Transfusion Center Research Articles

Iron supplementation and blood donation in Nigeria: Effect on Hemoglobin, red cell indices, and iron stores - The ranferon™ study.

Iron-deficiency anemia is an important limiting factor to a sustainable supply of blood units, especially in low- and middle-income countries. Blood transfusion practice in Nigeria is poorly developed and structured with paucity of voluntary nonremunerated blood donors and high rate of donor deferrals resulting from low hemoglobin (Hb) levels. This study aimed to assess the effect of daily supplementation of iron using Ranferon-12 on Hb level, red blood cell (RBC) indices, iron level, ferritin level, and Hb recovery in blood donors in Nigeria. This longitudinal study was conducted at a tertiary hospital blood transfusion center from March to July 2020. Blood samples of regular donors were collected at three points in the study for the measurement of Hb and hematocrit (HCT); RBC indices including mean cell volume (MCV), mean cell hemoglobin (MCH), and Mean cell haemoglobin concentration (MCHC); and iron stores including serum iron, serum ferritin, and serum transferrin. The first point was at recruitment before donation of one unit of blood; the second point after the blood donation; and the third point at 6 weeks post blood donation. Following donation, participants were placed on Ranferon capsules (iron fumarate - 100 mg elemental iron) and 100 mg of tablet Vitamin C, for 6 weeks. There was a moderate significant positive correlation between administration of Ranferon and change in the values of HCT, MCV, MCH, red cell distribution width, ferritin, and transferring (P < 0.05). Percentage recovery of Hb, red cell indices, and iron stores parameters after 6 weeks of daily Ranferon ranged between 89% and 100%. Iron supplementation using Ranferon capsule daily for 6 weeks enhances recovery of Hb, red cell indices, and iron stores with attainment of benchmark Hb levels for donation.

Transfüzyon Merkezi Antikor Tarama Sonuçlarının Analizi: Tanımlayıcı Bir Araştırma

Amaç: Çalışmamızın amacı, alıcı plazmasında kan grubu sistemi antijenlerine karşı gelişen ABO dışı antikorların, kliniğimizce takip edilen hasta profili içerisinde görülme sıklığını ve önemini saptamaktır. Gereç ve Yöntemler: 01 Ocak 2015-31 Aralık 2019 tarihleri arasında, Osmangazi Üniversitesi Tıp Fakültesi Hastanesi Transfüzyon Merkezi'nde serum antikor tarama ve tanımlama çalışılan hastalardan iç hastalıkları ana bilim dalına başvurusu olan hastaların dâhil edildiği bu çalışmada, hastaların verileri retrospektif olarak incelenmiştir. Bulgular: ABO dışı kan grubu ile immünizasyon saptanan 198 hastadan 61'inde otoantikor, 152'sinde ise alloantikor saptanmıştır. Tanımlanabilen alloantikorlar içinde en sık görülenler sırasıyla 36 hasta ile antiE, 27 hasta ile anti-D, 21 hasta ile anti-K, 16 hasta ile anti-c, 14 hasta ile anti-C, 9 hasta ile anti-Fya, 8 hasta ile anti-M, 7 hasta ile anti-e, 7 hasta ile anti-Lea, 5 hasta ile anti-Jka, 3 hasta ile anti-Jkb, 1 hasta ile anti-Leb, 1 hasta ile anti-Fyb ve 1 hasta ile anti-S'dir. Otuz hastada ise alloantikor tipi tanımlanamamıştır. Yüz otuz dört hastaya eritrosit süspansiyonu transfüzyonu yapılmış ve 20 hastada febril non-hemolitik transfüzyon reaksiyonu, 1 hastada ise alerjik transfüzyon reaksiyonu görüldüğü tespit edilmiştir. Alloantikora bağlı hemolitik transfüzyon reaksiyonu saptanmamıştır. Sonuç: Plazmalarında beklenmedik antikor bulunan hastaların büyük çoğunluğunda, Rh sistemi antijenlerine ve K antijenik yapısına ait antikor saptanmıştır. Hemolitik transfüzyon reaksiyonuna yol açma ihtimali yüksek olan bu antikorların oluşumunu önlemek için Rh kan grubu ve K antijenik yapıları ile uygun transfüzyon yapılmasının önem taşıdığını düşünmekteyiz.

Evaluation of Changes in Coagulation Factors in Cryoprecipitate Plasma During Storage at Kisii Teaching and Referral Hospital

Background: Cryoprecipitate is used without knowing the concentration of coagulation factors it contains which might cause circulatory overload with no any improvement if several bags are transfused with low factor levels. Objective: The objective was to assess the changes in coagulation factors in cryoprecipitate plasma during storage at -18°C for 5 weeks at Kisii Teaching and Referral Hospital. Methods: The study involved time series analysis design involving analysis of cryoprecipitate during storage at -18°C for 5 weeks. Blood collected from the Kisii satellite blood transfusion center was received at Hematology laboratory where factor assays were performed on Erba Mannheim ECL 105 semi-automated coagulation analyzer. Thawing for subsequent coagulation factor analysis and serial testing was done using Stericox Plasma Thawing Bath at 37°C, for 45 mins. Data were entered into Excel and analyzed by SPSS version 25. Results: The mean rank for cryoprecipitate from week one to week five was in a decreasing trend with 3.00, 1.99 and 1.01 respectively. This confirms a steady statistical significant difference in mean ranks for the time period. Conclusion: There was a significant reduction in coagulation factors in cryoprecipitate plasma during storage at -18°C for 5 weeks at Kisii Teaching and Referral Hospital.

Frequency of Human Platelet Antigens -1 to -5 and -15 in Turkmen Blood Donors.

Due to the presence of platelet antigen polymorphisms, human platelet membrane glycoproteins can be identified as an alloantigen or autoantigen. The aim of this study was to determine the frequencies of human platelet antigens (HPAs)-1 to-5 and-15 in Turkmen blood donors and establish a panel of accredited HPAs negative donors as well as an HPA-typed platelet donor registry. HPA-1 to-5 and-15 typing was performed by the polymerase chain reaction-sequence-specific primer techniques on 80 unrelated Turkmen donors who were referred to Aq-Qala Blood Transfusion Center in Golestan Province from September 2018 to October 2019. The frequencies of HPA phenotypes were determined as follows: HPA-1aa: 92.5%, HPA-1ab: 7.5%, HPA-2aa: 77.5%, HPA-2ab: 20.0%, HPA-2bb: 2.5%, HPA-3aa: 75.3%, HPA-3ab: 50%, HPA-3bb: 11.2%, HPA-4aa: 100%, HPA-5aa: 78.5%, HPA-5ab: 21.5%, HPA-15aa: 41.2%, HPA-15ab: 56.2% and HPA-15bb: 17.5%. Determining the genotype of HPAs that play an important role in platelet refractory can improve the management of alloimmunization due to the incompatibility of HPAs between the recipients and donors. Therefore, the registration process for national platelet donors can help patients accelerate and improve the quality of transfused platelets.

Pulmonary Embolism Revealing Acutisation of Vaquez Disease: A Case Report at the Haematology Department of the National Blood Transfusion Center in Bangui (Central African Republic)

Introduction: Primary polycythemia belongs to the group of myeloproliferatifs disorders whose natural course is marked by thrombohemorrhagic events in the short term and transformation into acute leukemia in the long term. Primary polycythemia is rarely seen in our department. It usually precedes a myelodysplastic phase. Arterial thrombosis as a revealing mode is exceptional. Case report: We report the case of a 78-year-old woman diagnosed with polycythemia vera in 2018, with signs of hyperviscosity in the setting of arterial hypertension treated with hydryuree. The appearance of unexplained dyspnea in 2023 led to the diagnosis of pulmonary embolism. The follow-up blood count unexpectedly revealed a bicytopenia consisting of severe anemia at 5g/dl and thrombocytopenia at 88,000/mm3. The myelogram was consistent with AML. The evolution was rapidly fatal in our context. The interest of this work lies in the rarity of this AML secondary to polycythemia vera, but also in its exceptional mode of manifestation, making management ambiguous due to treatment of a pulmonary embolism in a context of thrombocytopenia. Conclusion: This is the first case of its kind to be described in our department.

Exploring trends, challenges and issues of blood donation in Yaounde-Cameroon

Background: Access to a safe and adequate blood supply has proven to be challenging in sub-Saharan Africa, where systemic deficiencies have greatly been recorded. Blood availability is a public health issue of concern in Sub-Saharan Africa where both the demand and discard rates of blood are high and this includes Cameroon. Objective: This research study was carried out in order to capture the trends of blood donation, and to address the epidemiological aspects of blood donation in Yaounde. Study design and methods: The research was quantitative and relied on a cross-sectional study. With record base supplied by the National Blood Transfusion Center, as well as data from a random-sample survey of 300 blood donors at the Yaounde Central Hospitals’ blood bank. Statistical methods were applied to estimate national blood activities from January 2018 to September 2019, and the data subsequently analyzed using the Statistical Package for the Social Sciences (SPSS). Results: The results revealed a low frequency of blood donation, and portrayed that 81.3% of donors were first time donors. The majority of donors in our study were family/replacement (98.5%) while the minority voluntary (1.6%). More so, among the different aspects studied, five factors were found to be effectively associated to blood donation frequency namely: presence of tattoos/scarifications/piercings, the motivation underlying the blood donation, the blood group, the rhesus group and the occurrence of an accident during previous blood donations. Conclusion: Results could be useful to provide updates for the government and international organizations’ programs involved in the improvement of blood donor recruitment strategies in Cameroon. The outcome is to permit the elaboration of more effective strategies for recruiting and retaining voluntary regular blood donors and help move away from the use of replacement donors as the main source of blood, hence providing the population with safe blood and consequently reduce mortality rates linked to the availability and quality of blood.

THE LEVEL OF SUPPLYING UKRAINE WITH DONOR BLOOD AND BLOOD COMPONENTS: STATISTICAL ANALYSIS

The work aims to analyze the level of providing Ukraine with blood and blood components under stable conditions. During 2012–2020, the number of donors decreased twice; the plasma collection decreased by 30%, whole blood - by 56.8%; the number of blood transfusion centers decreased by 42.6%, transfusion departments of medical facilities - by 43.7%, hospitals collecting blood - by 15.1%. According to national reports, in 2020, the needs of Ukraine's healthcare institutions were met by 91.1% of donor blood, 94.6% of plasma, 88.9% of erythrocyte mass, and 124.1% of platelets. According to indicators recommended by WHO, the number of donations per 1,000 population in 2020 in Ukraine is three times less than necessary. Only the Sumy region has provided more than 33 donations per 1.000 population since 2015 (40.46–61.68), Crimea and Luhansk region in 2012–2013. In all other regions, the indicator is below the norm. According to this indicator, blood shortage was 952,546 donations or 66.2% of the recommended by WHO. Another recommended WHO indicator, the amount of collected blood per inhabitant during 2012–2020, was almost twice less as needed - 5.3 ml (WHO recommends 12-15 ml). The blood shortage in 2020 amounted to 276,990.5 liters or 55.7% of the WHO recommended amount. There are significant differences in approaches to the formation of needs for blood and blood components at the state level and the world. The study results show a need to create and implement a system of indicators that would reflect the country's and region's objective needs. In order to improve the provision of Ukraine with blood and blood components during stable conditions, it is necessary to implement marketing programs at the national level. For a significant increase in blood collection volume and its components, it is advisable to analyze the existing experience of leading blood centers in Ukraine and the experience of countries that fully satisfy their country's needs and implement them in their work. The organization of marketing activities and the marketing management system in blood centers should also be analyzed. It can be the subject of further research in this direction. The results of this study can be helpful to marketing specialists involved in blood service promotion.

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.

Hepatitis A virus (HAV) RNA detection in Polish blood donors and likely transmissions through blood components during the 2017-2019 epidemic.

In Poland, hepatitis A virus (HAV) RNA screening was performed in plasma for fractionation usually immediately before shipment. Our goal was to study epidemiology, rate of transfusion transmitted HAV during epidemic (2017-2019), and viral characteristics of infected plasma donors. HAV RNA was tested in 1,866,590 donations from 1,210,423 donors using RT-PCR in mini pools of 96 (MP96) or TMA in MP16. Virological characteristics included RNA level (RL), antibody testing, and sequencing. Twenty-one HAV infections were identified (1.13/100,000 donations; 95% confidence interval [95% CI]: 0.74-1.72) and (1.73/100,000 donors; 95% CI: 1.35-2.65). The Blood Transfusion Centers were also informed about three donors, who were hospitalized for hepatitis A soon after their blood donation. In addition, we identified a donor, who had reactive result for HAV after receiving HAV vaccination. He tested positive twice 10 days after receiving the first and the second dose. The highest RL was 16 million IU/ml, mean 1,706,905 IU/ml, and median 220 IU/ml. The longest detectable RL lasted for 113 days. HAV-infected donors were seronegative (36%) or IgM positive (64%). We followed up on 12 HAV contaminated blood components issued for transfusion. In two out of seven identified patients viral transmission was confirmed (28.6%). Based on our results, we propose a 6 month deferral after HAV infection and 14 days post HAV vaccination. The infectivity rate was below 30%. The HAV RNA testing could be considered as an additional safeguard against HAV transmission at the time of increased incidence of HAV infections in the general population.

High Expression of Inflammatory Cytokines and Chemokines in Human T-lymphotropic Virus 1-Associated Adult T-cell Leukemia/Lymphoma

Background: Human T-cell lymphotropic virus type 1 (HTLV-1) is the etiological agent of adult T-cell leukemia/lymphoma (ATLL) without any specific antiviral. Objectives: This study aimed to evaluate the expression level of inflammatory chemokines and pro-inflammatory cytokines in ATLL patients, asymptomatic carriers (ACs), and healthy individuals to assess the role of these inflammatory markers in ATLL pathogenicity. Methods: This study was conducted from May 2021 to August 2022. The ATLL blood samples were collected from the oncology wards of Imam Khomeini, Shariati, and Imam Hossein hospitals, in Tehran, Iran. The blood samples of ACs and normal control subjects were collected from blood donors referred to blood transfusion centers of Tehran and Alborz provinces, Iran. RNA extraction, complementary DNA (cDNA) synthesis, and real-time polymerase chain reaction (PCR) were done in targeted sample groups to investigate the correlation and expression rate of C-C motif chemokine ligand 3 (CCL3), C-C motif chemokine ligand 4 (CCL4), C-X-C motif chemokine ligand 8 (CXCL8), interleukin 23 subunit alpha (IL-23A), and interleukin 17 A (IL-17A). Results: A total of 30 samples were collected from 3 groups. The CCL3, CCL4, CXCL8, and IL-17A messenger RNA (mRNA) expression levels were significantly upregulated in the ATLL groups. There was a significant difference between CCL3 expression between the ACs and ATLL groups. In addition, CCL4 and CXCL8 expression levels were more significant in the ATLL group than in the normal control group. The IL-17A expression level significantly increased between groups. The IL-23A expression levels had no significant differences between the ATLL, ACs, and normal control groups. Conclusions: This study showed significant upregulation of pro-inflammatory cytokines and chemokines mRNAs in HTLV-1–associated ATLL compared to the ACs and normal control groups. Conducting more experiments to investigate the therapeutic effect of chemokines/cytokines in ATLL is essential.

Presence of Gram-negative bacteria and Staphylococcus aureus on the skin of blood donors in the Democratic Republic of the Congo.

Skin bacteria may contaminate blood products but few data are available on sub-Saharan Africa (sSA). We assessed the presence of Gram-negative bacteria and Staphylococcus aureus on blood donor skin and evaluated skin antisepsis in the Democratic Republic of the Congo (DRC). Among blood donors at the National Blood Transfusion Center (NBTC) and at a rural hospital, the antecubital fossa skin of the non-disinfected arm (not used for blood collection) was swabbed (25cm2 surface) and cultured for total and Gram-negative bacterial counts. Bacteria were identified with MALDI-TOF and tested for antibiotic susceptibility by disk diffusion. For evaluation of the NBTC antisepsis procedure (i.e., ethanol 70%), the culture results of the disinfected arm (used for blood collection) were compared with those of the non-disinfected arm. Median total bacterial counts on 161 studied non-disinfected arms were 1065 Colony-Forming Units (CFU) per 25 cm2 , with 43.8% (70/160) of blood donors growing Gram-negative bacteria and 3.8% (6/159) Staphylococcus aureus (2/6 methicillin-resistant). Non-fermentative Gram-negative rods predominated (74/93 isolates, majority Pseudomonas spp., Acinetobacter spp.). Enterobacterales comprised 19/93 isolates (mostly Pantoea spp. and Enterobacter spp.), 5/19 were multidrug-resistant. In only two cases (1.9%, 2/108) the NBTC antisepsis procedure met the acceptance criterion of ≤2CFU/25 cm2 . Skin bacterial counts and species among blood donors in DRC were similar to previously studied Caucasian populations, including cold-tolerating species and bacteria previously described in transfusion reactions. Prevention of contamination (e.g., antisepsis) needs further evaluation and customization to sSA.

The impact of COVID-19 on blood safety and availability in the Islamic Republic of Iran.

The COVID-19 pandemic has affected blood inventory and donation worldwide. The Islamic Republic of Iran was among the first countries to report the COVID-19 pandemic and it faced a significant blood shortage during the first weeks of the pandemic. We aimed to evaluate the impact of COVID-19 pandemic on the number, type, and safety of blood donations, comparing the periods before and during the pandemic. This retrospective study evaluated data from all volunteers who attended the blood transfusion centres in the Islamic Republic of Iran from March to December 2020 (during the COVID-19 pandemic) and during the same period in 2019, i.e. pre-pandemic. Data on the number of blood collections, confirmed transfusion transmissible infection marker test results, and donor demographic information were collected from the Iranian Blood Transfusion Organization integrated donor database. Total blood donations decreased by 8.38%. The number of first-time, lapsed, and female blood donors increased by 4.41%, 0.17%, and 0.90% respectively. Regular blood donation decreased by 4.58%. The distribution of the 3 main blood products, red cell concentrate, frozen fresh plasma and platelets, decreased by 7.86%. All changes were statistically significant. The prevalence rates of hepatitis C virus and hepatitis B surface antigen increased significantly during the pandemic. COVID-19 had a negative effect on blood safety and availability in the Islamic Republic of Iran. To improve blood supply and enhance regular blood donation, the Iranian Blood Transfusion Organization needs to reassure blood donors of the safety and hygiene measures being observed at blood collection sites.

In-line leukoreduction filters: A new source of microparticle for human and animal study

IntroductionThe isolation of microparticles (MPs) from leukoreduction filters (LRFs) during cell extraction process introduced LRFs as a precious source of MPs for animal and human study. MethodLRFs were collected from Tehran Blood Transfusion Center. The back-flushing method was used for leukocyte extraction from the LRFs. MPs were isolated through double-step centrifugation. Dynamic light scattering (DLS), electron microscopy (EM), and flow cytometry were performed for the evaluation of MPs size, morphology, and structural properties respectively. Statistical analyses were carried out to evaluation of differences between test and control groups. a p-value less than 0.05 indicates significant differences. ResultDLS analysis showed that the average MP size in the test and control groups was 654.83 nm and 233.68 nm respectively. SEM images showed the spherical, oval, cell fragment, and micro-aggregate particles and TEM images demonstrated the mitochondrial-like body in the MPs. Flow cytometry studies also showed a significant increase in the percent of CD41, and CD14, and a significant decrease in the percent of CD235a in the test group compared to control (P value=0.029, P value=0.035, P value= 0.001 respectively). Moreover, the percentage of CD34 MPs indicated a borderline difference between the two groups (P value= 0.075). Finally count of MPs in the test and control groups was 1202095.34 and 280948.64, respectively and the difference was significant (P value=0.008). ConclusionIt is concluded that LRFs are a potential source of the large volume of various cell MPs with different phenotypical and structural properties for animal and human phase studies. Moreover, the investigation of LRFs as a source of different types of exosomes can shed new light on extracellular vesicle studies.

"Blood Donation – Medical Benefits for Blood Donors, Regarding the Management of Metabolic Parameters"

Olivia Burta1,2*, Dorina Maria Farcas1, Roxana Burta1,2, Simona Babau2 and Beatrice Leahu2,3 Author Affiliations 1Faculty of Medicine and Pharmacy, University of Oradea, Romania 2Blood Transfusion Center Oradea, Bihor County, Romania 3Psychologist, Dietician, Nutritionist, Romania Received: October 18, 2022 | Published: October 28, 2022 Corresponding author: Olivia Burta, Faculty of Medicine and Pharmacy, University of Oradea, Blood Transfusion Center Oradea, Bihor County, Romania DOI: 10.26717/BJSTR.2022.46.007419

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 ].

Diagnosis and Management of Autoimmune Hemolytic Anemias

Autoimmune hemolytic anemia (AIHA) is usually categorized, as other immune-mediated cytopenias, in so-called benign hematology, and it is consequently managed in various settings, namely, internal medicine, transfusion centers, hematology and, more rarely, onco-hematology departments [...].

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.

Transfusion-transmitted arboviruses: Update and systematic review.

BackgroundThe detection of the first cases of transfusion-transmitted West Nile virus in 2002 posed a new challenge for transfusion safety. Institutions like the World Health Organization have stated that blood transfusion centers need to know the epidemiology of the different emerging infectious agents and their impact on blood transfusion. The aim of the study is to review the published cases of arbovirus transmission through transfusion of blood or blood components and to analyze their main clinical and epidemiological characteristics.Material and methodsSystematic literature searches were conducted in MEDLINE, Embase and Scopus. Pairs of review authors selected a variety of scientific publications reporting cases of transfusion-transmitted arboviruses. Main clinical and epidemiological characteristics were reviewed of the cases described. The study protocol was registered in PROSPERO CRD42021270355.ResultsA total of 74 cases of transfusion-transmitted infections were identified from 10 arboviruses: West Nile virus (n = 42), dengue virus (n = 18), Zika virus (n = 3), yellow fever vaccine virus (n = 3), tick-borne encephalitis virus (n = 2), Japanese encephalitis virus (n = 2), Powassan virus (n = 1), St. Louis encephalitis virus (n = 1), Ross River virus (n = 1) and Colorado tick fever virus (n = 1). The blood component most commonly involved was red blood cells (N = 35, 47.3%; 95% confidence interval [CI] 35.9% to 58.7%). In 54.1% (N = 40; 95% CI: 42.7%-65.47%) of the cases, the recipient was immunosuppressed. Transmission resulted in death in 18.9% (N = 14; 95% CI: 10.0%-27.8%) of the recipients. In addition, 18 additional arboviruses were identified with a potential threat to transfusion safety.DiscussionIn the last 20 years, the number of published cases of transfusion-transmitted arboviruses increased notably, implicating new arboviruses. In addition, a significant number of arboviruses that may pose a threat to transfusion safety were detected. In the coming years, it is expected that transmission of arboviruses will continue to expand globally. It is therefore essential that all responsible agencies prepare for this potential threat to transfusion safety.

Prevalence and Molecular Evaluation of Hepatitis C Virus Infection among Multi-transfused Thalassemia Patients in South of Iran.

ObjectivesInformation regarding the magnitude of hepatitis C virus (HCV) infection among thalassemia patients is of great importance for health care providers to assess blood safety and improve the quality of screening systems. Therefore, this study evaluated the prevalence, risk factors, and genotypic pattern of HCV infection among β-thalassemia patients in South Iran.MethodsThis descriptive-analytical cross-sectional study was conducted from March to June 2019. All patients with β-thalassemia major from Borazjan, Bushehr, Delvar, Kangan, and Ahram cities participated in the study and attended the transfusion center of the Bushehr University of Medical Sciences located in southern Iran. Serum samples were tested for the presence of anti-HCV antibodies by an enzyme-linked immunosorbent assay. The seropositive serum samples were tested for detection of HCV viremia and genotypes by semi-nested reverse transcriptase-polymerase chain reaction and sequencing.ResultsOf 125 thalassemia patients, 22 (17.6%) were positive for anti-HCV antibodies and two (1.6%) had HCV viremia with genotype 3a. HCV seroprevalence increased with age, so anti-HCV seropositive thalassemia patients had significantly higher mean age than anti-HCV seronegative patients. HCV seroprevalence was higher among female patients, residents of Kangan, patients with blood transfusion every two weeks, Fars patients, and thalassemia patients with alanine aminotransferase levels of < 20 IU/L and aspartate aminotransferase levels of > 80 IU/L. Nevertheless, anti-HCV seroprevalence among thalassemia patients was not statistically associated with these variables.ConclusionsThese results indicate ongoing HCV incidence among the thalassemia population in this region. Transfusion of HCV-seronegative viremic blood units donated during the infectious window period contributes to HCV infection in thalassemia patients. These findings highlight the need to include sensitive molecular assays in the screening process of donated blood for HCV infection in Iran.

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 ( &lt; 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.