Regional Blood Transfusion Centre Research Articles

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 < 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 > 27.5/m2 with odds ratio 2.5 (1.4–4.3). Having an estimated blood volume < 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.

Pre-transfusion compatibility tests in Malagasy sickle cell patients

Introduction: Blood transfusion is a key component of sickle cell disease management. However, iterative transfusions of labile blood products for sickle cell patients increase the risk of anti-erythrocyte alloimmunization. It is usual to perform pre-transfusion compatibility tests in order to check ABO compatibility and to detect the possible existence of irregular antibodies in patients against the donor's antigens. Methods: This is a prospective and descriptive study dealing with pre-transfusion compatibility tests over a 3-month period, from September 2018 to November 2018, at the Regional Blood Transfusion Centre (CRTS) of Analamanga Region, the capital of Madagascar. Results: We included 33 out of 113 patients during the study period. Compatibility test was positive in 21.21%, of all tested samples. Major and minor compatibility tests were positive alone respectively in 6.25% and 12.50%. And both were positive in 3.12%. The self-test was positive in 3.03% with a positive direct antiglobulin test. Positive compatibility tests were more frequent in patients who received more than two transfusions. Compatible blood bag for the patient was found after testing 2 donor pockets in 27.27% of cases, and after testing 3 pockets in 3.03%. Conclusion: Pre-transfusion compatibility tests are essential and have to be performed systematically on each blood bag before any transfusion. They are used to identify the presence of alloantibodies and provide compatible blood products to patients.

Review of haemovigilance at the Rabat Regional Blood Transfusion Centre in Morocco (2017-2021).

blood transfusion remains an essential therapeutic intervention, but the occurrence of transfusion reactions makes its administration even more complex. Vigilant reporting of such reactions by recipients of blood products is essential for effective haemovigilance. This study aimed to determine the frequency and nature of transfusion reactions. conducted over five years (2017-2021) at the Haemovigilance Department of the Rabat Regional Blood Transfusion Centre, this retrospective study exploited incident forms notified by health establishments and data from the regional blood transfusion centre's computer system. from 1 January 2017 and 31 December 2021, the Rabat Regional Blood Transfusion Centre distributed 435,651 labile blood products to various healthcare establishments, which reported 191 transfusion reactions involving 191 patients. The median age of the patients was 44.3 years, with an overall cumulative incidence of transfusion reactions of 0.44 per 1000 labile blood products delivered. The predominant reactions were non-haemolytic febrile and allergic reactions, accounting for 41.36% and 35.60% respectively. Grade 1 reactions accounted for 87% of all reactions recorded. During the study period, three deaths were recorded, with ABO incompatibility and transfusion-related acute lung injury (TRALI) accounting for two and one case respectively. Transfusion reactions involving erythrocyte components were significantly more frequent than those involving platelet and plasma components. this study revealed a relatively low incidence of transfusion reactions (0.44%), dominated by non-haemolytic febrile and allergic reactions. Several levels of failure were identified, in particular under-reporting of reactions and inadequate training in transfusion practices and haemovigilance, as well as the need for an effective electronic transfusion reaction reporting system to facilitate reporting and identification of underlying problems and risk factors to improve the quality of transfusion care provided to patients.

Necessity of Implementing Ferritin Testing for Regular Blood Donors – A Cross-sectional Analysis of Serum Ferritin Levels in Individuals Donating Blood at Various Frequencies in a Year at a Regional Blood Transfusion Center

Background and Objectives: The virtuous act of blood donations should be encouraged and promoted by all means while safeguarding the well-being of the donor. If regular blood donations lead to iron store depletion in any individual, it may be identified and preventive measures should be taken. The current practice of hemoglobin (Hb) testing alone before donation may not detect the depletion of iron stores. Yet, a policy to introduce tests for iron stores and iron supplementation in regular donors requires extensive research in this area because of the cost and feasibility concerns. The objectives were to study the prevalence of subclinical anemia among voluntary blood donors using serum ferritin levels attending the blood transfusion center and to compare the average Hb and serum ferritin levels of donors across different age groups, gender, and donation frequencies. Methods: A cross-sectional study was done on 300 consecutively enrolled voluntary whole-blood donors (December 2018–November 2019) who fulfilled eligibility criteria. Donors were further divided into four groups, depending on their number of donations. Their samples were tested for Hb and serum ferritin to check for reduced body iron stores. The data obtained were analyzed using SPSS version 23. Results: A total of 300 regular voluntary donors were included in the study. 57.7% of donors were in the age group of 20–29 years, of which 83.33% were males. The total prevalence of subclinical anemia was 16%, in whom 54.2% were males and 45.8% were females. Out of the total female donors in our study (50), 44% suffered from subclinical anemia. Out of the total male donors in the study (250), 10.4% suffered from subclinical anemia. There was a significant association between frequency of donation and subclinical anemia (odds ratio [OR] =6.36, P < 0.001). There was a significant association between subclinical anemia across gender (high for females; OR = 6.76, P < 0.001). There was a significant correlation between the frequency of donation and serum ferritin (Spearman correlation coefficient: −0.299), but there was no correlation observed between the frequency of donation and Hb levels. Conclusion: The study demonstrates the depletion of iron store with increasing donation frequency. This calls for continual supervision of body iron stores rather than Hb alone to ensure the continuous supply of healthy blood donors.

Prevalence of antinuclear antibodies among healthy blood donors: An experience of a regional blood transfusion center

Objectives: Antinuclear antibodies (ANAs) are antibodies directed against one or more molecules within the nucleus. Although ANA is present in patients suffering from connective tissue diseases, few reports reveal the presence of ANA in a healthy population. The present study aimed to identify the prevalence of ANA in healthy blood donors. Materials and Method: Blood samples from 370 healthy blood donors were included in the present study. To detect serum ANA, an indirect immunofluorescence technique was used using HEp-2000 slides. A titer of 1:80 was used and the type of pattern (if positive) cases were also noticed. Results: Out of 370 healthy donors, there were 187 males and 183 females (M: F = 1.02:1). ANA was detected in four out of 370 samples (1.081%). All the positive donors were female (100%). Among all the positive cases, three cases showed a speckled pattern and one showed a homogenous pattern at 1:80 dilution. Conclusion: In conclusion, there is a low prevalence of ANA positivity among healthy individuals. Although, along with clinical signs and symptoms, ANA is diagnostic of autoimmune disease, the mere presence of ANA is not synonymous with the presence of clinically significant autoimmune disease.

The highest Duffy (FYX) allele frequency ever reported for Scottish population: A cross-sectional study.

The Duffy (FY) blood group system has six known antigens among which the Fya and Fyb are known as major antigens. Fyx phenotype forms as a result of two point mutations in the FYB allele leading to instability of Duffy protein and so reduction of Duffy antigen expression in the cells. This study aimed to investigate the FYX allele frequency in the Scottish population. The Duffy blood group system was serologically and molecularly investigated in 222 samples collected from donors of Aberdeen Regional Blood Transfusion Center (BTC). The haemagglutination and BeadChip microarray chemistry methods were used for phenotyping and genotyping. Confirmatory tests were also used to check the discrepant results. In this study, the frequency of Duffy blood group phenotypes including Fya+, Fya+b+, and Fyb+ were 17.57%, 42.79%, and 39.64%, respectively. Furthermore, the frequency of FYA/FYA, FYA/FYB, and FYB/FYB genotypes was estimated to be 14.41%, 45.95%, and 39.64%, respectively, using the Bioarray method. In the present study, based on Duffy DNA sequencing results, 12 samples (5.41%) had just one FYX allele. The frequency of the FYX allele in this study was estimated to be 0.0270% which is more than the results reported so far.

Link between human ABO blood groups with diseases influencing blood donors and recipients frequency at RBTC, Delhi, India.

Blood groups had associations with many diseases that affect blood transfusion services by increasing or decreasing the blood demand of particular blood group. The present study was designed to compare the frequency of ABO and Rh blood groups among blood donors and blood component recipients. The ABO and Rh(D) blood groups of donors and recipients were determined using Gel card method. The frequency of blood donors and blood component recipients from January 1, 2020, to December 31, 2023, at regional blood transfusion centre of Delhi, were compared using χ² test. The ABO blood group frequencies of blood donors (n=23025) were: A(23.1%), B(37.53%), AB(10.09%), and O(29.29%). The blood issue (n=20255) was significantly (p=0.0000) higher in A(24.96%), B(39.92%), and lower in AB(9.76%) and O(25.37%). The RDP issue (n=7239) was significantly (p=0.0000) higher in A(24.71%), B(39.34%), and AB(11.53%) and lower in O(24.41%). The FFP issue (n=4164) was significantly (p=0.00024) higher in AB (12.3%) and lower in A (22.05%), B(37.32%), and O(28.14%). The difference between the blood donor frequencies of Rh(D)+Ve(95.19%) and Rh(D)-Ve(4.81%) and the blood issued by Rh(D)+Ve(95.06%) and Rh(D)-Ve(4.94%) was statistically not significant(P=0.52).Blood issues were higher in blood group A and B than in O, platelet issues were higher in A, B and AB than in O, and FFP issues were higher in the AB. Non-O blood groups may have a higher frequency of blood transfusions, while O blood groups may have a protective influence against diseases due to their innate immune response.

Effect of COVID-19 pandemic on blood transfusion service: an experience from a regional blood transfusion center.

The unforeseen and uncertain life-threatening situation of the COVID-19 pandemic dramatically affected all areas of the human daily work schedule. This study was designed to assess the impact of the COVID-19 pandemic on blood transfusion services and discuss the adopted confrontation measures for uninterrupted blood supply during the pandemic situation. The data on blood donation, blood component preparation, and issue from January 2019 to December 2022 were collected from the inventory registers of the RBTC, Delhi, India. Compared to the non-pandemic year 2019, during the year 2020, all variables decreased gradually. The observed maximum decrease in variables such as blood collection (-79.16%) in the month of October, blood issue (-71.61%) in the month of August, random donor platelets (RDP) preparation (-98.09%) in the month of October, RDP issue (-86.08%) in the month of September, fresh frozen plasma (FFP) preparation (-100%) in the month of October, and FFP issue (-96.08%) in the month of July with an annual decrease of -45.52%, -42.87%, -33.00%, -59.79%, -40.98%, and -54.48%, respectively, as compared to year 2019. Compared to year 2020, in year 2021, the annual increase in blood collection, blood issue, FFP preparation, FFP issue, RDP preparation, and RDP issue was +50.20%, +21.68%, +65.31%, +78.52%, +116.23%, and +213.30%, respectively. Our study results show that the COVID-19 pandemic has significantly affected blood transfusion services at our blood bank. The adopted coping strategies to maintain the safe and uninterrupted blood transfusion chain at our blood bank gave us lessons for future preparedness if faced with a similar situation.

Phenotype, allele and genotype frequency distribution of ABO and Rh(D) blood group among blood donors attending regional blood transfusion centre in Delhi, India.

The ABO and Rh blood group phenotypes, alleles, and genotype frequencies have many biological and medical implications. The frequency differs broadly according to races, geographical borders and ethnicity, even within the same region. This study was designed to determine the frequency of ABO and Rh blood groups among blood donors attending the regional blood transfusion centre in Delhi. The gel card method was used to determine the ABO and Rh(D) blood groups of donors who donated blood between January 1, 2020, and June 30, 2022. The assumption of Hardy-Weinberg equilibrium was used to determine allele and genotype frequencies of blood donors. A total of 16,925 blood units were donated during the study period. Donors phenotype frequencies of ABO were as follows: 'A' (23.88%), 'B' (37.38%), 'AB' (9.97%) and 'O '(29.27%). Rh(D)+Ve (D) were (94.9%) and Rh(D)-Ve (d) were (5.01%), which follow an order of B > O > A > AB and Rh-D > d for Rh. Donors ABO and Rh (D) allele frequencies were IA-0.183, IB-0.277, IO-0.541 and ID-0.776, Id-0.224 respectively. Allele frequencies follow an order of IO > IB > IA and Rh- ID > Id. Donors ABO genotype frequencies were AA-0.0333, AO-0.198, BB-0.0768, BO-0.30, AB-0.101, OO-0.293 and Rh(D) genotype frequencies were DD-0.602, Dd-0.347, dd-0.0501. Genotype frequencies follow an order of BO > OO > AO > AB > BB > AA and DD > Dd > dd. Among our donors, which were mostly from northern India, the ABO and Rh(D) blood groups have the highest proportion of ABO-B and Rh(D)+Ve and the lowest proportion of ABO-AB and Rh(D)-Ve, with a stable order of B > O > A > AB and D > d for phenotype, IO > IB > IA and ID > Id for allele and BO > OO > AO > AB > BB > AA and DD > Dd > dd for genotype.

Indicators of immunity in workers engaged in the processing of natural gas and condensate

Introduction. Despite the unique measures being taken at the Astrakhan Gas Processing Plant for personnel protection, the harmful exposure to the staff is not eliminated completely yet. Examination of the immune system is one of the methods of laboratory control over the gas-processing workers’ health and the system of measures for hygienic normalization of the working conditions. Materials and methods. The present study describes the working environment and evaluates the state of the immune system in workers with the use of the standard unified methods and approaches. A Brüel & Kjear 1302 multi gas monitor and a Tsvet-550 gas chromatograph were used to indicate pollutants. Examination involved one hundred sixty workers and 81 person from the control group (donors of Astrakhan Regional Blood Transfusion Center). The immune system was evaluated using the System 9000 Plus hematological analyser, Cyto FLEX LX flow cytometer, UNICO 2100UV specrophotometer, and KFK-3-03-ZOMZ photometer Results. The established set of the main unfavourable production factors includes air pollution of the work area with sulphur dioxide, nitrogen oxides, carbon, hydrogen sulphide, saturated and unsaturated hydrocarbons, and unfavourable microclimatic conditions. Occupational hazards cause in employees changes in the immune status including leukocytosis, lymphocytosis, changes in the composition of the lymphocyte population and T lymphocyte subpopulation, a decrease in the immunoglobulin content, lysozyme activity and phagocytosis index. Limitations. The study took into account only the effect of occupational hazards on the deviation of the immune status of workers engaged in natural gas and condensate processing. Conclusion. The authors consider the recorded changes to be adaptive. It suggests the possibility of normalization of the workers’ immune system functions with adequate rehabilitation measures.

Occurrence of red blood cell abnormalities in donor blood donated at the regional blood transfusion centre, Mombasa, Kenya

During transfusion, components of blood including red blood cells, platelets and plasma are directly administered into the recipient to treat conditions such as anaemia and haemostatic deficiencies. In most cases, effective blood transfusions will positively impact patient prognosis. Red blood cell abnormalities greatly impact on the effectiveness of blood transfusion. This is because the efficacy of a red blood cell unit depends on the amount of blood delivered, the quality of cells and the life span of a given unit. The aim of this study was to establish the occurrence of red cell abnormalities in donor blood. This descriptive cross-sectional study was done at the regional blood transfusion centre, Mombasa and at the Technical University of Mombasa, Kenya. Consecutive blood samples were analyzed for selected red cell parameters. A total of 676 samples were analyzed. The study found that 31.07 % of the donor samples had one or more of the abnormalities assayed. There was a significant variation (t - 0.03, CI 95%) in the total red blood cell count. A significant Pearson’s positive correlation was realized between the osmotic fragility and haemoglobin concentration (r = 0.195; p < 0.001). This shows that a significant proportion of donated red blood cells in the donor pool had intrinsic or extrinsic abnormalities. There is therefore need to develop strategies that may better help to filter out these abnormalities as well as investigate the effect of such abnormalities to the recipient.

Seroprevalence of SARS-CoV-2 IgG antibodies among asymptomatic whole blood donors at a regional blood transfusion center and association of prevalence with ABO blood group

Background: Serological tests in asymptomatic donors provide may be a source of information on estimate of population-based infection. Serological tests using immunoglobulin G (IgG) can be a useful tool in assessing the disease’s spread if they are carried out serially in a regular manner. We analyzed the pattern in seroprevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) IgG in frequent intervals in an unvaccinated population. Aims and Objectives: This study aimed to study the prevalence of SARS-CoV-2 in asymptomatic blood donors in the period just before vaccine enrollment in Kerala and assess risk factors for SARS-CoV-2 positivity. Materials and Methods: The study was a cross-sectional study in which SARS-CoV-2 IgG positivity was estimated in blood donors attending Government Medical College, Trivandrum from February 1, 2021, to March 31, 2021. The participants responded to a questionnaire also about their demographic characteristics and risk factors. Data were analyzed in SPSS version 17. Results: The overall seroprevalence of COVID-19 anti-IgG antibody in blood donors was 26.4% (191/724). Periodic prevalence was 21.7% in the first half of February, 25.9% in the second half of February, 47.6% in the first half of March, and 25% in 2nd half of March 2021. Non-O group donors carried a higher risk for COVID seropositivity. Conclusion: The seroprevalence of SARS-CoV-2 was higher among the blood donors compared to the general population who were asymptomatic but it reflected the pattern in the general population. No specific risk factor among donor characteristics was identified which can predict seropositivity.

Prevalence of Alloimmunizations in Moroccan Pregnant Women

Introduction: Erythrocyte fetomaternal incompatibility is defined by the binding of erythrocyte alloantibodies of a pregnant woman to fetal antigens, inherited from the father. Alloantibodies are produced by the immune system after prior contact with these same antigens during transfusion, transplant or previous pregnancy. In Morocco, data concerning fetomaternal incompatibilities are insufficient despite the severe cases of hemolytic disease in newborns recorded. Our aim is to determine the prevalence of anti-erythrocytes alloimmunizations in Moroccan pregnant women as well as the frequencies of alloantibody specificities. Patients and Methods: A population of parturients with no obstetrical history was randomly recruited to the Blood Bank of Kenitra. A second population was formed by pregnant women referred to the Regional Blood Transfusion Center of Rabat for reasons of obstetrical and/or immunohaematological history. The tests were carried out using the gel cards and 2 panels of 11 red blood cells. Antibody titration was performed by indirect Coombs technique. Results: Immunohematological tests and analysis of clinical-biological data made it possible to detect and confirm alloimmunization in 16 RhD negative and positive women. The prevalence of alloimmunization in RhD negative women is 2.46 % and the prevalence of alloimmunization in both RhD-/+ parturients was 1,06 %. In parturients with an obstetric history, the frequencies of alloantibodies are respectively 35.48% (11/31) and 100% (3/3) directed against 7 antigenic specificities: D, C, E, c, e, Jka and s. None of the parturients had received timely anti-D prophylaxis or prenatal RhD genotyping. Conclusion: The discussion of our results highlights the problem of the management of pregnant women at risk of alloimmunization, putting Morocco in front of a challenge of setting up a health policy, including above all the training of health professionals and the accessibility at the national level to the biological examinations necessary for the follow-up of the pregnant women to reduce the prevalence of the HDFN.

Analysis of ABO subgroups which result in ABO discrepancies in Iranian blood donors

The ABO blood group system plays a vital role in the blood transfusion and transplantation medicine [ [1] Hosseini‐Maaf B. Hellberg Å. Chester M.A. Olsson M.L. An extensive polymerase chain reaction–allele‐specific polymorphism strategy for clinical ABO blood group genotyping that avoids potential errors caused by null, subgroup, and hybrid alleles. Transfusion. 2007; 47: 2110-2125 Crossref PubMed Scopus (43) Google Scholar ]. It consists of the major A, B, O alleles and many of subtypes with weak expression of A or B antigens on red blood cells. The results of both forward and reverse ABO typing are necessary for ABO blood group typing, as they are both necessary for interpreting the results [ [2] Arumugam P. Hamsavardhini S. Ravishankar J. Bharath R. Resolving ABO discrepancies by serological workup‐an analysis of few cases. Int J Res Med Sci. 2017; 5: 893-900 Crossref Google Scholar ]. ABO discrepancies may be due to technical or human errors, weak subgroups, the transient expression of antigens in some disease like carcinomas and mixed-filled agglutination after massive or chronic transfusion [ 3 Kaur G. Kaur P. Basu S. Kaur R. Blood group discrepancies at a tertiary care centre–analysis and resolution. Int J Lab Hematol. 2014; 36: 481-487 Crossref PubMed Scopus (18) Google Scholar , 4 Meny G. Recognizing and resolving ABO discrepancies. Immunohematology. 2017; 33: 76-81 Crossref PubMed Google Scholar , 5 Storry J.R. Condon J. Hult A.K. Harrison A. Jørgensen R. Olsson M.L. An age‐dependent ABO discrepancy between mother and baby reveals a novel A weak allele. Transfusion. 2015; 55: 422-426 Crossref PubMed Scopus (7) Google Scholar ]. The incidence of ABO discrepancies among blood donors was reported from 0.02 % to 0.06 %, Also the ABO subgroups are considered the most common cause of ABO discrepancies [ 3 Kaur G. Kaur P. Basu S. Kaur R. Blood group discrepancies at a tertiary care centre–analysis and resolution. Int J Lab Hematol. 2014; 36: 481-487 Crossref PubMed Scopus (18) Google Scholar , 6 Sharma T. Garg N. Singh B. ABO blood group discrepancies among blood donors in Regional Blood Transfusion Centre GTB Hospital, Delhi, India. Transfus Apher Sci. 2014; 50: 75-80 Abstract Full Text Full Text PDF PubMed Scopus (13) Google Scholar , 7 Makroo R.N. Kakkar B. Agrawal S. Chowdhry M. Prakash B. Karna P. Retrospective analysis of forward and reverse ABO typing discrepancies among patients and blood donors in a tertiary care hospital. Transfus Med. 2019; 29: 103-109 Crossref PubMed Scopus (10) Google Scholar ]. Weak ABO subgroups are categorized as type II (Weak/missing antigen) or type IV (due to presence of Anti–A1) ABO discrepancy [ [8] Jain A. Gupta A. Malhotra S. Marwaha N. Sharma R.R. An ABO blood grouping discrepancy: Probable B (A) phenotype. Transfus Apher Sci. 2017; 56: 459-460 Abstract Full Text Full Text PDF PubMed Scopus (3) Google Scholar ]. Mistyped A and B weak blood group as O and B(A) as cisAB and AxB during routine serologic tests can have serious consequences, such as hemolytic adverse transfusion reactions [ [9] Jiao L.X. Zhang J.Y. Chen L. Yu X.L. Han Y. Yang F. et al. Gene identification of rare B (A) blood group. Transfus Apher Sci. 2017; 56: 855-857 Abstract Full Text Full Text PDF PubMed Scopus (2) Google Scholar ].

Challenges facing blood transfusion services at a regional blood transfusion center in Western Kenya

Aims: The demand for blood and blood products in sub-Saharan Africa is occasioned by tropical infectious diseases and obstetric complications that cause anemia. We therefore need a well-organized blood transfusion service with sufficient resources to process blood and blood products, especially in the Western Kenya, where co-infections of tropical diseases are rampant. This study was aimed at determining the blood deficiency and challenges experienced by Eldoret Regional Blood Transfusion Center (ERBTC). Methods: A cross-sectional descriptive design was used to conduct the study. All the ERBTC staffs, donor records, and blood requisition and dispatch registers were studied. Self-administered questionnaires and data collection abstraction forms were used to collect data. The extracted data from ERBTC registers included those on demand and supply mismatches and blood discards. The obtained data were entered into Microsoft Excel and analyzed using descriptive statistics. Results: A total of 16 staffs, 230 donor records, and 9612 units of requested blood were reviewed. The ERBTC reported many challenges ranging from understaffing, limited funding, insufficient equipment, and irregular reagents and other laboratory supplies. During the study period, the blood bank only managed to supply 4740 units of blood against a demand of 9612 units, thus occasioning a 50.7% deficit. A discard rate of 7.8% after the screening was also reported due to insufficient volumes after collection and transfusion transmissible infections. However, there were no wastages during the study period. Conclusion: The main challenges experienced by ERBTC were understaffing, insufficient funding, limited equipment, frequent reagent outages, and discards of unsuitable blood, resulting in very high deficits. We recommend hiring staff, increased funding, acquiring modern equipment and reagents, and recruiting known regular blood donors to alleviate frequent shortage.

Retrospective analysis of selected aspects of public blood transfusion service activities as a starting point for assessment of the status of transfusion medicine in Poland. Part 3: Donations of blood and blood components in the period 1997–2017

Background: Blood donation is primarily an activity of collecting blood from healthy people for the benefit of those who require transfusion (e.g. surgery, oncology and hematology patients or those who suffer massive blood loss) or for the purpose of manufacturing blood products. The overall availability of blood in a country is reflected by the whole blood donation rate (WB) per 1000 inhabitants. It is accepted that the minimum of 30 WB donations/1000 inhabitants provides sufficient protection for the healthcare system, whereas blood supply is considered insufficient when the number of donors drops below 10/1000 inhabitants. A European country is at the basic level of self-sufficiency in terms of blood supply if approximately 2.5% of its population donates blood regularly. Poland has been self-sufficient for many years now, but there is growing awareness that the self-sufficiency may be disturbed mainly because of ongoing demographic changes. One such change is the growing number of elderly people which means an increase in the overall percentage of the sick. In the recent years, Poland has reached a certain level of blood donations (about 1.2 mil per year) and it may be difficult to improve the result without altering the approach to donor recruitment. Material and methods: Material for analyses were the available annual reports from 21 Polish Regional Blood Transfusion Centers (RBTCs) forwarded to the Institute of Hematology and Blood Transfusion (IHTM). The following tools were used for statistical analysis of the available data: Microsoft Office: Access and Excel, Microsoft Power Business Intelligence (Power BI) software and STATISTICA version 13.3 software (TIBCO Software Inc.). Results: In the years 1997–2017, a total of over 20.5 mil WB units were collected (mainly from voluntary non-remunerated donors > 99.7%). The largest number of voluntary nonremunerated donations was collected in RBTC in Warsaw and RBTC in Katowice (2.05 and 2.02 mil respectively), while the lowest number in RBTC in Słupsk and RBTC in Radom (0.43 and 0.39 mil respectively). Blood components were also obtained from apheresis: platelet cell concentrate (Aph. PC) — a total of 522.4 thous donations, plasma from automated plasmapheresis — a total of > 1.9 mil donations, plasma from manual plasmapheresis — a total of > 55.4 thous donations, granulocyte concentrate — 1.5 thous donations and red blood cells from apheresis (Aph RBCs) > 2.2 thous donations (in 2005–2017). Throughout the analyzed period, the indicator of the number of donations per one donor was within the 1.69–2.08 range, while in the last 6 years — at the level of approximately 2. In individual RBTCs the total indicator for the period 1997–2017 was calculated at the level of 1.74–2.16. Conclusion: The study analysis of the number of donations collected throughout the 1997–2017 period, indicates that whole blood was the most often collected component in all RBTCs, while the least frequent one were RBCs from apheresis and granulocyte concentrate (GC). The number of WB donations in RBTCs varied — most donations were collected in RBTC in Warsaw and Katowice, while the least in Słupsk and Radom, which is most certainly related to the number of inhabitants/potential donors in the area of activity of these RBTCs.

Analysis of the frequency of post transfusion adverse reactions and their association with blood components supplied by the Regional Blood Transfusion Center in Poznań (2011–2018)

Background: Blood component transfusions are common, often life-saving therapies, however they sometimes (0.2–10% ) result in adverse reactions (ARs). The study aim was to analyse AR frequency and relation to transfusion in patients treated with blood components as well as to present recipient, donor, and blood component factors that induce ARs. Material and methods: The retrospective analysis included 650 cases of ARs following transfusion which were reported to the Blood Transfusion Center in Poznań in the period 2011–2018. The reported ARs were analysed for their intensity/severity, component modification and storage time prior to transfusion, patient’s clinical condition and transfusion history as well as sex and age of both donors and recipients. Finally, for each AR case the imputability with transfusion was assessed. Results: In the study population, ARs were infrequent ( < 0.1%) and depended on the type of blood component, age and sex of the recipient and donor as well as on transfusion history. The symptoms observed were found to be related to transfusion in less than 50% of cases. It has been demonstrated that the deaths reported in the study were related to patients whose clinical condition was either severe or fairly/relatively good and who usually manifested severe adverse reactions (SARs) following transfusion. Conclusions: (i) identified ARs were rarely reported. The lower incidence rate as compared to the published data indicates that not all ARs are reported. The reporting procedure needs to be changed. (ii) Confirmed relation with transfusion was determined in less than 50% of cases. (iii) Some donor/recipient/blood component — specific factors may induce certain types of adverse reactions.

Plateletpheresis: A Donors Perspective

Objective: To determine the plateletpheresis procedure adverse reactions as described by donors in a regional blood transfusion centre.
 Study Design: Cross-sectional study.
 Place and Duration of Study: Armed Forces Institute of Transfusion (AFIT), Rawalpindi Pakistan, from Oct to Dec 2018.
 Methodology: The data of 300 plateletpheresis donors, who underwent the procedure, was collected from the donor record of AFIT. All these donors were contacted through cell phone for interviews. The donors willing to participate were interviewed as per the structured questions.
 Results: Out of the 300 plateletpheresis donors contacted, only one was female (0.3%). The 166 (55%) male donors responded and showed willingness for inclusion in the study. The overall experience was described as very good by 89 (54%), good by 52 (31%), satisfactory by 23 (14%) and unpleasant by 2 (1%) donors. No adverse effects were observed in 144 (87%) donors, while 22 (13%) had mild adverse reactions. The 152 (91%) blood donors were willing to donate blood again in future.
 Conclusion: Plateletpheresis was considered, by donors, a very safe and pleasant procedure if appropriately performed, taking all necessary precautions. However, chances of adverse reactions exist as in all procedures related to blood donation. Our study shows that the minor common adverse reactions do not limit the donors from future blood donations.

Management of blood and blood components at the Cardinal Stefan Wyszyński National Institute of Cardiology

Background: The clinical activity of the Institute of Cardiology is focused on diagnosis and therapy of coronary artery disease, arterial hypertension, cardiomyopathy, heart failure, acquired and congenital heart defects. On the other hand, interventional cardiology, concentrates on the treatment of acute coronary syndromes, percutaneous aortic valve implantation, transcatheter aortic valve implantation, transcatheter pulmonary valve implantation, percutaneous mitral commissurotomy, percutaneous closure of intra- and extra-cardiac defects as well as carotid, renal and peripheral angioplasty. Material and methods: The study aim was to analyze data and estimate the number of blood/blood component transfusions in the departments of the Institute of Cardiology over a two-year period (1st July 2018–30th June 2020). The data was supplied by the Transfusion Committee (TC) which cooperates with the Blood Bank and the Immunohematology Laboratory. Results: At the Institute of Cardiology, blood and blood components were most often transfused in the 1st Department of Anaesthesiology and Intensive Therapy and in the operating room of the Department of Cardiac Surgery and Transplantology (over 87% of all blood components). Cryoprecipitate was transfused only in the operating room and in the 1st Department of Anaesthesiology and Intensive Therapy. Before and after transplantation, patients were transfused with irradiated leukoreduced packed RBCs, inactivated FFP and pathogen inactivated leukoreduced apheresis PCs. Similar volumes of leukoreduced PCs (47.72%) and leukoreduced apheresis PCs (48.64%) were transfused. Patients allergic to plasma proteins were administered washed blood components (0.15% of all blood components transfused). Conclusions: Rational management of blood and blood components at the National Institute of Cardiology is ensured by following procedures, regular training of personnel and close cooperation between the Regional Blood Transfusion Center in Warsaw, members of the Transfusion Committee, the employees of the Blood Bank and staff of the clinics.

Cw Alloimmunization in Multitransfused Thalassemic Patients of North India

Background and Objectives: The C Willis or Cw antigen is a low-incidence antigen of Rh system. The antibody against the Cw antigen (anti-Cw) is an IgG antibody which may occur naturally or may be immune in nature. The identification of Cw antibody is important since it has the potential to cause hemolytic disease of the newborn as well as hemolytic transfusion reaction. This study was conducted with the aim of determining the prevalence of Cw antibody in multitransfused thalassemic patients enrolled in a Regional Blood Transfusion Center (RBTC) of North India. Methods: A retrospective descriptive observational study was conducted at the Department of Immunohematology and Blood Transfusion, LHMC and Associated Hospitals. All transfusion-dependent thalassemic (TDT) patients and non-TDT (NTDT) patients enrolled in the RBTC of the hospital till December 2018 were included in the study. Antibody screening was performed in all recipients before each transfusion. The prevalence of anti-Cw was estimated. Results: A total of 567 thalassemic patients (including TDT and NTDT) were registered in RBTC, LHMC till December 2018. On pretransfusion antibody screening and identification, 3 out of 567 thalassemic patients were found to have alloimmunization against Cw antigen. The prevalence of anti-Cw in multitransfused thalassemics was 0.53%. Conclusion: The prevalence of anti-Cw is variable in different populations and it is not a very commonly reported antibody in patients with thalassemia. One should be aware of the approach to transfusion in thalassemic patients who develop Cw alloimmunization.