Hospital Blood Bank Research Articles

Knowledge and Attitudes of Blood Donors Toward Sickle Cell Anemia in Ibadan.

Background Sickle cell anemia (SCA) is a common condition of public health concern in Nigeria. Different therapeutic approaches have been developed to manage SCA, including blood transfusion. In a bid to develop a sustainable solution to the blood supply pool, the SmileBuilders Initiative organizes a blood donation drive (Donate-A-Pint Project) quarterly in Ibadan, Nigeria. This study aimed to assess the awareness, knowledge, and attitudes of blood donors in Ibadan, Nigeria, towards SCA. Methods A descriptive cross-sectional study was conducted at the University College Hospital Blood Bank in Ibadan over a period of three months. A validated questionnaire, based on similar studies in Nigeria, was used to collect data from blood donors. The SPSS version 23 was used for data analysis, and the chi-square test of independence assessed associations between variables, with a significance level of 0.05. Results Among 205 donors, 68.8% were male, and 42.4% were in the age category of ≥25 years. Most donors (60.0%) were university students. While 12.3% had never heard of SCA, 79.5% were aware of their genotype. Regarding the intrauterine diagnosis of hemoglobin SS (HbSS), 20.0% would allow pregnancy, 31.7% would abort, and 48.3% were undecided. Most respondents (73.2%) had good knowledge of SCA (mean score = 7.0/10.0). If partners were found to have SCA after marriage, 42.9% were undecided. Knowledge of SCA was significantly associated with sex (p = 0.017) and education level (p = 0.001). Conclusion Blood donors in Ibadan have good knowledge, awareness, and attitudes toward SCA. However, more health education would benefit the population.

Risk factor stratification for urgent and nonurgent transfusion in patients giving birth

BackgroundA common approach to attempt to reduce maternal morbidity from hemorrhage is to recognize patients at increased risk, and to make advance preparations for possible blood transfusion in these patients. Preparation may consist of a hold clot, type, and screen, or crossmatch. Most hospitals, including ours, have pathways or guidelines that lay out which of these preparations should be made at the time a patient is admitted to labor and delivery. These are often based on risk factors for hemorrhage but do not take into account the probability that transfusion will be needed. The cost-effectiveness of performing a type and screen or routine crossmatch on patients admitted for delivery has been questioned. Several studies have shown that the chance of transfusions in individuals giving birth is very low. In terms of the need for routine blood preparation, the need for urgent transfusion is most relevant. This has not been included in studies of transfusion rates. ObjectiveThe purpose of this study was to quantify the relative importance of risk factors present on admission for needing a blood transfusion and to develop a formula to define each individual's risk. This could then be used to decide an appropriate level of initial blood preparation for patients at different risk levels. Study DesignRisk factors for hemorrhage and the level of transfusion preparation were extracted from the medical records of a cohort of 89,881 patients delivering in an 18-hospital healthcare system over 40 months. We tabulated the number who required at least one RBC transfusion and the number needing an urgent transfusion-defined as receiving blood during labor or within 4 hours after delivery. Odds ratios for requiring a transfusion were calculated for each risk factor. We then calculated the probability of needing a transfusion for each patient based on their risk factor profile. ResultsA total of 643 patients had any transfusion during their hospitalization (0.72% of deliveries), and 311 had an urgent transfusion (0.35% of deliveries). The calculated probability of needing a transfusion was less than 1% in 87.8% of patients and was greater than 5% in 1.2% of patients. The chance of needing a transfusion was highest for placenta accreta spectrum, admission Hgb <8.0, and placenta previa. A second tier of risk factors included abruption, bleeding with no specific diagnosis, and Hgb between 8.0 and 10.0. ConclusionIn our cohort, very few patients received a transfusion. Applying a formula derived from patient-specific risk factors, we found that almost all patients have a very low probability of needing a transfusion, especially an urgent transfusion. Based on these results, we suggest that a hold clot be used except for the highest-risk patients or in settings with barriers to procuring blood in the rare case of urgent transfusion need. Making this change would greatly reduce hospital blood bank charges.

Improving Blood Transfusion Request Form Documentation: A Quality Improvement Project.

The transfusion quality improvement project (QIP) serves as a valuable toolfor assessing and educating individuals who request blood components.The World Health Organization (WHO) recommends that each institution utilize a blood transfusion request form to ensure the effective conveyance of patient information to the hospital's blood bank. This QIPaimed to implement a transfusion request form and measure compliance with its use. A prospective study was conducted at Al Managil Teaching Hospital, Sudan, from May 1 to August 3, 2024, to address the lack of standardized transfusion request forms. The study included three cycles involving pre-intervention analysis, two phases of intervention with training sessions, and post-intervention evaluations. The interventions focused on developing and implementing a new transfusion request form, training clinical physicians, and reinforcing the form's use. Data from 100 randomly selected transfusion request forms were analyzed for completeness and adherence. The study showed significant improvements in the completeness of transfusion request forms across three cycles. In the first cycle, no data were collected, highlighting the absence of standardized forms. During the second cycle, with the introduction of the new form, the completion rates varied: some fields, such as patient information and clinical details, were fully completed in 50 cases (100%), while critical clinical parameters, such as current hemoglobin (Hb) and platelet (PLT) levels, were completed in only four requests (8%). By the third cycle, there was a substantial increase in completion rates across all domains. For example, patient information fields achieved 100% completion in 50 cases, and clinical parameters saw significant improvement, with current Hb and PLT levels documented in 48 cases (96%). The mean percentage completion increased from 68.1% in the second cycle to 97.9% in the third cycle, demonstrating the effectiveness of the interventions and training sessions. Minor decreases were observed in health insurance documentation and certain clinical details, indicating areas for further improvement. The systematic implementation and iterative evaluation of transfusion request forms significantly enhanced documentation completeness.

Seroprevalence of transfusion transmissible infections (TTIS) among blood donors in SOS hospital Heliwa, Somalia

BackgroundA transfusion-transmissible infection (TTI) refers to any infection that can be spread from one person to another through the injection of blood or blood products. The prevalence of these infections varies across countries, influenced by the disease burden within each population. To assess the severity of TTIs, the World Health Organization (WHO) has mandated pre-transfusion blood tests for Human Immunodeficiency Virus (HIV), Hepatitis B Virus (HBV), Hepatitis C Virus (HCV), and syphilis. This study aimed to determine the seroprevalence and trends of TTIs among blood donors at SOS Hospital in Mogadishu, Somalia, from 2016 to 2022. MethodsA retrospective cross-sectional analysis was performed by examining SOS Hospital's blood bank records spanning from 2016 to 2022. The research included all blood donors screened for transfusion-transmissible infections (TTIs) during this period. Data obtained was input and analyzed utilizing Statistical Package for Social Science (SPSS) v.25.0 and Microsoft Excel 2010. Frequencies and percentages were calculated as part of the descriptive statistics. To analyze trends, Chi-square analysis was applied, and statistical significance between variables was determined using the p-value. ResultsThere was a total of 36,296 people donated blood during study period. The majority of blood donors were males (99.8 %), primarily aged between 25 and 44 years (80.4 %) with family donors constituting 80.8 % of the participants. Among 36,296 donors, 1087 (2.99 %) tested positive for transfusion-transmissible infections (TTIs), declining from 4.27 % in 2016 to 1.98 % in 2022. The Chi-Square test confirmed a highly significant reduction in TTIs from 2016 to 2022 (X2 = 57.625, p < 0.0001), indicating a decreasing trend over the seven-year period. Conclusion and recommendationsThis study uncovers a moderate prevalence of transfusion-transmitted infections, indicating a notable decrease over time. Additionally, the findings underscore a gender disparity in blood donation, with replacement donors being predominant. It is imperative to conduct multi-center research endeavors to precisely identify the factors influencing transfusion-transmitted infections among blood donors.

The Relationship between the Level of Satisfaction of Blood Delivery Workers with Five Dimensions of Service Quality at UDD PMI Bekasi Regency in 2023

(1) Hospital Blood Bank (BDRS) is one of the health service facilities to meet the needs of blood transfusions of patients but does not rule out the possibility that blood stocks in BDRS are not available so they require assistance from the Indonesian Red Cross Blood Donor Unit (UDD PMI) in meeting the blood needs of patients. UDD PMI Bekasi Regency is carried out almost every time, regardless of the time and weather at that time. Blood collection is usually done by special officers from the hospital. This officer is what connects the chain of blood requests BDRS to UDD PMI Bekasi Regency, where later the officer will carry out blood retention and memory. (2) This research aims to determine the level of ability to use five dimensions quality services to have reliability, response, empathy, and blood transmission in UDD PMI District Bekasii. (3) Methodology This study by distributing questionnaires to 52 blood delivery officer respondents, data processing using data analysis of satisfaction index and ordinal logistic regression, namely simultaneous tests, partial tests, and model conformity tests (Hosmer-Lemeshow Goodness-of-fit Test). (4) The results of this study show that the level of satisfaction of blood delivery officers is based on five dimensions of satisfaction with UDD PMI district services. Bekasi has very satisfactory criteria.

The Relationship of PCLR Therapy on Hemoglobin Levels in Anemia Patients at BDRS MMC Jakarta (January-April 2022)

Anemia is generally characterized by a decrease in hemoglobin levels. In terms of function, a decrease in hemoglobin causes a reduction in the body's need for oxygen in sufficient quantities. PCLR (Packed Red Cell Leukoreduced) is a concentrated red blood cell product obtained through the process of reducing leukocytes, so PCLR transfusion is expected to increase Hb levels in anemia patients. This study aims to determine the relationship between PCLR administration and hemoglobin levels in anemia patients and to determine the increase in hemoglobin levels after PCLR transfusion at MMC Hospital Blood Bank (BDRS MMC) Jakarta. Quantitative (analytical) research methods. The sample in this study was 140 data from anemia patients who underwent PCLR transfusion (January-April 2022). Data analysis was carried out univariate and bivariate. The research was carried out at MMC Jakarta Hospital in July 2022. Research results: the majority of patients were elderly (56-&lt;65 years) 67 people (47.9%), the majority gender was female 82 people (58.6%); there was an increase in Hb levels after PCLR transfusion, namely 1.89 gr/dL with an average use of 2 bags; and there is a relationship between PCLR administration and hemoglobin levels in anemia patients at BDRS MMC Jakarta. Suggestion: to achieve an increase in hemoglobin in anemia patients, PCLR can be used as a blood component of choice for transfusion at the right dose.

An Overview Of Temperature And Quality Of Packed Red Cell (PRC) Components Based On Distance And Delivery Time

The Indonesian Red Cross is responsible for the distribution of blood products to hospital blood banks. The daily blood distribution route will vary due to the fact that the number of blood requests and the number of hospital blood banks vary on a daily basis. The implementation of a cold chain system is one method of optimizing blood distribution and transportation activities. The objective of this investigation is to evaluate the temperature and quality of PRC components in relation to their delivery time and distance. This research method is quantitative-descriptive. The population of this study consisted of all blood that was donated to the hospital blood bank in Sidoarjo Regency between October and November 2022. The blood sample used in this study was collected from the UDD PMI Sidoarjo Regency. The sampling technique of accidental sampling would be employed to visually identify the quality of PRC and temperature. The results of this study indicated that 460 PRC bags were delivered to three hospital blood banks in the UDD PMI Sidoarjo Regency. The PRC did not experience lysis, and 50 bags (10.86%) of the 460 PRC bags experienced a temperature change of over 10 °C. Conclusion: The temperature of the dropped PRC components is influenced by the delivery time and distance. The SOP must be strictly adhered to by all officers who distribute and transport blood to guarantee that the quality of the blood remains in good condition.

Assessing the implications of using RDTS in donor blood screening for transfusion-transmissible infections (TTIs): analysis of trans-in donor blood at a Tertiary Hospital in Ghana

BackgroundBlood transfusion is a critical hemotherapeutic intervention. However, the widespread utilization of Rapid Diagnostic Test (RDT) methods in screening potential donors for TTIs poses a serious public health challenge. We investigated the prevalence of TTIs in donor blood units that were transported from external health facilities (Trans-in blood) to Ho Teaching Hospital for critical care. MethodWe adopted a cross-sectional design to investigate 727 units of Trans-in blood at the Ho Teaching Hospital's blood bank between January 1, 2021, to December 31, 2022. An apriori-developed data capture form was used to collect the data for this study. The chi-square test and Cramer's V or Phi were used to assess the association between variables of interest. Binary logistic regression analysis was used to determine the association between TTIs and donor's blood groups whereas spatial visualization was employed to present the distribution of missed TTIs. ResultsThe overall prevalence of missed TTIs was 6.19 % (95 % CI: 4.66–8.18), comprising missed HIV, HBV, and Syphilis infection rates of 1.79 % (95 % CI: 1.72–1.86), 1.24 % (95 % CI: 1.17–1.31), and 3.16 % (95 % CI: 3.09–3.23), respectively. There was a higher rate of missed HIV infections in 2022 (2.04 %, 95 % CI: 1.04–3.97) compared to 2021 (1.49 %, 95 % CI: 0.64–3.45), and a decline in the rates of missed HBV and Syphilis infection within the period. The prevalence of TTI was highest among donors with ABO blood group 'O' (68.89 %, 95 % CI: 54.34–80.47) and Rh 'D' Positive blood group (95.56 %, 95 % CI: 85.17–98.77). Compared to donors with blood group O, non-O donors had 4.53 times the odds (95 % CI: 1.12–18.27; p-value=0.034) of missed HBV infection. ConclusionThe observed prevalence of missed TTIs highlights potential gaps in current screening practices, posing a significant public health concern. Efforts made to clamp down on the spread of these infections within the population may be impeded if the current trend of missed TTIs continues. Further studies on a larger scale with more comprehensive data are advised to better appreciate the public health implications of missed TTIs in Ghana.

Blood Donor Characteristics at a Hospital Blood Bank in Saudi Arabia: A Trend-analysis

Abstract BACKGROUND: Identification of blood donor profiles helps with recruitment and retention strategies. OBJECTIVES: To describe donor characteristics at a hospital blood bank and to describe any changes in donor characteristics throughout the study period. METHODS: In this retrospective observational study, we reviewed the blood bank records from 2005 to 2022. Characteristics of donors (age 18 or above) were collected. Percentages of donors according to various characteristics were described in 3-year intervals and compared using the Chi-square test. RESULTS: Over the study period, 226,576 blood donations were identified. Most donors were men, and half were non-Saudi nationals. Approximately two-thirds of the blood donors (145,794, 64.3%) were between 25 and 44 years old, and (59,650, 26.3%) were between 18 and 24 years old. When donors were compared across time intervals according to the age group, the percentage of donors 18–24 years old decreased over time from 31.4% in the interval 2005–2007 to 23.5% in the 2020–2022 interval. Significant changes were seen in the percentages of repeat donors as well. CONCLUSIONS: Donation trends showed significant changes related to donor age, gender, and nationality as well as donor type (new or repeat donor), the most notable being that donations by younger adults have decreased. Marketing plans must be implemented to target and retain this donor population. Further research is required for the detailed characterization of donors across the country to ensure the sustainability of the blood supply.

Evolución de la seroprevalencia de COVID-19 en bancos de sangre durante la pandemia en la región Lima, Perú

Introduction. Peru was one of the countries most affected by the COVID-19 pandemic, with more than 220,000 deaths recorded due to SARS-CoV-2 infection. Given the constant mutations of the virus and registered variants, it is important to carry out research that reflects the evolution of the humoral immune state. Objective. Measure the seroprevalence of COVID-19 during the pandemic in the department of Lima in the period between April 1, 2020 and June 30, 2022, in donor samples from 6 hospital blood banks public of Lima, Peru. Methods. A descriptive, transversal, observational and retrospective study was carried out evaluating the presence of IgM/IgG antibodies against SARS-CoV-2 using lateral flow chromatographic immunoassay in samples from healthy and asymptomatic donors from blood banks of 6 health facilities in the department of Lima. Results. A progressive increase in the seroprevalence of IgG and total reactivity of IgM/ IgG antibodies against SARS-CoV-2 will be observed as follows: 22,6% - 32,7% during 2020; 53,9% - 58,1% during 2021; 88,9% - 93,3% during the first half of 2022. Conclusions. The reactivity and presence of anti- SARS-CoV-2 antibodies progressively increase during the COVID-19 pandemic from 11,2% to 98,4% in the samples evaluated, possibly with the impact of the pandemic waves and the active vaccination campaign against COVID-19.

Advances in Human Leukocyte Antigen Testing Technologies and Management Strategies for Platelet Transfusion Refractoriness.

The blood bank is often consulted for transfusion support of patients with suspected platelet transfusion refractoriness (PTR). The workup is complex because testing includes specialized assays that are uncommonly ordered with limited availability. Add to this the variety of possible products-crossmatched platelets, human leukocyte antigen (HLA)-matched platelets, HLA antigen-negative platelets-and the approach to PTR can be overwhelming. Moreover, most literature on the subject is published in transfusion medicine journals aimed at transfusion medicine physicians and blood bank specialists in academic settings. Resources tailored to community hospital blood banks are lacking. To provide pathologists who may not have subspecialized training in transfusion medicine and who direct blood banks algorithmic workflows based on clinical scenario and test availability to provide appropriate transfusion support for patients with PTR. This review is a comprehensive overview of terminology, HLA testing procedures, interpretations, and practical recommendations for managing PTR in various scenarios based on expert opinion as well as relevant medical literature published from 2007 to 2022. Consultation on PTR is complicated and encompasses many clinical and laboratory aspects. The lack of guidelines derived from high-quality prospective studies poses challenges in the workup and management of PTR. Hindering the process further are limited test availability, unfamiliarity with the technical assays, and the various specialized platelet products. The clinical evaluation algorithm presented herein along with the workflow pathways offer pathologists user-friendly and best-practice guidelines with different options based on the clinical scenario and the tests available.

Blood Link

Abstract: In the face of medical emergencies, the rapid and reliable delivery of blood to hospitals can be a matter of life and death. This project presents "BloodLink," a comprehensive solution that leverages modern web technologies and drone delivery systems to streamline the blood supply chain between blood banks and hospitals. The front-end of the system is developed using HTML, CSS, and JavaScript, ensuring a user-friendly interface for hospital staff to post blood group requirements. The backend is powered by the Flask framework of Python, facilitating robust and scalable server-side operations. Utilizing the Google Maps API, our platform dynamically identifies and displays the nearest blood banks in response to hospital requests, ensuring timely and accurate information. For critical situations requiring immediate action, we have integrated an innovative drone delivery system designed to expedite the transportation of blood to the requesting hospitals. The software development phase of the project is complete, and efforts are currently focused on the practical design and implementation of the drone system. This paper details the architecture, development process, and potential impact of "BloodLink" in revolutionizing emergency blood delivery and hospital blood bank coordination.

Analysis And Reason For Discard Of Blood Products: A Retrospective Study In A Tertiary Care Hospital Blood Bank From Parul Sevashram Hospital, Vadodara.

Background: A life-saving procedure is a blood transfusion, but there is often a shortage in blood supply due to various factors. Despite the enormous advancements in medical research, there is still no substitute for blood, making blood transfusions a crucial component of contemporary healthcare. The study aimed to evaluate the discard reasons for blood components, particularly Fresh Frozen Plasma, Platelet Concentration, and Red Cell Concentration and to suggest possible strategies to reduce wastage. Methods: The Retrospective analysis of discarded blood components was carried out from July, 1st 2023 to December 31st 2023 in the blood bank of Parul Sevashram. Data was collected using a discard register and computer data of discard available in blood bank and was analysed in SPSS software version 26.0 and Microsoft Excel. The wastage rate was calculated with a percentage of total number of units wastage against the total number of collections. Results: A total of 4990 blood component were prepared out of which 706 blood component was discarded. The total discard ratio of the study was 14.14%. Total replacement donors were 83.91% and 16.31% were voluntary donations. The discard rate for PC, RCC, and FFP was 86.30%, 6.82%, and 2.01%. HbsAg was the most common reason for the discard due to seropositivity of TTIs. Conclusion: The Most common component discarded was platelet and the reason for discard was the date of expiry due to non-utilization. Seropositivity was the reason for discarding red cell concentration and leakage was the most common reason for fresh frozen plasma. The wastage can be reduced by implementing proper strategies such as FIFO policy, avoiding Mega camps, proper staff training and wastage reduced protocol.

Evaluation of Blood Transfusion Request form: The Experience in a Tertiary Health Facility in Jos, Nigeria

Background: There is a thin line between a safe blood transfusion and transfusion-related fatality hence the need to be diligent in every aspect of the blood transfusion process. Appropriate and complete documentation on a blood transfusion request form is one of the most important preanalytic activities serving as a communication tool between the clinician and the blood transfusion laboratory personnel. Aims: To evaluate compliance with appropriate and complete documentation of information on our blood transfusion request forms for a reliable preanalytic process towards an efficient blood transfusion service. Study Design: It is a retrospective study. Place and Duration of Study: Blood Bank of the Jos University Teaching Hospital between January to December 2023. Methodology: Six thousand, three hundred and sixty (6360) blood transfusion request forms from the Jos University Teaching Hospital Blood bank were evaluated for complete or incomplete documentation retrospectively and results were presented in frequencies and percentages. Results: There was 100% compliance in filling in the patients' surnames and other names as well as the laboratory number and blood groups of the patients while only 4779 (75.14%) filled in the patients' ages with 1416(22.26%) using the prefix of adult(ad) while 165(2.59%) fail to document the patients' age. There were 2829 (44.48%) males with 3522 (55.38%) females while no sex was indicated in 9 of the reviewed forms. Obstetrics history has the least cumulated documented response of 0.38% while a significant 1008 (15.85%) did not indicate either blood grouping or blood grouping with cross-match request. Conclusion: Appropriate and complete documentation of information on blood transfusion request forms is a problem among clinicians and will require continuous education on its importance, periodic auditing, provision of electronic data system and attitudinal change for a better blood transfusion compatibility service.

Meeting the transfusion needs of a patient with anti-Ena requires an international effort.

This extraordinary case showcases the identification of a rare anti-Ena specificity that was assisted by DNA-based red blood cell antigen typing and collaboration between the hospital blood bank in the United States, the home blood center in Qatar, the blood center Immunohematology Reference Laboratory, as well as the American Rare Donor Program (ARDP) and the International Society for Blood Transfusion (ISBT) International Rare Donor Panel. Ena is a high-prevalence antigen, and blood samples from over 200 individuals of the extended family in Qatar were crossmatched against the patient's plasma with one compatible En(a-) individual identified. The ISBT International Rare Donor Panel identified an additional donor in Canada, resulting in a total of two En(a-) individuals available to donate blood for the patient.

Clinical significance of viral markers testing by ELISA and Individual Donation Nucleic Acid Testing (ID-NAT) for blood screening in blood bank: Single center study in Egypt

Prevention of transfusion-transmitted viral infections and insurance of safe blood transfusion are the main goals of all blood banks worldwide. Despite the high sensitivity and specificity of currently used enzyme linked immunosorbent assay (ELISA) for hepatitis B virus (HBV), hepatitis C virus (HCV) and human immunodeficiency virus (HIV) testing, viral transmission could still occur during the window period. Introducing viral individual donation nucleic acid testing (ID-NAT) can greatly decrease such risk providing an additional layer in securing blood transfusion. We aimed to assess the clinical significance of viral markers testing by ELISA and ID-NAT for blood screening in the Blood Bank of Suez Canal University Hospital. We studied all donations (2132) collected during a two-months period. Blood donor samples were screened by ELISA and ID-NAT tests for HBV, HCV, and HIV. Serological testing results for HCV by ELISA revealed 2,122 (99.5 %) negative donations compared to 2,131 (99.95 %) negative donations by ID-NAT testing. Of the positive ELISA samples, only one was NAT positive. For HBV ELISA testing, 2,115 (99.2 %) donations were negative, also by ID-NAT testing 2,115 (99.2 %) donations were HBV DNA negative. Out of the negative ELISA samples, two samples were ID-NAT reactive donors which were missed by serology assay being in the window period. HIV ELISA testing revealed negative 2,130 (99.9 %) donations while ID-NAT testing showed 2,131 (99.95 %) negative donations and one positive donation. In conclusion, this is the first study carried out in the Suez Canal and Sinai region, Egypt to assess the importance of ID-NAT implementation. The introduction of ID-NAT in blood banks is an effective method for increasing safety of the blood transfusion.

Transfusion transmitted infections among blood donors of Kamenge Teaching Hospital blood bank in Burundi.

The current risk of contracting a transfusion transmitted infections (TTIs) is unknown in Burundi. The aim of this study was to assess sociodemographic profiles of blood bank donors at Kamenge Teaching Hospital, the prevalence and associated risk factors of HIV, syphilis, HBV and HCV from 2015 to 2020. We conducted a cross-sectional study including all blood donors of Kamenge Teaching Hospital blood bank. During this study, 1370 blood samples were screened for HIV, Syphilis, HBV and HCV. We calculated prevalence of TTIs and performed logistic regression to know associated risk factors. Blood donors were males at 77% and 23% females. They were mostly students (54.2%). On screening, 83 blood samples (6.06%) were seropositive for at least one TTI. The overall prevalence rate of HIV, Syphilis, HBV and HCV among blood donors was 1.3%, 0.2% ,1.6%, 2.9% respectively. There was difference in distribution of the four TTIs among blood donors which is statistically significant (x2=33.997, ϱ-value<0.001). Private donors were associated with a high risk of syphilis and being a first-time donor was associated with a high HBV risk factor. The prevalence of TTIs found still to be high; mandatory and continuous screening is necessary.

A global analysis of the use of immunoglobulin, shortages in supply, and mitigating measures: A survey of hospital providers (a BEST Collaborative study).

Immunoglobulin (IG) therapy is widely used to treat primary and secondary immune deficiencies and as immunomodulatory agent for various disorders. There is great concern that shortages of IG may rise, potentially affecting medical treatment options. An international survey was developed to study how intravenous immunoglobulins (IVIGs) are used and managed within hospitals in case of shortages. Study data were collected and managed using REDCap electronic data capture tools hosted by the Biomedical Excellence for Safer Transfusion (BEST) Collaborative. The survey was directed to hospital pharmacists and blood bank transfusion professionals and disseminated through members of the BEST Collaborative network. Survey respondents from institutions in the USA, Canada, Europe, Japan, and Australia (n = 13) confirmed that the primary specialties utilizing IG are neurology, hematology, and immunology. More than 60% of respondents reported IG supply shortages, but mitigation strategies were not well developed. As IG is the leading driver in plasma demand, more studies are needed to understand current and future demand for IG from the clinical perspective. Necessity lies in establishing clinical guidance to address shortages.

Implementation of a prehospital whole blood program: Lessons learned.

Early blood administration by Emergency Medical Services (EMS) to patients suffering from hemorrhagic shock improves outcomes. Prehospital blood programs represent an invaluable resuscitation capability that directly addresses hemorrhagic shock and mitigates subsequent multiple organ dysfunction syndrome. Prehospital blood programs must be thoughtfully planned, have multiple safeguards, ensure adequate training and credentialing processes, and be responsible stewards of blood resources. According to the 2022 best practices model by Yazer etal, the four key pillars of a successful prehospital program include the following: (1) the rationale for the use and a description of blood products that can be transfused in the prehospital setting, (2) storage of blood products outside the hospital blood bank and how to move them to the patient in the prehospital setting, (3) prehospital transfusion criteria and administration personnel, and (4) documentation of prehospital transfusion and handover to the hospital team. This concepts paper describes our operational experience using these four pillars to make Maryland's inaugural prehospital ground-based low-titer O-positive whole blood program successful. These lessons learned may inform other EMS systems as they establish prehospital blood programs to help improve outcomes and enhance mass casualty response.

Impact of Implementing a Standard Operating Procedure to Reduce Blood Wastage in Blood Centers of Iran.

Blood wastage leads to additional costs and reduced blood availability to patients. Above all is the moral issue of wasting donor gifts. This study aimed to determine the rate of blood wastage before and after implementing a new standard operating procedure (SOP) in Iran. In this interventional study, a SOP for wastage management was prepared and implemented in all blood centers throughout the country. Data were extracted from the integrated software of the Iranian Blood Transfusion Organization (IBTO). The wastage rate of blood components in the post-intervention years (2016-2017) was then compared with that in the pre-intervention years (2013-2015) using the Z test. The overall wastage rate decreased by 36.86% (P<0.001, 95% CI [36.84-36.88]) after the intervention. Red blood cell (RBC) wastage decreased from 2.6% to 2.5%, platelet wastage from 19.5% to 10.6% and plasma wastage from 15.5% to 7.3% (P<0.001). The highest percentage of waste reduction pertained to plasma components, which decreased by 52.90% (P<0.001, 95% CI [52.86-52.94]). Expiration was the most common cause of RBC and platelet wastage. The most common causes of plasma wastage were RBC contamination and rupture or leakage of the bags. The intervention resulted in a drop of over 250000 discarded components each year, equal to approximately thirty-six million dollars in savings. This intervention effectively reduced waste and increased efficiency. Ongoing blood wastage reviews, auditing, and receiving feedback from the central headquarters were powerful tools in following the compliance of blood centers. Further studies are recommended, especially concerning blood wastage in hospital blood banks and various wards.