65 years coming for voluntary blood donation from July 2021 to October 2022. Blood samples were collected in K2EDTA, analyzed on the Sysmex XN-31 hematology analyzer, and using statistical tools, the normal reference ranges were calculated. The reference ranges for hemoglobin (HB) (137-185 g/L), WBC (5.1-1.7 × 109/L), platelet count (115.6-370.0 × 109/L) were noted. No statistically significant changes were observed in different age groups. There were gender-wise differences noted in nearly all parameters. The HB and hematocrit (HCT) range was slightly higher in other Indian and other Asian populations with comparable values with the Chinese, Korean populations, and Western populations; RBC parameters were overall comparable with minor differences; the WBC count was higher than the other Indian and Asian populations particularly the upper limit of lymphocyte and monocyte; and the range of platelet counts had a comparable upper limit with all populations and had the lowest lower value in males in our study, which was comparable to only the Chinese population. It is concluded that reference ranges of common parameters were calculated with minor changes noted in all hematological parameters on comparing with other Indian, Asian population, and Western data.

Laparoscopic Live Donor Nephrectomy: An Initial Moroccan Experience.

Introduction Laparoscopic nephrectomy is the gold standard for kidney removal in living donors, offering advantages such as reduced pain and quicker recovery. In Morocco, where end-stage renal disease (ESRD) is a growing concern, this approach could significantly impact the demand for kidney transplants. This study evaluates the safety and efficacy of laparoscopic live donor nephrectomy in the Moroccan healthcare system. Materials and methods Fifteen laparoscopic nephrectomies were analyzed, focusing on donor demographics, procedure details, and outcomes. Key parameters included donor age, BMI, operative time, warm ischemia time, and blood loss. Complications and graft outcomes were also assessed. Results The procedure was safe and effective, even in obese donors. Donors were predominantly female (80%), with an average age of 49.4 years. Obese donors had longer operative times (282 minutes vs. 220 minutes). Left kidney retrieval was preferred (95%). Warm ischemia averaged 6.27 minutesand blood loss was 207 mL. One donor had elevated creatinine postoperatively, while most maintained stable renal function. Eighteen complications, mostly minor, were reported. Conclusion Laparoscopic live donor nephrectomy is a safe and adaptable procedure in Morocco, offering low complication rates and favorable outcomes. It is effective for a diverse donor population, including older and obese individuals, and may help address the country's growing transplant needs.

RHD Genotyping Characteristics of RhD-Negative Blood Donors in Wuhu Area

To investigate the molecular mechanism and distribution characteristics of RhD negative phenotypes in Han population of blood donors in Wuhu city. A total of 210 RhD- samples from August 2021 to August 2022 were screened by serological test and collected from Wuhu Central Blood Station for the voluntary blood donor population. Exons 1 and 10 of the RHD gene were amplificated by PCR to determine whether the samples had the RHD gene. Exons 1-10 of the RHD gene were amplificated by PCR and zygosity analysis were performed in 82 samples containing D gene, and Sanger sequencing was performed on 55 samples containing all RHD exons to determine the genotype. Among 210 RhD- specimens, 128 cases (60.38%) had RHD gene deletion. 27 cases had partial exons of RHD, including 2 cases with RHD*DVI.3/RHD*01N.01, 24 cases with RHD*01N.04/RHD*01N.01, and 1 case with RHD-CE(2-10)/RHD*01N.01. 55 cases had retained all of 10 exons, including 4 cases with RHD*01/RHD*01N.01, 6 cases with RHD*15/RHD*01N.01, 1 case with RHD*01W.72/RHD*01N.01, 1 case with RHD*15/RHD*01EL.01, 39 cases with RHD*01EL.01/RHD*01N.01, and the remaining 4 cases were determined to have no RHD gene deletion by zygosity analysis and sequencing showed the presence of 1227G>A mutation loci. There is polymorphism in the molecular mechanism of RhD- D gene in Wuhu blood donor population, among which RHD*01EL.01 and RHD*15 are the main variants in this region. The results of this study provide a theoretical basis for RhD blood group identification and clinical blood transfusion in this region.

Genetic differentiation and diversity do not explain variation in heterosis or inbreeding depression: empirical evidence from a long-lived iteroparous plant

AbstractAssisted gene flow can restore genetic diversity when genetic drift has driven deleterious alleles to high frequencies in small, isolated populations. Previous crosses among 20 populations of Gymnadenia conopsea documented the strongest heterosis and the weakest inbreeding depression in sparse and small populations, consistent with fixation of mildly deleterious alleles by genetic drift. We genotyped the populations used for crosses, and used 1200–1728 SNPs to test the following predictions: (1) heterosis increases with genetic differentiation (FST) to donor populations and decreases with genetic diversity in the recipient population, (2) inbreeding depression increases with genetic diversity, and (3) genetic diversity increases, and mean FST to other populations decreases, with population size and density. Pairwise FST ranged from very low to moderate (0.005–0.20) and genetic diversity varied moderately among populations (proportion of polymorphic loci = 0.52–0.75). However, neither FST between populations, nor genetic diversity in the recipient population, were related to the strength of heterosis. There was also no association between genetic diversity and the strength of inbreeding depression. Genetic diversity increased and mean FST decreased with population size, consistent with reduced diversity and increased differentiation of small populations by genetic drift. The results indicate that the loci conferring heterosis are not mirrored by overall population differentiation, and limited additional information on potential source populations for genetic rescue is gained by the genetic data. Instead, the use of controlled crosses can directly reveal positive effects of introducing new genetic material, and is a simple method with high potential in conservation.

A decision-making framework to maximise the evolutionary potential of populations - Genetic and genomic insights from the common midwife toad (Alytes obstetricans) at its range limits

Anthropogenic habitat modification and climate change are fundamental drivers of biodiversity declines, reducing the evolutionary potential of species, particularly at their distributional limits. Supportive breeding or reintroductions of individuals are often made to replenish declining populations, sometimes informed by genetic analysis. However, most approaches utilised (i.e. single locus markers) do not have the resolution to account for local adaptation to environmental conditions, a crucial aspect to consider when selecting donor and recipient populations. Here, we incorporate genetic (microsatellite) and genome-wide SNP (ddRAD-seq) markers, accounting for both neutral and putative adaptive genetic diversity, to inform the conservation management of the threatened common midwife toad, Alytes obstetricans at the northern and eastern edges of its range in Europe. We find geographically structured populations (n = 4), weak genetic differentiation and fairly consistent levels of genetic diversity across localities (observed heterozygosity and allelic richness). Categorising individuals based on putatively adaptive regions of the genome showed that the majority of localities are not strongly locally adapted. However, several localities present high numbers of private alleles in tandem with local adaptation to warmer conditions and rough topography. Combining genetic diversity and local adaptations with estimates of migration rates, we develop a decision-making framework for selecting donor and recipient populations which maximises the geographic dispersal of neutral and putatively adaptive genetic diversity. Our framework is generally applicable to any species, but especially to amphibians, so armed with this information, conservationists may avoid the reintroduction of unsuitable/maladapted individuals to new sites and increase the evolutionary potential of populations within species.

Low-gainer diet-induced obese microbiota transplanted mice exhibit increased fighting.

Weight gain variation is a great challenge in diet-induced obesity studies since low-gainer animals are of limited experimental value. The inbred C57BL/6 (B6) mice are frequently used models due to their genetic homogeneity and susceptibility to diet-induced obesity (DIO). The aim of this study is to investigate if the gut microbiota (GM) influences the fraction of low weight gainers in DIO studies. A total of 100 male B6 mice (donor population) were fed a high-fat diet for 14 weeks and divided into the study groups high gainer (HG) and low gainer (LG) based on their weight gain. Subsequently, fecal matter transplantation (FMT) was done on germ-free B6 mice with GM from HG and LG donors (FMT population). LG (13.35 ± 2.5 g) and HG (25.52 ± 2.0 g) animals were identified by the weight gain from week 1 to week 12. Interestingly, the start weight of the LG (20.36 ± 1.4 g) and HG (21.59 ± 0.7 g) groups differed significantly. Transplanting LG or HG fecal matter to germ-free mice resulted in significant differences in weight gain between HG and LG, as well as differences in serum leptin levels and epididymal fat pad weight. A clear LG-specific GM composition could not be distinguished by 16S rRNA gene amplicon sequencing. Surprisingly, significantly more fighting was recorded in LG groups of both donor populations and when transplanted to germ-free mice. The HG and LG phenotypes could be transferred to germ-free mice. The increased fighting in the LG group in both studies suggests not only that the tendency to fight can be transferred by FMT in these mice, but also that fighting should be prevented in DIO studies to minimize the number of LG animals.

Screening Potential Cornea Donors for Signs of Sepsis

Purpose: This study sought to expand upon previous works to explore correlations between cornea donor characteristics and incidence of sepsis/donor ineligibility. Methods: The medical records of 837 potential cornea donors with signs of possible sepsis from 2 Eye Bank Association of America–accredited eye banks between 2009 and 2022 were reviewed by an infectious disease clinician consultant for US Food and Drug Administration-designated signs of sepsis. Data and machine learning analysis were performed to explore relationships between different donor features and donor eligibility. Results: A review of the potential cornea donor records revealed that the presence of a greater number of signs of sepsis was not associated with a higher probability of donor ineligibility (P = 0.45). The only single sign of sepsis that was associated with a higher likelihood of donor ineligibility determination was positive blood cultures (P &lt; 0.001). Finally, if the patient's length of hospitalization was less than 24 hours, these potential donors were more likely to be deemed ineligible for cornea donation (P &lt; 0.001). Machine learning analysis revealed length of hospitalization to be the most importantly weighted factor in determining donor eligibility. Conclusions: Based on our analysis of hundreds of medical records over more than a decade, the data suggest that potential cornea donors who 1) have a positive blood culture or 2) have a length of stay of less than 24 hours may be reasonably deemed likely not eligible for donation and not all forwarded to infectious disease consultants or their respective medical director. The results of this study call for further exploration with the collection of larger sample sizes and more representative populations of cornea donors to pursue potential protocols with respect to determining cornea donor eligibility.

Urban arbovirus exposure in blood donations from an endemic area of Brazil.

In Brazil, urban arboviruses, such as dengue virus (DENV), Zika virus (ZIKV) and chikungunya virus (CHIKV), constitute a major public health problem, and due to their endemicity and asymptomatic cases, they pose a potential threat to blood donations. Rio de Janeiro (RJ), Brazil, has been impacted by extensive DENV epidemics over the last 30 years and, after 2015, by CHIKV and ZIKV. Urban arboviruses DENV, ZIKV and CHIKV were investigated in blood donations (n = 778) at the State Institute of Hematology, HEMORIO (RJ) from 2019 to 2022 by serological and molecular methods. An overall arbovirus exposure was observed in 26.1% of the blood donations. Anti-DENV IgM was detected in 4.0% of samples and two donations were DENV NS1 positive. Positive anti-CHIKV IgM was observed in 4.7% of the donations. Co-detection of anti-CHIKV IgMand anti-DENV IgM was observed in 1.0% of donors, and CHIKV prevalence was 21.3%. All blood donations tested were negative for the DENV, ZIKV and CHIKV RNA. IgM seroprevalence to the arboviruses analyzed here is an indicator of recent infection in asymptomatic donors, showing that the population of blood donors can be a vehicle for new infections, especially during epidemic periods.

Ex-situ restoration of the Mediterranean forest-forming macroalga Ericaria amentacea: optimizing growth in culture may not be the key to growth in the field

Evidence of local and regional declines in the canopy-forming alga Ericaria amentacea, a foundation species of diverse marine forest communities on exposed Mediterranean coasts, have spurred restoration efforts focused on sustainable ex-situ techniques. The need to balance the costs of culture maintenance and the susceptibility of early life stages to stressors in the native habitat, including rapid, often extreme shifts in temperature, hydrodynamics and nutrient availability, have driven current efforts to create a culture environment that primes seedlings for outplant, increasing their resilience rather than maximizing growth. We tested the effects of 1) higher culture temperature (25°C) combined with wave simulation and 2) reduced nutrient loads (10% of standard protocol) with wave simulation on post-culture and outplant outcomes relative to optimal growth conditions in established protocols (20°C, no waves, high-nutrient culture medium). While increased temperature and water motion negatively affected seedling growth in culture, and higher nutrients caused oxidative stress likely associated with enhanced epiphyte overgrowth, these effects were not clearly translated into patterns of long-term growth in the field. Instead, survival in the initial days post-outplant appeared to be the bottleneck for restoration potential, where substrates with persisting seedlings at one month were generally found with flourishing juveniles at four months. Larger clumps of seedlings, in turn, were strongly associated with both initial survival and future growth. These results underscore the importance of the zygote settlement phase to establish high seedling densities, which may be optimized by phenological monitoring of the donor population. They also suggest that less-controlled, more environmentally-realistic culture conditions involving the introduction of mild stress may enhance the survival of early life stages of E. amentacea during the transition to the native environment, simultaneously providing a means to reduce human resource costs in culture and move toward scaling up.

A risk prediction model for vasovagal reactions in whole blood donors including the physical and psychological factors: Results from a case–control study done in a regional blood transfusion center

Abstract: BACKGROUND AND OBJECTIVES: Blood centers strive to maintain a safe and adequate supply of blood products from healthy volunteer donors. Primary responsibility of a medical officer is to assess donor risk for vasovagal reaction (VVR) and alert the phlebotomist. The study attempts to identify the significant risk factors of VVR which may help in decision-making. METHODS: This was a case–control study including blood donors donating 350 ml Whole blood in Department of Transfusion Medicine, Medical College, Thiruvananthapuram from December 19, 2017 to June 31, 2018. Donors who suffered VVRs during or after blood donation were considered as cases and compared with controls. The prevalence of risk factors such as age, sex, number of previous donations, body mass index (BMI), blood volume, sleep duration, food intake, fear and anxiety, and pain perception was compared between the groups. RESULTS: 174 cases and 348 controls were studied. Most of the donors were &lt; 35 years of age (63.2%) younger age groups (18–25 year) had a higher odds of VVR (5.54 with 95% confidence interval [CI] 2.4–12.5). First time donations carried an increased risk of VVR with an ODDs ratio of 5.8 (3.81–9.131) compared to repeat donors. Around 45% of cases were first timers whereas only 12% of controls were first time donors. There was a significantly higher rate of reactions in donors who had episodes of VVRs in the previous donations. Odds 1.99 (CI 1.09–3.74) other risk factors identified were female gender (6.3, 95% CI 2–20), lack of sleep at previous night (32.9; CI 16.17–67.18), and high BMI &gt; 27.5/m2 with odds ratio 2.5 (1.4–4.3). Having an estimated blood volume &lt; 3500 ml also was associated with higher odds of VVRs. CONCLUSION: In spite of having a strict criteria for donor deferral based on risk factors, vasovagal reactions still occur and risk factors are prevalent in blood donor population. Special attention should be given to donors having one more of such risk factors and attempts should be made to avert VVRs.

Incidence, Nature and Natural History of Additional Histological Findings in Preimplantation and Implantation Kidney Transplant Biopsies.

The quality assurance provided by preimplantation biopsy quantification of chronic damage may allow greater use of kidneys from expanded criteria donors, and thereby expand the deceased donor pool. Preimplantation biopsy may, however, identify additional acute or chronic pathologies not considered in the scoring of chronic damage, and these may influence the decision to implant or discard the kidney. This single-centre retrospective cohort study of a contemporary UK donor population systematically characterised the nature of additional findings in 1,046 preimplantation and implantation biopsies over an eight-year period. A diverse range of findings were identified in 111/1,046 (11%) organs; most frequently diabetic glomerulopathy, focal segmental glomerulosclerosis, (micro)thrombi, neutrophil casts, and immunoglobulin/complement staining. Seventy (63%) of these were transplanted, with subsequent biopsy in 41 (58%) cases confirming that 80% of the initial acute changes had spontaneously resolved, while there was no progression of diabetic glomerulopathy, and the lesions of focal segmental glomerulosclerosis were not identified. Over 75% of assessable grafts with additional histological findings at the time of transplant showed adequate function at one-year following transplant. In conclusion, most histological abnormalities that may be identified in addition to chronic scarring in preimplantation kidney biopsies would not preclude transplantation nor predict poor graft function.

Analysis of The Results of The Rhesus System Blood Group Phenotyping Examination in Routine Type O Blood Donors

The Rhesus (Rh) system is the second most important blood group system after ABO, has the highest immunogenicity and tends to produce alloantibodies that cause most transfusion reactions. In the Rh blood group system, there are more than 55 antigens, but the main ones are D, C, E, c, and e. Currently, only the D antigen is carried out without examining four other important Rh antigens. Still scarce, studies on the proportion of Rh antigens, except D, in Indonesia; in this study we have determined Rh antigens and phenotypes among a population of routine blood donors. The purpose of this study was to determine the phenotypic variation and frequency distribution of the main antigens of the Rhesus blood group system in routine blood type O blood donors at UDD PMI Depok City. This study was descriptive and observational with a cross-sectional design. Primary data are obtained from the Rhesus system antigen examination results on donor blood samples. The sample was 140 blood samples from 140 routine donors. A rhesus phenotyping examination was carried out using the gel method. The study was conducted on 140 routine donor blood samples at UDD PMI Depok City. The characteristics of the subjects were male (69.29%) and female (30.71%), with an average age of 38 years. Samples are analyzed for five major Rhesus antigens. Rhesus antigen test shows D antigen (100%), e antigen (97.14%), C antigen (95.71%), c antigen (36.43%) and E antigen (27.86%). Rhesus phenotype results were R1R1 (DCe/Dce) (62.86%), R1R2 (DCe/DcE) (22.86%), R1r (DCe/dce) (9.29%), R2R2 (DcE/DcE) (2.86%), R2r (DcE/dce) (1.43%), and R1RZ (DCe/DCE) (0.71%). In conclusion, the frequency of phenotypic changes in the Rh blood group system of regular blood donors at UDD PMI Depok City is classified as the most common types: DCe/DCe, DCe/DcE, DCe/dce, DcE/DcE, DcE/dce and DCe/DCE.

Characteristics of human donor lungs utilized for research.

Many fundamental discoveries have occurred using primary cells from deceased donor lungs. These cells respond differently to injury when there are underlying co-morbidities like diabetes mellitus, hypertension, aging and exposures to cigarette smoke, cocaine and chronic alcohol use. However, the prevalence of these characteristics in donor lungs utilized for research is currently unknown. This retrospective cohort study procured data of lung transplant donors from Mid-America Transplant from January 2017 until July 2023. The donors were characterized based on lung utilization into three groups - lungs used for research, lungs used for transplant, and lungs not recovered from donors for either research or transplantation. The mean age of donors whose lungs were utilized for research was 41±18 years. 25% of them were expanded criteria donors (ECD) while 10% of the donors in the transplant cohort were ECD. 14% of the donors whose lungs were utilized for research had history of diabetes compared to 8% of donors whose lungs were transplanted. A quarter of the research donor population had positive history of cigarette use within the preceding 20 years. At least 40% of donors had a positive history of non-intravenous drug use, of whom a majority had a history of continued non-intravenous drug use. No strict selection criteria or protocols exist when human donor lungs are obtained for ex-vivo research. There is a high prevalence of diabetes mellitus, history of smoking and non-intravenous drug use along with older age distribution in donors whose lungs used are for research.