Packed Red Blood Cells Research Articles

Addition of exogenous γ-glutamyl hydrolase eliminates the need for lengthy incubation of whole blood lysate for quantitation of folate vitamers by high performance liquid chromatography-tandem mass spectrometry

BackgroundMeasurement of folate monoglutamates by HPLC-MS/MS in whole blood lysate (WBL) requires lengthy incubation prior to analysis, risking degradation of labile folate vitamers. ObjectiveWe explored whether addition of a commercially available recombinant exogenous γ-glutamyl hydrolase (exoGGH) enzyme reduced the required incubation time of WBL for measurement of folate as monoglutamates. MethodsFor conventional deglutamylation of polyglutamates, WBL was incubated 4 h at 37°C. Alternatively, we added exoGGH to WBL at varying concentrations (1–10 µg/mL) and incubation times (0–90 min). We also investigated modifications to the sample diluent (pH, ascorbic acid vs. sodium ascorbate, and ascorbate concentration). Finally, we tested the effect of the enzyme in different sample types: WBL from frozen whole blood vs. frozen WBL or vs. frozen washed red blood cells (RBC). Samples (n ≤ 15 per experiment) were analyzed by HPLC-MS/MS for 6 folate monoglutamates and 5-methyltetrahydrofolate diglutamate. ResultsOptimal deconjugation of folate polyglutamates was achieved using 1% ascorbic acid and 5 µg enzyme/mL WBL, requiring ≤ 30 min incubation time to achieve complete folate recovery as monoglutamates. This treatment resulted in similar folate concentrations as conventional deglutamylation (4 h at 37°C). The exoGGH enzyme was effective in samples stored frozen as whole blood and as WBL. However, extended thaw time of whole blood resulted in 5-methyltetrahydrofolate loss and unacceptable changes to non-methyl folate concentration. Total folate (with exoGGH) measured in washed RBC was ∼15% lower than RBC folate calculated from WBL concentrations (conventional deglutamylation). ConclusionsUse of exoGGH minimized incubation time and thus may avoid degradative losses of labile folate forms during sample preparation. The lower folate results in washed RBC may be due to inadequate packing of RBC among other unidentified factors. A larger study is required to confirm lack of differences in folate concentrations determined with and without the use of exoGGH.

Major Pelvic Ring Injuries: Fewer Transfusions Without Deaths from Bleeding During the Last Decade

BackgroundPelvic fracture-associated bleeding can be difficult to control with historically high mortality rates. The impact of resuscitation advancements for trauma patients with unstable pelvic ring injuries is unknown. We hypothesized that the time elapsed since introduction of our protocol would be associated with decreased blood transfusion requirements.MethodsA level 1 trauma center’s prospective pelvic fracture database was reviewed from 01/01/2009–31/12/2018. All patients with unstable pelvic ring injuries initially presenting to our institution were included. Adjusted regression analysis was performed on the overall cohort and separately for patients in traumatic shock (TS). The primary outcome was 24 h packed red blood cell (PRBC) requirements. Secondary outcomes were 24 h plasma, cryoprecipitate, platelet and intravenous fluid (IVF) requirements, length of stay and mortality.ResultsPatients with mechanically unstable pelvic ring injuries (n = 144, median [Q1–Q3] age 44 [28–55] years, 74% male) received a median (Q1–Q3) of 0 (0–4) units PRBC within 24 h, with TS patients (n = 47, 42 [28–60] years, 74% male) receiving 6 (4–9) units PRBC. There was no decrease in 24 h PRBC requirements for the overall cohort (years; IRR = 0.91, 95% CI 0.83–1.01; p = 0.07). TS patients had decreases in 24 h PRBC (years; IRR = 0.90, 95%CI 0.84–0.96; p = 0.002), plasma (IRR = 0.92, 95%CI 0.85–0.99; p = 0.019), cryoprecipitate (IRR = 0.88, 95%CI 0.81–0.95; p = 0.001) and IVF (IRR = 0.94, 95%CI 0.90–0.98; p = 0.004). There were 5 deaths (5/144, 3.5%) with no deaths due to acute hemorrhage.ConclusionsOver this 10-year period, there was no hemorrhage-related mortality among patients presenting with pelvic fractures. Crystalloid and transfusion requirements decreased for patients presenting with traumatic shock.

Monocyte antigen-presenting capacity to iNKT cells is influenced by the blood collection conditions

It is widely accepted that different blood collection conditions, including anticoagulants, influence leukocyte phenotype and function. Buffy Coats originated from a donated whole blood bag unit are commonly used in immunological research as a source of leukocytes. They are a residual product of healthy donor whole blood processing. The preservative solution present in the blood bag unit and consequently in the derived Buffy Coat is Citrate-Phosphate-Dextrose (CPD), in which citrate is the anticoagulant. There is a lack of information on the possible difference in the functionality of leukocytes from Buffy Coats originated from a blood bag unit vs leukocytes isolated from blood collection tubes with various anticoagulants.Herein, we aimed at studying monocyte function when the monocytes are isolated from Buffy Coats originated from a blood bag unit vs blood collection tube containing EDTA, CPD with adenine (CPDA), or sodium citrate. The function of monocytes, isolated 20 h after blood collection, to present lipid antigens to invariant Natural Killer T (iNKT) cells was investigated. iNKT cells are activated by lipids bound to CD1d, a non-polymorphic MHC-class I-like molecule, present on the surface of antigen-presenting cells.A striking result showed that monocytes isolated from EDTA blood tubes have a lower capacity to present lipid antigens to iNKT cells than monocytes isolated from Buffy Coats originated from a blood bag unit. No differences were found between monocytes isolated from sodium citrate or CPDA and the ones isolated from Buffy Coats originated from a blood bag unit. This was accompanied by a decrease in viability of the EDTA-isolated monocytes. Expression of the surface markers CD1d and CD86 was higher for monocytes isolated from EDTA than those isolated from Buffy Coats.In conclusion, EDTA-containing blood tubes are not the ideal choice of anticoagulant for monocyte antigen presentation assays. We advise that the blood collection condition and the time between biospecimen collection and analysis should be carefully considered when designing experimental procedures.

Hematological Changes in Whole Blood Stored in Blood Bags Containing CPDA-1 Over a Period of 28 Days

Introduction: Blood storage is needed to ensure a readily available and safe blood supply. During blood storage in blood bank, biochemical and physical properties of RBCs are altered because of storage conditions. In normal conditions in the body circulation, these do not occur as optimum pH, temperature, nutrient concentration and waste products removal are maintained. The aim of this study was to observe the changes in whole blood stored in blood bags containing CPDA-1 over a period of 28 days.
 Materials and Methods: This was a hospital based observational study conducted in Blood Bank, National Medical College and Teaching Hospital (NMCTH), Birgunj. A total of 450 ml blood was drawn from 50 healthy volunteer donors into blood bags containing CPDA–1 anticoagulant and placed on the quarantine shelf of the blood bank refrigerator maintained at 2-8o centigrade. The blood bags were screened for HCV, HBsAg, syphillis and HIV. Ten milliliters blood was withdrawn from the blood bags on 1st, 7th, 14th, 21st, and 28th day and tested for hematological parameters using Yumizen H550 (HORIBA) fully automated hematology analyzer.
 Results: At the end of 28 days, whole blood storage in CPDA-1 revealed significant decrease in WBC (T = 4.79, p < 0.01) and platelets count (T=180.09, p < 0.01). Hematocrit increased significantly after 21 days of storage (T = 40.86, p < 0.01). MCHC and MCH also demonstrated significant increase during the storage period (T = 37.32, p < 0.01) and (T = 29.38, p < 0.01), respectively.
 Conclusion: WBC and platelets are significantly altered (decreased) when stored in blood bags containing CPDA- 1 after one week period. The study recommends whole blood transfusion before seventh day of donation in order to avoid the adverse outcome of hematological changes in stored blood. In case it has to be used beyond one week, then it should be leukodepleted before storage.

Upregulation of miR-20a-5p as the Potential MicroRNA Marker in Red Blood Cell Storage Lesion.

Packed red blood cells (PRBCs) can be preserved for 42 days, and stored PRBCs have slow, dangerous changes over time during storage. miRNA is approximately 22 nucleotides long, a small single-stranded noncoding RNA molecule. miRNA guides by pairing bases with their downstream target mRNA to regulate negative expression. They are essential in many life processes, including cell differentiation, proliferation, and apoptosis. Therefore, miRNA alterations may represent possible biomarkers of PRBC storage lesions. This study is aimed at validating the miR-20a-5p in PRBC storage. Study Design and Methods. A total of 20 PRBC samples were divided into day 1 and day 20 storage groups. Total miRNA was extracted and quantified by probe-based RT-qPCR assays to explore the potential role of miRNAs in PRBC storage lesions. Upregulated miR-20a-5p in PRBC storage on day 20 compared to day 1. MiR-20a-5p promoted cell survival, which may affect the downstream regulation and decrease PRBC viability in prolonged storage. On this basis, this detection may help to assess the quality of stored PRBCs.

Early clinical outcomes of surgical myocardial revascularization in patients with preoperative platelet dysfunction

Background/Aim. Coronary artery bypass grafting (CABG) is the treatment of choice for a significant number of patients with ischemic heart disease. Some of the postoperative complications are closely linked with the preoperative antiplatelet therapy (APT). The aim of this study was to compare the early clinical outcomes of CABG in patients with preserved platelet (PLT) function and patients with PLT function impaired by the residual therapeutic effect of APT. Methods. A total of 181 patients with isolated CABG were enrolled in this prospective, nonrandomized, observational study. Patients were divided into four groups: control group (arachidonic acid-dependent PLT aggregation group), with aspirin-induced platelet inhibition (ASPI) test ? 790 aggregation units (AU)/min; mild (M) acetylsalicylic acid (ASA) effect (MASAE) group, with ASPI test = 410?789 AU/min; pronounced (P) ASA effect (PASAE) group, with ASPI test ? 409 AU/min; dual (D) APT (DAPT) group, with ASPI test ? 789 AU/min and adenosine diphosphate (ADP) test ? 405 AU/min. Preoperative data, intraoperative characteristics, and postoperative outcomes were obtained and com-pared between the groups. Results. A significant difference was found regarding the average time of APT cessation be-tween groups (p < 0.001). The DAPT group had a significantly higher frequency of drainage compared to the control (p = 0.004), MASAE (p = 0.001), and PASAE (p = 0.006) groups. The PASAE group had a significantly higher rate of chest reexploration compared to the MASAE group (p = 0.032). The DAPT group required significantly more packed red blood cells (PRBC) compared to the control (p < 0.001) and MASAE (p = 0.009) groups. The PASAE group received significantly more PRBC compared to the control (p < 0.001) and MASAE (p = 0.019) groups. The DAPT group required higher amounts of PLTs compared to the control (p < 0.001), MASAE (p = 0.002), and PASAE (p < 0.001) groups. The DAPT group received higher amounts of cryoprecipitate compared to the control (p = 0.002), MASAE (p = 0.009), and PASAE (p = 0.016) groups. Conclusion. Patients with a residual effect of DAPT, as well as patients with a pronounced residual effect of ASA, have a higher risk of postoperative bleeding and chest reexploration, as well as increased transfusion demands.

The Effect of Prehospital Blood Transfusion on Patient Body Temperature from the Time of Emergency Medical Services Transfusion to Arrival at the Emergency Department.

Transfusion of blood products is life-saving and time-sensitive in the setting of acute blood-loss anemia, and is increasingly common in the emergency medical services (EMS) setting. Prehospital blood products are generally "cold-stored" at 4°C, then warmed with a portable fluid-warming system for the purpose of preventing the "lethal triad" of hypothermia, acidosis, and coagulopathy. This study aims to evaluate body temperature changes of EMS patients receiving packed red blood cells (PRBC) and/or fresh frozen plasma (FFP) when using the LifeWarmer Quantum Blood & Fluid Warming System (LifeWarmer, https://www.lifewarmer.com/). From 1 January 2020 to 31 August 2021, patients who qualified for and received PRBC and/or FFP were retrospectively reviewed. Body-temperature homeostasis pre- and post-transfusion were evaluated with attention given to those who arrived to the emergency department (ED) hypothermic (<36°C). For all 69 patients analyzed, the mean initial prehospital temperature (°C) was 36.5 ± 1.0, and the mean initial ED temperature was 36.7 ± 0.6, demonstrating no statically significant change in value pre- or post-transfusion (0.2 ± 0.8, p = .09). Shock index showed a statistically significant decrease following transfusion: 1.5 ± 0.5 to 0.9 ± 0.4 (p < .001). Use of the Quantum prevents the previously identified risk of hypothermia with respect to unwarmed prehospital transfusions. The data is favorable in that body temperature did not decrease in critically ill patients receiving cold-stored blood warmed during administration with the Quantum.

Management of massive transfusion and coagulation during bilateral hand transplantation surgery

Dear Editor, Massive transfusion (MT) aims to limit hypoperfusion till surgical hemostasis could be attained and takes into account volume status, tissue oxygenation, management of bleeding, and coagulation abnormalities.[1] However, it may not be possible to follow recommended protocols of MT strictly during hand transplant surgeries as, in addition to restoring blood volume, ensuring good perfusion and avoidance of thrombus formation in transplanted hands is critical. A 46 year-old-female, bilateral hand amputee, was posted for bilateral upper extremity allotransplantation (supracondylar level on the right side and mid-arm level on the left side). The donor was a 45 year-old-female who was declared brain dead following trauma. The recipient received standardized general anesthesia and immunosuppressants as per protocol. Femoral arterial, internal jugular, femoral venous, and two 16G saphenous catheters were placed. Her initial hemoglobin was 13.2 g/dL. Reperfusion of transplanted hands was done around 6 h intraoperatively following which there was major surgical bleeding and hemoglobin dropped <5 g/dL multiple times despite aggressive fluid replacements. The surgery lasted 15 h, and she received 12 units of packed red blood cells (PRBCs), 4 units of fresh frozen plasma (FFP), 2 L of hydroxyethyl starch, 600 mL albumin, 15 L of Kabilyte (acetated intravenous fluid), and 40 mL of 10% calcium gluconate. Intraoperative fluid management was guided by continuous arterial and central venous pressure monitoring, frequent arterial blood gas analysis including electrolyte levels, platelet count, prothrombin time, and thromboelastography (TEG). She required noradrenaline infusion up to 0.2 mcg/kg to maintain mean arterial pressure >65 mmHg, and urine output was >1 mL/kg/h. Intraoperatively, perfusion of transplanted hands was impeded by arterial and venous thrombi which required multiple thrombectomy and reanastomoses and fasciotomies for decompression. Therefore, a certain degree of coagulopathy was accepted to prevent further thrombus formation and hence MT protocols were not strictly followed. The aim was to maintain good perfusion of hands with target hemoglobin of 10 g/dL with hemodilution to facilitate perfusion across anastomoses. In 48 h, she had received a total of 21 units of PRBC and 9 units of FFP. Coagulation parameters were maintained at safe acceptable levels [Table 1]. Other than hypothermia, she did not develop any major complications such as renal or lung injury secondary to MT.Table 1: Laboratory investigation results and interventionsMT is defined as replacement of one entire blood volume within 24 h, transfusion of >10 units of PRBCs in 24 h, transfusion of >4 units of PRBCs in 1 h, or replacement of 50% of total blood volume within 3 h.[2] Consumption of coagulation factors during massive bleeding and dilution of remaining factors due to volume expanders add to coagulopathy and altered hemostasis.[3] Coagulation tests are usually time-consuming and may not greatly help in guiding therapy during ongoing massive bleeding. TEG tests the entire hemostatic system including platelet function and fibrinolytic system. Therefore it is useful in managing complicated coagulopathies with timely intervention.[2] Ideally, MT protocols are to be activated after transfusion of 4–10 units which have a predefined ratio of RBCs, FFP/cryoprecipitate, and platelet units (1:1:1 or 2:1:1 ratio).[4,5] It is concluded that during bilateral hand transplantation surgeries, management of MT should be individualized taking into account hemoglobin levels, coagulation profile, and perfusion of transplanted hands. Declaration of patient consent The authors certify that they have obtained all appropriate patient consent forms. In the form, the patient has given her consent for her images and other clinical information to be reported in the journal. The patient understands that her name and initials will not be published and due efforts will be made to conceal identity, but anonymity cannot be guaranteed. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.

Incidence of anemia and red blood cell (RBC) transfusion requirement in breast cancer.

Cancer-related anaemia is one of the main burdens in oncology, although the available data on its prevalence and treatment options such as blood transfusion are often contradictory. This study aimed to evaluate the prevalence of anaemia and the requirement for packed red blood cell (PRBC) transfusion among women with breast cancer (BC) and to determine the associated factors for chemotherapy-induced anaemia (CIA). This cross-sectional retrospective study conducted in Kelantan involved 104 newly diagnosed female BC patients from 2015 to 2016 who underwent chemotherapy. For statistical analysis, chi-square was used to compare between CIA and non-CIA groups. In addition, simple and multiple logistic regression were used to determine the association of the CIA. Our study revealed that 34.6% (n=36) of patients had mild anaemia, and 59.6% (n=62) had normal haemoglobin at pre-chemotherapy. The prevalence of anaemia increased from 40.4% to 77% at the end of our study. About 30.8% of patients received PRBC transfusion during chemotherapy with mean haemoglobin before the first transfusion of 7.9 g/dl. CIA was observed in 54.8% of cases. There was no significant association between CIA concerning the patient characteristic, cancer characteristic, or cancer treatment. We concluded that a significant proportion (40.4%) of BC patients was anaemic even before chemotherapy, with the red blood cell requirements up to 30.8% throughout chemotherapy. A larger prospective study is needed to determine the predictors for the CIA and subsequently improve patient management.

In Solid Organ Injury Patients Requiring Blood Transfusion, Hemostatic Procedures are Associated with Improved Survival Over Observation.

Selective nonoperative management (NOM) is the standard of care for blunt solid organ injury (SOI). Hemodynamic instability is a contraindication for NOM, but it is unclear whether the need for blood transfusion should be a criterion for instability. This study looks at the outcome of blood-transfused SOI patients to determine whether NOM is safe for this group. This is a retrospective cohort study using the National Trauma Data Bank years 2017 through 2019. We selected patients with blunt liver, spleen, and kidney injuries. Within this group, we compared the mortality for those managed with NOM versus the hemostatic procedures of laparotomy and angioembolization. Significance for univariate analysis is tested with Chi-square for categorical variables. Multivariate analysis is performed with Cox proportional hazards regression with time-dependent covariate. 108,718 (3.5%) patients for the years 2017 through 2019 had a SOI. 20,569 (18.9%) of these received at least one unit of packed red blood cells (PRBCs) within the first 4 h. Of the SOI patients who received blood, 8264 (40.2%) underwent laparotomy only, 2924 (14.2%) underwent embolization only, and 1119 (5.4%) underwent both procedures. The adjusted odds ratios (ORs) of death for transfused SOI patients who underwent laparotomy only, embolization only, and both procedures are 0.93 (P = not significant), 0.27 (P < 0.001), and 0.48 (P < 0.001), respectively. The ORs of death with laparotomy for patients receiving >1 through 4 units are 0.87, 0.78, 0.75, and 0.72, respectively (P ≤ 0.01 for all). For embolization, the ORs are 0.27, 0.30, 0.30, and 0.30, respectively (P < 0.001 for all). Laparotomy is independently associated with survival for patients who receive >1 unit of PRBCs. Angioembolization is independently associated with survival for the entire cohort, including transfused patients. Given the protective association of laparotomy in the blood-transfused SOI group, need for blood transfusion should be considered a meaningful index of instability and a relative indication for laparotomy. The protective association with angioembolization supports current practices for angioembolization of high-risk patients in the transfused and nontransfused groups.

Utilisation of Different Blood Components in Paediatric Patients: A Cross-sectional Study

Introduction: The term “blood component” refers to the separation of Whole Blood (WB) into packed red cells, platelet- rich plasma, Fresh Frozen Plasma (FFP), cryoprecipitate, and leukocytes. The practice of separating donated WB units into different blood components and supplying only those components to patients is now considered a standard practice in all blood banks. Therefore, regular auditing of blood usage and its components is essential to assess blood utilisation patterns. Aim: The aim of this study was to analyse the distribution and appropriateness of blood and blood product transfusions in children aged 1-18 years. Materials and Methods: A cross-sectional study was conducted over an 18-month period from December 1, 2014, to June 30, 2016, involving paediatric patients requiring blood and blood product transfusions, who presented to the Department of Paediatrics, Shri B.M. Patil Medical Hospital, Vijayapura, Karnataka, India. The study population consisted of children aged 1-18 years. Data from blood component requisition forms were collected, and reports of investigations such as pre-transfusion/ post-transfusion haematological parameters, coagulogram, and peripheral smear were recorded. Predetermined criteria were used to assess each transfusion episode. The results were then analysed, tabulated, and expressed as a percentage. The appropriateness of Packed Red Blood Cell (PRBC), platelet, and FFP transfusions was estimated using predetermined criteria. Data from blood component requisition forms were collected, coded, tabulated, analysed, and expressed as a percentage. Results: The study included 149 paediatric patients aged 1 to 18 years. Out of a total of 214 episodes of blood and blood component transfusions among the 149 patients, 102 episodes (47.7%) were WB transfusions, 67 episodes (31.3%) were packed red cell transfusions, 26 episodes (12.1%) were platelet transfusions, and 19 episodes (8.9%) were FFP transfusions. Out of the total 214 transfusion episodes, 126 (58.5%) were deemed appropriate, while 88 (41.5%) were deemed inappropriate. The most commonly inappropriately used component was WB, followed by platelets, FFP, and packed red cells. Inappropriateness of WB usage was primarily due to attempts to achieve haemostasis in bleeding patients, while sepsis was the most common indication for inappropriate platelet usage. Conclusion: This audit highlights significant variation in transfusion practice patterns among paediatricians. The most common indications for usage were found to be achieving haemostasis, threshold haemoglobin concentration, and sepsis in children.

White thrombus "fibrin" in the blood bag.

White thrombus "fibrin" in the blood bag.

Frequency of Dirofilaria immitis infection in blood donor dogs of the Rio de Janeiro state.

Dirofilariasis, a parasitic disease caused by the nematode Dirofilaria immitis, commonly known as heartworm, primarily inhabits the pulmonary artery and right heart of dogs and other animals. The disease is transmitted through diptera, predominantly from the Culex, Aedes, and Anopheles genera. Dirofilariasis is cosmopolitan in nature, endemic in coastal regions and tropical climates. Factors such as temperature, humidity, vector density, and the presence of definitive hosts significantly contribute to the spread of this parasitic disease. In the state of Rio de Janeiro, a prevalence of 58.6% of D. immitis infected animals has been recorded in municipalities like Niterói. Given that blood transfusions are routine clinical procedures and blood bags are not always accurately evaluated, an investigation into D. immitis infection in blood donor dogs from the metropolitan region of Rio de Janeiro was conducted. A total of 1044 blood donor dog files from a blood bank in Niterói, RJ, collected from January 2019 to December 2022, were analyzed. These samples, originating from kennels in various municipalities in the Metropolitan Region, were tested for the presence of microfilariae through direct examination using tubes and microhematocrit evaluated in optical microscopy. Additionally, the search for antigens was conducted using the enzyme-linked immunosorbent assay technique. Out of the 1044 records evaluated, 17.8% (186/1044) were positive for heartworm infection, with 2% (21/1044) samples positive for microfilariae and 14.8% (154/1044) positive for D. immitis antigens. The high prevalence rate indicates that canine D. immitis infection remains prevalent in the state of Rio de Janeiro, necessitating effective guidelines for prescribing preventive medications by veterinarians and an increase in epidemiological surveillance in the region.

Validation of Specimen Pooling Versus Individual Samples for Screening of Viral Markers and Syphilis in Blood Bag Strategy Single-Center Study

Validation of Specimen Pooling Versus Individual Samples for Screening of Viral Markers and Syphilis in Blood Bag Strategy Single-Center Study

Awareness, Motivation, and Barrier of Blood Donation among Adults in Puncak Alam

Background: In Malaysia and other countries, the availability of blood products is closely linked to the number of individuals who volunteer to donate blood. However, the capacity usage of blood nowadays is very demanding and has raised concern for many health facilities as the blood supply is below the reserve target. Objective: This study aimed to determine the relationship between the level of awareness, motivation, and barriers to blood donation among adults in Puncak Alam, Selangor. Methods: The study involved a cross-sectional survey that utilized web-based questionnaires to collect responses from 194 participants. The respondents were selected through convenience sampling. Results: It was found that the highest percentage of the respondents, 90 (46.4%) had a moderate level of awareness towards blood donation. The mean for motivating factors was 100.38 (SD=21.15). The majority of the respondents, 151 (77.8%) voted "I donate blood because it is important to help other people" as the primary reason that motivates them to donate blood. The mean for the barrier was 5.84 (SD=2.40). It was found that more than half of the 120 (61.9%) respondents cited fear of feeling faint or dizzy after donation as the most deterring factor. The relationship between the level of awareness and motivation and barriers was statistically significant, with weak correlations (p&lt;0.05, r=0.176) and (p&lt;0.01, r=0.197), respectively. Conclusion: Most of the respondents had moderate awareness, high motivation, and fewer barrier to donating blood. Thus, a campaign about blood donation can be held at attractive centres such as shopping complexes, universities, hospitals, and blood donation centres in order to increase the number of blood bags.

Skrining parasit malaria pada kantong darah di Unit Transfusi Darah Palang Merah Indonesia (PMI) Cabang Kota Banda Aceh

Background: Blood screening of donors has been routinely conducted to anticipate various infectious diseases transmitted through blood transfusion. However, screening for malaria has not been a top priority at the Blood Transfusion Unit (BTU), despite Banda Aceh City being a malaria-endemic area. Screening for malaria is essential to reduce transmission risk and ensure recipient transfusion safety.Objectives: The study aimed to determine the results of the Rapid Diagnostic Test (RDT) examination of malaria in blood bags at the BTU in the Indonesian Red Cross (IRC) branch in Banda Aceh.Methods: The study used an experimental design with the RDT method, which was conducted at the IRC Banda Aceh in December 2021. This study uses a descriptive research design through a cross-sectional approach. The total sample in this study was 30 donor blood bags taken by simple random sampling.Results: The results showed that malaria was found positive in 1 donor blood sample (3.33%) and 29 (96.67%) negative for malaria.Conclusion: The frequency of malaria screening results is predominantly negative. However, there are some positive ones in donor blood at the Banda Aceh branch of the Indonesian Red Cross Blood Transfusion Unit.

Horizontal collaboration in a decentralised system: Indonesian blood supply chain

ABSTRACT This paper examines the impacts of horizontal collaboration among blood transfusion units (BTUs) in the Indonesian blood supply chain to anticipate problems such as uncertainty of supply and demand. The conceptual model developed in this study, as well as its implementation, considers the uncertainty. A discrete event simulation is used to evaluate the horizontal collaboration with three main performance indicators: the rate of blood shortages, the rate of outdated blood bags, and the total profits. Two blood transfusion units (BTUs) in Indonesia are examined as case studies in this research. Based on data from the two case studies in one year, a set of experiments, results, and sensitivity analyses were conducted to test the benefits of horizontal collaboration. The results show that the horizontal collaboration decreases blood shortages, outdated blood bags, and inventory costs and increases the total profits. The total revenues increased, and there was additional income from selling blood bags to partner collaboration.

Glassfrogs conceal blood in their liver to maintain transparency.

Transparency in animals is a complex form of camouflage involving mechanisms that reduce light scattering and absorption throughout the organism. In vertebrates, attaining transparency is difficult because their circulatory system is full of red blood cells (RBCs) that strongly attenuate light. Here, we document how glassfrogs overcome this challenge by concealing these cells from view. Using photoacoustic imaging to track RBCs in vivo, we show that resting glassfrogs increase transparency two- to threefold by removing ~89% of their RBCs from circulation and packing them within their liver. Vertebrate transparency thus requires both see-through tissues and active mechanisms that "clear" respiratory pigments from these tissues. Furthermore, glassfrogs' ability to regulate the location, density, and packing of RBCs without clotting offers insight in metabolic, hemodynamic, and blood-clot research.

Trends in unsuitability for blood donation in the Brazilian Amazon.

Sociodemographic and behavioral factors are usually associated with the unsuitability to donate blood. Understanding the reasons behind the exclusion of blood bags is crucial for reducing donor deferral rates. This study aimed to characterize the profile of unsuitable donors in the Blood Center of the northern Brazilian state of Amazonas. This is a retrospective study, based on documentary analysis of electronic medical records obtained in the Hematology and Hemotherapy Foundation of the state of Amazonas. This study included all individuals with complete medical records (n = 87,463) who tried to donate blood between 2017 and 2019. The overall rate of donor unsuitability was 19.12% (n = 16,627) and the main reason was poor nutritional status (15.17%), followed by chronic health problems (11.40%), risky sexual behavior (9.5%) and exposure to risk (8.83%). High blood pressure figured as the leading cause of unsuitability among chronic health conditions (85.19%), while having sex with multiple partners (92.63%) was the main sexual risk behavior. The risk of exposure to malaria was responsible for 99.45% of unsuitability among those who were unsuitable due to exposure to risk factors. Deferral rates were associated with increasing age and replacement donation, which was the predominant type of donation. Women had the highest rates of unsuitability, mainly during the first donation (37.04%). This study provides the first known profile of blood donor unsuitability in the Brazilian Amazon and raises awareness of the region-specific needs that must be met to reduce blood donor unsuitability.

Erythrocyte Membrane Resistance Of Actively Smoking Donors In Leukoreduced Packed Red Blood Cells During Storage: Focus On Oxidative Stress

Background — Leukoreduced (with removed white blood cells) packed red blood cells (PRC) are commonly for blood transfusions to reduce post-transfusion effects. The number of active smokers in Indonesia is relatively high; consequently, many of them could be blood donors since no regulations are set to rule them out. However, leukoreduced PRC in active smokers are highly risky as they may undergo erythrocyte membrane damage caused by oxidative stress, which hinders fighting the free radicals generated by smoking. Objective — Our study examined the impact of oxidative stress on membrane resistance of leukoreduced PRC, produced from actively smoking donors, during its storage. Material and Methods − The study was descriptive and cross-sectional in its design. It examined 12 nonsmoking (NS), 12 lightly smoking (LS), and 12 moderately smoking (MS) donors. Leukoreduced PRC produced from donors was separated into three groups: NS, LS, and MS. We performed assessments of malondialdehyde (MDA), superoxide dismutase enzyme (SOD) activity, and osmotic fragility test (OFT) on days 0 through day 35 of storage (D0-D35). We used nonparametric statistical tests (Kruskal-Wallis and Mann-Whitney). We assumed that p&lt;0.05 implied statistically significant difference. Results — The Kruskal-Wallis test demonstrated differences on D0, D7, D14, D21, D28, and D35 between all three groups in MDA, SOD, and OFT, with p &lt; 0.05. This study showed that leukoreduced PRC storage increased oxidative stress. The highest oxidative stress occurred in the MS group. Conclusion — Erythrocyte membrane fragility and resistance correlated with oxidative stress. Blood components of leukoreduced PRC produced from moderate smokers should be banned for repeated transfusions.