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Sample records for allogeneic blood transfusion

  1. The role of patient's profile and allogeneic blood transfusion in development of post-cardiac surgery infections: a retrospective study

    NARCIS (Netherlands)

    Vranken, N.P.; Weerwind, P.W.; Barenbrug, P.J.; Teerenstra, S.; Ganushchak, Y.M.; Maessen, J.G.

    2014-01-01

    OBJECTIVES: We aimed to investigate the association of patient characteristics and allogeneic blood transfusion products in development of post-cardiac surgery nosocomial infections. METHODS: This retrospective study was conducted in 7888 patients undergoing cardiac surgery with median sternotomy an

  2. Therapeutic options to minimize allogeneic blood transfusions and their adverse effects in cardiac surgery: A systematic review

    OpenAIRE

    dos Santos, Antônio Alceu; da Silva, José Pedro; da Silva, Luciana da Fonseca; Sousa,Alexandre Gonçalves de; Piotto, Raquel Ferrari; Baumgratz,José Francisco

    2014-01-01

    Introdution Allogeneic blood is an exhaustible therapeutic resource. New evidence indicates that blood consumption is excessive and that donations have decreased, resulting in reduced blood supplies worldwide. Blood transfusions are associated with increased morbidity and mortality, as well as higher hospital costs. This makes it necessary to seek out new treatment options. Such options exist but are still virtually unknown and are rarely utilized. Objective To gather and describe in a system...

  3. [The 2013 Seville Consensus Document on alternatives to allogenic blood transfusion. An update on the Seville Document].

    Science.gov (United States)

    Leal-Noval, S R; Muñoz, M; Asuero, M; Contreras, E; García-Erce, J A; Llau, J V; Moral, V; Páramo, J A; Quintana, M; Basora, M; Bautista-Paloma, F J; Bisbe, E; Bóveda, J L; Castillo-Muñoz, A; Colomina, M J; Fernández, C; Fernández-Mondéjar, E; Ferrándiz, C; García de Lorenzo, A; Gomar, C; Gómez-Luque, A; Izuel, M; Jiménez-Yuste, V; López-Briz, E; López-Fernández, M L; Martín-Conde, J A; Montoro-Ronsano, B; Paniagua, C; Romero-Garrido, J A; Ruiz, J C; Salinas-Argente, R; Sánchez, C; Torrabadella, P; Arellano, V; Candela, A; Fernández, J A; Fernández-Hinojosa, E; Puppo, A

    2013-05-01

    Since allogeneic blood transfusion (ABT) is not harmless, multiple alternatives to ABT (AABT) have emerged, though there is great variability in their indications and appropriate use. This variability results from the interaction of a number of factors, including the specialty of the physician, knowledge and preferences, the degree of anemia, transfusion policy, and AABT availability. Since AABTs are not harmless and may not meet cost-effectiveness criteria, such variability is unacceptable. The Spanish Societies of Anesthesiology (SEDAR), Hematology and Hemotherapy (SEHH), Hospital Pharmacy (SEFH), Critical Care Medicine (SEMICYUC), Thrombosis and Hemostasis (SETH) and Blood Transfusion (SETS) have developed a Consensus Document for the proper use of AABTs. A panel of experts convened by these 6 Societies have conducted a systematic review of the medical literature and have developed the 2013 Seville Consensus Document on Alternatives to Allogeneic Blood Transfusion, which only considers those AABT aimed at decreasing the transfusion of packed red cells. AABTs are defined as any pharmacological or non-pharmacological measure aimed at decreasing the transfusion of red blood cell concentrates, while preserving patient safety. For each AABT, the main question formulated, positively or negatively, is: « Does this particular AABT reduce the transfusion rate or not?» All the recommendations on the use of AABTs were formulated according to the Grades of Recommendation Assessment, Development and Evaluation (GRADE) methodology.

  4. Changes of Hemoglobin and Hematocrit in Elderly Patients Receiving Lower Joint Arthroplasty without Allogeneic Blood Transfusion

    Institute of Scientific and Technical Information of China (English)

    Qi Zhou; Yiqin Zhou; Haishan Wu; Yuli Wu; Qirong Qian; Hui Zhao; Yunli Zhu

    2015-01-01

    Background:It has rarely been reported about the changes of hemoglobin (Hb) and hematocrit (Hct) in elderly patients receiving total knee arthroplasty (TKA) or total hip arthroplasty (THA).This study aimed to evaluate the changes of Hb and Hct after TKA or THA in elderly patients,and analyze its relationship with sex and type of arthroplasty.Methods:This is a prospective cohort study,including 107 patients receiving TKA or THA without allogeneic blood transfusion.There were 54 males and 53 females,with a mean age of 69.42 years.Levels of Hb and Hct were examined preoperatively and during the 6 months follow-up after operation.Results:Levels of Hb and Hct decreased postoperatively and reached their minimum points on postoperative day 4.Thereafter,Hb and Hct recovered to their preoperative levels within 6-12 weeks.No significant differences in the levels of Hb and Hct were noticed between different sexes.THA patients showed significantly greater drop in Hb and Hct than TKA patients in the first 4 days postoperatively (P < 0.05).Conclusions:Levels of Hb and Hct decreased during the first 4 days after arthroplasty and gradually returned to their normal levels within 6-12 weeks postoperatively.THA may be associated with higher postoperative blood loss than TKA.

  5. Blood transfusions

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000431.htm Blood transfusions To use the sharing features on this ... several sources of blood which are described below. Blood From the Public (Volunteer Blood Donation) The most ...

  6. 滤除白细胞异体血对围术期患儿细胞免疫功能的影响%Effects of leukocyte-depleted allogeneic blood transfusion on perioperative cellular immunity in children

    Institute of Scientific and Technical Information of China (English)

    邢准; 王秋实; 刁艳妮

    2014-01-01

    Objective To evaluate the effects of leukocyte-depleted allogeneic blood transfusion on perioperative cellular immunity in children.Methods Three hundred and fifty-nine ASA Ⅰ or Ⅱ children (aged 3 months-14 years and weighing 5-74 kg) requiring allogeneic blood transfusion during operation were randomly divided into two groups:163 children receiving normal allogeneic blood transfusion (control group,group C) and 196 children receiving leukocyte-depleted allogeneic blood transfusion (group D).Blood samples were collected from the peripheral vein before blood transfusion,and 2 and 6 days after blood transfusion for determination of the levels of CD3+,CD4+,CD8 +,and CD56+ by flow cytometry.CD4+ /CD8+ ratio was calculated.The volume of allogeneic blood transfusion during operation,the duration of operation,postoperative drainage,antibiotic administration,hospital stay and the incidence of postoperative infection were recorded.Rssults The levels of CD3+,CD4+,CD56+ and CD4+/CD8+ ratio significantly increased at 6 days after blood transfusion while the duration of postoperative drainage,postoperative antibiotic administration,hospital stay and the incidence of postoperative infection significantly decreased in group D compared with group C.Conclusion Leukocyte-depleted allogeneic blood transfusion is helpful in improving the postoperative cellular immunity in children.

  7. Allogeneic hematopoietic stem cell transplantation: transfusion issues

    Directory of Open Access Journals (Sweden)

    Akkök ÇA

    2016-05-01

    Full Text Available Çiğdem Akalın Akkök,1,21Department of Immunology and Transfusion Medicine, Oslo University Hospital, Ullevaal, Oslo, Norway; 2Department of Clinical Immunology and Transfusion Medicine, Lund University Hospital, Lund, Sweden Abstract: Allogeneic hematopoietic stem cell transplantation (AHSCT is an intention-to-cure treatment strategy in several malignancies and nonmalignancies. The number of patients receiving AHSCT is increasing due to new indications, and more elderly patients with comorbidities are included in the protocols. Survival of the patients undergoing AHSCT has improved owing to better patient care, including optimization of transfusion support, which has a major contribution. However, transfusion can also be hazardous. Increasing awareness about transfusion and finding the balance between avoiding unnecessary transfusions and transfusing the correct component when needed are the key issues. Myeloablative conditioning results in pancytopenia, and the patients are prone to infections, anemia, and bleeding both before and after transplantation. Until red cell and platelet engraftment, the patients are usually transfusion dependent needing red cell and/or platelet components. Physicians dealing with AHSCT patients should be well informed about the attributes of the blood components they order. Knowledge about transfusion indications, triggers, and how to prevent and manage eventual transfusion complications is also required. The clinical picture can be challenging, and transplantation/treatment-related toxicity/complications can sometimes be difficult to distinguish from a transfusion complication, especially if the latter one took place, for instance, several days or weeks ago. ABO compatibility between the patient and the donor is not a prerequisite when choosing human leukocyte antigen-matched hematopoietic stem cell donor. Consequently, ABO incompatibility exists in ~40% of the cases and brings some immunohematological issues

  8. Outcome in hip fracture patients related to anemia at admission and allogeneic blood transfusion: An analysis of 1262 surgically treated patients

    NARCIS (Netherlands)

    A.J.H. Vochteloo (Anne); B.L. Borger van der Burg (Boudewijn); B. Mertens (Bart); A.H.P. Niggebrugge (Arthur); M.R. de Vries (Mark); W.E. Tuinebreijer (Wim); R.M. Bloem (Rolf); R.G.H.H. Nelissen (Rob); P. Pilot (Peter)

    2011-01-01

    textabstractBackground: Anemia is more often seen in older patients. As the mean age of hip fracture patients is rising, anemia is common in this population. Allogeneic blood transfusion (ABT) and anemia have been pointed out as possible risk factors for poorer outcome in hip fracture patients. Meth

  9. Storage time of intraoperative transfused allogeneic red blood cells is not associated with new-onset postoperative atrial fibrillation in cardiac surgery

    DEFF Research Database (Denmark)

    Gu, Jiwei; Skals, Regitze Kuhr; Torp-Pedersen, Christian

    2017-01-01

    BACKGROUND: Allogeneic red blood cell (RBC) transfusion has been associated with new-onset postoperative atrial fibrillation (POAF) following cardiac surgery. Prolonged storage time of RBC may increase the risk. The primary aim of the study was to evaluate whether the storage time of RBC is assoc......BACKGROUND: Allogeneic red blood cell (RBC) transfusion has been associated with new-onset postoperative atrial fibrillation (POAF) following cardiac surgery. Prolonged storage time of RBC may increase the risk. The primary aim of the study was to evaluate whether the storage time of RBC...... is associated with development of POAF. MATERIALS AND METHODS: Pre-, per- and postoperative data were retrieved from the Western Denmark Heart Registry and local blood banks regarding patients who underwent coronary artery bypass surgery, valve surgery or combined procedures in Aalborg or Aarhus University...

  10. Blood Transfusion (For Parents)

    Science.gov (United States)

    ... Old Feeding Your 1- to 2-Year-Old Blood Transfusions KidsHealth > For Parents > Blood Transfusions A A ... and help put your child at ease. About Blood Transfusions Blood is like the body's transportation system. ...

  11. [Modern coagulation management reduces the transfusion rate of allogenic blood products].

    Science.gov (United States)

    Weber, Christian Friedrich

    2012-06-01

    Evaluating the patient's individual bleeding history with a standardized questionnaire, using "point-of-care" - methods for coagulation analyses and providing autologous transfusion techniques are preconditions of a modern coagulation management. Therapy of coagulopathic patients should be based on structured hemotherapy algorithms. Surgical haemostasis and the maintenance of the basic conditions for haemostasis are elementary requirements for an effective therapy. In cases of diffuse bleeding, early antifibrinolytic therapy should be considered. Coagulation factor deficiencies should be corrected "goal-directed" using coagulation factor concentrates. Transfusion of fresh frozen plasma is only indicated in the clinical setting of massive transfusions. DDAVP and transfusion of platelet concentrates are options to optimize primary haemostasis. In cases of on-going bleeding, recombinant activated coagulation factor VII represents an option for "ultima-ratio" therapy.

  12. Blood Transfusions (For Teens)

    Science.gov (United States)

    ... many precautions to confirm a patient's and donor's blood are compatible before giving a transfusion. In almost every situation, the benefits of having a blood transfusion far outweigh the risks. The Red Cross ...

  13. Blood Transfusion

    Science.gov (United States)

    ... to their work or home. The availability of plastic bags that can have one or more satellite bags ... in preparing the donated blood. The use of plastic bags allows the blood center to make a variety ...

  14. Blood Transfusion and Donation

    Science.gov (United States)

    ... receiving the blood transfusion. To keep blood safe, blood banks carefully screen donated blood. The risk of catching ... one or more times before the surgery. A blood bank will store your blood for your use. NIH: ...

  15. Survival after blood transfusion

    DEFF Research Database (Denmark)

    Kamper-Jørgensen, Mads; Ahlgren, Martin; Rostgaard, Klaus

    2008-01-01

    of transfusion recipients in Denmark and Sweden followed for up to 20 years after their first blood transfusion. Main outcome measure was all-cause mortality. RESULTS: A total of 1,118,261 transfusion recipients were identified, of whom 62.0 percent were aged 65 years or older at the time of their first...... the SMR remained significantly 1.3-fold increased. CONCLUSION: The survival and relative mortality patterns among blood transfusion recipients were characterized with unprecedented detail and precision. Our results are relevant to assessments of the consequences of possible transfusion-transmitted disease...... as well as for cost-benefit estimation of new blood safety interventions....

  16. [2013: The Seville document on consensus on the alternatives to allogenic blood transfusion. Update to the Seville document. Spanish Societies of Anaesthesiology (SEDAR), Haematology and Haemotherapy (SEHH), Hospital Pharmacy (SEFH), Critical Care Medicine (SEMICYUC), Thrombosis and Haemostasis (SETH) and Blood Transfusion (SETS)].

    Science.gov (United States)

    Leal-Noval, S R; Muñoz, M; Asuero, M; Contreras, E; García-Erce, J A; Llau, J V; Moral, V; Páramo, J A; Quintana, M

    2013-01-01

    As allogeneic blood transfusion (ABT) is not harmless, multiple alternatives to TSA (AABT) have emerged, but there is a huge variability with respect to their indications and appropriate use. This variability results from the interplay of a number of factors, which include physicians specialty, knowledge and preferences, degree of anaemia, transfusion policy, and AABT availability. Since the ABBT are not harmless and may not meet costeffectiveness criteria, such avariability is unacceptable. The Spanish Societies of Anaesthesiology (SEDAR), Haematology and Haemotherapy (SEHH), Hospital Pharmacy (SEFH), Critical Care Medicine (SEMICYUC), Thrombosis and Haemostasis (SETH) and Blood Transfusion (SETS) have developed a Consensus Document for the proper use of AABTs. A panel of experts convened by these six Societies have conducted a systematic review of the medical literature and developed the «2013. Seville Document of Consensus on Alternatives to Allogeneic Blood Transfusion», which only considers those AABT aimed to decrease the transfusion of packed red cells. The AABTs are defined as any pharmacological and non-pharmacological measure aimed to decrease the transfusion of of red blood cell concentrates, while preserving the patient safety. For each AABT, the main question is formulated, positively or negatively, as: «Does or does not this particular AABT reduce the transfusion rate?» All the recommendations on the use of AABTs were formulated according to the GRADE (Grades of Recommendation Assessment, Development and Evaluation) methodology.

  17. Detrimental effects of perioperative blood transfusion

    DEFF Research Database (Denmark)

    Nielsen, Hans Jørgen

    1995-01-01

    Evidence suggests that perioperative allogeneic blood transfusion increases the risk of infectious complications after major surgery and of cancer recurrence after curative operation. This has been attributed to immunosuppression. Several authors have suggested that filtered whole blood and/or red...... similar postoperative infectious complications and cancer recurrence and/or survival rates in patients receiving autologous blood donated before operation and those receiving allogeneic blood. Future studies should identify common risk factors associated with blood storage....... cell concentrate, or leucocyte- and buffy coat-reduced red cells in artificial medium or their own plasma, may reduce postoperative immunosuppression. It was also anticipated that the use of autologous blood might minimize the risk of perioperative transfusion, but studies have unexpectedly shown...

  18. Detrimental effects of perioperative blood transfusion

    DEFF Research Database (Denmark)

    Nielsen, Hans Jørgen

    1995-01-01

    Evidence suggests that perioperative allogeneic blood transfusion increases the risk of infectious complications after major surgery and of cancer recurrence after curative operation. This has been attributed to immunosuppression. Several authors have suggested that filtered whole blood and/or red...... cell concentrate, or leucocyte- and buffy coat-reduced red cells in artificial medium or their own plasma, may reduce postoperative immunosuppression. It was also anticipated that the use of autologous blood might minimize the risk of perioperative transfusion, but studies have unexpectedly shown...... similar postoperative infectious complications and cancer recurrence and/or survival rates in patients receiving autologous blood donated before operation and those receiving allogeneic blood. Future studies should identify common risk factors associated with blood storage....

  19. [The "Seville" Consensus Document on Alternatives to Allogenic Blood Transfusion. Sociedades españolas de Anestesiología (SEDAR), Medicina Intensiva (SEMICYUC), Hematología y Hemoterapia (AEHH), Transfusión sanguínea (SETS) Trombosis y Hemostasia (SETH)].

    Science.gov (United States)

    Alberca, Ignacio; Asuero, Ma Soledad; Bóveda, José L; Carpio, Nelly; Contreras, Enric; Fernández-Mondéjar, Enrique; Forteza, Alejandro; García-Erce, José A; García de Lorenzo, Abelardo; Gomar, Carmen; Gómez, Aurelio; Llau, Juan V; López-Fernández, María F; Moral, Victoria; Muñoz, Manuel; Páramo, José A; Torrabadella, Pablo; Quintana, Manuel; Sánchez, Calixto

    2006-07-18

    The Consensus Document on Alternatives to Allogenic Blood Transfusion (AABT) has been drawn up by a panel of experts from 5 scientific societies. The Spanish Societies of Anesthesiology (SEDAR), Critical Care Medicine and Coronary Units (SEMICYUC), Hematology and Hemotherapy (AEHH), Blood Transfusion (SETS) and Thrombosis and Hemostasis (SETH) have sponsored and participated in this Consensus Document. Alternatives to blood transfusion have been divided into pharmacological and non-pharmacological, with 4 modules and 12 topics. The main objective variable was the reduction of allogenic blood transfusions and/or the number of transfused patients. The extent to which this objective was achieved by each AABT was evaluated using the Delphi method, which classifies the grade of recommendation from A (supported by controlled studies) to E (non-controlled studies and expert opinion). The experts concluded that most of the indications for AABT were based on middle or low grades of recommendation, "C", "D", or "E", thus indicating the need for further controlled studies.

  20. Laryngospasm after autologous blood transfusion.

    Science.gov (United States)

    Hong, Jung; Grecu, Loreta

    2006-07-01

    Although perioperative autologous blood transfusions are associated with few side effects, transfusion reactions can occur and can be life-threatening. We report the occurrence of postoperative laryngospasm in a patient who underwent spinal anesthesia for hip surgery. The laryngospasm could not be attributed to any cause other than the autologous blood transfusion and recurred when the transfusion was restarted. Laryngospasm was successfully treated both times with positive pressure ventilation. Autologous transfusions can trigger febrile nonhemolytic transfusion reactions, which may result in airway compromise.

  1. Blood transfusion exposure in Denmark and Sweden

    DEFF Research Database (Denmark)

    Kamper-Jørgensen, Mads; Edgren, Gustaf; Rostgaard, Klaus

    2009-01-01

    Although essential for the evaluation of blood transfusion safety, the prevalence of blood transfusion in the general population is not presently known. This study estimated the exposure to blood transfusion in the general Scandinavian population....

  2. Perioperative blood transfusion does not decrease survival after surgical treatment of spinal metastases

    DEFF Research Database (Denmark)

    Clausen, Caroline; Lönn, Lars; Morgen, Søren Schmidt;

    2014-01-01

    PURPOSE: To assess whether perioperative allogenic blood transfusions in patients undergoing surgical treatment for spinal metastases independently influence patient survival. METHODS: A retrospective study including 170 consecutive patients undergoing surgical treatment for spinal metastases...

  3. Intraoperative transfusion practices in Europe

    DEFF Research Database (Denmark)

    Meier, J; Filipescu, D; Kozek-Langenecker, S;

    2016-01-01

    BACKGROUND: Transfusion of allogeneic blood influences outcome after surgery. Despite widespread availability of transfusion guidelines, transfusion practices might vary among physicians, departments, hospitals and countries. Our aim was to determine the amount of packed red blood cells (p...

  4. Red blood cell alloimmunization after blood transfusion

    NARCIS (Netherlands)

    Schonewille, Henk

    2008-01-01

    Current pretransfusion policy requires the patients’ serum to be tested for the presence of irregular red blood cell antibodies. In case of an antibody, red blood cells lacking the corresponding antigen are transfused after an antiglobulin crossmatch. The aim of the studies in this thesis is primari

  5. Effect of perioperative blood transfusion on clinical outcomes in hepatic surgery for cancer

    Institute of Scientific and Technical Information of China (English)

    Gianlorenzo Dionigi; Luigi Boni; Francesca Rovera; Stefano Rausei; Salvatore Cuffari; Giovanni Cantone; Alessandro Bacuzzi; Renzo Dionigi

    2009-01-01

    Allogeneic blood transfusion during liver resection for malignancies has been associated with an increased incidence of different types of complications:infectious complications,tumor recurrence,decreased survival.Even if there is clear evidence of transfusion-induced immunosuppression,it is difficult to demonstrate that transfusion is the only determinant factor that decisively affects the outcome.In any case there are several motivations to reduce the practice of blood transfusion.The advantages and drawbacks of different transfusion alternatives are reviewed here,emphasizing that surgeons and anesthetists who practice in centers with a high volume of liver resections,should be familiar with all the possible alternatives.

  6. [Blood components and good practices in transfusion].

    Science.gov (United States)

    Andreu, Georges

    2015-02-01

    Each year, more than three millions of blood components are transfused to more than five hundred thousand patients in France. The optimal use of blood components requires that physicians prescribing blood components master the clinical indications of red blood cells concentrates, platelet concentrates and fresh frozen plasma. In addition, physicians in charge of blood component prescription should provide adequate pre- and post-transfusion information to their patients. Compliance of blood components administration in patients with safety guidelines contributes as well to their optimal use. In addition, for each blood component transfused, a proper evaluation of its safety and its efficacy should be done. Finally, a regular evaluation of transfusion practice in hospital services were blood components are used, through audits made in cooperation with their blood component provider, either blood transfusion centre or the hospital blood bank, enables to appreciate the level of compliance with safety and clinical guidelines, and more globally how the transfusion process is mastered.

  7. Restrictive versus liberal transfusion strategy for red blood cell transfusion

    DEFF Research Database (Denmark)

    Holst, Lars B; Petersen, Marie W; Haase, Nicolai;

    2015-01-01

    OBJECTIVE: To compare the benefit and harm of restrictive versus liberal transfusion strategies to guide red blood cell transfusions. DESIGN: Systematic review with meta-analyses and trial sequential analyses of randomised clinical trials. DATA SOURCES: Cochrane central register of controlled...... trials, SilverPlatter Medline (1950 to date), SilverPlatter Embase (1980 to date), and Science Citation Index Expanded (1900 to present). Reference lists of identified trials and other systematic reviews were assessed, and authors and experts in transfusion were contacted to identify additional trials....... TRIAL SELECTION: Published and unpublished randomised clinical trials that evaluated a restrictive compared with a liberal transfusion strategy in adults or children, irrespective of language, blinding procedure, publication status, or sample size. DATA EXTRACTION: Two authors independently screened...

  8. Effect of Comprehensive and Whole Process Blood Management on Allogeneic Transfusion in Orthopedic Surgical Patients%综合、全程血液管理措施对骨科手术患者异体输血的影响

    Institute of Scientific and Technical Information of China (English)

    蔡思逸; 沈建雄; 翁习生; 张保中; 杨波; 冯宾; 邱贵兴

    2015-01-01

    目的:回顾分析综合、全程血液管理措施对骨科手术患者异体输血情况的影响。方法纳入北京协和医院骨科2013年1月至2014年12月接受骨科手术的7082例患者,其中2013年3320例,2014年3762例;高出血风险手术2013年2178例,2014年2322例。2014年1月起,骨科开始全面采取涉及全围术期的自体输血技术、改进手术及围术期治疗技术、药物干预和科学执行输血原则四方面的个体化综合血液管理措施。将2014年异体输血情况与2013年情况进行回顾性比较,评估新措施对骨科手术患者异体输血的影响。结果2013、2014两年度患者性别、年龄、高出血风险手术类型及分布情况类似。2014年总手术量及高出血风险手术量均大于2013年度。2014年所有患者异体总输血量106950 ml (713例)低于2013年121600 ml (760例),异体总输入浓缩红细胞单位数2543 U低于2013年2804 U。2014年异体输血总花费680720元,占异体输血患者医疗总费用比例0.97%(680720元/70287242.03元),占总医疗费用0.35%(680720元/196100485元)均低于2013年(分别为1.04%和0.42%)。2014年平均住院日(12.46 d比12.90 d)和并发症发生率(2.02%比5.03%)均低于2013年。结论通过执行全面、科学的综合血液管理措施,可以在保障患者医疗安全、保持高效医疗服务能力的同时,减少骨科手术患者的异体输血量。%Objective To retrospectively analyze the effect of comprehensive and whole process blood man-agement on allogeneic transfusion in patients undergoing orthopedic surgery.Methods A total of 7082 patients (3320 in 2013, 3762 in 2014) who underwent orthopedic surgery in the period from January 2013 to December 2014 in Department of Orthopedics, Peking Union Medical College Hospital were retrospectively analyzed, among which 2178 cases in 2013 and 2322 cases in 2014 were considered at high hemorrhage risk

  9. [Blood transfusion: the challenges for tomorrow?].

    Science.gov (United States)

    Folléa, Gilles; Garraud, Olivier; Tiberghien, Pierre

    2015-02-01

    As any therapeutic means, blood transfusion requires regular evaluation, particularly for its indications, effectiveness and risks. The availability of randomized clinical trials, the evolution of the quality of blood components, and the economic constraints shared by all countries, all lead to rethink both transfusion therapy as a whole and the organization of the transfusion chain from donor to recipient. The main tools available to improve transfusion and the transfusion chain management are the following: programs of patient blood management (PBM) to optimize the use of blood products with a patient centred approach, blood supply management tools to improve the effectiveness and efficiency of the transfusion chain, donor management tools to adapt donor collections to the patients' needs in compliance with safety requirements for patients and donors, and coordination of these activities. A better understanding of these tools and their implementation will certainly be major challenges for transfusion medicine in the near future. Integrating these evolutions in regulations through the revision of the European Directives on blood and blood components (the review process is expected to be launched in 2015) should enroll them in the long term, for the benefit of patients, donors and all other stakeholders involved in the transfusion chain.

  10. Transfusion of blood and blood products: indications and complications.

    Science.gov (United States)

    Sharma, Sanjeev; Sharma, Poonam; Tyler, Lisa N

    2011-03-15

    Red blood cell transfusions are used to treat hemorrhage and to improve oxygen delivery to tissues. Transfusion of red blood cells should be based on the patient's clinical condition. Indications for transfusion include symptomatic anemia (causing shortness of breath, dizziness, congestive heart failure, and decreased exercise tolerance), acute sickle cell crisis, and acute blood loss of more than 30 percent of blood volume. Fresh frozen plasma infusion can be used for reversal of anticoagulant effects. Platelet transfusion is indicated to prevent hemorrhage in patients with thrombocytopenia or platelet function defects. Cryoprecipitate is used in cases of hypofibrinogenemia, which most often occurs in the setting of massive hemorrhage or consumptive coagulopathy. Transfusion-related infections are less common than noninfectious complications. All noninfectious complications of transfusion are classified as noninfectious serious hazards of transfusion. Acute complications occur within minutes to 24 hours of the transfusion, whereas delayed complications may develop days, months, or even years later.

  11. Transfusion of blood during cardiac surgery is associated with higher long-term mortality in low-risk patients

    DEFF Research Database (Denmark)

    Jakobsen, Carl-Johan; Ryhammer, Pia Katarina; Jensen, Mariann Tang

    2012-01-01

    Numerous reports have emphasized the need for reduction in transfusions of allogeneic red blood cells (RBC) due to increased morbidity and mortality. Nevertheless, transfusion rates are still high in several cardiac surgery institutions. Reports on long-term survival after cardiac surgery and RBC...

  12. Profiles of blood and blood component transfusion recipients in Zimbabwe

    NARCIS (Netherlands)

    Mafirakureva, Nyashadzaishe; Khoza, Star; Hassall, Oliver; Faragher, Brian E.; Kajja, Isaac; Mvere, David A.; Emmanuel, Jean C.; Postma, Maarten J.; van Hulst, Marinus

    2015-01-01

    Background. There are limited published data on the characteristics of blood transfusion recipients in sub-Saharan Africa. This study describes the demographic characteristics of blood transfusion recipients and patterns of blood and blood component use in Zimbabwe. Materials and methods. Data on th

  13. Blood transfusion practices in obstetric anaesthesia

    Directory of Open Access Journals (Sweden)

    Ashok Jadon

    2014-01-01

    Full Text Available Blood transfusion is an essential component of emergency obstetric care and appropriate blood transfusion significantly reduces maternal mortality. Obstetric haemorrhage, especially postpartum haemorrhage, remains one of the major causes of massive haemorrhage and a prime cause of maternal mortality. Blood loss and assessment of its correct requirement are difficult in pregnancy due to physiological changes and comorbid conditions. Many guidelines have been used to assess the requirement and transfusion of blood and its components. Infrastructural, economic, social and religious constraints in blood banking and donation are key issues to formulate practice guidelines. Available current guidelines for transfusion are mostly from the developed world; however, they can be used by developing countries keeping available resources in perspective.

  14. Infections Transmitted By the Transfusion of Blood and Blood Products

    Directory of Open Access Journals (Sweden)

    Tekin A.

    2011-05-01

    Full Text Available Especially viral hepatitis viruses and human immunodeficiency virus(HIV which were transmitted by the transfusion of blood and blood products have been an important public health problem for a long time on the world. Transfusion of blood and blood products is an ideal and an easiest and a simplest route for transmission of infectious diseases. It is known that many infectious agents, either bacterial, viral, parasitic and fungal agents may be transmitted by the transfusion of blood and blood products. In present study, we reviewed infection diseases that transmitted by the transfusion of blood and blood products.Additionally, we were aimed to emphasize a rare but a very important complication of transfusion of blood and blood products.

  15. [Blood transfusion and supply chain management safety].

    Science.gov (United States)

    Quaranta, Jean-François; Caldani, Cyril; Cabaud, Jean-Jacques; Chavarin, Patricia; Rochette-Eribon, Sandrine

    2015-02-01

    The level of safety attained in blood transfusion now makes this a discipline better managed care activities. This was achieved both by scientific advances and policy decisions regulating and supervising the activity, as well as by the quality system, which we recall that affects the entire organizational structure, responsibilities, procedures, processes and resources in place to achieve quality management. So, an effective quality system provides a framework within which activities are established, performed in a quality-focused way and continuously monitored to improve outcomes. This system quality has to irrigate all the actors of the transfusion, just as much the establishments of blood transfusion than the health establishments.

  16. Repeat Minimally Invasive Mitral Valve Replacement for Recurrent Mitral Stenosis after OMC in Patients Who Decline Blood Product Transfusion for Religious Reasons.

    Science.gov (United States)

    Ito, Yujiro; Nakamura, Yoshitsugu; Tagusari, Osamu; Yoshida, Shigehiko

    2015-01-01

    Cardiac surgery for Jehovah's Witness (JW) patients is considered to be high risk because of patients' refusal to receive blood transfusion. We report a successful mitral valve replacement for recurrent mitral stenosis after OMC with minimally invasive right thoracotomy, without any transfusion of allogeneic blood or blood products. This minimally invasive mitral valve replacement through right thoracotomy was an excellent approach for JW patients.

  17. [Research advance on clinical blood transfusion and tumor therapy].

    Science.gov (United States)

    Jiang, Xue-Bing; Zhang, Li-Ping; Wang, Yan-Ju; Ma, Cong

    2010-08-01

    Clinical blood transfusion is one of the most important supportive therapy for patients with tumor. The blood transfusion has dual effects for patients with tumor. First, blood transfusion can rectify anemia and improve oxygen saturation, accelerate oxidation and necrosis for tumor cells; the second, blood transfusion can induce immunosuppression, tumor recurrence and postoperative infection for tumor patients. Filtering white blood cells (WBC) before blood transfusion can decrease the incidence of the adverse reactions. The rational perioperative autotransfusion for patients with tumors is focus to which the world medical sciences pay close attention. In this article, the support effect of blood transfusion for treatment of tumor patients, blood transfusion and immunosuppression, blood transfusion and postoperative infection and relapse of tumor patients, depleted leukocyte blood transfusion and autologous transfusion of tumor patients are reviewed.

  18. Blood transfusion practices in cancer surgery

    Directory of Open Access Journals (Sweden)

    Juan P Cata

    2014-01-01

    Full Text Available Cancer patients are commonly transfused with blood products immediately before, during or after major surgery. Blood loss and haemodilution are the most common causes of red blood cells (RBCs administration and coagulopathies are the indications for the infusion of fresh-frozen plasma (FFP, cryoprecipitates and platelets. Transfusion-related immune modulation is a complication associated with the administration of blood products. A decreased immune surveillance as a consequence of blood transfusions has been linked to cancer recurrence and progression. Moreover, soluble factors present in packed RBCs, platelets and FFP can directly stimulate tumour growth and spread. Two meta-analyses suggest that the administration of blood products is associated with shorter recurrence-free survival and overall survival after colorectal cancer surgery. More studies are needed to show such association in different cancer patient populations.

  19. Cancer incidence in blood transfusion recipients

    DEFF Research Database (Denmark)

    Hjalgrim, Henrik; Edgren, Gustaf; Rostgaard, Klaus

    2007-01-01

    BACKGROUND: Blood transfusions may influence the recipients' cancer risks both through transmission of biologic agents and by modulation of the immune system. However, cancer occurrence in transfusion recipients remains poorly characterized. METHODS: We used computerized files from Scandinavian...... blood banks to identify a cohort of 888,843 cancer-free recipients transfused after 1968. The recipients were followed from first registered transfusion until the date of death, emigration, cancer diagnosis, or December 31, 2002, whichever came first. Relative risks were expressed as ratios...... of the observed to the expected numbers of cancers, that is, standardized incidence ratios (SIRs), using incidence rates for the general Danish and Swedish populations as a reference. All statistical tests were two-sided. RESULTS: During 5,652,918 person-years of follow-up, 80,990 cancers occurred...

  20. Transfusion and blood donation in comic strips.

    Science.gov (United States)

    Lefrère, Jean-Jacques; Danic, Bruno

    2013-07-01

    The representation of blood transfusion and donation of blood in the comic strip has never been studied. The comic strip, which is a relatively recent art, emerged in the 19th century before becoming a mass medium during the 20th century. We have sought, by calling on collectors and using the resources of Internet, comic strips devoted, wholly or in part, to the themes of transfusion and blood donation. We present some of them here in chronologic order, indicating the title, country of origin, year of publication, and names of authors. The theme of the superhero using transfusion to transmit his virtues or his powers is repeated throughout the 20th century in North American comic strips. More recently, comic strips have been conceived from the outset with a promotional aim. They perpetuate positive images and are directed toward a young readership, wielding humor to reduce the fear of venipuncture. Few comic strips denounce the abuse of the commercialization of products derived from the human body. The image of transfusion and blood donation given by the comic strips is not to be underestimated because their readership is primarily children, some of whom will become blood donors. Furthermore, if some readers are transfused during their lives, the impact of a memory more or less conscious of these childhood readings may resurface, both in hopes and in fears.

  1. Análisis de la transfusión sanguínea alogénica en cirugía oncológica oral y maxilofacial: Análisis de variables Analysis of allogeneic blood transfusion in oral and maxillofacial cancer surgery: Analysis of variables

    Directory of Open Access Journals (Sweden)

    O. Altura Guillén

    2008-06-01

    -four patients received transfusions (32 men. The mean age of patients was 65 years and the tumor was lingual in 36.36%. The most frequent intervention was tumor exeresis, which was associated with bone resection and cervical lymph node clearance in 56.82% of cases and with simple reconstruction in 63% of cases. The mean duration of the intervention was 5.7 hours, mean ASA risk was 3, and mean transfusion volume was 2.9 units. Seventy percent of patients had stage IV tumors. Mean hemoglobin concentration before transfusion was 7.71 g/dl. Surgical time, preoperative hemoglobin concentration, and preoperative hematocrit were statistically significant in multivariate analysis. Conclusions. Allogeneic blood transfusions originate adverse effects that can condition the evolution of patients with cancer. Strict transfusion criteria should be followed (Hb < 8g/dl to prevent or diminish these deleterious effects. Preoperative Hb is the only variable that we can act on to reduce transfusion volume. Blood-sparing programs should be implemented.

  2. Transmission of Neurodegenerative Disorders Through Blood Transfusion

    DEFF Research Database (Denmark)

    Edgren, Gustaf; Hjalgrim, Henrik; Rostgaard, Klaus

    2016-01-01

    : Multivariable Cox regression models were used to estimate hazard ratios for dementia of any type, Alzheimer disease, and Parkinson disease in patients receiving blood transfusions from donors who were later diagnosed with any of these diseases versus patients who received blood from healthy donors. Whether...... excess occurrence of neurodegenerative disease occurred among recipients of blood from a subset of donors was also investigated. As a positive control, transmission of chronic hepatitis before and after implementation of hepatitis C virus screening was assessed. RESULTS: Among included patients, 2.......9% received a transfusion from a donor diagnosed with one of the studied neurodegenerative diseases. No evidence of transmission of any of these diseases was found, regardless of approach. The hazard ratio for dementia in recipients of blood from donors with dementia versus recipients of blood from healthy...

  3. Delayed massive immune hemolysis mediated by minor ABO incompatibility after allogeneic peripheral blood progenitor cell transplantation.

    OpenAIRE

    Salmon, Jean; Michaux, S.; Hermanne, J. P.; Baudoux, Etienne; Gerard, Christiane; Sondag, Danièle; Fillet, Georges; Beguin, Yves

    1999-01-01

    BACKGROUND: Bone marrow transplantation with minor ABO incompatibility may be followed by moderate delayed hemolysis of the recipient's red cells by donor-derived ABO antibodies. This reaction may be more severe after transplantation of peripheral blood progenitor cells (PBPCs). CASE REPORT: A 16-year-old boy underwent an allogeneic PBPC transplant from his HLA-mismatched mother as treatment for acute myeloblastic leukemia that had proved resistant to induction chemotherapy. Transfusion of th...

  4. Blood doping: the flip side of transfusion and transfusion alternatives.

    Science.gov (United States)

    Cacic, Daniel Limi; Hervig, Tor; Seghatchian, Jerard

    2013-08-01

    Blood doping in sports has been a hot topic of present. Longitudinal follow up of hematological parameters in different endurance sports, during the 1990s and early 2000s, has provided considerable suspicions about extensive blood manipulation, with performance enhancing effects. Recent doping revelations in the media also prove that blood doping is not an anticipated myth but it is, in fact, real. Erythropoiesis stimulating agents and autologous blood transfusions are used in synergy with substantial effect on the maximum oxygen uptake and delivery to muscles. Whilst both methods of blood manipulation represent a potential health hazard, in the context of an elevated hematocrit, nevertheless despite a number of suspicious deaths amongst athletes, this has not yet been fully documented. A reliable test for detection of recombinant human erythropoietin was implemented in 2000, but this is probably circumvented by microdose regimens. The Athlete's Biological Passport represents the progeny of the idea of an indirect approach based on long term monitoring of hematological parameters, thus making it possible to detect autologous blood doping and erythropoietin use after the substance is excreted. Nevertheless with advances in anti-doping measures it is possible that the levels of excretion of substances used can be masked. Clearly more sensitive and specific diagnostic tools and research/development in these areas of major concern are warranted, which, combined with changes in the athlete's attitude, will help in reaching the vision of fair play.

  5. Anemia of prematurity : time for a change in transfusion management?

    NARCIS (Netherlands)

    Khodabux, Chantal Muriel

    2013-01-01

    In this thesis we investigated clinical effects of allogeneic red blood cell (RBC) transfusions in premature infants, different transfusion volumes in relation to neonatal outcome in premature infants and the use of autologous cord blood (CB) as an alternative for allogeneic transfusions. Despite th

  6. Association of blood transfusion with increased mortality in myocardial infarction

    DEFF Research Database (Denmark)

    Chatterjee, Saurav; Wetterslev, Jørn; Sharma, Abhishek;

    2013-01-01

    The benefit of blood transfusion in patients with myocardial infarction is controversial, and a possibility of harm exists.......The benefit of blood transfusion in patients with myocardial infarction is controversial, and a possibility of harm exists....

  7. Neurological Complications following Blood Transfusions in Sickle Cell Anemia

    Science.gov (United States)

    Khawar, Nayaab; Kulpa, Jolanta; Bellin, Anne; Proteasa, Simona; Sundaram, Revathy

    2017-01-01

    In Sickle Cell Anemia (SCA) patient blood transfusions are an important part of treatment for stroke and its prevention. However, blood transfusions can also lead to complications such as Reversible Posterior Leukoencephalopathy Syndrome (RPLS). This brief report highlights two cases of SCA who developed such neurological complications after a blood transfusion. RLPS should be considered as the cause of neurologic finding in patients with SCA and hypertension following a blood transfusion.

  8. Clinical Response and Transfusion Reactions of Sheep Subjected to Single Homologous Blood Transfusion

    Directory of Open Access Journals (Sweden)

    Rejane Santos Sousa

    2014-01-01

    Full Text Available Studies in relation to blood conservation and responses to transfusion are scarce for ruminants. We evaluated the clinical manifestations of sheep that received a single homologous transfusion of whole blood, focusing on transfusion reactions. Eighteen adult sheep were subjected to a single phlebotomy to withdraw 40% of the total blood volume, which was placed into CPDA-1 bags and then divided into G0, animals that received fresh blood, and G15 and G35, animals that received blood stored for 15 or 35 days, respectively. Clinical observations were recorded throughout the transfusion, whereas heart rate, respiratory rate, and rectal temperature were assessed at the following times: 24 hours after phlebotomy and before transfusion; 30 minutes, six, twelve, 24, 48, 72, and 96 hours and eight and 16 days after transfusion. All groups presented transfusion reactions, among which hyperthermia was the most frequent (50% of animals. Tachycardia occurred most frequently in the G35 animals (50% of them. During transfusion G35 animals presented more clinical manifestation (P<0.05. Transfusion of fresh or stored total blood improved the blood volume, but transfusion reactions occurred, demonstrating that a single transfusion of fresh or stored blood can cause inflammatory and febrile nonhemolytic transfusion reactions in sheep.

  9. Transfusions of blood and blood products and viral infections

    Directory of Open Access Journals (Sweden)

    Marta Wróblewska

    2002-06-01

    Full Text Available Transfusions of blood and blood products are commonly used in medicine, but being biological materials they carry a risk of transmitting infections--viral, bacterial, parasitic, as well as prions. Laboratory tests used for screening of donated blood for viral infections at present cannot detect all infectious units. Criteria for selection of blood donors therefore must be very strict, while methods of inactivation of viruses and laboratory assays for detection of their presence must be improved. Indications for blood transfusion should be restricted.

  10. Screening for autologous blood transfusions

    DEFF Research Database (Denmark)

    Mørkeberg, J; Belhage, B; Ashenden, M

    2009-01-01

    The ratio between the amount of hemoglobin in the mature erythrocyte population and the reticulocytes (RBCHb:RetHb ratio) has previously been suggested as a marker to screen for EPO-abuse. We speculated that the reinfusion of blood would lead to a marked increase in this ratio, making it a valuab...... doping after reinfusion, and the parameter could be used in a testing setting, once stability validation has been performed....... parameter in the screening for autologous blood doping. Three bags of blood (approximately 201+/-11 g of Hb) were withdrawn from 16 males and stored at either -80 degrees C (-80 T, n=8) or +4 degrees C (+4 T, n=8) and reinfused 10 weeks or 4 weeks later, respectively. Seven subjects served as controls...

  11. Severe hyperkalemia following blood transfusions: Is there a link?

    Science.gov (United States)

    Rizos, Christos V; Milionis, Haralampos J; Elisaf, Moses S

    2017-01-01

    Patients with gastrointestinal bleeding often require large volume blood transfusion. Among the various side effects of blood transfusion, the increase of potassium levels is a serious one which is often overlooked. We report a case of severe hyperkalemia in a patient with gastric bleeding after large volume transfusion of packed red blood cells. The patient had hyperkalemia at baseline associated with his receiving medication as well as acute renal failure following hypovolemia. The baseline hyperkalemia was further aggravated after massive transfusions of packed red blood cells in a short period of time. The associated pathogenetic mechanisms resulting in the increase of potassium levels are presented. A number of risk factors which increase the risk of hyperkalemia after blood transfusion are discussed. Moreover, appropriate management strategies for the prevention of blood transfusion associated hyperkalemia are also presented. Physicians should always keep in mind the possibility of hyperkalemia in cases of blood transfusion. PMID:28101452

  12. Effect of blood transfusions on canine renal allograft survival

    Energy Technology Data Exchange (ETDEWEB)

    van der Linden, C.J.; Buurman, W.A.; Vegt, P.A.; Greep, J.M.; Jeekel, J.

    1982-04-01

    In this study significantly prolonged canine renal allograft survival has been demonstrated after transfusion of 100 ml of third-party whole blood given peroperatively. Peroperative transfusions of third-party leukocyte-free blood or pure lymphocyte cell suspensions did not influence graft survival. Furthermore, no improvement in graft survival has been found after a peroperative transfusion of irradiated whole blood (2500 rad). These data suggest that delayed graft rejection after blood transfusions can only be expected after the administration of whole blood. The role of competent lymphocytes in whole blood is questionable, since a transfusion or irradiated whole blood in combination with nonirradiated lymphocytes did not lead to prolonged graft survival. Immunosuppression of the recipient directly after transfusion seems to be essential to induce the beneficial effect of blood transfusions. This has been demonstrated for a transfusion of whole blood 14 days before transplantation. A single transfusion of 100 ml of whole blood 14 days before transplantation could effectively prolong graft survival if immunosuppression with azathioprine and prednisone was started on the day of transfusion. No improvement in graft survival has been found with such a transfusion if preoperative immunosuppression has been omitted.

  13. Comparing the usage of autologous blood transfusion with homologous blood transfusion in spine surgery

    Directory of Open Access Journals (Sweden)

    Hamdan Hamdan

    2004-03-01

    Full Text Available Autologous Blood Transfusion (ABT is the safest type of blood transfusion for the operator and the patient. The preoperative donation technique had already been reduced the homologous blood requirements successfully. Homologous Blood Transfusion (HBT brings more risks in complications such as transmission of diseases, anaphylactic reactions, haemolitic reactions etc. This was a parallel study, comparing one group receiving ABT and a second group receiving HBT where in both groups were performed spine surgery. The parameter used was the hemoglobin(Hb and hematocrit(Ht content preoperatively (after donation of ABT and after transfusion, total days in hospitalization after surgery. Another purpose of this study was also to achieve understandings in using ABT by considering the total patients who finally required additional HBT. There were 74 patients with diagnosis of spine fracture, tuberculous spondylitis, scoliosis, spinal stenosis and spondylolisthesis. In the ABT group the average age was 33,9 ± 14 years old and the HBT group was 29,1 ± 11,5 years old. Both groups consisted of 21 males and 16 females. Body weight of the ABT group was 55,3 ± 11,1 kg and the HBT group 52,8 ± 9,7 kg. Amount of donations preoperatively in ABT was 798,6 ± 170 cc. There were 12 patients (32,4% where the donated blood amount preoperatively did not match up the requests. There were eight patients (21,6% in the ABT group that required additional HBT of about 550 cc. Three patients (8,1% of the ABT group received transfusion that did not match the indications (blood loss < 15% of the total blood volume. The Hb and Ht content preoperatively (after donation of the ABT group significantly was less than the HBT group (p= 0,001. Hb content after transfusion in the ABT group was not significantly less than the HBT group (p = 0,30. Hospitalization days after surgery were significantly higher in the HBT group (p = 0,000. In conclusions : there was 21,6% of the ABT group

  14. [The precaution principle and blood transfusion].

    Science.gov (United States)

    Sicard, D

    2000-06-01

    Because of the HIV and HCV virus transmission by transfusion during the eighties, there has been a retrospective reflection about the non-application of the precautionary principle, which has appeared only recently in the medical world. Since it was difficult to identify the real cause of the above-cited transmission in France, mainly because of the bad selection of blood donors, we feel we are justified in applying this precautionary principle more and more, in a monopolistic way, for biological security reasons. As a result, the biological research is not limited to looking for a 'degree zero' risk. Whether it concerns the 'PCR', the research of a new potential virus, the excessive fear regarding the transfusion of the new ESB agent, the worry caused by the blood donors who lived in the British Isles, the need for security based upon the precautionary principle is increasing endlessly. It is, however, more reasonable to consider that the precautionary principle should be essence incite a multi-disciplinary reflection involving biological sciences as well as social sciences. The precautionary principle would not make sense if it were not questioned for bad estimations, its harmful influences or its opportunistic use. Transfusion security, which is so important as a goal and as a principle, cannot appeal to the precautionary principle all the time, since the excessive use of this principle would lead to the paradox of not being able to identify the issues anymore.

  15. Effect of blood transfusions on canine renal allograft survival

    Energy Technology Data Exchange (ETDEWEB)

    Van Der Linden, C.J.; Buurman, W.A.; Vegt, P.A.; Greep, J.M.; Jeekel, J.

    1982-04-01

    In this study significantly prolonged canine renal allograft survival has been demonstrated after transfusion of 100 ml of third-party whole blood given peroperatively. Peroperative transfusions of third-party leukocyte-free blood or pure lymphocyte cell suspensions did not influence graft survival. Futhermore, no improvement in graft survival has been found after a peroperative transfuson of irradiated whole blood (2500 rad). These data suggest that delayed graft rejection after blood transfusions can only be expected after the administration of whole blood. The role of competent lymphocytes in whole blood is questionable, since a transfusion of irradiated whole blood in combination with nonirradiated lymphocytes did not lead to prolonged graft survival. Immunosuppression of the recipient directly after transfusion seems to be essential to induce the beneficial effect of blood transfusions. This has been demonstrated for a transfusion of whole blood 14 days before transplantation. A single transfusion of 100 ml of whole blood 14 days before transplantation could effectively prolong graft survival if immunosuppression with azathioprine and prednisone was started on the day of transfusion. No improvement in graft survival has been found with such a transfusion if preoperative immunosuppression has been omitted.

  16. Blood transfusion: patient identification and empowerment.

    Science.gov (United States)

    Stout, Lynn; Joseph, Sundari

    Positive patient identification is pivotal to several steps of the transfusion process; it is integral to ensuring that the correct blood is given to the correct patient. If patient misidentification occurs, this has potentially fatal consequences for patients. Historically patient involvement in healthcare has focused on clinical decision making, where the patient, having been provided with medical information, is encouraged to become involved in the decisions related to their individualised treatment. This article explores the aspects of patient contribution to patient safety relating to positive patient identification in transfusion. When involving patients in their care, however, clinicians must recognise the diversity of patients and the capacity of the patient to be involved. It must not be assumed that all patients will be willing or indeed able to participate. Additionally, clinicians' attitudes to patient involvement in patient safety can determine whether cultural change is successful.

  17. Blood transfusion requirement in surgery for femoral artery aneurysms

    DEFF Research Database (Denmark)

    Levi, N; Schroeder, T V

    1997-01-01

    Audit of blood usage in various surgical specialities have shown that over-ordering of blood is widespread, causing unnecessary pressure on the transfusion facilities and giving growing concern over the expense of cross-matching blood. The aim of this study was to assess the blood transfusion...

  18. Blood Conservation Strategies and Liver Transplantation Transfusion-Free Techniques Derived from Jehovah's Witness Surgical Cohorts.

    Science.gov (United States)

    Sheth, Mansi; Kulkarni, Sujit; Dhanireddy, Kiran; Perez, Alexander; Selby, Rick

    2015-01-01

    Red blood cell and component transfusions are a frequent and widely accepted accompaniment of surgical procedures. Although the risk of specific disease transmission via allogeneic blood transfusions (ABT) is very low, the occurrence of transfusion related immune modulation (TRIM) still remains a ubiquitous concern. Recent studies have shown that ABT are linked to increased morbidity and mortality across various specialties, with negative outcomes directly correlated to number of transfusions. Blood conservation methods are therefore necessary to reduce ABT. Acute normo-volemic hemodilution (ANH) along with pre-operative blood augmentation and intraoperative cell salvage are blood conservation techniques utilized in tertiary and even quaternary (transplantation) surgery in Jehovah's Witnesses with excellent outcomes. The many hematologic complications such as anemia, thrombocytopenia and coagulopathies that occur with liver transplantation present a significant barrier when trying to avoid ABT. Despite this, living donor liver transplantation (LDLT) has been successfully performed in a transfusion-free environment, providing valuable insight into the possibilities of limiting ABT and its associated risks in all patients.

  19. Comparison of Stored Umbilical Cord Blood and Adult Donor Blood: Transfusion Feasibility

    Directory of Open Access Journals (Sweden)

    Rola Sahyoun-tokan

    2012-09-01

    Full Text Available OBJECTIVE: This study aimed to compare the storage properties of red blood cell (RBC concentrates of umbilical cord blood (UCB and adult donor blood (ADB, and to evaluate the feasibility of UCB-RBC concentrate as an autologous source for blood transfusion in very low birth weight (VLBW preterm neonates. METHODS: In all, 30 newborn (10 preterm, 20 full term UCB and 31 ADB units were collected. RBC concentrates were stored and compared with regard to pH, potassium (K+, 2,3-biphosphoglycerate (2-3-BPG, adenosine tri-phosphate (ATP, plasma Hb, and bacterial contamination on d 1, 21, and 35 of storage. RESULTS: The K+ level increased with time and differed significantly between storage d 1 and 21, and between storage d 1 and 35 in both the UCB and ADB units. Initial and d 21 K+ levels were higher in the UCB units than in the ADB units. The 2,3-BPG level did not differ significantly between the UCB-PRC and ADB-PRC samples. After 35 d of storage both UCB-PRC and ADB-PRC samples exhibited significant differences from the initial free Hb, intracellular ATP, and pH values. Significant differences in intracellular ATP and pH were also observed between the UCB-PRC and ADB-PRC samples. CONCLUSION: The volume of harvested and prepared UCB-PRC can be used for some of the blood transfusions required during the neonatal period and thus may decrease the number of allogeneic transfusions, especially in preterm newborns. The hematological and biochemical changes that occurred in UCB during storage were comparable with those observed in ADB, and do not pose a risk to the immature metabolism of neonates. UCB-RPC prepared and stored under standard conditions can be a safe alternative RBC source for transfusions in VLBW newborns.

  20. Potential cost saving of Epoetin alfa in elective hip or knee surgery due to reduction in blood transfusions and their side effects: a discrete-event simulation model.

    Directory of Open Access Journals (Sweden)

    Jörg Tomeczkowski

    Full Text Available OBJECTIVES: Transfusion of allogeneic blood is still common in orthopedic surgery. This analysis evaluates from the perspective of a German hospital the potential cost savings of Epoetin alfa (EPO compared to predonated autologous blood transfusions or to a nobloodconservationstrategy (allogeneic blood transfusion strategyduring elective hip and knee replacement surgery. METHODS: Individual patients (N = 50,000 were simulated based on data from controlled trials, the German DRG institute (InEK and various publications and entered into a stochastic model (Monte-Carlo of three treatment arms: EPO, preoperative autologous donation and nobloodconservationstrategy. All three strategies lead to a different risk for an allogeneic blood transfusion. The model focused on the costs and events of the three different procedures. The costs were obtained from clinical trial databases, the German DRG system, patient records and medical publications: transfusion (allogeneic red blood cells: €320/unit and autologous red blood cells: €250/unit, pneumonia treatment (€5,000, and length of stay (€300/day. Probabilistic sensitivity analyses were performed to determine which factors had an influence on the model's clinical and cost outcomes. RESULTS: At acquisition costs of €200/40,000 IU EPO is cost saving compared to autologous blood donation, and cost-effective compared to a nobloodconservationstrategy. The results were most sensitive to the cost of EPO, blood units and hospital days. CONCLUSIONS: EPO might become an attractive blood conservation strategy for anemic patients at reasonable costs due to the reduction in allogeneic blood transfusions, in the modeled incidence of transfusion-associated pneumonia andthe prolongedlength of stay.

  1. Red blood cell transfusion during septic shock in the ICU

    DEFF Research Database (Denmark)

    Perner, A; Smith, S H; Carlsen, S

    2012-01-01

    Transfusion of red blood cells (RBCs) remains controversial in patients with septic shock, but current practice is unknown. Our aim was to evaluate RBC transfusion practice in septic shock in the intensive care unit (ICU), and patient characteristics and outcome associated with RBC transfusion....

  2. Blood Transfusion Strategies in Patients Undergoing Extracorporeal Membrane Oxygenation

    Directory of Open Access Journals (Sweden)

    Hyoung Soo Kim

    2017-02-01

    Full Text Available Extracorporeal membrane oxygenation (ECMO is frequently associated with bleeding and coagulopathy complications, which may lead to the need for transfusion of multiple blood products. However, blood transfusions are known to increase morbidity and mortality, as well as hospital cost, in critically ill patients. In current practice, patients on ECMO receive a transfusion, on average, of 1-5 packed red blood cells (RBCs/day, with platelet transfusion accounting for the largest portion of transfusion volume. Generally, adult patients require more transfusions than neonates or children, and patients receiving venovenous ECMO for respiratory failure tend to need smaller transfusion volumes compared to those receiving venoarterial ECMO for cardiac failure. Observation studies have reported that a higher transfusion volume was associated with increased mortality. To date, the evidence for transfusion in patients undergoing ECMO is limited; most knowledge on transfusion strategies was extrapolated from studies in critically ill patients. However, current data support a restrictive blood transfusion strategy for ECMO patients, and a low transfusion trigger seems to be safe and reasonable.

  3. Tranexamic Acid Decreases Incidence of Blood Transfusion in Simultaneous Bilateral Total Knee Arthroplasty.

    Science.gov (United States)

    Bagsby, Deren T; Samujh, Christopher A; Vissing, Jacqueline L; Empson, Janene A; Pomeroy, Donald L; Malkani, Arthur L

    2015-12-01

    Blood management for simultaneous bilateral total knee arthroplasty (TKA) patients is more challenging than in unilateral arthroplasty. We examined if administration of tranexamic acid (TXA) to patients undergoing simultaneous bilateral TKA would reduce blood loss and decrease allogeneic blood transfusion requirements. A retrospective review of 103 patients, 57 in the control and 46 in the TXA group, was performed. There was higher postoperative day 1 hemoglobin in patients receiving TXA (2.95±1.33 versus 4.33±1.19, Ptransfusion incidence with administration of TXA (17.4% versus 57.9%, Ptransfusion rates by almost 70% in simultaneous bilateral total knee arthroplasty.

  4. Clinical observation of factors in the efficacy of blood component transfusion in patients following hematopoietic stem cell transplantation.

    Directory of Open Access Journals (Sweden)

    Xi Zhang

    Full Text Available BACKGROUND: Factors affecting the efficacy of platelet and red blood cell (RBC transfusion in patients undergoing hematopoietic stem cell transplantation (HSCT have not been studied extensively. We aimed to evaluate platelet and RBC transfusion efficacy by measuring the platelet corrected count increment and the hemoglobin increment, respectively, 24 h after transfusion in 105 patients who received HSCT. METHODOLOGY/PRINCIPAL FINDINGS: Using retrospective analysis, we studied whether factors, including gender, time of transplantation, the compatibility of ABO group between HSC donors and recipients, and autologous or allogenic transplantation, influence the efficacy of blood component transfusion. We found that the infection rate of HSCT patients positively correlated with the transfusion amount, and the length of stay in the laminar flow room was associated with transfusion. We found that platelet transfusion performed during HSCT showed significantly better efficacy than that performed before HSCT. The effect of platelet transfusion in auto-transplantation was significantly better than that in allo-transplantation. The efficacy of RBC transfusion during HSCT was significantly lower than that performed before HSCT. The efficacy of RBC transfusion in auto-transplantation was significantly higher than that in allo-transplantation. Allo-transplantation patients who received HSCs from compatible ABO groups showed significantly higher efficacy during both platelet and RBC transfusion. CONCLUSIONS: We conclude that the efficacy of platelet and RBC transfusions does not correlate with the gender of patients, while it significantly correlates with the time of transplantation, type of transplantation, and ABO compatibility between HSC donors and recipients. During HSCT, the infection rate of patients positively correlates with the transfusion amount of RBCs and platelets. The total volume of RBC units transfused positively correlates with the length of

  5. Restrictive versus liberal transfusion strategy for red blood cell transfusion

    DEFF Research Database (Denmark)

    Holst, Lars B; Petersen, Marie W; Haase, Nicolai;

    2015-01-01

    trials, SilverPlatter Medline (1950 to date), SilverPlatter Embase (1980 to date), and Science Citation Index Expanded (1900 to present). Reference lists of identified trials and other systematic reviews were assessed, and authors and experts in transfusion were contacted to identify additional trials...

  6. One-year period prevalence of blood transfusion

    DEFF Research Database (Denmark)

    Madsen, J T; Kimper-Karl, M L; Sprogøe, U;

    2010-01-01

    Transfusion practice is reported to differ considerably between countries. Comparisons often rely on transfusion rates, incidence - or prevalence rates. In this paper, the one-year period prevalence rate (1-YPPR) of transfusion of red cells (RBC) is presented. Transfusion data, demographic data...... was 9.2/1000 citizens. Most of the transfused patients had a main diagnosis of neoplasm (22% of recipients), diseases of the circulatory system (15%), the digestive system (15%), injuries (13%) and diseases of the blood (8%). Age standardization reversed the relation between sex specific 1-YPPRs...

  7. Anemia and Blood Transfusions in Critically Ill Patients

    Directory of Open Access Journals (Sweden)

    M. Kamran Athar

    2012-01-01

    Full Text Available Anemia is common in critically ill patients. As a consequence packed red blood cell (PRBC transfusions are frequent in the critically ill. Over the past two decades a growing body of literature has emerged, linking PRBC transfusion to infections, immunosuppression, organ dysfunction, and a higher mortality rate. However, despite growing evidence that risk of PRBC transfusion outweighs its benefit, significant numbers of critically ill patients still receive PRBC transfusion during their intensive care unit (ICU stay. In this paper, we summarize the current literature concerning the impact of anemia on outcomes in critically ill patients and the potential complications of PRBC transfusions.

  8. 'Blind' transfusion of blood products in exsanguinating trauma patients.

    NARCIS (Netherlands)

    Geeraedts, L.M.G.; Demiral, H.; Schaap, N.P.M.; Kamphuisen, P.W.; Pompe, J.C.; Frolke, J.P.M.

    2007-01-01

    BACKGROUND: In trauma, as interventions are carried out to stop bleeding, ongoing resuscitation with blood products is of vital importance. As transfusion policy in exsanguinating patients cannot be based on laboratory tests, transfusion of blood products is performed empirically or 'blindly'. The a

  9. Blood transfusion indications in neurosurgical patients: A systematic review.

    Science.gov (United States)

    Bagwe, Shefali; Chung, Lawrance K; Lagman, Carlito; Voth, Brittany L; Barnette, Natalie E; Elhajjmoussa, Lekaa; Yang, Isaac

    2017-04-01

    Neurosurgical procedures can be complicated by significant blood losses that have the potential to decrease tissue perfusion to critical brain tissue. Red blood cell transfusion is used in a variety of capacities both inside, and outside, of the operating room to prevent untoward neurologic damage. However, evidence-based guidelines concerning thresholds and indications for transfusion in neurosurgery remain limited. Consequently, transfusion practices in neurosurgical patients are highly variable and based on institutional experiences. Recently, a paradigm shift has occurred in neurocritical intensive care units, whereby restrictive transfusion is increasingly favored over liberal transfusion but the ideal strategy remains in clinical equipoise. The authors of this study perform a systematic review of the literature with the objective of capturing the changing landscape of blood transfusion indications in neurosurgical patients.

  10. Why and how to rationalize allogeneic blood in surgery
    Porque e como racionalizar o uso de sangue alogênico em cirurgia

    OpenAIRE

    2002-01-01

    The authors have assessed the use of allogeneic blood in surgery procedures and its influence on American Medical Centers. Physiology and physiopathology in transfusion surgery are evaluated, alerting to the possibility of occurring some risks such as infection and immunological diseases, mainly the “Transfusion Related Acute Lung Injury” (TRALI), that has concerned the scientific community as it is misdiagnosed and underreported. The authors point out safe, effective and simple alternatives ...

  11. The Global Application of ISBT 128 in Blood Transfusion

    Institute of Scientific and Technical Information of China (English)

    Paul Ashford

    2006-01-01

    @@ Blood Transfusion is a global activity, both in terms of its widespread application, and because of the need in specific circumstances for blood to move across organizational and national boundaries in its journey from donor to patient.

  12. Scientific and forensic standards for homologous blood transfusion anti-doping analyses.

    Science.gov (United States)

    Giraud, Sylvain; Robinson, Neil; Mangin, Patrice; Saugy, Martial

    2008-07-18

    Since the introduction in 2001 of a urine-based detection method for recombinant erythropoietin (rHuEPO), transfusion-doping practices have regained interest. To address this problem, an efficient antidoping test designed to obtain direct proof of allogeneic blood transfusion was developed and validated. This test, based on flow cytometry analysis of red blood cell (RBCs) phenotypes, was used to determine the absence or the presence of numerous RBCs populations in a blood sample. A such, it may constitute a direct proof of an abnormal blood population resulting from homologous transfusion. Single-blind and single-site studies were carried out to validate this method as a forensic quality standard analysis and to allow objective interpretation of real cases. The analysis of 140 blood samples containing different percentages (0-5%) of a minor RBCs population were carried on by four independent analysts. Robustness, sensitivity, specificity, precision and stability were assessed. ISO-accredited controls samples were used to demonstrate that the method was robust, stable and precise. No false positive results were observed, resulting in a 100% specificity of the method. Most samples containing a 1.5% minor RBCs population were unambiguously detected, yielding a 78.1% sensitivity. These samples mimicked blood collected from an athlete 3 months after a homologous blood transfusion event where 10% of the total RBCs present in the recipient originated in the donor. The observed false negative results could be explained by differences in antigen expression between the donor and the recipient. False negatives were more numerous with smaller minor RBCs populations. The method described here fulfils the ISO-17025 accreditation and validation requirements. The controls and the methodology are solid enough to determine with certainty whether a sample contains one or more RBCs populations. This variable is currently the best indicator for homologous blood transfusion doping.

  13. Profile of Blood Transfusion Requests from Hospitals to Bandung Blood Transfusion Unit, Indonesian Red Cross in 2011

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    Syahla Nisaa Amalia

    2015-09-01

    Full Text Available Background: Blood transfusion as a part health services should be provided under appropriate indications and in a safe manner. In Indonesia, blood collection is run by the Blood Transfusion Unit of Indonesian Red Cross, where the blood is screened, processed into blood components, and finally distributed to hospitals. The purpose of this study was to describe the profile of blood transfusion requests from hospitals that do not have blood bank facility to the Bandung Blood Transfusion Unit, Indonesian Red Cross. Methods: A descriptive study was carried out using secondary data from Bandung Blood Transfusion Unit Indonesian Red Cross (UTD PMI Bandung. All blood request forms from hospitals during 2011 were collected and analyzed. Variables in this study were the amount of blood units, blood components, blood type, and indications of blood transfusion. Results: The number of blood units requested by hospitals were 35,841 units. The most blood units requested was in August 2011. The blood component requested was the packed red cell (61.1%, whole blood (17.4%, thrombocyte concentrate (10.6%, and fresh frozen plasma (7%. The total percentage of O, A, B and AB blood types were 36.1%, 28.6%, 27.5%, and 7.9% respectively. The most frequent indication for transfusion was anemia (61.7%, followed by surgery and other causes of bleeding. Conclusions: The total blood units requested by hospitals vary each month. The most blood component requested is Packed Red Cell and the type of blood is O blood type. The most frequent indication is anemia.

  14. History of blood transfusion in sub-saharan Africa.

    Science.gov (United States)

    Schneider, William H

    2013-01-01

    The adequacy and safety of blood transfusion in sub-Saharan Africa is the subject of much concern, yet there have been very few studies of its history. An overview of that record finds that transfusions were first reported in Africa (sub-Saharan and excluding South Africa) in the early 1920s, and organized transfusion practices were established before the Second World War. Blood transfusion grew rapidly after 1945, along with the construction of new hospitals and expanded health services in Africa. Significant differences existed between colonial powers in the organization of transfusion services, but these converged after independence as their use continued to grow and decentralized and hospital-based practices were adopted. It was only after the oil crisis in the mid-1970s that health spending declined and the collection, testing, and transfusion of blood began to level off. Thus, when the AIDS crisis hit transfusion services, they were already struggling to meet the needs of patients. At this time, foreign assistance as well as the World Health Organization and the League of Red Cross Societies helped respond to both the immediate problem of testing blood, and for some countries, support existed for the broader reorganization of transfusion. Overall, the history shows that transfusion was adopted widely and quickly, limited mainly by the availability of knowledgeable doctors and hospital facilities. There was less resistance than expected by Africans to receive transfusions, and the record shows a remarkable flexibility in obtaining blood. The dangers of disease transmission were recognized from an early date but were balanced against the potential lifesaving benefits of transfusion.

  15. The prevalence of transfusion transmitted virus infection in blood donors

    Institute of Scientific and Technical Information of China (English)

    Cheng Hui Huang; Ru Guang Chen; Yu Sen Zhou; Hai Tao Wang; Chun Ying Xie

    2000-01-01

    @@INTRODUCTION A newly discovered DNA virus,transfusion transmitted virus (TTV), was reported as a cause of post-transfusion hepatitis of unknown etiology in Japan[1]. In order to investigate TTV prevalence in southern China, a study was carried out among blood donors, patients with liver diseases and hemodialysis to determine the epidemiological charateristics.

  16. Perceived blood transfusion safety: A cross-European comparison

    NARCIS (Netherlands)

    Merz, E.M.; Zijlstra, B.J.H.; de Kort, W.L.A.M.

    2016-01-01

    Background and Objectives During the past decades, blood transfusions have become an ever safer clinical procedure in developed countries. Extensive donor screening together with improved infectious disease testing has led to a minimization of risks for transfusion recipients. Still, the general pub

  17. The Effects of Blood Transfusion on Delirium Incidence

    NARCIS (Netherlands)

    van der Zanden, Vera; Beishuizen, Sara J.; Scholtens, Rikie M.; de Jonghe, Annemarieke; de Rooij, Sophia E.; van Munster, Barbara C.

    2016-01-01

    Background: Both anemia and blood transfusion could be precipitating factors for delirium; hence in postoperative patients with anemia at high risk for delirium, it is controversial whether transfusion is the best option. The aim of this study is to investigate the association of anemia and delirium

  18. National audit of the blood transfusion process in the UK.

    Science.gov (United States)

    Murphy, M F; Wilkinson, J; Lowe, D; Pearson, M

    2001-10-01

    The objectives of this initiative were to produce nationally tested audit tools, to influence the content of national guidelines, and to enable performance indicators to be set for the clinical transfusion process. Audit tools were developed for blood transfusion practice through a collaboration between Royal Colleges and specialist Societies with an interest in blood transfusion. National audits were carried out involving 50 hospitals in the first audit and 23 of the same hospitals in the second. Over 20% of participating hospitals did not have Hospital Transfusion Committees. Most hospitals had written policies for the taking of blood samples for grouping and compatibility testing. Formal training for the phlebotomists and nurses who took blood samples was almost universal, but only one-third gave training to doctors. The audits of transfusion practice demonstrated considerable variation in the performance of standard procedures in relation to the administration of blood, and little change in practice between the two audits. The first two objectives have been met in that audit tools were developed and published, and information from the first audits was used in the development of national guidelines for the administration of blood. A significant shortfall in the systems for monitoring and delivering transfusions is present in many hospitals. This justifies pursuing the third objective but this will require a new initiative. The type of analysis and the method used for the presentation of audit data developed in this study may be useful for setting performance indicators for the clinical transfusion process.

  19. The Red Blood Cell Transfusion Trigger: Has the Sin of Commission Now Become a Sin of Omission?.

    Science.gov (United States)

    1997-05-01

    concentration of 10 to 12 g/dl. Human recombinant erythropoietin is also recommended for the reduction of allogeneic blood transfusions in surgical...patients. Human recombinant erythropoietin is recommended for anemic patients with hemoglobin concentrations of ■, greater than 10 g/dl and less than 13...with recombinant erythropoietin also reduces the defects in platelet adhesion and aggregation caused by uremic plasma. Thromb. Haemost. 1991;66:638

  20. Acute HIV illness following blood transfusion in three African children.

    Science.gov (United States)

    Colebunders, R; Greenberg, A E; Francis, H; Kabote, N; Izaley, L; Nguyen-Dinh, P; Quinn, T C; Van der Groen, G; Curran, J W; Piot, P

    1988-04-01

    Three children are described in whom pre-transfusion samples were HIV-seronegative and post-transfusional samples, obtained within 1 week after transfusion, were HIV-seropositive. Two of them developed a transient fever within 1 week of receiving the blood transfusion, and a transient generalized skin eruption which lasted for about 2 weeks. All three developed persistent generalized lymphadenopathy. One child developed a lumbar herpes zoster 7 months after transfusion. IgM Western blots demonstrated the presence of antibodies to protein bands p17, p24 and p55 in all three children. These three case reports suggest that children who receive a seropositive blood transfusion are at high risk for developing acute manifestations of HIV infection.

  1. Prevalence of transfusion transmitted infections amongst multiple blood transfused patients of β-thalassemia major in a tertiary care hospital

    Directory of Open Access Journals (Sweden)

    Kundan Mittal

    2016-12-01

    Conclusions: Thalassemia is a chronic transfusion dependent disease complicated by the effects of iron overload on various organs leading to increased morbidity and mortality. The risk of transmission of TTI in thalassemia increases with time as number of transfusions increase. Use of advanced technology in blood screening, voluntary donations, donor selection, asepsis during blood transfusion should be used to curtail the transmission.

  2. 自体血回输对开颅手术患者凝血功能的影响%Effect of Autologous Blood Transfusion on Blood Coagulation Functionduring Craniotomy

    Institute of Scientific and Technical Information of China (English)

    邓佳; 蒋璐; 许婷; 蔡兵

    2016-01-01

    Objective To investigate the effect of intraoperative autologous blood transfusion on blood coagulation function in patients with craniotomy. Methods 40 cases of patients with craniotomy were randomly divided into experimental group( autolo-gous blood transfusion group) and control group( allogeneic blood transfusion group) and the blood and coagulation indicators before and after transfusion were monitored. Results In the experimental group,indicators before transfusion like coagulation,PLT and FIB significantly declined compared with those before operation while PT,APTT and INR significantly increased(P0.05)。结论输入自体血与输入异体血对凝血功能的影响无差异,大量输血时应监测凝血功能,适当补充血小板和凝血因子。

  3. Acquired haemophilia A as a blood transfusion emergency

    Science.gov (United States)

    Tagariello, Giuseppe; Sartori, Roberto; Radossi, Paolo; Risato, Renzo; Roveroni, Giovanni; Tassinari, Cristina; Giuffrida, Annachiara; Gandini, Giorgio; Franchini, Massimo

    2008-01-01

    Introduction Acquired haemophilia is a rare autoimmune disorder caused by autoantibodies directed in the majority of the cases against clotting factor VIII. This disorder is characterised by the sudden onset of bleeding that not rarely may be life-threatening and need transfusion support. Most reports on this condition describe the need for blood transfusions during the acute, haemorrhagic phase, but the number of transfused red cell units is often unknown. Patients and methods In the last 5 years, 14 patients with acquired haemophilia A were identified in the transfusion and haemophilia centres of Verona and Castelfranco Veneto. The transfusion support for these 14 patients was analyzed in this retrospective survey. Results The 14 patients required a total of 183 red cell units. The average transfusion requirement was 13 red cells units/patient, with a range from 0 to 38 units. Conclusions Eleven of the 14 patients studied needed strong transfusion support to enable any further management of the haemorrhages, as well as for eradication treatment of the autoantibodies to factor VIII. A relevant part of the management of haemorrhagic symptoms as well as the first choice for any further treatment (bleeding or the cure of the underlying disease) is transfusion of red blood cells. PMID:18661918

  4. Efficiency and Cost Analysis of Cell Saver Auto Transfusion System in Total Knee Arthroplasty

    Science.gov (United States)

    Bilgili, Mustafa Gökhan; Erçin, Ersin; Peker, Gökhan; Kural, Cemal; Başaran, Serdar Hakan; Duramaz, Altuğ; Avkan, Cevdet

    2014-01-01

    Background: Blood loss and replacement is still a controversial issue in major orthopaedic surgery. Allogenic blood transfusion may cause legal problems and concerns regarding the transmission of transfusion-related diseases. Cellsaver Systems (CSS) were developed as an alternative to allogenic transfusion but CSS transfusion may cause coagulation, infection and haemodynamic instability. Aims: Our aim was to analyse the efficiency and cost analysis of a cell saver auto-transfusion system in the total knee arthroplasty procedure. Study Design: Retrospective comparative study. Methods: Those patients who were operated on by unilateral, cemented total knee arthroplasty (TKA) were retrospectively evaluated. Group 1 included 37 patients who were treated using the cell saver system, and Group 2 involved 39 patients who were treated by allogenic blood transfusion. The groups were compared in terms of preoperative haemoglobin and haematocrit levels, blood loss and transfusion amount, whether allogenic transfusion was made, degree of deformity, body mass index and cost. Results: No significant results could be obtained in the statistical comparisons made in terms of the demographic properties, deformity properties, preoperative laboratory values, transfusion amount and length of hospital stay of the groups. Average blood loss was calculated to be less in Group 1 (p<0.05) and cost was higher in Group 1 (p<0.05). Conclusion: Cell saver systems do not decrease the amount of allogenic blood transfusion and costs more. Therefore, the routine usage of the auto-transfusion systems is a controversial issue. Cell saver system usage does not affect allogenic blood transfusion incidence or allogenic blood transfusion volume. It was found that preoperative haemoglobin and body mass index rates may affect allogenic blood transfusion. Therefore, it is foreseen that auto-transfusion systems could be useful in patients with low haemoglobin level and body mass index. PMID:25207187

  5. Lichenoid Variant of Chronic Cutaneous Graft Versus Host Reaction Post Blood Transfusion: A Rare Event Post Blood Transfusion.

    Science.gov (United States)

    Ramakrishnaiah, Pushpa Kodipalya; Lakshman, Archana; Aradhya, Sacchidanand Sarvajnamurthy; Veerabhadrappa, Nataraja Holavanahally

    2015-01-01

    Chronic graft versus host disease (GVHD) is a less frequently seen disease that occurs post solid organ or bone marrow transplantation. Chronic GVHD occurring post blood transfusion is an even more uncommon disease. It can present either as a lichenoid disease or as a sclerodermatous disease involving multiple systems. In this article, we report a case of chronic graft versus host reaction occurring in skin secondary to blood transfusion.

  6. Syphilis screening practices in blood transfusion facilities in Ghana

    Directory of Open Access Journals (Sweden)

    Francis Sarkodie

    2016-02-01

    Conclusions: Despite international and national recommendations, more than half of the studied health facilities that provide blood transfusions in Ghana are not screening blood donations for syphilis. These data show a considerable mismatch between recommendations and practice, with serious consequences for blood safety and public health.

  7. Syphilis screening practices in blood transfusion facilities in Ghana

    DEFF Research Database (Denmark)

    Sarkodie, Francis; Hassall, Oliver; Owusu-Dabo, Ellis

    2016-01-01

    OBJECTIVES: The primary objective of this study was to compare laboratory practices for screening blood donors for syphilis at blood transfusion facilities in Ghana with the recommendations of the World Health Organization and the National Blood Service, Ghana (NBSG). The prevalence of syphilis.......9%, compared to 4.0% in family donations (p=0.001). Only 6.9% of the health facilities were using standard operating procedures (SOPs). CONCLUSIONS: Despite international and national recommendations, more than half of the studied health facilities that provide blood transfusions in Ghana are not screening...... antibodies in blood donors in Ghana was also estimated. METHODS: Over an 11-month period, from February 2014 to January 2015, a semi-structured questionnaire was administered to 122 laboratory technical heads out of a total of 149 transfusion facilities in Ghana. The response rate was 81.9%. RESULTS: A total...

  8. Timing and Location of Blood Product Transfusion and Outcomes in Massively Transfused Combat Casualties

    Science.gov (United States)

    2012-01-01

    blood components in a 1:1:1 ratio of platelets:fresh frozen plasma:red blood cells (RBCs) is based on analyses of massive transfusion (MT, Q10 RBC units in 24 hours). These 24-hour analyses are weakened by survival bias and do not describe the timing and location of transfusions. Mortality outcomes associated with early (first 6 hours) resuscitation incorporating platelets, for combat casualties requiring MT, have not been reported. METHODS: We analyzed records for 8,618 casualties treated at the United States military hospital in Baghdad, Iraq, between January 2004 and

  9. Study of role of blood transfusion in obstetric emergencies

    Directory of Open Access Journals (Sweden)

    Vibhuti Pravinbhai Patel

    2014-08-01

    Full Text Available Background: Blood Transfusion is recognized as one of the eight essential component of comprehensive emergency obstetric care which has been shown to reduce the maternal mortality.1,2 In developing country like India, efforts should be done to make blood and transfusion services well maintained and quickly available to reduce maternal morbidity from haemorrhage and thus decrease the incidence of maternal mortality. Aims and objectives: (1 To study clinical status of the patients at time of admission. (2 To study the role of antenatal visits in all patients required blood transfusion. (3 To study the effect of blood components on the patients' health. (4 To screen out the patients of high risk pregnancy and treat them safely. (5 To study causes of maternal mortality. Methods: Retrospective study of requirement of blood transfusion in antenatal and postnatal patients who came in labour room during last 3 month period at tertiary care Centre, Ahmedabad. Results: during the whole study out of 2200 patients 440 patients required blood transfusion among which 70% required due to obstetric hemorrhage and 30% due to severe anemia (less than 7 gm/dl. Major associated complications in the transfused patients were anemia (34% and PPH (36%. 4 patients expired among them 2 were due to development of DIC and septicemia, 1 due to severe anemia and 1 due to severe PPH. Conclusions: Ensuring a safe supply of blood and blood products and the appropriate and rational clinical use of blood. Strategies made to maximize the haemoglobin (Hb level at the time of delivery as well as to minimize blood loss. Active management of the third stage of labour is required to prevent avoidable morbidities, such as PPH, Retained product of conception, and vaginal lacerations. [Int J Reprod Contracept Obstet Gynecol 2014; 3(4.000: 1002-1005

  10. Toward a patient-based paradigm for blood transfusion

    Directory of Open Access Journals (Sweden)

    Farrugia A

    2014-01-01

    Full Text Available Albert Farrugia,1,2 Eleftherios Vamvakas31College of Medicine, Biology and Environment, Australian National University, Acton, ACT, Australia; 2Centre for Orthopaedic Research, Department of Surgery, Faculty of Medicine and Surgery, University of Western Australia, Perth, WA, Australia; 3Cedars-Sinai Medical Center, Los Angeles, CA, USAAbstract: The current "manufacturing paradigm" of transfusion practice has detached transfusion from the clinical environment. As an example, fresh whole blood in large-volume hemorrhage may be superior to whole blood reconstituted from multiple components. Multicomponent apheresis can overcome logistical difficulties in matching patient needs with fresh component availability and can deliver the benefits of fresh whole blood. Because of the different transfusion needs of patients in emerging economies and the vulnerability of these blood systems to emerging infections, fresh whole blood and multicomponent apheresis can better meet patient needs when compared with transplants of the "manufacturing paradigm". We propose that patient blood management, along with panels of repeat, paid, accredited apheresis and fresh whole-blood donors can be used in emerging economies to support decentralized blood services. This alternative transfusion–medicine paradigm could eventually also be adopted by established economies to focus transfusion medicine on local patient needs and to alleviate the problem of the aging volunteer donor base.Keywords: indications, emerging countries, patient blood management

  11. Red blood cell transfusion in preterm neonates: current perspectives

    Directory of Open Access Journals (Sweden)

    Chirico G

    2014-06-01

    Full Text Available Gaetano ChiricoNeonatology and Neonatal Intensive Care Unit, Children Hospital, Spedali Civili, Brescia, ItalyAbstract: Preterm neonates, especially very low birth weight infants, remain a category of patients with high transfusion needs; about 90% of those with <1,000 g birth weight may be transfused several times during their hospital stay. However, neonatal red blood cells (RBC transfusion is not without risks. In addition to well-known adverse events, several severe side effects have been observed unique to preterm infants, such as transfusion-related acute gut injury, intraventricular hemorrhage, and increased mortality risk. It is therefore important to reduce the frequency of RBC transfusion in critically ill neonates, by delayed clamping or milking the umbilical cord, using residual cord blood for initial laboratory investigations, reducing phlebotomy losses, determining transfusion guidelines, and ensuring the most appropriate nutrition, with the optimal supplementation of iron, folic acid, and vitamins. Ideally, RBC transfusion should be tailored to the individual requirements of the single infant. However, many controversies still remain, and the decision on whether to transfuse or not is often made on an empirical basis. Recently, a few clinical trials have been performed with the aim to compare the risk/benefit ratio of restrictive versus liberal transfusion criteria. No significant differences in short-term outcomes were observed, suggesting that the restrictive criteria may reduce the need for transfusion and the related side effects. Neurodevelopmental long-term outcome seemed more favorable in the liberal group at first evaluation, especially for boys, and significantly better in the restrictive group at a later clinical investigation. Magnetic resonance imaging scans, performed at an average age of 12 years, showed that intracranial volume was substantially smaller in the liberal group compared with controls. When sex effects

  12. Precautions and Adverse Reactions during Blood Transfusion

    Science.gov (United States)

    ... given washed red blood cells. Washing the red blood cells removes components of the donor blood that may cause allergic ... cross-matching of blood, mismatches due to subtle differences between donor and recipient blood (and, very rarely, ...

  13. Development of blood transfusion service in Sultanate of Oman

    Directory of Open Access Journals (Sweden)

    Joshi Sanmukh

    2010-01-01

    Full Text Available Background: Sultanate of Oman is geographically situated in south-west of Asia, having common borders on western side by the land with United Arab Emirates, Saudi Arabia and Yemen and with the Arabian Sea and the Gulf of Oman in the east and the north respectively. The country enjoys one of the best health care facilities including blood transfusion services in the region. Study design: Information was collected through informal personal interviews, digging out the past records, and the report presentations at various forums. Results: A modest start by providing blood units through import, the country is now self-reliant on procuring blood units from voluntary non-remunerate blood donors within the sultanate. A steady growth of blood banks is witnessed in every aspect of blood banking including blood collection, blood processing and supply. Various modalities are adapted in promoting voluntary blood donation programme. Conclusion: Sultanate of Oman has created one of the best blood transfusion services in the region in providing safe blood for transfusion through voluntary donation, a use of blood components and irradiating blood products.

  14. Perioperative Red Blood Cell Transfusion: What We Do Not Know

    Institute of Scientific and Technical Information of China (English)

    Chong Lei; Li-Ze Xiong

    2015-01-01

    Objective:Blood transfusion saves lives but may also increase the risk of injury.The objective of this review was to evaluate the possible adverse effects related to transfusion of red blood cell (RBC) concentrates stored for prolonged periods.Data Sources:The data used in this review were mainly from PubMed articles published in English up to February 2015.Study Selection:Clinical and basic research articles were selected according to their relevance to this topic.Results:The ex vivo changes to RBC that occur during storage are collectively called storage lesion.It is still inconclusive if transfusion of RBC with storage lesion has clinical relevance.Multiple ongoing prospective randomized controlled trials are aimed to clarify this clinical issue.It was observed that the adverse events related to stored RBC transfusion were prominent in certain patient populations,including trauma,critical care,pediatric,and cardiac surgery patients,which leads to the investigation of underlying mechanisms.It is demonstrated that free hemoglobin toxicity,decreasing of nitric oxide bioavailability,and free iron-induced increasing of inflammation may play an important role in this process.Conclusion:It is still unclear whether transfusion of older RBC has adverse effects,and if so,which factors determine such clinical effects.However,considering the magnitude of transfusion and the widespread medical significance,potential preventive strategies should be considered,especially for the susceptible recipients.

  15. Soluble vascular endothelial growth factor in various blood transfusion components

    DEFF Research Database (Denmark)

    Nielsen, Hans Jørgen; Werther, K; Mynster, T;

    1999-01-01

    BACKGROUND: Blood transfusion may reduce survival after curative surgery for solid tumors. This may be related to extracellular content of cancer growth factors present in transfusion components. Vascular endothelial growth factor (VEGF) is a potent stimulator of angiogenesis in solid tumors....... The potential content of VEGF in various blood components for transfusion was evaluated. STUDY DESIGN AND METHODS: Soluble VEGF (sVEGF, isotype 165) was determined by an enzyme-linked immunosorbent assay (EIA) in serum and plasma samples and in lysed cells from healthy volunteers. Subsequently, total content...... of platelet-derived soluble plasminogen activator inhibitor type 1 (sPAI-1) was determined by an EIA in the same samples. Finally, the extracellular accumulation of sVEGF was determined in nonfiltered WB and SAGM blood during storage for 35 days and in BCP pools during storage for 7 days. RESULTS...

  16. The impact of storage time of transfused blood on postoperative infectious complications in rectal cancer surgery. Danish RANX05 Colorectal Cancer Study Group

    DEFF Research Database (Denmark)

    Mynster, T; Nielsen, Hans Jørgen

    2000-01-01

    BACKGROUND: We have studied the impact of storage time of transfused allogeneic blood together with other known risk factors on postoperative infectious complications after operation for rectal cancer. METHODS: Intra-abdominal abscess, anastomotic leakage, septicaemia, wound infection......, and pneumonia were prospectively recorded in 303 patients undergoing elective resection for primary rectal cancer in 18 Danish hospitals. Patient risk variables and variables related to operation technique and transfusion were recorded prospectively, whereas amount given before infectious complication...... and storage time of saline-adenine-glucose-mannitol (SAGM) blood, administered to each patient, were recorded retrospectively. RESULTS: The overall infection rate was 24% in 78 non-transfused and 40% in 225 transfused patients (P = 0.011). The proportion of SAGM blood stored for > or = 21 days administered...

  17. Blood Transfusion Strategies for Hemostatic Resuscitation in Massive Trauma.

    Science.gov (United States)

    McGrath, Caroline

    2016-03-01

    Massive transfusion practices were transformed during the 1970s without solid evidence supporting the use of component therapy. A manual literature search was performed for all references to the lethal triad, acute or early coagulopathy of trauma, fresh whole blood, and component transfusion therapy in massive trauma, and damage control resuscitation. Data from recent wars suggest traditional component therapy causes a nonhemostatic resuscitation worsening the propagation of the lethal triad hastening death. These same studies also indicate the advantage of fresh whole blood over component therapy even when administered in a 1:1:1 replacement ratio.

  18. The impact of storage time of transfused blood on postoperative infectious complications in rectal cancer surgery. Danish RANX05 Colorectal Cancer Study Group

    DEFF Research Database (Denmark)

    Mynster, T; Nielsen, Hans Jørgen

    2000-01-01

    BACKGROUND: We have studied the impact of storage time of transfused allogeneic blood together with other known risk factors on postoperative infectious complications after operation for rectal cancer. METHODS: Intra-abdominal abscess, anastomotic leakage, septicaemia, wound infection, and pneumo......BACKGROUND: We have studied the impact of storage time of transfused allogeneic blood together with other known risk factors on postoperative infectious complications after operation for rectal cancer. METHODS: Intra-abdominal abscess, anastomotic leakage, septicaemia, wound infection...... and storage time of saline-adenine-glucose-mannitol (SAGM) blood, administered to each patient, were recorded retrospectively. RESULTS: The overall infection rate was 24% in 78 non-transfused and 40% in 225 transfused patients (P = 0.011). The proportion of SAGM blood stored for > or = 21 days administered...... to each transfused patient was a median of 60% in patients developing postoperative infections versus 25% (P = 0.037) in patients without infections. A multivariate analysis of significant risk variables showed weight > 75 kg (odds ratio, 2.0 versus blood stored > or = 21...

  19. Legal and ethical issues in safe blood transfusion

    Directory of Open Access Journals (Sweden)

    Shivaram Chandrashekar

    2014-01-01

    Full Text Available Legal issues play a vital role in providing a framework for the Indian blood transfusion service (BTS, while ethical issues pave the way for quality. Despite licensing of all blood banks, failure to revamp the Drugs and Cosmetic Act (D and C Act is impeding quality. Newer techniques like chemiluminescence or nucleic acid testing (NAT find no mention in the D and C Act. Specialised products like pooled platelet concentrates or modified whole blood, therapeutic procedures like erythropheresis, plasma exchange, stem cell collection and processing technologies like leukoreduction and irradiation are not a part of the D and C Act. A highly fragmented BTS comprising of over 2500 blood banks, coupled with a slow and tedious process of dual licensing (state and centre is a hindrance to smooth functioning of blood banks. Small size of blood banks compromises blood safety. New blood banks are opened in India by hospitals to meet requirements of insurance providers or by medical colleges as this a Medical Council of India (MCI requirement. Hospital based blood banks opt for replacement donation as they are barred by law from holding camps. Demand for fresh blood, lack of components, and lack of guidelines for safe transfusion leads to continued abuse of blood. Differential pricing of blood components is difficult to explain scientifically or ethically. Accreditation of blood banks along with establishment of regional testing centres could pave the way to blood safety. National Aids Control Organisation (NACO and National Blood Transfusion Council (NBTC deserve a more proactive role in the licensing process. The Food and Drug Administration (FDA needs to clarify that procedures or tests meant for enhancement of blood safety are not illegal.

  20. Quality Assessment of Established and Emerging Blood Components for Transfusion

    Directory of Open Access Journals (Sweden)

    Jason P. Acker

    2016-01-01

    Full Text Available Blood is donated either as whole blood, with subsequent component processing, or through the use of apheresis devices that extract one or more components and return the rest of the donation to the donor. Blood component therapy supplanted whole blood transfusion in industrialized countries in the middle of the twentieth century and remains the standard of care for the majority of patients receiving a transfusion. Traditionally, blood has been processed into three main blood products: red blood cell concentrates; platelet concentrates; and transfusable plasma. Ensuring that these products are of high quality and that they deliver their intended benefits to patients throughout their shelf-life is a complex task. Further complexity has been added with the development of products stored under nonstandard conditions or subjected to additional manufacturing steps (e.g., cryopreserved platelets, irradiated red cells, and lyophilized plasma. Here we review established and emerging methodologies for assessing blood product quality and address controversies and uncertainties in this thriving and active field of investigation.

  1. Quality Assessment of Established and Emerging Blood Components for Transfusion

    Science.gov (United States)

    Marks, Denese C.

    2016-01-01

    Blood is donated either as whole blood, with subsequent component processing, or through the use of apheresis devices that extract one or more components and return the rest of the donation to the donor. Blood component therapy supplanted whole blood transfusion in industrialized countries in the middle of the twentieth century and remains the standard of care for the majority of patients receiving a transfusion. Traditionally, blood has been processed into three main blood products: red blood cell concentrates; platelet concentrates; and transfusable plasma. Ensuring that these products are of high quality and that they deliver their intended benefits to patients throughout their shelf-life is a complex task. Further complexity has been added with the development of products stored under nonstandard conditions or subjected to additional manufacturing steps (e.g., cryopreserved platelets, irradiated red cells, and lyophilized plasma). Here we review established and emerging methodologies for assessing blood product quality and address controversies and uncertainties in this thriving and active field of investigation. PMID:28070448

  2. Quality Assessment of Established and Emerging Blood Components for Transfusion.

    Science.gov (United States)

    Acker, Jason P; Marks, Denese C; Sheffield, William P

    2016-01-01

    Blood is donated either as whole blood, with subsequent component processing, or through the use of apheresis devices that extract one or more components and return the rest of the donation to the donor. Blood component therapy supplanted whole blood transfusion in industrialized countries in the middle of the twentieth century and remains the standard of care for the majority of patients receiving a transfusion. Traditionally, blood has been processed into three main blood products: red blood cell concentrates; platelet concentrates; and transfusable plasma. Ensuring that these products are of high quality and that they deliver their intended benefits to patients throughout their shelf-life is a complex task. Further complexity has been added with the development of products stored under nonstandard conditions or subjected to additional manufacturing steps (e.g., cryopreserved platelets, irradiated red cells, and lyophilized plasma). Here we review established and emerging methodologies for assessing blood product quality and address controversies and uncertainties in this thriving and active field of investigation.

  3. [Possibility of using DST-30 thermoelastoplast in blood transfusion systems].

    Science.gov (United States)

    Il'iakov, E V; El'tsefon, B S; Polezhaev, V V; Zotkina, I V; Krivonosov, A I

    1979-01-01

    Investigating possible application of the DCT-30 thermoelastoplastic shows advantages of some physico-technical properties of this product based on natural caoutchouc and latex by comparison with base-rubber onene. It justifies recommending the former for making injection tubes in the blood transfusion systems.

  4. Potassium changes associated with blood transfusion in pediatric patients.

    Science.gov (United States)

    Olson, Jordan; Talekar, Mala; Sachdev, Mansi; Castellani, William; De la Cruz, Nestor; Davis, Jerry; Liao, Jason; George, Melissa

    2013-06-01

    Storing packed red blood cells (pRBCs) increases the potassium concentration. This effect is characterized in citrate phosphate dextrose/citrate phosphate dextrose adenine units but not published for Adsol (AS-5) units. The change in whole-blood potassium concentration in pediatric patients during routine transfusion is also poorly characterized. In this study, pediatric patients undergoing transfusion had pre- and posttransfusion whole-blood potassium measurements. The pRBC unit transfused and the unit's segment were sampled, with potassium concentration measured. In addition, potassium concentration in AS-5 units was measured over 42 days of storage. Unit extracellular potassium increased in AS-5 units after day 7 at 0.83 mmol/L/d. The mean change in patient potassium concentration was 0.08 mmol/L (range, -0.5 to 0.5 mmol/L). No correlation with unit age or unit potassium concentration was identified with change in patient whole-blood potassium concentration. The lack of clinical effect on patient potassium does not support the use of "fresh" pRBC units with routine pediatric transfusion.

  5. Red blood cell transfusion in septic shock

    DEFF Research Database (Denmark)

    Rosland, Ragnhild G; Hagen, Marte U; Haase, Nicolai

    2014-01-01

    general intensive care units (ICUs) including all adult patients with septic shock in a 5-month period. RESULTS: Ninety-five of the 213 included patients (45%) received median 3 (interquartile range 2-5) RBC units during shock. The median pre-transfusion haemoglobin level was 8.1 (7.4-8.9) g...... Sepsis-related Organ Failure Assessment (SOFA) scores (days 1 and 5), more days in shock (5 (3-10) vs. 2 (2-4), p = 0.0001), more days in ICU (10 (4-19) vs. 4 (2-8), p = 0.0001) and higher 90-day mortality (66 vs. 43%, p = 0.001). The latter association was lost after adjustment for admission category...

  6. [Ratio of erythrocyte and plasma in massive blood transfusion].

    Science.gov (United States)

    Wen, Xian-Hui; Liu, Feng-Xia; Zhang, Jun-Hua; Gui, Rong

    2014-06-01

    This study was purposed to explore the suitable ratio between fresh frozen plasma and erythrocyte by retrospective analysis of coagulation in patients with massive blood transfusion. The clinical data of 151 cases with massive blood transfusion from January 2011 to January 2013 were analyzed retrospectively. According to coagulation, patients were divided into coagulation normal group (138 cases) and coagulation dysfunction group (13 cases). Based on the ratio of 1:1 of fresh frozen plasma and erythrocyte, the patients were divided into high plasma group(2:1), medium plasma group (1:1) and low plasma (transfusion. The results showed that prothrombin time (PT), activated partial thromboplastin time (APTT) and thrombin time (TT) were prolonged, fibrinogen (FIB) level decreased significantly (all P transfusion 24 h; the high plasma and the medium plasma group of coagulation normal group had no significant changes in coagulation (P > 0.05); prothrombin time, activated partial thromboplastin time, thrombin time and fibrinogen level in the medium plasma and low plasma subgroup of coagulation dysfunction group after massive transfusion was still in abnormal levels (P > 0.05), coagulation function in high plasma subgroup was improved significantly (P transfusion, the ratio between fresh frozen plasma and erythrocyte is recommended to be 2:1 in patients of coagulation dysfunction in order to improve the patient's coagulation function and to reduce the incidence of adverse event, the ratio of fresh frozen plasma to erythrocyte is recommended to be 1:1 in patients with normal coagulation so as to reduce the dilutional coagulopathy and hypervolemia of blood.

  7. Comparison of Platelet Transfusion as Fresh Whole Blood Versus Apheresis Platelets for Massively Transfused Combat Trauma patients

    Science.gov (United States)

    2011-02-01

    T R A N S F U S I O N P R A C T I C E Comparison of platelet transfusion as fresh whole blood versus apheresis platelets for massively transfused...is able to provide blood products to include apheresis platelets (aPLT), but also has extensive experience using fresh whole blood (FWB). In massively...bleeding, resuscitation with blood products is an ABBREVIATIONS: AIS(s) = Abbreviated Injury Scale(s); aPLT = apheresis platelets; ARDS = adult

  8. Transmission of BSE by blood transfusion in sheep.

    Science.gov (United States)

    Houston, F; Foster, J D; Chong, A; Hunter, N; Bostock, C J

    2000-09-16

    We have shown that it is possible to transmit bovine spongiform encephalopathy (BSE) to a sheep by transfusion with whole blood taken from another sheep during the symptom-free phase of an experimental BSE infection. BSE and variant Creutzfeldt-Jakob disease (vCJD) In human beings are caused by the same infectious agent, and the sheep-BSE experimental model has a similar pathogenesis to that of human vCJD. Although UK blood transfusions are leucodepleted--a possible protective measure against any risk from blood transmission--this report suggests that blood donated by symptom-free vCJD-infected human beings may represent a risk of spread of vCJD infection among the human population of the UK.

  9. Protocol for a national blood transfusion data warehouse from donor to recipient

    NARCIS (Netherlands)

    van Hoeven, Loan R; Hooftman, Babette H; Janssen, Mart P; de Bruijne, Martine C; de Vooght, Karen M K; Kemper, Peter; Koopman, Maria M W

    2016-01-01

    INTRODUCTION: Blood transfusion has health-related, economical and safety implications. In order to optimise the transfusion chain, comprehensive research data are needed. The Dutch Transfusion Data warehouse (DTD) project aims to establish a data warehouse where data from donors and transfusion rec

  10. Effect of perioperative blood transfusions on long term graft outcomes in renal transplant patients.

    LENUS (Irish Health Repository)

    O'Brien, Frank J

    2012-06-01

    It is established that blood transfusions will promote sensitization to human leucocyte antigen (HLA) antigens, increase time spent waiting for transplantation and may lead to higher rates of rejection. Less is known about how perioperative blood transfusion influence patient and graft outcome. This study aims to establish if there is an association between perioperative blood transfusion and graft or patient survival.

  11. Blood transfusion practices in obstetric care at a tertiary referral hospital in Zimbabwe

    NARCIS (Netherlands)

    Nyashadzaishe Mafirakureva, N.; Mberi, Y.T.; Khoza, S.; Mvere, D.A.; Emmanuel, J.C.; Postma, M.J.; Van Hulst, M.

    2015-01-01

    Background: Blood transfusions are an essential element of obstetric care and may have a role in reducing maternal mortality, if used appropriately. Monitoring of transfusion practices provides information on current and future needs of blood. It may also lead to rational use of blood transfusions.

  12. Postoperative infection and natural killer cell function following blood transfusion in patients undergoing elective colorectal surgery

    DEFF Research Database (Denmark)

    Jensen, L S; Andersen, A J; Christiansen, P M

    1992-01-01

    The frequency of infection in 197 patients undergoing elective colorectal surgery and having either no blood transfusion, transfusion with whole blood, or filtered blood free from leucocytes and platelets was investigated in a prospective randomized trial. Natural killer cell function was measured...... before operation and 3, 7 and 30 days after surgery in 60 consecutive patients. Of the patients 104 required blood transfusion; 48 received filtered blood and 56 underwent whole blood transfusion. Postoperative infections developed in 13 patients transfused with whole blood (23 per cent, 95 per cent...... function was significantly (P less than 0.001) impaired up to 30 days after surgery in patients transfused with whole blood. These data provide a strong case against the use of whole blood transfusion in patients undergoing elective colorectal surgery. Udgivelsesdato: 1992-Jun...

  13. Acquired immunodeficiency syndrome associated with blood-product transfusions

    Energy Technology Data Exchange (ETDEWEB)

    Jett, J.R.; Kuritsky, J.N.; Katzmann, J.A.; Homburger, H.A.

    1983-11-01

    A 53-year-old white man had fever, malaise, and dyspnea on exertion. His chest roentgenogram was normal, but pulmonary function tests showed impaired diffusion capacity and a gallium scan showed marked uptake in the lungs. Results of an open-lung biopsy documented Pneumocystis carinii pneumonia. Immunologic test results were consistent with the acquired immunodeficiency syndrome. The patient denied having homosexual contact or using intravenous drugs. Twenty-nine months before the diagnosis of pneumocystis pneumonia was made, the patient had had 16 transfusions of whole blood, platelets, and fresh-frozen plasma during coronary artery bypass surgery at another medical center. This patient is not a member of any currently recognized high-risk group and is believed to have contracted the acquired immunodeficiency syndrome from blood and blood-product transfusions.

  14. Transfusion reaction in a case with the rare Bombay blood group

    Directory of Open Access Journals (Sweden)

    Hayedeh Javadzadeh Shahshahani

    2013-01-01

    Full Text Available Bombay phenotype is extremely rare in Caucasian with an incidence of 1 in 250,000. When individuals with the Bombay phenotype need blood transfusion, they can receive only autologous blood or blood from another Bombay blood group. Transfusing blood group O red cells to them can cause a fatal hemolytic transfusion reaction. In this study, we report a case with the rare Bombay blood group that was misdiagnosed as the O blood group and developed a hemolytic transfusion reaction. This highlights the importance of both forward and reverse typing in ABO blood grouping and standard cross-matching and performing standard pretransfusion laboratory tests in hospital blood banks.

  15. Transfusion reaction in a case with the rare Bombay blood group.

    Science.gov (United States)

    Shahshahani, Hayedeh Javadzadeh; Vahidfar, Mohamad Reza; Khodaie, Seyed Ali

    2013-01-01

    Bombay phenotype is extremely rare in Caucasian with an incidence of 1 in 250,000. When individuals with the Bombay phenotype need blood transfusion, they can receive only autologous blood or blood from another Bombay blood group. Transfusing blood group O red cells to them can cause a fatal hemolytic transfusion reaction. In this study, we report a case with the rare Bombay blood group that was misdiagnosed as the O blood group and developed a hemolytic transfusion reaction. This highlights the importance of both forward and reverse typing in ABO blood grouping and standard cross-matching and performing standard pretransfusion laboratory tests in hospital blood banks.

  16. Blood Transfusions and Organ/Tissue Transplants

    Science.gov (United States)

    ... who need blood! It is also possible to purchase a rapid home-use HIV test kit . Testing ... Care Services Search for Providers Follow Us twitter facebook youtube instagram Pinterest flickr 4 square Tools Subscribe ...

  17. Tranexamic acid reduces the blood loss and blood transfusion requirements following peri-acetabular osteotomy.

    Science.gov (United States)

    Wassilew, G I; Perka, C; Janz, V; Krämer, M; Renner, L

    2015-12-01

    We have investigated the effect of using tranexamic acid (TXA) during peri-acetabular osteotomy (PAO) on peri-operative blood loss and blood transfusion requirements. In addition we analysed whether the use of TXA was associated with an increased risk of venous thromboembolism (VTE) following this procedure. A consecutive series of 96 PAOs, performed by a single surgeon, were reviewed. A total of 48 patients received TXA and 48 did not. The TXA group received a continuous infusion of TXA at a rate of 10 mg/kg/h. The primary outcome measure was the requirement for blood transfusion. Secondary outcomes included total blood loss, the decrease in the level of haemoglobin in the blood, the length of hospital stay, and the complications of this treatment. The mean rate of transfusion was significantly lower in the TXA group (62.5% vs 12.5%, p transfusion after PAO significantly, without adverse effects such as an increased rate of VTE.

  18. [Chagas' disease in patients in chronic hemodialysis. Prevalence and risk of transmission by blood transfusion].

    Science.gov (United States)

    Lorca, M; Lorca, E; Atías, A; Plubins, L

    1989-06-01

    A serologic study of Chagas disease was performed in 110 patients submitted to chronic hemodialisis and blood transfusions. Immunofluorescence antibody testing (IgG and IgM) was positive in 6 out of 62 patients receiving multiple blood transfusions (9.7%), but negative in all 48 subjects without transfusions. Thus, repeated blood transfusion is a significant risk for T cruzi infection in chronic hemodialized patients.

  19. Unique risks of red blood cell transfusions in very-low-birth-weight neonates: associations between early transfusion and intraventricular hemorrhage and between late transfusion and necrotizing enterocolitis.

    Science.gov (United States)

    Christensen, Robert D; Baer, Vickie L; Del Vecchio, Antonio; Henry, Erick

    2013-10-01

    Red blood cell transfusions can be life-saving for neonates with severe anemia or active hemorrhage. However, risks of transfusions exist and should always be weighed against potential benefits. At least two transfusion risks are unique to very low birth weight neonates. The first is an association between transfusions given in the first days after birth and the subsequent occurrence of a grade 3 or 4 intraventricular hemorrhage. The second is an association between "late" RBC transfusions and the subsequent occurrence of necrotizing enterocolitis. Much remains to be discovered about the pathogenesis of these two outcomes. Moreover, work is needed to clearly establish whether transfusions are causatively-associated with these outcomes or are co-variables. This review will provide basic data establishing these associations and propose mechanistic explanations.

  20. [Blood transfusion and homosexuality: Ethical considerations].

    Science.gov (United States)

    Béranger, A; Bellis, R; Bracconi, M; Mouysset, A

    2016-09-01

    Since the context of the contaminated blood affair in 1983, the homosexual male were excluded from the blood donation in France. This exclusion is often called into question in several countries and is an actual lively debate. In France, reform process is ongoing for a practical change. Three issues make up the discussion: the infectious risk bound to sexual behavior, the feasibility of the powerful biological tests but having a silent window and the protection of the blood recipient. The infectious risk in the homosexual male is higher for the human immunodeficiency virus (HIV) than in the rest of the population. Even if every person has his/her own individual risk depending on his/her habits, everyone is confronted to the same law. The challenge is to build a consensus, along with the precautionary principle, the non-discrimination policy, and the individual and collective responsibilities.

  1. Blood transfusion in the para-Bombay phenotype.

    Science.gov (United States)

    Lin-Chu, M; Broadberry, R E

    1990-08-01

    The H-deficient phenotypes found in Chinese so far, have all been secretors of soluble blood group substances in saliva. The corresponding isoagglutinin activity (e.g. anti-B in OB(Hm) persons) has been found to be weak in all cases. To determine the clinical significance of these weak isoagglutinins 51Cr red cell survival tests were performed on three OB(Hm) individuals transfused with small volumes (4 ml) of groups B and O RBC. Rapid destruction of most of the RBC occurred whether or not the isoagglutinins of the OB(Hm) individuals were indirect antiglobulin test (IAGT) reactive. When a larger volume (54 ml packed RBC) of group B cells (weakly incompatible by IAGT) was transfused to another OB(Hm) individual with IAGT active anti-HI, the survival of the transfused RBC was 93% at 24 h, with 30% of the RBC remaining in the circulation at 28 d in contrast to 76% as would be expected if the survival was normal. Therefore when whole units of blood of normal ABO blood groups, compatible by IAGT, are transfused, the survival is expected to be almost normal. These weak isoagglutinins may not be very clinically significant and we suggest that when para-Bombay blood is not available, the compatibility testing for OA(Hm) persons should be performed with group A and group O packed RBC; OB(Hm) with group B and group O packed RBC: OAB(Hm) with groups A, B, AB and O packed RBC. For cross matching, the indirect antiglobulin test by a prewarmed technique should be used.

  2. Blood Transfusion Therapy in Patients with Heart Disease.

    Science.gov (United States)

    1982-04-07

    good health will not require the same transfusion therapy as patients with valvular heart disease who have congestive heart failure and...normal red cell volume and normal red cell oxygen transport function. 1 ,13 When the patient has valvular heart disease or myo- cardiopathy with...cardio- pulmonary bypass patients and in patients with severe valvular heart disease . Blood 1978;52:13-23. : 81. 197. Frledenberg WR, Myers WO, Plotka

  3. Age of transfused blood is not associated with increased postoperative adverse outcome after cardiac surgery.

    LENUS (Irish Health Repository)

    McKenny, M

    2011-05-01

    This study investigated the hypothesis that storage age of transfused red blood cells (RBCs) is associated with adverse outcome after cardiac surgery, and examined association between volume of RBC transfusions and outcome after cardiac surgery.

  4. Efficacy of fresh packed red blood transfusion in organophosphate poisoning

    Science.gov (United States)

    Bao, Hang-xing; Tong, Pei-jian; Li, Cai-xia; Du, Jing; Chen, Bing-yu; Huang, Zhi-hui; Wang, Ying

    2017-01-01

    Abstract The mortality rate caused by organophosphate (OP) poisoning is still high, even the standard treatment such as atropine and oxime improves a lot. To search for alternative therapies, this study was aimed to investigate the effects of packed red blood cell (RBC) transfusion in acute OP poisoning, and compare the therapeutic effects of RBCs at different storage times. Patients diagnosed with OP poisoning were included in this prospective study. Fresh RBCs (packed RBCs stored less than 10 days) and longer-storage RBCs (stored more than 10 days but less than 35 days) were randomly transfused or not into OP poisoning patients. Cholinesterase (ChE) levels in blood, atropine usage and durations, pralidoxime durations were measured. We found that both fresh and longer-storage RBCs (200–400 mL) significantly increased blood ChE levels 6 hours after transfusion, shortened the duration for ChE recovery and length of hospital stay, and reduced the usage of atropine and pralidoxime. In addition, fresh RBCs demonstrated stronger therapeutic effects than longer-storage RBCs. Packed RBCs might be an alternative approach in patients with OP poisoning, especially during early stages. PMID:28296779

  5. Generation of red blood cells from human embryonic/induced pluripotent stem cells for blood transfusion.

    Science.gov (United States)

    Ebihara, Yasuhiro; Ma, Feng; Tsuji, Kohichiro

    2012-06-01

    Red blood cell (RBC) transfusion is necessary for many patients with emergency or hematological disorders. However, to date the supply of RBCs remains labile and dependent on voluntary donations. In addition, the transmission of infectious disease via blood transfusion from unspecified donors remains a risk. Establishing a large quantity of safe RBCs would help to address this issue. Human embryonic stem (hES) cells and the recently established human induced pluripotent stem (hiPS) cells represent potentially unlimited sources of donor-free RBCs for blood transfusion, as they can proliferate indefinitely in vitro. Extensive research has been done to efficiently generate transfusable RBCs from hES/iPS cells. Nevertheless, a number of challenges must be overcome before the clinical usage of hES/iPS cell-derived RBCs can become a reality.

  6. Blood transfusions in critical care: improving safety through technology & process analysis.

    Science.gov (United States)

    Aulbach, Rebecca K; Brient, Kathy; Clark, Marie; Custard, Kristi; Davis, Carolyn; Gecomo, Jonathan; Ho, Judy Ong

    2010-06-01

    A multidisciplinary safety initiative transformed blood transfusion practices at St. Luke's Episcopal Hospital in Houston, Texas. An intense analysis of a mistransfusion using the principles of a Just Culture and the process of Cause Mapping identified system and human performance factors that led to the transfusion error. Multiple initiatives were implemented including technology, education and human behaviour change. The wireless technology of Pyxis Transfusion Verification by CareFusion is effective with the rapid infusion module efficient for use in critical care. Improvements in blood transfusion safety were accomplished by thoroughly evaluating the process of transfusions and by implementing wireless electronic transfusion verification technology. During the 27 months following implementation of the CareFusion Transfusion Verification there have been zero cases of transfusing mismatched blood.

  7. Advantage of autologous blood transfusion in surgery for hepatocellular carcinoma

    Institute of Scientific and Technical Information of China (English)

    Yoshito Tomimaru; Hiroaki Nagano; Hidetoshi Eguchi; Shigeru Marubashi; Hiroshi Wada; Shogo Kobayashi; Masahiro Tanemura; Koji Umeshita; Yuichiro Doki; Masaki Mori

    2011-01-01

    AIM: To evaluate the significance of autologous blood transfusion (AT) in reducing homologous blood trans-fusion (HT) in surgery for hepatocellular carcinoma (HCC).METHODS: The proportion of patients who received HT was compared between two groups determined by the time of AT introduction; period A (1991-1994, n = 93) and period B (1995-2000, n = 201). Multivariate logistic regression analysis was performed in order to identify independent significant predictors of the need for HT. We also investigated the impact of AT and HT on long-term postoperative outcome after curative sur-gery for HCC.RESULTS: The proportion of patients with HT was significantly lower in period B than period A (18.9% vs 60.2%, P < 0.0001). Multivariate logistic regression analysis identified AT administration as a significant independent predictor of the need for HT (P < 0.0001). Disease-free survival in patients with AT was com-parable to that without any transfusion. Multivariate analysis identified HT administration as an independent significant factor for poorer disease-free survival (P = 0.0380).CONCLUSION: AT administration significantly de-creased the need for HT. Considering the postoperative survival disadvantage of HT, AT administration could improve the long-term outcome of HCC patients.

  8. Primary immunization-like response without hepatitis following transfusion of HBeAg-positive blood

    DEFF Research Database (Denmark)

    Gluud, C; Aldershvile, J; Kryger, P;

    1983-01-01

    An accidental transfusion of hepatitis B surface antigen (HBsAg) and hepatitis B e antigen (HBeAg) positive whole blood was given to a 19-yr-old male, bleeding after tonsillectomy. Serum obtained from the patient before the transfusion revealed no hepatitis B antigens or antibodies. After...... the transfusion the patient became HBsAg-positive, cleared this antigen and developed antibodies to both HBsAg and HBeAg. The transfusion blood was positive for total antibody and IgM antibody to hepatitis B core antigen (HBcAg). The patient's blood became positive for these antibodies after the transfusion...

  9. PATTERN, INDICATIONS AND REVIEW OF COMPLICATIONS OF NEONATAL BLOOD TRANSFUSION IN IBADAN, SOUTHWEST NIGERIA

    OpenAIRE

    Ayede, A.I.; Akingbola, T.S.

    2011-01-01

    Background and objectives: There is a huge need for blood transfusion in the newborn particularly due to the reduced marrow activity in the neonatal period. Despite widely use of blood products in the neonatal period, there is paucity of local data on the pattern, indications and reactions to blood transfusions in Nigerian newborns. This study evaluates the blood transfusion indications and patterns in special care baby unit and C12nd of University College Hospital, Ibadan, Nigeria. Methodolo...

  10. Retrospective evaluation of adverse transfusion reactions following blood product transfusion from a tertiary care hospital: A preliminary step towards hemovigilance

    Directory of Open Access Journals (Sweden)

    Praveen Kumar

    2013-01-01

    Full Text Available Background: The goal of hemovigilance is to increase the safety and quality of blood transfusion. Identification of the adverse reactions will help in taking appropriate steps to reduce their incidence and make blood transfusion process as safe as possible. Aims : To determine the frequency and type of transfusion reactions (TRs occurring in patients, reported to the blood bank at our institute. Materials and Methods : A retrospective review of all TRs reported to the blood bank at the All India Institute of Medical Sciences, between December 2007 and April 2012 was done. All the TRs were evaluated in the blood bank and classified using standard definitions. Results: During the study period a total of 380,658 bloods and blood components were issued by our blood bank. Out of the total 196 adverse reactions reported under the hemovigilance system, the most common type of reaction observed was allergic 55.1% (n = 108, followed by febrile non-hemolytic transfusion reaction (FNHTR 35.7% (n = 70. Other less frequently observed reactions were Anaphylactoid reactions 5.1% (n = 10, Acute non-immune HTRs 2.6% (n = 5, Circulatory overload 0.5% (n = 1, Transfusion related acute lung injury 0.5% (n = 1, Delayed HTRs 0.5% (n = 1. Not a single case of bacterial contamination was observed. Conclusion: The frequency of TRs in our patients was found to be 0.05% (196 out of 380,658. This can be an underestimation of the true incidence because of under reporting. It should be the responsibility of the blood transfusion consultant to create awareness amongst their clinical counterpart about safe transfusion practices so that proper hemovigilance system can be achieved to provide better patient care.

  11. Modification of tumor growth by blood transfusion and perioperative procedures : a study in rats

    NARCIS (Netherlands)

    S.K. Singh

    1988-01-01

    textabstractA blood transfusion is a transplantation of all or part of the blood cells in the peripheral blood. The survival of grafted organ transplantation has been shown to be prolonged following blood transfusion. The mechanism is thought to be immunological in nature. The possibility of a relat

  12. Effect of antifibrinolytic drugs on transfusion requirement and blood loss during orthotopic liver transplantation: Results from a single center

    Directory of Open Access Journals (Sweden)

    Devi A

    2008-01-01

    Full Text Available Background: During orthotopic liver transplantation (OLT, activation of the fibrinolytic system can contribute significantly to perioperative bleeding. Prophylactic administration of antifibrinolytic agents has been shown to reduce blood loss and the need for allogenic transfusion. Objective: To study the effect of antifibrinolytics on requirement of blood components, blood loss and operative time during OLT in patients with end stage liver disease, reporting to a single centre. Materials and Methods: Consecutive patients who underwent OLT at this centre during the period February 2003-October 2007 were the subjects of this study. Based on the individual anesthesiologist′s preference, patients were assigned to receive either two million units of aprotinin (AP as a bolus followed by 5,00,000 units/hour or 10 mg/kg tranexamic acid (TAas a bolus followed by 10 mg/kg every six to eight hours, administered from the induction till the end of the surgery. Transfusion policy was standardized in all patients. Intraoperative red cell salvage was done wherever possible. The effect of these two antifibrinolytic drugs on transfusion requirement was evaluated as a whole and in a sub group of patients from each treatment group and compared with a concurrent control group that did not receive antifibrinolytic drugs. Results: Fifty patients (40 M / 10 F, 44 adults, 6 pediatric patients underwent OLT in the study period. Fourteen patients were given AP, 25 patients were given TA and 11 patients did not receive any of the agents(control group. The median volume of total blood components transfused in antifibrinolytic group (n=39 was 4540 ml(0-19,200ml, blood loss 5 l(0.7-35l and operative time 9h (4.5-17h and that of control group(n=11 was 5700 ml(0-15,500ml, 10 l(0.6-25 l and 9h (6.4-15.8h respectively. The median volume of blood transfusions, blood loss and operative time was lesser in AP group(n=14 than that of TA group(n=25. Conclusion: There is definite

  13. Soluble vascular endothelial growth factor in various blood transfusion components

    DEFF Research Database (Denmark)

    Nielsen, Hans Jørgen; Werther, K; Mynster, T

    1999-01-01

    of sVEGF was determined in nonfiltered and prestorage white cell-reduced whole blood (WB), buffy coat-depleted saline-adenine-glucose-mannitol (SAGM) blood, platelet-rich plasma (PRP), and buffy coat-derived platelet (BCP) pools obtained from volunteer, healthy blood donors. As a control, total content....... The potential content of VEGF in various blood components for transfusion was evaluated. STUDY DESIGN AND METHODS: Soluble VEGF (sVEGF, isotype 165) was determined by an enzyme-linked immunosorbent assay (EIA) in serum and plasma samples and in lysed cells from healthy volunteers. Subsequently, total content......: In the healthy volunteers, median total sVEGF content was 97 (range, 20-303) pg per mL in serum and 19 (13-37) pg per mL in plasma (n = 12, p plasma, and 95 (78...

  14. Survey of Blood Collection Centers and Implementation of Guidance for Prevention of Transfusion-Transmitted Zika Virus Infection--Puerto Rico, 2016.

    Science.gov (United States)

    Vasquez, Amber M; Sapiano, Mathew R P; Basavaraju, Sridhar V; Kuehnert, Matthew J; Rivera-Garcia, Brenda

    2016-04-15

    Since November 2015, Puerto Rico has reported active mosquito-borne transmission of Zika virus. Because of the potential for Zika virus to be transmitted through transfusion of blood components, and because a high percentage of persons infected with Zika virus are asymptomatic, the Food and Drug Administration (FDA) recommended that blood collections cease in areas of the United States affected by active vector-borne transmission of Zika virus until laboratory screening of blood donations or pathogen reduction technology (PRT) for treatment of blood components can be implemented. To inform efforts to maintain the safety and availability of the blood supply in Puerto Rico, CDC, in collaboration with the Puerto Rico Department of Health, conducted a rapid assessment of blood collection and use on the island. A total of 139,369 allogeneic red blood cell (RBC) units, 45,243 platelet units, and 56,466 plasma units were collected in or imported to Puerto Rico during 2015, and 135,966 allogeneic RBC units, 13,526 therapeutic platelet units, and 25,775 plasma units were transfused. Because of the potential for local Zika virus transmission in areas with a competent mosquito vector, other areas of the United States should develop plans to ensure local blood safety and adequacy. Blood collection organizations and public health agencies should collaborate to maintain the safety and availability of local blood supplies in accordance with FDA guidance.

  15. Bedside practice of blood transfusion in a large teaching hospital in Uganda: An observational study

    Directory of Open Access Journals (Sweden)

    de Graaf J

    2009-01-01

    Full Text Available Background: Adverse transfusion reactions can cause morbidity and death to patients who receive a blood transfusion. Blood transfusion practice in Mulago Hospital, Kampala, Uganda is analyzed to see if and when these practices play a role in the morbidity and mortality of patients. Materials and Methods: An observational study on three wards of Mulago Hospital. Physicians, paramedics, nurses, medical students and nurse students were observed using two questionnaires. For comparison, a limited observational study was performed in the University Medical Centre Groningen (UMCG in Groningen, The Netherlands. Results: In Mulago Hospital guidelines for blood transfusion practice were not easily available. Medical staff members work on individual professional levels. Students perform poorly due to inconsistency in their supervision. Documentation of blood transfusion in patient files is scarce. There is no immediate bedside observation, so transfusion reactions and obstructions in the blood transfusion flow are not observed. Conclusion: The poor blood transfusion practice is likely to play a role in the morbidity and mortality of patients who receive a blood transfusion. There is a need for a blood transfusion policy and current practical guidelines.

  16. Occult hepatitis B virus infection and blood transfusion

    Institute of Scientific and Technical Information of China (English)

    Dong Hee Seo; Dong Hee Whang; Eun Young Song; Kyou Sup Han

    2015-01-01

    Transfusion-transmitted infections including hepatitis Bvirus (HBV) have been a major concern in transfusionmedicine. Implementation of HBV nucleic acid testing(NAT) has revealed occult HBV infection (OBI) in blooddonors. In the mid-1980s, hepatitis B core antibody(HBc) testing was introduced to screen blood donorsin HBV non-endemic countries to prevent transmissionof non-A and non-B hepatitis. That test remains inuse for preventing of potential transmission of HBVfrom hepatitis B surface antigen (HBsAg)-negativeblood donors, even though anti-hepatitis C virus testshave been introduced. Studies of anti-HBc-positivedonors have revealed an HBV DNA positivity rate of0%-15%. As of 2012, 30 countries have implementedHBV NAT. The prevalence of OBI in blood donors wasestimated to be 8.55 per 1 million donations, accordingto a 2008 international survey. OBI is transmissible byblood transfusion. The clinical outcome of occult HBVtransmission primarily depends on recipient immunestatus and the number of HBV DNA copies present in theblood products. The presence of donor anti-HBs reducesthe risk of HBV infection by approximately five-fold. Therisk of HBV transmission may be lower in endemic areasthan in non-endemic areas, because most recipientshave already been exposed to HBV. Blood safety forHBV, including OBI, has substantially improved, but thepossibility for OBI transmission remains.

  17. Real-time blood cross-matching sensor for intelligent management of transfusion safety.

    Science.gov (United States)

    Ramasubramanian, M K; Anthony, Steven R

    2004-01-01

    Blood transfusion errors are not uncommon. In some cases the error is fatal. This is primarily due to lack of an automated system at the point of application and over-reliance on bar-coding and paperwork to catch these critical errors. In emergency situations, human errors contribute to transfusion and transplantation of incompatible blood types and organs resulting in rejection and possible fatality. We present a sensing concept that will monitor blood compatibility between the patient and the transfusion bag before allowing the valve to open for transfusion to take place. This will eliminate all transfusion errors and provide 100% safe transfusions automatically. The operating principle of the sensor is based on the light scattering characteristics of dilute blood and the effect of agglutination on scattering. The device proposed is an optical system based on spectrophotometric methods. The device configuration, and results from several tests with combinations of known blood samples will be presented.

  18. [Effects of perioperative blood transfusion on the severity of postoperative infection].

    Science.gov (United States)

    Zhuang, Yuan; Zhang, Dong-Qing; Wang, Shu-Ying; Zhou, Wu; Pan, Ji-Chun; Wang, De-Qing

    2013-02-01

    This study was purposed to explore whether the blood transfusion of surgical patients can increase the severity of postoperative infection by a retrospective analysis of patients with postoperative infection in Chinese PLA General Hospital. By using a software "clinical transfusion database" developed by our department, 150 infected surgical cases were retrieved and divided into deep infection group and superficial infection group according to the infected location. These two groups were compared in term of the patient's age, duration of hospitalization, red blood cell transfusion volume, none-red cell transfusion volume, transfusion frequency and average transfusion volume. The results showed that red blood cell transfusion volume or none-red cells transfusion volume of patients with superficial infection was 4.50 (0 - 59) U or 2.95 (0 - 119.6) U, and that of deep infection was 9.00 (0 - 153) U and 8.05 (0 - 136.6) U, the differences was significant (P transfusion frequency showed the most significant difference, median in the patients with superficial infection was about 2 (1 - 31) times, less than the deep infection group about 4 (1 - 49) times (P transfusion volume. It is concluded that perioperative blood transfusion volume and frequency of surgical patients seems to display a positive correlation with the degree of postoperative infection.

  19. Blood transfusion in Europe: basic principles for initial and continuous training in transfusion medicine: an approach to an European harmonisation.

    Science.gov (United States)

    Mueller, M M; Seifried, E

    2006-11-01

    Over the past few decades, transfusion medicine and haemotherapy have evolved into complex medical disciplines comprising a broad field of subspecialties such as immunohaematology, blood component production, haemapheresis and haemostaseology. Transfusion medicine is thus an important qualification at the interfaces of analytical laboratory medicine, pharmaceutical production and clinical disciplines such as internal medicine, anaesthesiology or surgery. Physicians specialising in transfusion medicine are valuable and competent partners for these related disciplines when it comes to safe, effective and tailored haemotherapy. Why has transfusion medicine become so complex? On the one hand, one can discern problems such as infectious diseases like the HIV disaster in the past century, resulting in guidelines, directives and laws such as the transfusion law in Germany. Thereby, we now enjoy the highest level of blood product safety ever regarding viral transmission thanks to the broad implementation of PCR testing. On the other hand, there are numerous positive reasons for the increasing complexity of transfusion medicine: Modern medical therapies like stem cell transplantation, cellular therapy, transplantation of solid organs, regenerative medicine and surgery cannot exist without a safe supply of blood products and high quality standard as well as special blood products and laboratory services provided by blood banks and transfusion medicine specialists. Good laboratory practice (GLP), good manufacturing practice (GMP), quality management systems and quality control on the pharmaceutical manufacturer's level are only few examples of the standards in today's blood banking. European directives in the field of blood products, stem cell preparations and tissue have led to higher uniform quality standards for biological preparations in a unified Europe, which is the desired outcome, but which also increases the complexity of this field. In contrast, directives 93/16/EEC

  20. Role of the blood transfusion service in tissue banking.

    Science.gov (United States)

    Warwick, R M; Eastlune, T; Fehily, D

    1996-01-01

    Tissue transplantation and banking are rapidly growing services throughout the world reflecting the widening availability of transplantable cadaver tissue and the mounting clinical indications particularly in orthopaedic, plastic and cardiovascular surgery. In the US tissue banking is more established, yet continues to show a rapid growth profile. In the UK it is currently organised in a variety of different ways and by a number of different organisations. The risks of disease transmission by tissue transplantation are similar to those for blood transfusion and the majority of tissues are grafted during procedures that are not life saving. The danger of disease transmission has resulted in the introduction of legislation in the US which allows the FDA to inspect tissue banks and to recall and destroy tissues. In the UK, there is currently no regulation or inspection of tissue banks to demonstrate that donor selection, tissue processing and tracking are conducted to acceptable standards. Blood transfusion services in the UK, US, New Zealand, Australia and possibly other countries have extended their roles to include organ and tissue donation to varying degrees, with the collection, processing and distribution of bone and tendon allografts most commonly undertaken. They have readily available special capabilities and experience with an established infrastructure, compliant with Good Manufacturing Practice, placing them in an ideal position to provide this service safely and cost-effectively.

  1. Mortality risk is dose-dependent on the number of packed red blood cell transfused after coronary artery bypass graft

    OpenAIRE

    dos Santos, Antônio Alceu; de Sousa, Alexandre Gonçalves; Piotto, Raquel Ferrari; Pedroso, Juan Carlos Montano [UNIFESP

    2013-01-01

    Introduction Transfusions of one or more packed red blood cells is a widely strategy used in cardiac surgery, even after several evidences of increased morbidity and mortality. The world's blood shortage is also already evident. Objective To assess whether the risk of mortality is dose-de>pendent on the number of packed red blood cells transfused after coronary artery bypass graft. Methods Between June 2009 and July 2010, were analyzed 3010 patients: transfused and non-transfused. Transfused ...

  2. Consequences of Transfusing Blood Components in Patients With Trauma: A Conceptual Model.

    Science.gov (United States)

    Jones, Allison R; Frazier, Susan K

    2017-04-01

    Transfusion of blood components is often required in resuscitation of patients with major trauma. Packed red blood cells and platelets break down and undergo chemical changes during storage (known as the storage lesion) that lead to an inflammatory response once the blood components are transfused to patients. Although some evidence supports a detrimental association between transfusion and a patient's outcome, the mechanisms connecting transfusion of stored components to outcomes remain unclear. The purpose of this review is to provide critical care nurses with a conceptual model to facilitate understanding of the relationship between the storage lesion and patients' outcomes after trauma; outcomes related to trauma, hemorrhage, and blood component transfusion are grouped according to those occurring in the short-term (≤30 days) and the long-term (>30 days). Complete understanding of these clinical implications is critical for practitioners in evaluating and treating patients given transfusions after traumatic injury.

  3. Why and how to rationalize allogeneic blood in surgery Porque e como racionalizar o uso de sangue alogênico em cirurgia

    Directory of Open Access Journals (Sweden)

    Aryeh Shander

    2002-11-01

    Full Text Available The authors have assessed the use of allogeneic blood in surgery procedures and its influence on American Medical Centers. Physiology and physiopathology in transfusion surgery are evaluated, alerting to the possibility of occurring some risks such as infection and immunological diseases, mainly the “Transfusion Related Acute Lung Injury” (TRALI, that has concerned the scientific community as it is misdiagnosed and underreported. The authors point out safe, effective and simple alternatives for the use of allogeneic blood that will shortly be the standard conduct in surgeries in the best medical centers.   Os autores avaliam a utilização do sangue alogênico em procedimentos cirúrgicos e suas repercurssões em centros médicos norte-americanos. Evidenciam aspectos fisiológicos e fisiopatológicos na prática transfusional, como a ocorrência de processos infecciosos e imunológicos, salientando a atual intercorrência denominada “Lesão Pulmonar Agúda Relacionada a Transfusões” (TRALI, que têm preocupado a comunidade científica por ser subdiagnosticada e subnotificada. Os autores mostram ainda, que existem alternativas ao uso de sangue alogênico que são seguras, efetivas e simples, as quais tem sido difundidas e possivelmente tornar-se-ão a conduta padrão em centros médicos de excelência.

  4. Transmission of HIV by transfusion of HIV-screened blood: the value of a national register. The 'Recipients' Study Group of the French Society of Blood Transfusion.

    Science.gov (United States)

    Courtois, F; Jullien, A M; Chenais, F; Noel, L; Pinon, F

    1992-03-01

    A National Register of transfusion-transmitted infections was opened by the French Society of Blood Transfusion on 1 October, 1986. Out of 54 initially reported cases of HIV-infection, allegedly transmitted by blood components, further investigation could be completed in 33 cases. The transfusional origin of contamination was considered as established or probable in 28/33 cases, either because a potentially infectious unit was identified among those transfused to the recipient (23/28), or because the recipient was known to be seronegative before transfusion (5/28), or both (10/28). In 5/33 cases transfusion was considered as presumably responsible for contamination because no other risk factor was found in the recipient. Among the 33 documented cases of HIV-transmission by screened blood, 29 (88%) occurred between 1985 and 1987, and four (12%) during 1988. Out of 19 implicated donors later found seropositive, 16 belonged to a high-risk group for HIV-infection. The majority of HIV-infections occurred as a consequence of blood donation in the window period between contamination and the appearance of detectable antibodies in the donor's serum (11/19). In three instances, however, human and operational errors led to the release of seropositive units. We conclude that the main value of this Register is to provide a potential trend-indicator of transfusion-related infectious risks, to allow objective documentation of reported cases and to contribute to the improvement of blood transfusion practice.

  5. Hypomethylating agents after allogeneic blood stem cell transplantation

    Science.gov (United States)

    Rautenberg, Christina; Haas, Rainer; Kobbe, Guido

    2016-01-01

    Allogeneic blood stem cell transplantation (allo-SCT) is a potentially curative treatment for patients with myeloid malignancies such as acute myeloid leukemia (AML) and myelodysplastic syndromes (MDS), but relapse remains the major cause of treatment failure. So far, therapeutic options for patients with AML or MDS who relapse after allo-SCT generally consisted of palliative care, low-dose or intensive chemotherapy as well as cellular therapies such as donor lymphocyte infusions (DLI) and second transplantation in selected cases. Nevertheless, the prognosis of patients with myeloid malignancies relapsing after allo-SCT remains dismal therefore asking for novel treatment strategies. Considering their well-balanced profile of good efficacy and moderate toxicity in the non-transplant setting, the hypomethylating agents (HMA) azacitidine (Aza) and decitabine (DAC) have also been tested either alone or in combination with DLI in the post-transplant period. This review summarizes the current knowledge about the use of these two HMA as pre-emptive, salvage or consolidation therapy mostly retrieved from retrospective studies but also from a few prospective trials. Within this review, we also comment on some practical issues such as optimal dose and schedule, the choice of HMA candidates and the role of additional cellular interventions. Finally, we also give an overview on the assumed mode of actions, ongoing research, clinical studies and potential combination partners aiming to improve this treatment approach. PMID:28066786

  6. CYTOMEGALOVIRUS INTERSTITIAL PNEUMONITIS FOLLOWING ALLOGENEIC PERIPHERAL BLOOD STEM CELL TRANSPLANTATION

    Institute of Scientific and Technical Information of China (English)

    XU Xiao-hua; HUANG Lian-sheng; ZHANG Xiao-hong; ZHU Kang-er; XU Yang; WU Dong; ZHAO Xiao-ying

    2005-01-01

    Objective: To explore the risk factors and prophylaxis and treatment of cytomegalovirus interstitial pneumonitis(CMV-IP) after allogeneic peripheral blood stem cell transplantation (allo-PBSCT). Methods: 43 patients who received allo-PBSCT were allocated to either a Gancyclovir(GCV)-prophylaxis group (n=19) or a non-GCV prophylaxis group (n=24).A comparison was made of the incidence of CMV-IP in patients given or not given prophylactic gancyclovir. Results: 9patients in non-GCV prophylaxis group developed late CMV-IP (P<0.05). Graft-versus-host-disease (GVHD) may be associated with a high risk of CMV-IP. 5 cases of CMV-IP were successfully treated with GCV, but 3 cases died of CMV-IP.The most common adverse event of GCV was neutropenia, but was reversible. Conclusion: CMV infection was a major cause of interstitial pneumonitis after allo-PBSCT, which correlated strongly with the severity of GVHD. Gancyclovir was shown to be effective in both prophylaxis and treatment of CMV-IP.

  7. Bacteriological safety of blood collected for transfusion at university of gondar hospital blood bank, northwest ethiopia.

    Science.gov (United States)

    Wondimu, Hailegebriel; Addis, Zelalem; Moges, Feleke; Shiferaw, Yitayal

    2013-01-01

    Background. Transfusion associated bacterial infection has remained more frequent with a sever risk of morbidity and mortality. This study assessed the bacteriological safety of blood collected for transfusion. Method. A cross-sectional study was conducted at University of Gondar hospital blood bank from December 2011 to June 2012. Bacterial isolation, identification, and antimicrobial susceptibility tests were done as per the standard procedure. Chi-square test and P value were used to assess associations between risk factors and the bacterial isolation rate. Results. Twenty-one (15.33%) blood units were found contaminated with bacteria, and 95.24% contamination was due to external sources. The commonly isolated bacteria were Staphylococcus aureus, Coagulase negative Staphylococci, Escherichia coli, Klebsiella species, Streptococci species, Enterobacter species, and Citrobacter species. All of the bacteria isolated were 100% sensitive to Gentamicin, Chloramphenicol, Amoxicillin, and Doxycycline. Multiple antimicrobial resistances were observed in 66.7% of the isolates. Not using glove by phlebotomist, touching disinfected phlebotomy site and double puncture at the same hand or both hands of a donor were found to be risk factors for bacterial contamination. Conclusion. Bacterial contamination of blood to be transfused is a common problem in the hospital. So attention should be given to activities performed at the blood bank for safe transfusion practices.

  8. Incompatible blood transfusion: Challenging yet lifesaving in the management of acute severe autoimmune hemolytic anemia

    Directory of Open Access Journals (Sweden)

    Sudipta Sekhar Das

    2014-01-01

    Full Text Available Background and Aim: Autoimmune hemolytic anemia (AIHA is characterized by the production of autoantibodies directed against red cell antigens. Most patients of AIHA arrive in the emergency or out-patient department (OPD with severe anemia requiring urgent blood transfusion. Here we share our experience of managing these patients with incompatible blood transfusions and suggest the minimal test required to assure patient safety. Materials and Methods: A total of 14 patients admitted with severe anemia, diagnosed with AIHA and requiring blood transfusion urgently were included in the study. A series of immunohematological investigations were performed to confirm the diagnosis and issue "best match" packed red blood cells (PRBC to these patients. Results: A total of 167 PRBC units were crossmatched for 14 patients of which 46 units (28% were found to be best match ones and 26 (56.5% of these units were transfused. A mean turn around time of 222 min was observed in issuing the ′best match′ blood. Severe hemolysis was observed in all patients with a median hemoglobin increment of 0.88 g/dl after each unit PRBC transfusion. Conclusion: Decision to transfuse in AIHA should be based on the clinical condition of the patient. No critical patient should be denied blood transfusion due to serological incompatibility. Minimum investigations such as direct antiglobulin test (DAT, antibody screening and autocontrol should be performed to ensure transfusion safety in patients. All transfusion services should be capable of issuing "best match" PRBCs in AIHA.

  9. Blood transfusion at the time of the First World War--practice and promise at the birth of transfusion medicine.

    Science.gov (United States)

    Boulton, F; Roberts, D J

    2014-12-01

    The centenary of the start of the First World War has stirred considerable interest in the political, social, military and human factors of the time and how they interacted to produce and sustain the material and human destruction in the 4 years of the war and beyond. Medical practice may appear distant and static and perhaps seems to have been somewhat ineffectual in the face of so much trauma and in the light of the enormous advances in medicine and surgery over the last century. However, this is an illusion of time and of course medical, surgical and psychiatric knowledge and procedures were developing rapidly at the time and the war years accelerated implementation of many important advances. Transfusion practice lay at the heart of resuscitation, and although direct transfusion from donor to recipient was still used, Geoffrey Keynes from Britain, Oswald Robertson from America and his namesake Lawrence Bruce Robertson from Canada, developed methods for indirect transfusion from donor to recipient by storing blood in bottles and also blood-banking that laid the foundation of modern transfusion medicine. This review explores the historical setting behind the development of blood transfusion up to the start of the First World War and on how they progressed during the war and afterwards. A fresh look may renew interest in how a novel medical speciality responded to the needs of war and of post-war society.

  10. Analysis of immediate transfusion incidents reported in a regional blood bank

    Directory of Open Access Journals (Sweden)

    Adriana Lemos de Sousa Neto

    2011-10-01

    Full Text Available BACKGROUND: Blood transfusion is imperative when treating certain patients; however, it is not risk free. In addition to the possible transmission of contagious infectious diseases, incidents can occur immediately after transfusion and at a later time. AIMS: This study aimed to examine the immediate transfusion incidents reported in a regional blood bank in the state of Minas Gerais between December 2006 and December 2009. A retrospective quantitative epidemiological study was conducted. Data were obtained from 202 transfusion incident reports of 42 health institutions served by the blood bank. Data processing and analysis were carried out using the Statistical Package for the Social Sciences (SPSS software. RESULTS: The rate of immediate transfusion incidents reported in the period was 0.24%; febrile non-hemolytic reactions were the most common type of incident (56.4%. The most frequent clinical manifestations listed in transfusion incident reports were chills (26.9% and fever (21.6%. There was a statistically significant association (p-value < 0.05 between the infusion of platelet concentrates and febrile non-hemolytic reactions and between fresh frozen plasma and febrile non-hemolytic reaction. The majority (73.3% of transfused patients who suffered immediate transfusion incidents had already been transfused and 36.5% of the cases had previous transfusion incident reports. CONCLUSIONS: Data from the present study corroborate the implementation of new professional training programs aimed at blood transfusion surveillance. These measures should emphasize prevention, identification and reporting of immediate transfusion incidents aiming to increase blood transfusion quality and safety.

  11. Introduction to Iranian Blood Transfusion Organization and Blood Safety in Iran

    Directory of Open Access Journals (Sweden)

    H Abolghasemi

    2009-03-01

    Full Text Available "nCurrently, in Iran blood transfusion is an integral part of the national health system and blood donation is voluntary and non­remu­nerated and blood and its components may not be a source of profit. In 1974 and following establishment of Iranian Blood Transfusion Organization (IBTO all blood transfusion activities from donor recruitment to production of blood com­po­nents and delivery of blood and blood products were centralized. The activities of IBTO are followed the laws and regu­la­tions of Ministry of Health and criteria of Iran National Regulatory Authority. In order to meet the country's demand in 2007 IBTO collected about 1.7 millions units of blood from the population of 70 millions. In 1979 coincided with the Is­lamic revolution the number of  blood units collected throughout the country were 124,000 units or 3.4 unit per 1000 popu­la­tion whereas after about 30 years this increased to about 25 unit per 1000 population. With improving the pool of vol­un­tary donors, IBTO has been successful in excluding "family replacement" donation since 2007 and reached to 100% volun­tary and nonremunerated blood donation. Currently more than 92% of blood donors in Iran are male and contribution of fe­male in blood donation is less than 8%. Although all donated blood in Iran screened for HBsAg since 1974, screening of blood units for HIV and HCV started since 1989 and 1996, respectively. The frequency of HBV infection in blood do­nors showed a significant decline from 1.79% in 1998 to 0.4% in 2007. The overall frequency of HCV and HIV infection are 0.13% and 0.004% respectively.

  12. [Spectrophotometric characteristics of the amniotic fluid in Rh isoimmunization following intrauterine fetal blood transfusions].

    Science.gov (United States)

    Matrova, T S; Vasileva, Iu

    1989-01-01

    The amniotic fluids of 7 pregnant women with Rh-isoimmunization were examined. On the basis of the data of this investigation as well as of the clinical and ultrasound data intrauterine blood transfusions were made in fetuses--from 4 to 8 in number. Forty two spectrophotometric analyses were made in all, but the amniotic fluids were examined before intrauterine blood transfusions as well as before the performance of each subsequent blood transfusion. The authors found changes in the characteristic of the amniotic fluid after intrauterine blood transfusion, which were manifested by the fact that the pigment peak of delta 450 nm was reduced, but the peak of delta 410 nm was increased. In connection with these findings after intrauterine blood transfusions delta 450 nm lost its diagnostic and prognostic value. delta 410 nm before intrauterine blood transfusions manifested gravity of fetal hemolytic disease. After intrauterine blood transfusions its increase was due to blood transfusions and accumulation of methemoglobin in the amniotic fluid.

  13. The effects of non-leukoreduced red blood cell transfusions on microcirculation in mixed surgical patients.

    NARCIS (Netherlands)

    Ayhan, B.; Yuruk, K.; Koene, S.; Sahin, A.; Ince, C.; Aypar, U.

    2013-01-01

    BACKGROUND: The impact of the storage process on oxygen-carrying properties of red blood cells and the efficacy of red blood cell (RBC) transfusions concerning tissue oxygenation remain an issue of debate in transfusion medicine. Storage time and leukocyte content probably interact since longer stor

  14. Preoperative factors associated with red blood cell transfusion in hip fracture patients

    DEFF Research Database (Denmark)

    Madsen, Christian Medom; Jørgensen, Henrik Løvendahl; Norgaard, Astrid;

    2014-01-01

    Red blood cell (RBC) transfusion is a frequently used treatment in patients admitted with a fractured hip, but the use remains an area of much debate. The aim of this study was to determine preoperative factors associated with the risk of receiving a red blood cell transfusion in hip fracture...

  15. Outpatient red blood cell transfusion payments among patients on chronic dialysis

    Directory of Open Access Journals (Sweden)

    Gitlin Matthew

    2012-11-01

    Full Text Available Abstract Background Payments for red blood cell (RBC transfusions are separate from US Medicare bundled payments for dialysis-related services and medications. Our objective was to examine the economic burden for payers when chronic dialysis patients receive outpatient RBC transfusions. Methods Using Truven Health MarketScan® data (1/1/02-10/31/10 in this retrospective micro-costing economic analysis, we analyzed data from chronic dialysis patients who underwent at least 1 outpatient RBC transfusion who had at least 6 months of continuous enrollment prior to initial dialysis claim and at least 30 days post-transfusion follow-up. A conceptual model of transfusion-associated resource use based on current literature was employed to estimate outpatient RBC transfusion payments. Total payments per RBC transfusion episode included screening/monitoring (within 3 days, blood acquisition/administration (within 2 days, and associated complications (within 3 days for acute events; up to 45 days for chronic events. Results A total of 3283 patient transfusion episodes were included; 56.4% were men and 40.9% had Medicare supplemental insurance. Mean (standard deviation [SD] age was 60.9 (15.0 years, and mean Charlson comorbidity index was 4.3 (2.5. During a mean (SD follow-up of 495 (474 days, patients had a mean of 2.2 (3.8 outpatient RBC transfusion episodes. Mean/median (SD total payment per RBC transfusion episode was $854/$427 ($2,060 with 72.1% attributable to blood acquisition and administration payments. Complication payments ranged from mean (SD $213 ($168 for delayed hemolytic transfusion reaction to $19,466 ($15,424 for congestive heart failure. Conclusions Payments for outpatient RBC transfusion episodes were driven by blood acquisition and administration payments. While infrequent, transfusion complications increased payments substantially when they occurred.

  16. An Analysis of and Recommendations for the Peruvian Blood Collection and Transfusion System

    Science.gov (United States)

    George, Paul E; Vidal, Julio; Garcia, Patricia J

    2016-01-01

    Background Peru experienced a crisis in its blood collection and supply system in the mid-2000s, as contaminated blood led to several transfusion-transmitted infections (TTI), occurring in the backdrop of extremely low voluntary donation rates and a national blood supply shortage. Thus, the Peruvian Ministry of Health (MINSA) implemented a national investigation on the safety and quality of the Peruvian blood collection/transfusion network. Methods Every Peruvian blood bank was evaluated by MINSA from 2007–2008. These evaluations consisted of an update of the national registry of blood banks and visits to each blood bank from MINSA oversight teams. Information was collected on the condition of the blood bank personnel, equipment, supplies, and practices. Further, previously-collected blood at each blood bank was randomly selected and screened for TTI-causing pathogens. Results Uncovered in this investigation was a fragmented, under-equipped, and poorly-staffed blood collection and transfusion network, consisting of 241 independent blood banks and resulting in suboptimal allocation of resources. Further, blood with evidence of TTI-causing pathogens (including Hepatitis B, Hepatitis C, and syphilis) and set for transfusion was discovered at three separate blood banks as part of the random screening process. Conclusion Using the successful reorganizations of national blood supply systems in other Latin American countries as examples, Peru would be well-served to form large, high-volume, regional blood collection and transfusion centers, responsible for blood collection and screening for the entire country. The small, separate blood banks would then be transformed into a network of blood transfusion centers, not responsible for blood collection. This reorganization would allow Peru to better utilize its resources, standardize the blood collection and transfusion process, and increase voluntary donation, resulting in a safer, more abundant national blood product.

  17. Basics of fluid and blood transfusion therapy in paediatric surgical patients

    Directory of Open Access Journals (Sweden)

    Virendra K Arya

    2012-01-01

    Full Text Available Perioperative fluid, electrolyte and blood transfusion therapy for infants and children can be confusing due the numerous opinions, formulas and clinical applications, which can result in a picture that is not practical and is often misleading. Perioperatively, crystalloids, colloids and blood components are required to meet the ongoing losses and for maintaining cardiovascular stability to sustain adequate tissue perfusion. Recently controversies have been raised regarding historically used formulas and practices of glucose containing hypotonic maintenance crystalloid solutions for perioperative fluid therapy in children. Paediatric intraoperative transfusion therapy, particularly the approach to massive blood transfusion (blood loss ≥ one blood volume can be quite complex because of the unique relationship between the patient′s blood volume and the volume of the individual blood product transfused. A meticulous fluid, electrolyte and blood transfusion management is required in paediatric patients perioperatively because of an extremely limited margin for error. This article reviews the basic concepts in perioperative fluid and blood transfusion therapy for paediatric patients, along with recent recommendations. For this review, Pubmed, Ovid MEDLINE, HINARI and Google scholar were searched without date restrictions. Search terms included the following in various combinations: Perioperative, fluid therapy, paediatrics, blood transfusion, electrolyte disturbances and guidelines. Only articles with English translation were used.

  18. Basics of fluid and blood transfusion therapy in paediatric surgical patients.

    Science.gov (United States)

    Arya, Virendra K

    2012-09-01

    Perioperative fluid, electrolyte and blood transfusion therapy for infants and children can be confusing due the numerous opinions, formulas and clinical applications, which can result in a picture that is not practical and is often misleading. Perioperatively, crystalloids, colloids and blood components are required to meet the ongoing losses and for maintaining cardiovascular stability to sustain adequate tissue perfusion. Recently controversies have been raised regarding historically used formulas and practices of glucose containing hypotonic maintenance crystalloid solutions for perioperative fluid therapy in children. Paediatric intraoperative transfusion therapy, particularly the approach to massive blood transfusion (blood loss ≥ one blood volume) can be quite complex because of the unique relationship between the patient's blood volume and the volume of the individual blood product transfused. A meticulous fluid, electrolyte and blood transfusion management is required in paediatric patients perioperatively because of an extremely limited margin for error. This article reviews the basic concepts in perioperative fluid and blood transfusion therapy for paediatric patients, along with recent recommendations. For this review, Pubmed, Ovid MEDLINE, HINARI and Google scholar were searched without date restrictions. Search terms included the following in various combinations: Perioperative, fluid therapy, paediatrics, blood transfusion, electrolyte disturbances and guidelines. Only articles with English translation were used.

  19. The lost art of whole blood transfusion in austere environments.

    Science.gov (United States)

    Strandenes, Geir; Hervig, Tor A; Bjerkvig, Christopher K; Williams, Steve; Eliassen, Håkon S; Fosse, Theodor K; Torvanger, Hans; Cap, Andrew P

    2015-01-01

    The optimal resuscitation fluid for uncontrolled bleeding and hemorrhagic shock in both pre- and in-hospital settings has been an ongoing controversy for decades. Hemorrhage continues to be a major cause of death in both the civilian and military trauma population, and survival depends on adequacy of hemorrhage control and resuscitation between onset of bleeding and arrival at a medical treatment facility. The terms far-forward and austere are defined, respectively, as the environment where professional health care providers normally do not operate and a setting in which basic equipment and capabilities necessary for resuscitation are often not available. The relative austerity of a treatment setting may be a function of timing rather than just location, as life-saving interventions must be performed quickly before hemorrhagic shock becomes irreversible. Fresh whole blood transfusions in the field may be a feasible life-saving procedure when facing significant hemorrhage.

  20. Non-invasive spectroscopy of transfusable red blood cells stored inside sealed plastic blood-bags.

    Science.gov (United States)

    Buckley, K; Atkins, C G; Chen, D; Schulze, H G; Devine, D V; Blades, M W; Turner, R F B

    2016-03-07

    After being separated from (donated) whole blood, red blood cells are suspended in specially formulated additive solutions and stored (at 4 °C) in polyvinyl chloride (PVC) blood-bags until they are needed for transfusion. With time, the prepared red cell concentrate (RCC) is known to undergo biochemical changes that lower effectiveness of the transfusion, and thus regulations are in place that limit the storage period to 42 days. At present, RCC is not subjected to analytical testing prior to transfusion. In this study, we use Spatially Offset Raman Spectroscopy (SORS) to probe, non-invasively, the biochemistry of RCC inside sealed blood-bags. The retrieved spectra compare well with conventional Raman spectra (of sampled aliquots) and are dominated by features associated with hemoglobin. In addition to the analytical demonstration that SORS can be used to retrieve RCC spectra from standard clinical blood-bags without breaking the sterility of the system, the data reveal interesting detail about the oxygenation-state of the stored cells themselves, namely that some blood-bags unexpectedly contain measurable amounts of deoxygenated hemoglobin after weeks of storage. The demonstration that chemical information can be obtained non-invasively using spectroscopy will enable new studies of RCC degeneration, and points the way to a Raman-based instrument for quality-control in a blood-bank or hospital setting.

  1. Blood transfusion : Transfusion-related acute lung injury: back to basics

    NARCIS (Netherlands)

    Peters, A.L.

    2017-01-01

    Transfusion-related acute lung injury (TRALI) is a life-threatening disease affecting the lungs. TRALI can develop within 6 hours after transfusion and almost all patients with TRALI require mechanical ventilation at the intensive care department. Nevertheless up to 40% of patients do not recover fr

  2. Study on effectiveness of transfusion program in thalassemia major patients receiving multiple blood transfusions at a transfusion centre in Western India

    Directory of Open Access Journals (Sweden)

    Shah Neeraj

    2010-01-01

    Full Text Available Background : Children suffering from beta-thalassemia major require repeated blood transfusions which may be associated with dangers like iron overload and contraction of infections such as HIV, HCV, and HBsAg which ultimately curtail their life span. On the other hand, inadequate transfusions lead to severe anemia and general fatigue and debility. Materials and Methods: Data were obtained from 142 beta-thalassemia major patients aged 3 years or more receiving regular blood transfusions at a transfusion centre in Western India from 1 April 2009 to 30 June 2009. The clinical data and laboratory results were subsequently analyzed. Results: Of the 142 patients, 76 (53.5% were undertransfused (mean Hb <10 gm%. 96 (67% of the patients were taking some form of chelation therapy but out of them only 2 (2% were adequately chelated (S. ferritin <1000 ng/ml. 5 (3.5% of the patients were known diabetics on insulin therapy. 103 (72% of the patients were retarded in terms of growth. The prevalence of transfusion-transmitted infections (TTIs such as HCV, HIV, and HBsAg was respectively 45%, 2%, and 2%, with the prevalence of HCV being significantly more than the general population. The HCV prevalence showed positive correlation with the age of the patients and with the total no of blood transfusions received. As many as 15% (6 out of 40 children who were born on or after 2002 were HCV positive despite the blood they received being subjected to screening for HCV. Conclusions: The study suggests the need to step up the transfusions to achieve hemoglobin goal of 10 gm% (as per the moderate transfusion regimen and also to institute urgent and effective chelation measures with the aim of keeping serum ferritin levels below 1000 ng/ml to avoid the systemic effects of iron overload. In addition, strict monitoring of the children for endocrinopathy and other systemic effects of iron overload should be done. Rigid implementation of quality control measures for the

  3. Length of Storage of Red Blood Cells and Patient Survival After Blood Transfusion

    DEFF Research Database (Denmark)

    Halmin, Märit; Rostgaard, Klaus; Lee, Brian K

    2017-01-01

    Background: Possible negative effects, including increased mortality, among persons who receive stored red blood cells (RBCs) have recently garnered considerable attention. Despite many studies, including 4 randomized trials, no consensus exists. Objective: To study the association between...... received transfusions from 2003 to 2012. Measurements: Patients were followed from first blood transfusion. Relative and absolute risks for death in 30 days or 1 year in relation to length of RBC storage were assessed by using 3 independent analytic approaches. All analyses were conducted by using Cox...... proportional hazards regression. Results: Regardless of the analytic approach, no association was found between the length of RBC storage and mortality. The difference in 30-day cumulative mortality between patients receiving blood stored for 30 to 42 days and those receiving blood stored for 10 to 19 days...

  4. Detection of malaria infection in blood transfusion: a comparative study among real-time PCR, rapid diagnostic test and microscopy: sensitivity of Malaria detection methods in blood transfusion.

    Science.gov (United States)

    Hassanpour, Gholamreza; Mohebali, Mehdi; Raeisi, Ahmad; Abolghasemi, Hassan; Zeraati, Hojjat; Alipour, Mohsen; Azizi, Ebrahim; Keshavarz, Hossein

    2011-06-01

    The transmission of malaria by blood transfusion was one of the first transfusion-transmitted infections recorded in the world. Transfusion-transmitted malaria may lead to serious problems because infection with Plasmodium falciparum may cause rapidly fatal death. This study aimed to compare real-time polymerase chain reaction (real-time PCR) with rapid diagnostic test (RDT) and light microscopy for the detection of Plasmodium spp. in blood transfusion, both in endemic and non-endemic areas of malaria disease in Iran. Two sets of 50 blood samples were randomly collected. One set was taken from blood samples donated in blood bank of Bandar Abbas, a city located in a malarious-endemic area, and the other set from Tehran, a non-endemic one. Light microscopic examination on both thin and thick smears, RDTs, and real-time PCR were performed on the blood samples and the results were compared. Thin and thick light microscopic examinations of all samples as well as RDT results were negative for Plasmodium spp. Two blood samples from endemic area were positive only with real-time PCR. It seems that real-time PCR as a highly sensitive method can be helpful for the confirmation of malaria infection in different units of blood transfusion organization especially in malaria-endemic areas where the majority of donors may be potentially infected with malaria parasites.

  5. Blood genotyping for improved outcomes in chronic transfusion patients: current and future perspectives

    Directory of Open Access Journals (Sweden)

    Kutner JM

    2014-09-01

    Full Text Available Jose Mauro Kutner,1 Mariza Mota,1 Fabiana Conti,1 Lilian Castilho1,2 1Hemotherapy and Cell Therapy Department, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil; 2Hemocentro Unicamp, Campinas, SP, Brazil Abstract: Blood transfusions are life sustaining in chronically transfused patients. However, certain complications, such as alloimmunization to red blood cells, can create challenges in the management of those patients. Routine phenotyping of blood recipients and the use of phenotype-matched blood units for transfusion have been useful to lower the occurrence of red cell alloantibodies in chronically transfused individuals. Nevertheless, extensive phenotyping is expensive, laborious, and cannot be performed in certain situations. The molecular understanding of blood groups has enabled the design of assays that may be used to better guide matched red blood cell transfusions. This review summarizes key findings related to red cell alloimmunization, the already identified and potential future benefits of blood group genotyping, and how molecular typing is being incorporated in the blood bank's routine to improve clinical and long-term outcomes in chronically transfused patients. Keywords: blood group genotyping, chronically transfused patients, platelet genotyping, RBC alloimmunization

  6. Predictors and complications of blood transfusion in total hip and knee arthroplasty.

    Science.gov (United States)

    Frisch, Nicholas B; Wessell, Nolan M; Charters, Michael A; Yu, Stephen; Jeffries, James J; Silverton, Craig D

    2014-09-01

    Perioperative patient optimization can minimize the need for blood transfusions in patients undergoing total hip arthroplasty (THA) and total knee arthroplasty (TKA). The purpose of this study was to determine predictors and complications of transfusions. This retrospective review analyzed 1795 patients who underwent primary THA and TKA at our institution between January 2011 and December 2012. Of the 1573 patients ultimately included the rates of transfusion were 9.27% in TKA and 26.6% in THA. Significant predictors for transfusion include: preoperative hemoglobin, age, female gender, body mass index, creatinine, TKA, operating room time, operative blood loss, and intra-operative fluids. The DVT rate was comparable, but deep surgical site infection rate among transfused patients was 2.4% compared to 0.5% in non-transfused patients (P = 0.0065).

  7. Complications of blood transfusion. How to recognize and respond to noninfectious reactions.

    Science.gov (United States)

    Sloop, G D; Friedberg, R C

    1995-07-01

    Severe transfusion reactions occur much less often than minor reactions, but it is difficult to discriminate clinically between impending severe reactions and minor reactions. Therefore, whenever a reaction occurs, the transfusion should be discontinued and a laboratory workup initiated to rule out an acute hemolytic transfusion reaction. At a minimum, a direct antiglobulin (Coombs') test should be performed, and specimens obtained before and after transfusion should be assayed for hemoglobinemia and hemoglobinuria. If the product transfused included red blood cells, then typing and crossmatching should be repeated on a posttransfusion blood specimen. Routine premedication with antipyretics is not recommended, since they may mask early signs and symptoms of more severe reactions and their efficacy is questionable. Recent insights into the mechanisms of transfusion reactions have suggested interventions that may help minimize or prevent potentially serious sequelae.

  8. Significance of assess the iron reserves of severe renal anemia patients before and after blood transfusion

    Institute of Scientific and Technical Information of China (English)

    Gui-Fen Zhang

    2015-01-01

    Objective:To study the significance of evaluating hemoglobin and iron reserves in the severe renal anemia patient before and after blood transfusion, to guide clinical treatment.Methods:Simple randomly selected 120 patients in phase 5 of chronic renal failure from the department of nephrology, who are regular dialysis with severe renal anemia, according to the situation of iron reserves before blood transfusion, patients will be divided into its reserves of iron deficiency and iron overload group and normal group, and the three groups were divided into 1 U and 2 U group. Comparing the change of different unit quantity of hemoglobin, serum iron, iron, protein and total iron binding force before and after blood transfusion and variation is compared between groups.Results: Three groups of patients with 1U blood transfusion ,Hemoglobin, serum iron and ferritin, total iron binding force, transferrin saturation are higher before a blood transfusion,The differences were statistically significant; before and after blood transfusion hemoglobin, serum iron and ferritin, total iron binding force, transferrin saturation change in 1 U group normal iron reserves compared with Insufficient iron reserves 1 U group has no statistically significant difference, iron overload 1 U group before and after blood transfusion hemoglobin, serum iron and ferritin, total iron binding force, transferrin saturation change significantly greater than Insufficient iron reserves 1 U group and 1U with normal iron reserves group, the differences were statistically significant; Three groups of patients blood transfusion after 2 U, hemoglobin, serum iron and ferritin, total iron binding force, transferrin saturation were higher before a blood transfusion, differences were statistically significant; iron overload 2 U group before and after blood transfusion hemoglobin, serum iron and ferritin, total iron binding force, transferrin saturation change significantly greater than Insufficient iron reserves 2

  9. Storage time of transfused blood and disease recurrence after colorectal cancer surgery

    DEFF Research Database (Denmark)

    Mynster, T; Nielsen, Hans Jørgen

    2001-01-01

    BACKGROUND: Perioperative blood transfusion and subsequent development of postoperative infectious complications may lead to poor prognosis of patients with colorectal cancer. It has been suggested that the development of postoperative infectious complications may be related to the storage time...... of the transfused blood. Therefore, we studied the relationship between blood storage time and the development of disease recurrence and long-term survival after colorectal cancer surgery. METHODS: Preoperative and postoperative data were prospectively recorded in 740 patients undergoing elective resection...... complications. CONCLUSION: Transfusion of buffy-coat-depleted red cells suspended in saline, adenine, glucose, and mannitol blood stored for cancer surgery....

  10. Storage time of transfused blood and disease recurrence after colorectal cancer surgery

    DEFF Research Database (Denmark)

    Mynster, T; Nielsen, Hans Jørgen

    2001-01-01

    of the transfused blood. Therefore, we studied the relationship between blood storage time and the development of disease recurrence and long-term survival after colorectal cancer surgery. METHODS: Preoperative and postoperative data were prospectively recorded in 740 patients undergoing elective resection...... complications. CONCLUSION: Transfusion of buffy-coat-depleted red cells suspended in saline, adenine, glucose, and mannitol blood stored for cancer surgery.......BACKGROUND: Perioperative blood transfusion and subsequent development of postoperative infectious complications may lead to poor prognosis of patients with colorectal cancer. It has been suggested that the development of postoperative infectious complications may be related to the storage time...

  11. RED-BLOOD-CELL TRANSFUSIONS FOR TOTAL HIP-REPLACEMENT IN A REGIONAL-HOSPITAL - A 6-YEAR ANALYSIS

    NARCIS (Netherlands)

    Biesma, Douwe H.; van Iperen, Charlotte E.; Kraaijenhagen, Rob J.; Marx, Joannes J. M.; van de Wiel, Harry B. M.; van De Wiel, Albert

    1994-01-01

    To evaluate changes in the need for homologous blood and to assess the imp act of autologous blood transfusion, red cell transfusions in unilateral total hip replacement surgery, performed electively in the period 1986-1991, were studied in a regional hospital. Transfusion data, perioperative blood

  12. Blood transfusion after total shoulder arthroplasty: Which patients are at high risk?

    Directory of Open Access Journals (Sweden)

    Abdurrahman Kandil

    2016-01-01

    Full Text Available Purpose: There are multiple reported risk factors and a wide range of reported blood transfusion rates for total shoulder arthroplasty (TSA. There are no evidence-based guidelines for blood transfusions in TSA patients. Materials and Methods: We utilized the Nationwide Inpatient Sample to analyze 51,191 patients undergoing TSA between 1998 and 2011. The purpose was to describe the incidence and identify the preoperative factors that are independently associated with blood transfusion after TSA. In addition, we studied the association of blood transfusions with certain variables such as length of stay (LOS, total charges, and payer status. Results: The blood transfusion rate in our study was 6.1%. There was no difference in the rate of blood transfusions over the study period (P < 0.001. In our logistic regression model, significant associations were found with increased age (odds ratio [OR] =1.03, white race (OR = 1.05, higher Charlson-Deyo score (OR = 1.12, presence of ischemic heart disease (OR = 1.24, blood loss anemia (OR = 1.65, female gender (OR = 1.94, presence of coagulation disorders (OR = 2.25, and presence of deficiency anemia (OR = 3.5. Patients receiving a blood transfusion had higher total charges, a longer hospital LOS, and were more likely to be Medicare payers (P < 0.001. Conclusions: Our study found five clinically significant risk factors for blood transfusions for TSA: female gender, ischemic heart disease, deficiency anemia, coagulation disorder, and blood loss anemia. Patients with these risk factors should be considered higher risk for requiring a blood transfusion after TSA and counseled appropriately. Level of Evidence: Level II, retrospective cohort study, prognostic study.

  13. Adverse effects to transfusion with red donor blood cells are frequent

    DEFF Research Database (Denmark)

    Pommergaard, Hans-Christian; Nørgaard, Astrid; Burcharth, Jakob

    2014-01-01

    Adverse effects to transfusion with red donor blood cells are potentially life-threatening. Due to screening, transmission of infectious diseases has decreased; however, the risk is still present. Various immune reactions are common including simple allergic reactions as well as devastating...... conditions such as transfusion-related acute lung injury and circulatory overload in patients with heart disease. Knowledge of the clinical signs of transfusion-related complications is important for clinicians in order to provide the best possible treatment....

  14. Impact of red blood cell transfusion on global and regional measures of oxygenation.

    Science.gov (United States)

    Roberson, Russell S; Bennett-Guerrero, Elliott

    2012-01-01

    Anemia is common in critically ill patients. Although the goal of transfusion of red blood cells is to increase oxygen-carrying capacity, there are contradictory results about whether red blood cell transfusion to treat moderate anemia (e.g., hemoglobin 7-10 g/dL) improves tissue oxygenation or changes outcomes. Whereas increasing levels of anemia eventually lead to a level of critical oxygen delivery, increased cardiac output and oxygen extraction are homeostatic mechanisms the body uses to prevent a state of dysoxia in the setting of diminished oxygen delivery due to anemia. In order for cardiac output to increase in the face of anemia, normovolemia must be maintained. Transfusion of red blood cells increases blood viscosity, which may actually decrease cardiac output (barring a state of hypovolemia prior to transfusion). Studies have generally shown that transfusion of red blood cells fails to increase oxygen uptake unless oxygen uptake/oxygen delivery dependency exists (e.g., severe anemia or strenuous exercise). Recently, near-infrared spectroscopy, which approximates the hemoglobin saturation of venous blood, has been used to investigate whether transfusion of red blood cells increases tissue oxygenation in regional tissue beds (e.g., brain, peripheral skeletal muscle). These studies have generally shown increases in near-infrared spectroscopy derived measurements of tissue oxygenation following transfusion. Studies evaluating the effect of transfusion on the microcirculation have shown that transfusion increases the functional capillary density. This article will review fundamental aspects of oxygen delivery and extraction, and the effects of red blood cell transfusion on tissue oxygenation as well as the microcirculation.

  15. Early, Prehospital Activation of the Walking Blood Bank Based on Mechanism of Injury Improves Time to Fresh Whole Blood Transfusion.

    Science.gov (United States)

    Bassett, Aaron K; Auten, Jonathan D; Zieber, Tara J; Lunceford, Nicole L

    2016-01-01

    Balanced component therapy (BCT) remains the mainstay in trauma resuscitation of the critically battle injured. In austere medical environments, access to packed red blood cells, apheresis platelets, and fresh frozen plasma is often limited. Transfusion of warm, fresh whole blood (FWB) has been used to augment limited access to full BCT in these settings. The main limitation of FWB is that it is not readily available for transfusion on casualty arrival. This small case series evaluates the impact early, mechanism-of-injury (MOI)-based, preactivation of the walking blood bank has on time to transfusion. We report an average time of 18 minutes to FWB transfusion from patient arrival. Early activation of the walking blood bank based on prehospital MOI may further reduce the time to FWB transfusion.

  16. [Prescribing and performing autologous blood transfusion: experience at a University Medical Center].

    Science.gov (United States)

    Bregeon, Y F; Grouille, D; Roussanne, A; Lathelize, M; Feiss, P

    1995-01-01

    Prescription and carrying out of autologous blood transfusion in a university hospital during a whole year (1992) were investigated. 554 patients were involved. 88% of them gave at least one blood unit. Three surgical groups are specified: cardiac surgery with bypass (95 patients), orthopaedic procedures with knee or hip replacement or spine surgery (276 patients) and other types of surgery (117 patients). Prescriptions of blood donation before cardiac surgery were not carried out (by the transfusion centre) twice more often than in the other groups. This is why autologous blood taking is now effected in the anaesthetic unit. 88.9% (n = 434) of all patients did not receive homologous blood (90% in the orthopaedic group, 84% in the cardiac group). 25% of the collected units were not transfused. This figure is only 8% for the cardiac patients. An efficiency index is suggested taking in account the transfusion of autologous blood units and the need of homologous transfusion: % autologous used units x % procedures realized without homologous blood. The good rate to achieve could be 70%. In aorto-coronary bypass surgery when no autologous blood was collected preoperatively, 57.5% patients received homologous blood vs 16% when at least one unit was predeposited. A short review of literature shows an increasing place of predeposited autotransfusion, with some limits in orthopaedic surgery where a combination of autologous blood donation and other erythrocytes saving methods appears to give the best results. Erythropoietin, critical haemoglobine concentration threshold, autologous transfusion in cancer patients still need further studies.

  17. Ex-vivo expansion of red blood cells: How real for transfusion in humans?

    OpenAIRE

    Migliaccio, Anna Rita; Masselli, Elena; Varricchio, Lilian; Whitsett, Carolyn

    2011-01-01

    Blood transfusion is indispensable for modern medicine. In developed countries, the blood supply is adequate and safe but blood for alloimmunized patients is often unavailable. Concerns are increasing that donations may become inadequate in the future as the population ages prompting a search for alternative transfusion products. Improvements in culture conditions and proof-of-principle studies in animal models have suggested that ex-vivo expanded red cells may represent such a product. Compa...

  18. Presence of medication taken by blood donors in plasma for transfusion

    NARCIS (Netherlands)

    van Tilborgh-de Jong, A.J.W.; Wiersum-Osselton, J.C.; Touw, D.J.; Schipperus, M.R.

    2015-01-01

    Background and Objectives: The TRIP national hemovigilance and biovigilance office receives reports on side-effects and incidents associated with transfusion of labile blood products. Anaphylactic reactions accounted for the largest number of serious transfusion reactions in the period 2008-2012. In

  19. Informed consent in blood transfusion : Knowledge and administrative issues in Uganda hospitals

    NARCIS (Netherlands)

    Kajja, Isaac; Bimenya, Gabriel S.; Sibinga, Cees Th Smit

    2011-01-01

    Blood as a transplant is not free of risks. Clinicians and patients ought to know the parameters of a transfusion informed consent. A mixed methodology to explore patients' and clinicians' knowledge and opinions of administration and strategies to improve the transfusion informed consent process was

  20. Post-transfusion and maternal red blood cell alloimmunization in Uganda

    NARCIS (Netherlands)

    Natukunda, Bernard

    2013-01-01

    Over the last two decades, there has been substantial progress in the area of blood safety in Uganda. In contrast, little attention has been paid to transfusion safety in Uganda and there are gaps in laboratory and clinical transfusion practices within hospitals. Assessment of the current practice a

  1. Blood Transfusions in Total Hip and Knee Arthroplasty: An Analysis of Outcomes

    Directory of Open Access Journals (Sweden)

    Thomas Danninger

    2014-01-01

    Full Text Available Background. Various studies have raised concern of worse outcomes in patients receiving blood transfusions perioperatively compared to those who do not. In this study we attempted to determine the proportion of perioperative complications in the orthopedic population attributable to the use of a blood transfusion. Methods. Data from 400 hospitals in the United States were used to identify patients undergoing total hip or knee arthroplasty (THA and TKA from 2006 to 2010. Patient and health care demographics, as well as comorbidities and perioperative outcomes were compared. Multivariable logistic regression models were fitted to determine associations between transfusion, age, and comorbidities and various perioperative outcomes. Population attributable fraction (PAF was determined to measure the proportion of outcome attributable to transfusion and other risk factors. Results. Of 530,089 patients, 18.93% received a blood transfusion during their hospitalization. Patients requiring blood transfusion were significantly older and showed a higher comorbidity burden. In addition, these patients had significantly higher rates of major complications and a longer length of hospitalization. The logistic regression models showed that transfused patients were more likely to have adverse health outcomes than nontransfused patients. However, patients who were older or had preexisting diseases carried a higher risk than use of a transfusion for these outcomes. The need for a blood transfusion explained 9.51% (95% CI 9.12–9.90 of all major complications. Conclusions. Advanced age and high comorbidity may be responsible for a higher proportion of adverse outcomes in THA and TKA patients than blood transfusions.

  2. Red Blood Cell Transfusion Independence Following the Initiation of Iron Chelation Therapy in Myelodysplastic Syndrome

    Directory of Open Access Journals (Sweden)

    Maha A. Badawi

    2010-01-01

    Full Text Available Iron chelation therapy is often used to treat iron overload in patients requiring transfusion of red blood cells (RBC. A 76-year-old man with MDS type refractory cytopenia with multilineage dysplasia, intermediate-1 IPSS risk, was referred when he became transfusion dependent. He declined infusional chelation but subsequently accepted oral therapy. Following the initiation of chelation, RBC transfusion requirement ceased and he remained transfusion independent over 40 months later. Over the same time course, ferritin levels decreased but did not normalize. There have been eighteen other MDS patients reported showing improvement in hemoglobin level with iron chelation; nine became transfusion independent, nine had decreased transfusion requirements, and some showed improved trilineage myelopoiesis. The clinical features of these patients are summarized and possible mechanisms for such an effect of iron chelation on cytopenias are discussed.

  3. Intraoperative transfusion threshold and tissue oxygenation

    DEFF Research Database (Denmark)

    Nielsen, K; Dahl, B; Johansson, P I;

    2012-01-01

    Transfusion with allogeneic red blood cells (RBCs) may be needed to maintain oxygen delivery during major surgery, but the appropriate haemoglobin (Hb) concentration threshold has not been well established. We hypothesised that a higher level of Hb would be associated with improved subcutaneous...

  4. [Blood transfusion in the European Union: current status and future challenges].

    Science.gov (United States)

    Rouger, Philippe

    2006-01-01

    Blood transfusion is developing rapidly in the European Union. Though a compromise between technocrats, lobbies and blood transfusion professionals, the new specific EU directive (2002/98/EC) was a major step forward. In the future, blood transfusion in the EU must be centered on medical, scientific and social criteria, within a sound ethical and non commercial framework. Attention must be paid to the needs of patients and blood donors alike. The EuroNet-TMS survey is highly informative in this respect. National transfusion systems are extremely heterogeneous, ranging from public services to profit-oriented organizations. The approach to donors varies from one country and culture to another Some member states prescribe 2.5 times more blood products than others. Likewise, prevention and haemovigilance strategies are highly variable, with no attempt at harmonization.

  5. Rhesus Negative Woman Transfused With Rhesus Positive Blood: Subsequent Normal Pregnancy Without Anti D production.

    Science.gov (United States)

    Maya, E T; Buntugu, K A; Pobee, F; Srofenyoh, E K

    2015-03-01

    Clinicians sometimes are confronted with the challenge of transfusing haemorrhaging Rhesus (Rh) D negative patients with Rh D positive blood to save their lives. There are concerns about alloimmunization and future haemolytic disease of the newborn in women of the reproductive age. Another fear is transfusion reaction if they receive another Rh D positive blood in future. We present a 32-year-old Rh D negative woman, who had postpartum haemorrhage in her first pregnancy and was transfused with Rh D positive blood because of unavailability of Rh D negative blood. She did not receive anti D immunoglobin but subsequently had a normal term pregnancy of an Rh positive fetus without any detectable anti D antibodies throughout the pregnancy. In life threatening situations from obstetric haemorrhage, transfusion of Rh D negative women with Rh D positive blood should be considered as the last resort.

  6. Reduction of exposure to blood donors in preterm infants submitted to red blood cell transfusions using pediatric satellite packs

    Directory of Open Access Journals (Sweden)

    Cristina Lika Uezima

    2013-09-01

    Full Text Available OBJECTIVE: In preterm newborn infants transfused with erythrocytes stored up to 28 days, to compare the reduction of blood donor exposure in two groups of infants classified according to birth weight. METHODS: A prospective study was conducted with preterm infants with birth weight <1000g (Group 1 and 1000-1499g (Group 2, born between April, 2008 and December, 2009. Neonates submitted to exchange transfusions, emergency erythrocyte transfusion, or those who died in the first 24 hours of life were excluded. Transfusions were indicated according to the local guideline using pediatric transfusion satellite bags. Demographic and clinical data, besides number of transfusions and donors were assessed. . Logistic regression analysis was performed to determine factors associated with multiple transfusions. RESULTS: 30 and 48 neonates were included in Groups 1 and 2, respectively. The percentage of newborns with more than one erythrocyte transfusion (90 versus 11%, the median number of transfusions (3 versus 1 and the median of blood donors (2 versus 1 were higher in Group 1 (p<0.001, compared to Group 2. Among those with multiple transfusions, 14 (82% and one (50% presented 50% reduction in the number of blood donors, respectively in Groups 1 and 2. Factors associated with multiple transfusions were: birth weight <1000g (OR 11.91; 95%CI 2.14-66.27 and presence of arterial umbilical catheter (OR 8.59; 95%CI 1.94-38.13, adjusted for confounders. CONCLUSIONS: The efficacy of pediatrics satellites bags on blood donor reduction was higher in preterm infants with birth weight <1000g.

  7. Mass casualty events: blood transfusion emergency preparedness across the continuum of care.

    Science.gov (United States)

    Doughty, Heidi; Glasgow, Simon; Kristoffersen, Einar

    2016-04-01

    Transfusion support is a key enabler to the response to mass casualty events (MCEs). Transfusion demand and capability planning should be an integrated part of the medical planning process for emergency system preparedness. Historical reviews have recently supported demand planning for MCEs and mass gatherings; however, computer modeling offers greater insights for resource management. The challenge remains balancing demand and supply especially the demand for universal components such as group O red blood cells. The current prehospital and hospital capability has benefited from investment in the management of massive hemorrhage. The management of massive hemorrhage should address both hemorrhage control and hemostatic support. Labile blood components cannot be stockpiled and a large surge in demand is a challenge for transfusion providers. The use of blood components may need to be triaged and demand managed. Two contrasting models of transfusion planning for MCEs are described. Both illustrate an integrated approach to preparedness where blood transfusion services work closely with health care providers and the donor community. Preparedness includes appropriate stock management and resupply from other centers. However, the introduction of alternative transfusion products, transfusion triage, and the greater use of an emergency donor panel to provide whole blood may permit greater resilience.

  8. Strengthening of the Blood Safety System in the National Blood Transfusion Service - Implementation of the European Union IPA Project - at the Institute for Transfusion Medicine of the Republic of Macedonia

    Directory of Open Access Journals (Sweden)

    Rada M. Grubovic

    2014-09-01

    Full Text Available The Safety of the Blood Supply in any country is of utmost importance to safeguard patients from serious adverse events of blood transfusion. Implementation of a Quality System in the Blood Transfusion Service, with support of Government and Ministry of Health is a key element to guarantee safe blood. The IPA TAIB 2009 project - Strengthening of the Blood Safety System executed in 2013/14 provided the means to start implementing a Quality System in the Institute for Transfusion Medicine of the Republic of Macedonia. This project aimed to ultimately bring the Blood Transfusion Service to European Union standards, allowing the exchange of blood components and all other types of collaboration with other European Union countries in future. The project put the basis for unification of blood transfusion standards and operating procedures in the whole country as well as set up essential education of blood transfusion personnel.

  9. The history of blood transfusion prior to the 20th century--part 2.

    Science.gov (United States)

    Learoyd, P

    2012-12-01

    Although there are a number of descriptions of 'blood infusion' in antiquity, it was the publication of the discovery of the circulation of blood in 1628 by William Harvey and the work of Christopher Wren and Robert Boyle in 1663 on the infusion of different materials into dogs that paved the way to the possible practical attempts at actual blood transfusion. Although these early experiments, principally by Richard Lower in England and Jean Denis in France provided valuable information regarding inter-species incompatibility and the problems of blood coagulation, it was not until the work of James Blundell in the early part of the 19th century that blood transfusion was used as a means of blood replacement. However, blood transfusion was not to become an accepted therapeutic possibility until the discovery of practical anticoagulation and the ABO blood groups at the start of the 20th century.

  10. [The francophone Africa blood transfusion research network: a five-year report].

    Science.gov (United States)

    Tagny, Claude Tayou; Murphy, Edward L; Lefrère, Jean-Jacques

    2014-03-01

    There has been little blood safety research in sub-Saharan Africa, often consisting of local efforts whose findings had limited impact The "Francophone Africa Transfusion Research Network" was created in May 2007 with the objective of developing common evidence-based blood safety policies that may be adapted to each country's situation. The Group's activities to date have focused mainly on obtaining epidemiological and laboratory data on blood transfusion and on suggesting blood safety strategies, particularly in the field of TTIs. To carry out such research activities, the group works closely with the National Blood Transfusion Services (NBTS), the Regional Blood Transfusion Services (RBTS), the hospital blood banks (HBB) and collection stations. For the first 5years, four research priorities were identified: (i) descriptive studies of the characteristics of francophone African blood donors and blood centers; (ii) estimation of the residual risk of transfusion-transmitted major viral infections; (iii) an analysis of blood donor deferral strategies; and (iv) a description of TTI screening strategies and an external quality assurance system (EQAS) project. During this period, seven projects have been implemented at the national level and published and five multicenter studies were conducted and published. The present review reports the main observations and recommendations from those studies that could improve blood safety statute in Africa.

  11. Current issues relating to the transfusion of stored red blood cells.

    Science.gov (United States)

    Zimrin, A B; Hess, J R

    2009-02-01

    The development of blood storage systems allowed donation and transfusion to be separated in time and space. This separation has permitted the regionalization of donor services with subsequent economies of scale and improvements in the quality and availability of blood products. However, the availability of storage raises the question of how long blood products can and should be stored and how long they are safe and effective. The efficacy of red blood cells was originally measured as the increment in haematocrit and safety began with typing and the effort to reduce the risk of bacterial contamination. Appreciation of a growing list of storage lesions of red blood cells has developed with our increasing understanding of red blood cell physiology and our experience with red blood cell transfusion. However, other than frank haemolysis, rare episodes of bacterial contamination and overgrowth, the reduction of oxygen-carrying capacity associated with the failure of some transfused cells to circulate, and the toxicity of lysophospholipids released from membrane breakdown, storage-induced lesions have not had obvious correlations with safety or efficacy. The safety of red blood cell storage has also been approached in retrospective epidemiologic studies of transfused patients, but the results are frequently biased by the fact that sicker patients are transfused more often and blood banks do not issue blood products in a random order. Several large prospective studies of the safety of stored red blood cells are planned.

  12. [Correlation of hemogram changes during pregnancy of healthy women with postpartum blood transfusion].

    Science.gov (United States)

    Li, Hui; Chen, Lin-Feng; Wang, Shu-Ying; Wang, Yan; Shi, Hong-Mei; Wang, De-Qing

    2012-10-01

    This study was aimed to explore the correlation of hemogram changes during pregnancy of healthy women with postpartum blood transfusion. The outpatient and inpatient information of expectant lying-in women in our hospitals was collected, the route blood test, lever and kidney function and blood coagulation function tests were performed from the 4th to the 10th month of pregnancy. The pregnant women without underlying diseases and non-elderly pregnant women with single fetus were selected as the subjects of study. They were divided into postpartum blood transfusion group and non-blood transfusion group. The white blood cell (WBC) count, hemoglobin (Hb) level, platelet (Plt) count, plateletocrit (PCT), mean platelet volume (MPV), platelet distribution width (PDW) were compared in 2 groups. The results showed that 68 cases out of 450 expectant lying-in women received blood transfusion, among them 30 cases with complete data of puerperal transfusion were taken as blood transfusion group, the 28 cases of non transfusion puerperal as control group. There was no significant difference of hemogram changes between the two groups. However, there was a slight decline in Plt count and Hb level of late pregnant women. What is more, there was no correlation between Plt count change and the PCT, MPV and PDW. It is concluded that the changes of hemogram during pregnancy has no correlation with postpartum hemorrhage and blood transfusion in healthy pregnant women, the Plt count and Hb level of pregnant women slightly decline. Nevertheless, PCT, MPV and PDW are within the normal range.

  13. External financial aid to blood transfusion services in sub-Saharan Africa

    DEFF Research Database (Denmark)

    Ala, Fereydoun; Allain, Jean-Pierre; Bates, Imelda;

    2012-01-01

    Jean-Pierre Allain and colleagues argue that, while unintended, the foreign aid provided for blood transfusion services in sub-Saharan Africa has resulted in serious negative outcomes, which requires reflection and rethinking....

  14. Presence of medication taken by blood donors in plasma for transfusion

    NARCIS (Netherlands)

    Van Tilborgh, A.J.W.; Touw, D.J.; Wiersum-Osselton, J.C.; Zijlker-Jansen, P.Y.; Hudig, F.; Schipperus, M.R.

    2013-01-01

    Background: The TRIP national hemovigilance and biovigilance office receives reports on side effects and incidents associated with the transfusion of labile blood products. The findings are publicly reported in annual hemovigilance reports. The category of anaphylactic reaction, defined as allergic

  15. External financial aid to blood transfusion services in sub-Saharan Africa: a need for reflection.

    Directory of Open Access Journals (Sweden)

    Fereydoun Ala

    Full Text Available Jean-Pierre Allain and colleagues argue that, while unintended, the foreign aid provided for blood transfusion services in sub-Saharan Africa has resulted in serious negative outcomes, which requires reflection and rethinking.

  16. Efficacy and Safety of Frozen Blood for Transfusion in Trauma Patients - A Multi-Center Trial

    Science.gov (United States)

    2015-04-01

    shown to be a major risk factor for post-injury multiple organ failure [24,26,27,29,46,47]. Koch et al. found associations between age of blood...of stay, acute respiratory distress syndrome, acute renal failure, transfusion reaction, deep venous thrombosis , and mortality) were recorded. Acute...Blackwell J, Ciesla DJ, et al. Age of transfused blood is an independent risk factor for postinjury multiple organ failure. Am J Surg. 1999; 178(6):570

  17. Duration of red blood cell storage and survival of transfused patients (CME)

    DEFF Research Database (Denmark)

    Edgren, Gustaf; Kamper-Jørgensen, Mads; Eloranta, Sandra;

    2010-01-01

    Disquieting reports of increased complication and death rates after transfusions of red blood cells (RBCs) stored for more than 14 days prompted us to perform an observational retrospective cohort study of mortality in relation to storage time.......Disquieting reports of increased complication and death rates after transfusions of red blood cells (RBCs) stored for more than 14 days prompted us to perform an observational retrospective cohort study of mortality in relation to storage time....

  18. International Society of Blood Transfusion Working Party on red cell immunogenetics and blood group terminology: Cancun report (2012).

    Science.gov (United States)

    Storry, J R; Castilho, L; Daniels, G; Flegel, W A; Garratty, G; de Haas, M; Hyland, C; Lomas-Francis, C; Moulds, J M; Nogues, N; Olsson, M L; Poole, J; Reid, M E; Rouger, P; van der Schoot, E; Scott, M; Tani, Y; Yu, L-C; Wendel, S; Westhoff, C; Yahalom, V; Zelinski, T

    2014-07-01

    The International Society of Blood Transfusion Working Party on red cell immunogenetics and blood group terminology convened during the International congress in Cancun, July 2012. This report details the newly identified antigens in existing blood group systems and presents three new blood group systems.

  19. Influence of Perioperative Blood Transfusion on Prognosis in Patients with Colon Cancer

    Institute of Scientific and Technical Information of China (English)

    LIANG Han; WANG Xiaona; WANG Baogui; PAN Yuan; LIU Ning; WANG Dianchang; HAO Xishan

    2006-01-01

    Objective: To explore the influence of perioperative blood transfusion on the postoperative survival of patients with colon cancer. Methods: Univariate and multivariate retrospective analyses were performed on the survival in a total of 723 colon cancer patients which were treated surgically during a period of 10 years. Results: Kaplan-Meicr estimates showed that more than 800 mL perioperative blood transfusion was the survival predictor. Blood transfusion influenced significantly the prognosis of patients 40 years old and younger, those undergoing helicoloectomy left side, those with papillary adenocarcinoma,those with big tumors (diameter ≥8 em), those with stage I tumors, those with lymphatic node metastases and those without liver metastases. In multivariate analysis only the tumor location, radicality of operation, lymphatic invasion, liver metastasis, depth of tumor invasion and TNM stage retained their significance. Conclusion: Perioperative blood transfusion is the prognostic factor for patients with colon cancer to some extent. The indication of blood transfusion must be restricted strictly, specially in patients younger than 40 years old, with right side lesion, papillary adenocarcinoma, big tumors (diameter ≥8 em), stage I tumors and lymphatic node metastases or without liver metastases. But perioperative blood transfusion may not be deleterious for patients with staging Ⅳ disease and with distant metastases.

  20. Transfusion practice in coronary artery bypass surgeri in Denmark: a multicenter audit

    DEFF Research Database (Denmark)

    Andreasen, Jan J.; Westen, Mikkel; Pallesen, Peter A.

    2007-01-01

    Transfusion rates in coronary artery bypass grafting (CABG) continue to vary substantially, although guidelines for allogeneic transfusion have been developed. In order to evaluate ongoing transfusion practices, we performed a multicenter audit in four Danish hospitals regarding the use of alloge......Transfusion rates in coronary artery bypass grafting (CABG) continue to vary substantially, although guidelines for allogeneic transfusion have been developed. In order to evaluate ongoing transfusion practices, we performed a multicenter audit in four Danish hospitals regarding the use...... were discharged with a hemoglobin concentration >7 mmol/l, indicating inappropriate transfusions. The relative risk of receiving an allogeneic blood transfusion was 2.1 (95% CI: 1.6-2.7) in the hospital with the highest transfusion rate, after adjustment for patient-, drug-, and procedure......-related factors. Interesting differences in transfusion rates exists in Danish hospitals and these differences may reflect true variations in transfusion practices. Audits create a basis for educational efforts among surgeons and anesthesiologists to standardize transfusion practices....

  1. Saprochaete clavata invasive infection in a patient with severe aplastic anemia: Efficacy of voriconazole and liposomal amphotericin B with adjuvant granulocyte transfusions before neutrophil recovery following allogeneic bone marrow transplantation

    Directory of Open Access Journals (Sweden)

    Simon Favre

    2016-03-01

    Full Text Available We report a case of a 27-year old man with severe aplastic anemia who developed a Saprochaete clavata (Geotrichum clavatum disseminated invasive infection shortly prior a scheduled allogeneic bone marrow transplantation. Treatment with a combination of voriconazole, liposomal amphotericin B and adjuvant granulocyte transfusions was successful before neutrophil recovery.

  2. Ex-vivo expansion of red blood cells: how real for transfusion in humans?

    Science.gov (United States)

    Migliaccio, Anna Rita; Masselli, Elena; Varricchio, Lilian; Whitsett, Carolyn

    2012-03-01

    Blood transfusion is indispensable for modern medicine. In developed countries, the blood supply is adequate and safe but blood for alloimmunized patients is often unavailable. Concerns are increasing that donations may become inadequate in the future as the population ages prompting a search for alternative transfusion products. Improvements in culture conditions and proof-of-principle studies in animal models have suggested that ex-vivo expanded red cells may represent such a product. Compared to other cell therapies transfusion poses the unique challenge of requiring great cell doses (2.5×10(12) cells vs 10(7) cells). Although production of such cell numbers is theoretically possible, current technologies generate red cells in numbers sufficient only for safety studies. It is conceived that by the time these studies will be completed, technical barriers to mass cell production will have been eliminated making transfusion with ex-vivo generated red cells a reality.

  3. Analysis of blood transfusion predictors in patients undergoing elective oesophagectomy for cancer

    Directory of Open Access Journals (Sweden)

    Welch Neil T

    2008-01-01

    Full Text Available Abstract Background Oesophagectomy for cancers is a major operation with significant blood loss and usage. Concerns exist about the side effects of blood transfusion, cost and availability of donated blood. We are not aware of any previous study that has evaluated predictive factors for perioperative blood transfusion in patients undergoing elective oesophagectomy for cancer. This study aimed to audit the pattern of blood crossmatch and to evaluate factors predictive of transfusion requirements in oesophagectomy patients. Methods Data was collected from the database of all patients who underwent oesophagectomy for cancer over a 2-year period. Clinico-pathological data collected included patients demographics, clinical factors, tumour histopathological data, preoperative and discharge haemoglobin levels, total blood loss, number of units of blood crossmatched pre-, intra- and postoperatively, number of blood units transfused, crossmatched units reused for another patient and number of blood units wasted. Clinico-pathological variables were evaluated and logistic regression analysis was performed to determine which factors were predictive of blood transfusion. Results A total of 145 patients with a male to female ratio of 2.5:1 and median age of 68 (40–85 years were audited. The mean preoperative haemoglobin (Hb was 13.0 g/dl. 37% of males (Hb 70 years, Hb level Conclusion The cohort of patients audited was over-crossmatched. The identified independent predictors of blood transfusion should be considered in preoperative blood ordering for oesophagectomy patients. This study has directly led to a reduction in the maximum surgical blood-ordering schedule for oesophagectomy to 2 units and a reaudit is underway.

  4. MEDICAL PROFESSIONAL RESPONSIBILITY IN VIH CONTAGION AFTER BLOOD TRANSFUSIONS

    Directory of Open Access Journals (Sweden)

    R. Ortiz de Lejarazu Leonardo

    2005-01-01

    Full Text Available SUMMARYIn Spain a million and a half blood transfusions by year are carried out, that supposes between 2 and 10 cases of infection of VIH by year. The present state of science invites to do something more with tests to detect other virological and immunological markers, in order to identify seronegative carriers and thus avoid HIV transmission by them. We must consider the possibility to incur in professional responsibilities if we do not report adequate of this risk or if we do not provide patients all the cares that require, according to the state of the science so called lex artis.RESUMENEn España se realizan un millón y medio de transfusiones de sangre al año, lo que supone un riesgo de entre 2 y 10 casos de infección de VIH a través de las mismas. El estado actual de la ciencia invita a hacer algo más pudiéndose ampliar los estudios de marcadores víricos e inmunológicos, para identificar a portadores seronegativos y así tratar de evitar la transmisión del virus de inmunodeficiencia humana a través de ellos. Debemos considerar la posibilidad de incurrir en responsabilidades profesionales si no informamos adecuadamente de este riesgo o si no proporcionamos a los pacientes todos los cuidados que requieren, según el estado actual de la ciencia, lo que denominamos lex artis.

  5. Predictive factors for perioperative blood transfusion in surgeries for correction of idiopathic, neuromuscular or congenital scoliosis

    Directory of Open Access Journals (Sweden)

    Alexandre Fogaça Cristante

    2014-12-01

    Full Text Available OBJECTIVE: To evaluate the association of clinical and demographic variables in patients requiring blood transfusion during elective surgery to treat scoliosis with the aim of identifying markers predictive of the need for blood transfusion. METHODS: Based on the review of medical charts at a public university hospital, this retrospective study evaluated whether the following variables were associated with the need for red blood cell transfusion (measured by the number of packs used during scoliosis surgery: scoliotic angle, extent of arthrodesis (number of fused levels, sex of the patient, surgery duration and type of scoliosis (neuromuscular, congenital or idiopathic. RESULTS: Of the 94 patients evaluated in a 55-month period, none required a massive blood transfusion (most patients needed less than two red blood cell packs. The number of packs was not significantly associated with sex or type of scoliosis. The extent of arthrodesis (r = 0.103, surgery duration (r = 0.144 and scoliotic angle (r = 0.004 were weakly correlated with the need for blood transfusion. Linear regression analysis showed an association between the number of spine levels submitted to arthrodesis and the volume of blood used in transfusions (p = 0.001. CONCLUSION: This study did not reveal any evidence of a significant association between the need for red blood cell transfusion and scoliotic angle, sex or surgery duration in scoliosis correction surgery. Submission of more spinal levels to arthrodesis was associated with the use of a greater number of blood packs.

  6. Utilization and quality of cryopreserved red blood cells in transfusion medicine

    NARCIS (Netherlands)

    Henkelman, S.; Noorman, F.; Badloe, J. F.; Lagerberg, J. W. M.

    2015-01-01

    Cryopreserved (frozen) red blood cells have been used in transfusion medicine since the Vietnam war. The main method to freeze the red blood cells is by usage of glycerol. Although the usage of cryopreserved red blood cells was promising due to the prolonged storage time and the limited cellular det

  7. Intraoperative blood loss and blood transfusion requirements in patients undergoing orthognathic surgery.

    Science.gov (United States)

    Faverani, Leonardo Perez; Ramalho-Ferreira, Gabriel; Fabris, André Luis Silva; Polo, Tárik Ocon Braga; Poli, Guilherme Henrique Souza; Pastori, Cláudio Maldonado; Marzola, Clóvis; Assunção, Wirley Gonçalves; Garcia-Júnior, Idelmo Rangel

    2014-09-01

    Procedures for the surgical correction of dentofacial deformities may produce important complications, whether due to the potential for vascular injury or to prolonged surgery, both of which may lead to severe blood loss. Fluid replacement with crystalloid, colloid, or even blood products may be required. The aim of this study was to assess blood loss and transfusion requirements in 45 patients (18 males and 27 females; mean age 29.29 years, range 16-52 years) undergoing orthognathic surgery, assigned to one of two groups according to procedure type-rapid maxillary expansion or double-jaw orthognathic surgery. Preoperative hemoglobin and hematocrit levels and intraoperative blood loss were measured. There was a substantial individual variation in pre- and postoperative hemoglobin values (10.3-17 and 8.8-15.4 g/dL, respectively; p surgery and follow meticulous protocols to minimize the risks.

  8. Transfusion requirements in septic shock (TRISS) trial - comparing the effects and safety of liberal versus restrictive red blood cell transfusion in septic shock patients in the ICU

    DEFF Research Database (Denmark)

    Holst, Lars B; Haase, Nicolai; Wetterslev, Jørn

    2013-01-01

    BACKGROUND: Transfusion of red blood cells (RBC) is recommended in septic shock and the majority of these patients receive RBC transfusion in the intensive care unit (ICU). However, benefit and harm of RBCs have not been established in this group of high-risk patients. METHODS: The Transfusion...... and transfusion-related circulatory overload, and acute lung injury) and mortality at 28 days, 6 months and 1 year.The sample size will enable us to detect a 9% absolute difference in 90-day mortality assuming a 45% event rate with a type 1 error rate of 5% and power of 80%. An interim analysis will be performed...

  9. Red blood cells transfusions in oncological patients treated with radio- and chemoterapy

    Directory of Open Access Journals (Sweden)

    Antić Ana

    2011-01-01

    Full Text Available Background/Aim. Anemia is one of the most frequent hematology disorders in patients with malignant diseases. It has a great influence on reduction of the quality of life, so it requires early diagnosis and an adequate treatment. The aim of this study was to present and analyze the treatment of anemia using red blood cell transfusions in patients with malignancies, to analyze adequate use of red blood cell transfusions according to hemoglobin concentration, and also the influence of the treatment of malignant disease on the level of anemia and use of red blood cells transfusion. Methods. This retrospective analysis included the data on the use of red blood cells in Oncological Clinic of Clinical Center Niš in a period from the 1st January 2008 to the 31st December 2008. Results. None of the patients received the whole blood. In this period, 735 patients received 1,006 units of red blood cells (red blood cell concentrate, resuspended, washed, filtered. An average use of red blood cell transfusion was 1.37 unit per oncological patient who received transfusion. The use of red blood cell units was adequate (87.60% of patients received transfusion of red cells when Hgb < 80 g/L. During radio- and chemotherapy we noticed a decrease of hematological parameter values. The patients of the experimental group were dependant on red blood cells transfusion. Statistically, a significant decrease of hemoglobin level was observed in patients treated only with radiotherapy who are the greatest consumers of red blood cells. Two patients were registered who more likely to have febrile nonhemolytic transfusion reactions. Posttransfusion alloimmunization occurred in 0.68% of the patients. Conclusion. The use of red blood cells in oncological patients is in compliance with the up to date tendencies and recommendations published in clinical guidelines. For the purpose of efficient transfusion support in patients with malignant diseases, we have to follow the newest

  10. Almonte's great train disaster: Shaping nurses' roles and the civilian use of blood transfusion.

    Science.gov (United States)

    Toman, Cynthia

    2004-01-01

    Blood transfusion was initially a small-scale, labour-intensive therapy administered by physicians. Through the first decades of the 20th century, transfusion comprised a "last resort" measure used and tested primarily in the context of war. Media accounts of the Almonte train disaster on the night of 27 December 1942 linked survival to the newly established blood bank located 42 km east in Ottawa, Ontario. This event did not constitute a "first time" occurrence or a "great discovery" in the history of blood. But it did illustrate in a very visible and public manner that blood transfusion technology was now readily available for use in general hospitals and civilian populations. Canada had an infrastructure for the collection, processing, storage, and transportation of blood products, and for the recruitment of blood donors by the mid-1940s. As the need for blood declined toward the end of World War II, transfusion became a technology in need of application. The extension of transfusion to civilian populations, however, would require a ready source of labour-increased numbers of health care workers who were available continuously with the necessary knowledge and skills to assume the responsibility. Nurses were well situated for this technological role by a convergence of scientific, economic, labour, gender, professional, and educational influences that both facilitated and constrained blood transfusion as a nursing competency. This paper examines how the expanded use of one medical technology shaped related roles for nurses. Transfusion ultimately influenced nurses' work and the composition of the workforce as the first medical act "delegated" to nurses in Ontario (1947), setting a precedent for the delegation of further technologies over the next four decades.

  11. Raynaud's phenomenon in a child presenting as oxygen desaturation during transfusion with cold blood.

    Science.gov (United States)

    Zhang, Xiaopeng; Coté, Charles J

    2008-12-01

    We report a case of Raynaud's phenomenon (RP) triggered by transfusion of cold blood to a pediatric burn patient under general anesthesia. The child was febrile so a decision was made to not use a blood warmer. When the blood was rapidly administered the child suddenly developed 'desaturation'. The child was placed on 100% oxygen, adequate ventilation assured, and the color of his oral mucosa assessed as 'pink'. Placement of the oximeter on the opposite hand revealed 100% saturation. To our knowledge, this is the first case of apparent RP reported in a pediatric patient triggered by transfusion of cold blood.

  12. Transfusion audit of blood products using the World Health Organization Basic Information Sheet in Qazvin, Islamic Republic of Iran.

    Science.gov (United States)

    Sheikholeslami, H; Kani, C; Fallah-Abed, P; Lalooha, F; Mohammadi, N

    2012-12-04

    We assessed the practicality of using the transfusion Basic Information Sheet (BIS) for data collection, to determine the overall adequacy of physician documentation of blood product transfusion, and to make an audit of the appropriateness of blood product transfusion. The transfusion process and clinical indications for transfusions administered to adult hospitalized patients in 3 tertiary care teaching hospitals in Qazvin were prospectively reviewed. Adequate documentation was achieved in 62.6% of all transfusion episodes, range 41%-73%, depending on the medical specialty; 15.7% of red blood cells and whole blood requests, 40.8% of platelet requests and 34.1% of fresh frozen plasma requests were inappropriate. BIS-based information along with data collection can be used to provide feedback regarding the effectiveness of and compliance with local and national transfusion guidelines.

  13. [Results of Training for Personnel Involved in Blood-Transfusion Testing Outside of Regular Work Hours at Saga University Hospital].

    Science.gov (United States)

    Yamada, Marie; Yamada, Naotomo; Higashitani, Takanori; Ohta, Shoichiro; Sueoka, Eisaburo

    2015-11-01

    Laboratory testing prior to blood transfusion outside of regular hours in many hospitals and clinics is frequently conducted by technicians without sufficient experience in such testing work. To obtain consistent test results regardless of the degree of laboratory experience with blood transfusion testing, the number of facilities introducing automated equipment for testing prior to blood transfusion is increasing. Our hospital's blood transfusion department introduced fully automated test equipment in October of 2010 for use when blood transfusions are conducted outside of regular hours. However, excessive dependence on automated testing can lead to an inability to do manual blood typing or cross-match testing when necessitated by breakdowns in the automated test equipment, in the case of abnormal specimen reactions, or other such case. In addition, even outside of normal working hours there are more than a few instances in which transfusion must take place based on urgent communications from clinical staff, with the need for prompt and flexible timing of blood transfusion test and delivery of blood products. To address this situation, in 2010 we began training after-hours laboratory personnel in blood transfusion testing to provide practice using test tubes manually and to achieve greater understanding of blood transfusion test work (especially in cases of critical blood loss). Results of the training and difficulties in its implementation for such after-hours laboratory personnel at our hospital are presented and discussed in this paper. [Original

  14. Randomised comparison of leucocyte-depleted versus buffy-coat-poor blood transfusion and complications after colorectal surgery

    DEFF Research Database (Denmark)

    Jensen, L S; Kissmeyer-Nielsen, P; Wolff, B;

    1996-01-01

    surgery were randomised to receive buffy-coat poor (n = 299) or filtered leucocyte-depleted red-cells (n = 290) when transfusion was indicated. 260 patients actually received blood transfusion. Three patients were excluded from analysis. FINDINGS: The 142 patients randomised to and transfused with buffy...

  15. Prediction of postpartum blood transfusion – risk factors and recurrence

    DEFF Research Database (Denmark)

    Wikkelsø, Anne J; Hjortøe, Sofie; Gerds, Thomas A;

    2014-01-01

    OBJECTIVE: The aim was to find clinically useful risk factors for postpartum transfusion and to assess the joint predictive value in a population of women with a first and second delivery. METHODS: All Danish women with a first and second delivery from January 2001 to September 2009 who gave birth...... at a second vaginal delivery, and may also be used as an early predictor in parallel with a history of either placental abruption, postpartum transfusion or caesarean delivery. The positive predictive values of having more than one risk factor was low (2.2%-2.7%). CONCLUSIONS: Prediction of postpartum...

  16. A Systematic Review and Meta-Analysis of the Clinical Appropriateness of Blood Transfusion in China.

    Science.gov (United States)

    Zhu, Changtai; Gao, Yulu; Li, Zhiqiang; Li, Qinyun; Gao, Zongshuai; Liao, Yanqiu; Deng, Zhifeng

    2015-12-01

    The issue of the clinical appropriateness of blood transfusion has become a focus of transfusion medicine worldwide. In China, irrational uses of blood have often been reported in recent years. However, to date there lacks a systematic review of the rational uses of blood. This study aimed to determine the clinical appropriateness of blood transfusion in China. We searched PubMed, Web of Science, the Cochrane Library, China National Knowledge Infrastructure (CNKI), China Science and Technology Journal Database, WanFang Database, and Chinese BioMedical Literature Database, and the retrieval cut-off date was June 31, 2015. SPSS 17.0 and MetaAnalyst 3.13 were employed as the statistics tools in this review. A pooled rate of clinical inappropriateness of transfusion was analyzed by DerSimonian-Laird method. In this study, a total of 39 observational studies were included, which related to 75,132 cases of blood transfusion. According to the meta-analysis results, the overall incidence of clinical inappropriateness of transfusion in China was estimated to be 37.3% (95% confidence interval [CI] [32.1, 42.8]). The subgroup analyses revealed that the pooled rates of clinical inappropriateness of transfusion of plasma, red blood cells (RBCs), cryoprecipitate, and platelets were 56.3% (95% CI [45.8, 66.2]), 30.9% (95% CI [27.1, 35.0]), 25.2% (95% CI [13.2, 42.7]), and 14.1% (95% CI [8.8, 21.9]), respectively. However, the pooled incidence of inappropriateness of transfusion in operative departments was 47.5% (95% CI [36.8, 58.3]), which was significantly higher than that in nonoperative departments, 25.8% (95% CI [18.7, 34.4], P  0.05). In conclusion, China has suffered from a disadvantage in the clinical appropriateness of blood transfusion, especially in plasma and RBC use. In future, comprehensive measures should be implemented in order to improve the clinical appropriateness of blood transfusion.

  17. Requirements for blood and blood components intended for transfusion or for further manufacturing use. Final rule.

    Science.gov (United States)

    2015-05-22

    The Food and Drug Administration (FDA) is amending the regulations applicable to blood and blood components, including Source Plasma, to make the donor eligibility and testing requirements more consistent with current practices in the blood industry, to more closely align the regulations with current FDA recommendations, and to provide flexibility to accommodate advancing technology. In order to better assure the safety of the nation's blood supply and to help protect donor health, FDA is revising the requirements for blood establishments to test donors for infectious disease, and to determine that donors are eligible to donate and that donations are suitable for transfusion or further manufacture. FDA is also requiring establishments to evaluate donors for factors that may adversely affect the safety, purity, and potency of blood and blood components or the health of a donor during the donation process. Accordingly, these regulations establish requirements for donor education, donor history, and donor testing. These regulations also implement a flexible framework to help both FDA and industry to more effectively respond to new or emerging infectious agents that may affect blood product safety.

  18. Adverse blood transfusion reactions at tertiary care hospital

    Directory of Open Access Journals (Sweden)

    Surekha K. Chavan

    2016-06-01

    Conclusions: Not a single case of anaphylactic reactions, TRALI, acute immune hemolytic transfusion reaction, and Sepsis was observed. This can be an underestimation of the true incidence because of under reporting which can be improved by proper hemovigilence system to provide better patient care. [Int J Res Med Sci 2016; 4(6.000: 2402-2407

  19. The Use of Fresh Whole Blood Transfusions by the SOF Medic for Hemostatic Resuscitation in the Austere Environment

    Science.gov (United States)

    2010-11-24

    Injury; 30:619–622. 31. Miller , R. D., Robbins, T. O., et al. (1971). Coagulation de- fects associated with massive blood transfusions. Annals of...control. Critical Care; 8(Suppl):S57–S60. 37. American Society of Anesthesiologists Task Force on Peri- operative Blood Transfusion and Adjuvant... Anesthesiologists Task Force on Peri operative Blood Transfusion and Adjuvant Therapies. Anedthsiology;105(1):198-208. 38. Malone, D., Dunne, J. (2003

  20. Brazilian situation of blood component irradiation practice for the prevention of transfusion associated Graft-versus-Host disease

    Energy Technology Data Exchange (ETDEWEB)

    Goes, E.G.; Borges, J.C. [EE/COPPE-UFRJ (Brazil); Covas, D.T. [Faculdade deMedicina-USP-RP (Brazil); Motta, I. [Instituto Nacional do Cancer- Rio deJaneiro (Brazil)

    1998-12-31

    Transfusion-associated graft-versus-host disease (TA-GVHD) is a usually complication of transfusion of blood component containing T lymphocytes what recently has also involved immunocompetent patient. Gamma irradiation of cellular blood components has been the mainstay against TA-GVHD, nevertheless there is little information in the literature about current transfusion medicine practices regarding gamma irradiation of blood products. This work presents an overview of the Brazilian reality and suggests policies to optimize TA-GVHD prevention. (Author)

  1. Plasma and Plasma Protein Product Transfusion: A Canadian Blood Services Centre for Innovation Symposium.

    Science.gov (United States)

    Zeller, Michelle P; Al-Habsi, Khalid S; Golder, Mia; Walsh, Geraldine M; Sheffield, William P

    2015-07-01

    Plasma obtained via whole blood donation processing or via apheresis technology can either be transfused directly to patients or pooled and fractionated into plasma protein products that are concentrates of 1 or more purified plasma protein. The evidence base supporting clinical efficacy in most of the indications for which plasma is transfused is weak, whereas high-quality evidence supports the efficacy of plasma protein products in at least some of the clinical settings in which they are used. Transfusable plasma utilization remains composed in part of applications that fall outside of clinical practice guidelines. Plasma contains all of the soluble coagulation factors and is frequently transfused in efforts to restore or reinforce patient hemostasis. The biochemical complexities of coagulation have in recent years been rationalized in newer cell-based models that supplement the cascade hypothesis. Efforts to normalize widely used clinical hemostasis screening test values by plasma transfusion are thought to be misplaced, but superior rapid tests have been slow to emerge. The advent of non-vitamin K-dependent oral anticoagulants has brought new challenges to clinical laboratories in plasma testing and to clinicians needing to reverse non-vitamin K-dependent oral anticoagulants urgently. Current plasma-related controversies include prophylactic plasma transfusion before invasive procedures, plasma vs prothrombin complex concentrates for urgent warfarin reversal, and the utility of increased ratios of plasma to red blood cell units transfused in massive transfusion protocols. The first recombinant plasma protein products to reach the clinic were recombinant hemophilia treatment products, and these donor-free equivalents to factors VIII and IX are now being supplemented with novel products whose circulatory half-lives have been increased by chemical modification or genetic fusion. Achieving optimal plasma utilization is an ongoing challenge in the interconnected

  2. Acute iatrogenic polycythemia induced by massive red blood cell transfusion during subtotal abdominal colectomy

    Directory of Open Access Journals (Sweden)

    David Chiapaikeo

    2015-03-01

    Full Text Available A 46 year old man was transfused ten units of packed red blood cells during subtotal colectomy after intraoperative point-of-care testing values demonstrated hemoglobin values less than seven grams per deciliter (g/dL. A post-operative hemoglobin analyzed in a standard hematologic laboratory revealed a hemoglobin value of 27.8 g/dL. He underwent emergent red blood cell depletion therapy which decreased his hemoglobin to 7.5 g/dL. The physiologic consequences of iatrogenic polycythemia caused by massive transfusion during major abdominal surgery must take into account the fluid shifts that interplay between the osmotic load, viscosity of blood, and postoperative third spacing of fluid. Treatment of acute iatrogenic polycythemia can be effectively accomplished by red blood cell depletion therapy. However, fluid shifts caused by massive transfusion followed by rapid red cell depletion produce a unique physiologic state that is without a well-described algorithm for management.

  3. [Responsibility for prescribing and monitoring an act transfusion and safety blood transfusion].

    Science.gov (United States)

    Piercecchi-Marti, M D; Tuchtan-Torrents, L; Lassale, B; Leonetti, G; Bartoli, C

    2014-11-01

    The act to transfuse is a prescription following basic rules similar to drug prescriptions. If harm happens, potentially linked with this prescription, the harm's responsibility is borne by the physician, the paramedics, the care organization but by the supplier laboratory too. The setting of good practice rules consistent with science data at the time when the act is performed, the respect of the patient's rights and the quality of supplied products will be assessed during the expertise. Under restorative responsibility, it is necessary to previously establish a direct and certain causation between the litigious act and the harm to enforce the vicarious liability. Nowadays, legal precedents grant a larger protection to more and more numerous victims, enhancing the field of the fault with the appeal to assumption of fault. At the same time, the lawmaker himself promulgated objective conditions of compensation for many categories of victims of medical risk from which transfused people are part. The law of March the 4th of 2002 went one step closer devoting a new foundation of compensation: national solidarity.

  4. Seroprevalence of HBV and HCV in blood donors: A study from regional blood transfusion services of Nepal

    Directory of Open Access Journals (Sweden)

    Tiwari B

    2010-01-01

    Full Text Available Background and Objective : Hepatitis B and hepatitis C are significant health problems that might involve the late sequel of liver cirrhosis and hepatocellular carcinoma. A high prevalence of hepatitis B virus (HBV and hepatitis C virus (HCV in blood donors poses an increased risk of window period transmission through blood transfusion. The present study aimed to know the seroprevalence of hepatitis B virus (HBV and hepatitis C virus (HCV among blood donors in regional blood transfusion services of Nepal. Materials and Methods: This was a retrospective study conducted among blood donors in Banke (5,211, Morang (5,351, and Kaski (5,995 blood transfusion services. Serum samples were tested for hepatitis B surface antigen (HBsAg and anti-HCV antibodies using rapid enzyme immunoassays. The donors information was collected via the donor record register through their respective blood transfusion services. The software "Winpepi ver 3.8" was used for statistical analysis. Results: The seroprevalence rate of HBV was highest in the Banke (1.2% followed by Biratnagar (0.87% and Kaski (0.35% (P < 0.0001. The seroprevalence of HCV was highest in the Morang (0.26% followed by Kaski (0.16% and Banke (0.11% (P > 0.05. The seroprevalence of HBV was significantly higher than HCV in all three blood transfusion services. The burden of HBV as well as HCV seems to be higher in male donors (P > 0.05. Conclusion: The study revealed that the seroprevalence of HBV was alarmingly higher in two of the three blood transfusion services. Implementation of community-based preventive measures and improved strategies for safe blood supply might prove useful to decrease the seroprevalence.

  5. Progress Toward Strengthening National Blood Transfusion Services - 14 Countries, 2011-2014.

    Science.gov (United States)

    Chevalier, Michelle S; Kuehnert, Matthew; Basavaraju, Sridhar V; Bjork, Adam; Pitman, John P

    2016-02-12

    Blood transfusion is a life-saving medical intervention; however, challenges to the recruitment of voluntary, unpaid or otherwise nonremunerated whole blood donors and insufficient funding of national blood services and programs have created obstacles to collecting adequate supplies of safe blood in developing countries (1). Since 2004, the U.S. President's Emergency Plan for AIDS Relief (PEPFAR) has provided approximately $437 million in bilateral financial support to strengthen national blood transfusion services in 14 countries in sub-Saharan Africa and the Caribbean* that have high prevalence rates of human immunodeficiency virus (HIV) infections. CDC analyzed routinely collected surveillance data on annual blood collections and HIV prevalence among donated blood units for 2011-2014. This report updates previous CDC reports (2,3) on progress made by these 14 PEPFAR-supported countries in blood safety, summarizes challenges facing countries as they strive to meet World Health Organization (WHO) targets, and documents progress toward achieving the WHO target of 100% voluntary, nonremunerated blood donors by 2020 (4). During 2011-2014, overall blood collections among the 14 countries increased by 19%; countries with 100% voluntary, nonremunerated blood donations remained stable at eight, and, despite high national HIV prevalence rates, 12 of 14 countries reported an overall decrease in donated blood units that tested positive for HIV. Achieving safe and adequate national blood supplies remains a public health priority for WHO and countries worldwide. Continued success in improving blood safety and achieving WHO targets for blood quality and adequacy will depend on national government commitments to national blood transfusion services or blood programs through increased public financing and diversified funding mechanisms for transfusion-related activities.

  6. Alcohol-positive multiple trauma patients with and without blood transfusion: an outcome analysis

    Directory of Open Access Journals (Sweden)

    Stuttmann Ralph

    2009-03-01

    Full Text Available Abstract Background Blood transfusion is a common therapy for multiple trauma patients, and is often performed soon after hospital admission. It is unclear whether the need for a blood transfusion in multiply injured patients presenting with a positive blood alcohol concentration (BAC is associated with increased morbidity/mortality, since their risk behavior differs significantly from patients with a negative BAC. In this study, we evaluated the role of blood transfusion in the treatment of BAC-positive multiple trauma patients. Patients In a three-year period, 164 patients at a single trauma center presented with a positive BAC, and 145 met the inclusion criteria for further evaluation and regression analysis. We compared patients who were transfused (n = 76 with those who were not transfused (n = 69. Results In both groups, the most common causes of trauma were traffic accidents and falls. Most patients were admitted to the hospital from the scene of the accident (77.2% and were male (89.0%. Transfused patients had a lower GCS (p ≤ .001 and her ISS (p ≤ .001, were more likely to have severe head injuries (p ≤ .001, tended to have higher BACs (p = .053, had lower hemoglobin levels and prothrombin times in the first 24 hours (p ≤ .001, had lower lactate levels, had higher rates of intubation (p ≤ .001 and ICU admission, and had longer ICU stays and artificial ventilation times (p ≤ .001. Mortality was significantly higher in transfused patients (n = 15 vs. n = 3, p ≤ .001. Non-survivors were more likely to have severe head injuries; be intubated and ventilated; be older; have higher ISS scores, lactate levels, and numbers of transfusions in the first 24 hours; and have lower GCS scores, hemoglobin measurements, and prothrombin levels. In a binary logistic regression model, only age (p = .009 and ISS (p = .004 independently predicted mortality. Conclusion In our single-center study, the BAC of multiple trauma patients and the

  7. Decreasing the critical value of hemoglobin required for physician notification reduces the rate of blood transfusions

    Directory of Open Access Journals (Sweden)

    Larson EA

    2016-06-01

    Full Text Available Eric A Larson,1 Paul A Thompson,1,2 Zachary K Anderson,3 Keith A Anderson,4 Roxana A Lupu,1 Vicki Tigner,5 Wendell W Hoffman6,7 1Department of Internal Medicine, 2Department of Pediatrics, Sanford School of Medicine, University of South Dakota, Sioux Falls, SD, 3Department of Internal Medicine, Fairview Health Services, Edina, MN, 4Department of Laboratory Medicine, Sanford School of Medicine, University of South Dakota, 5Medical Staff Services, 6Department of Infectious Disease, Sanford Health, Sanford USD Medical Center, 7Department of Infectious Disease, Sanford School of Medicine, University of South Dakota, Sioux Falls, SD, USAAbstract: Red blood cell transfusions have been cited as one of the most overused therapeutic interventions in the USA. Excessively aggressive transfusion practices may be driven by mandatory physician notification of critical hemoglobin values that do not generally require transfusion. We examined the effect of decreasing the critical value of hemoglobin from 8 to 7 g/dL at our institution. Along with this change, mandatory provider notification for readings between 7 and 8 g/dL was rescinded. Transfusion rates were compared retrospectively during paired 5-month periods for patients presenting in three key hemoglobin ranges (6.00–6.99, 7.00–7.99, and 8.00–8.99 g/dL. A change in transfusion practices was hypothesized in the 7–8 g/dL range, which was no longer labeled critical and for which mandated physician calls were rescinded. Transfusion rates showed a statistically significant 8% decrease (P≤0.0001 during the 5-month period post change in our transfusion practices. This decrease in the 7.00–7.99 g/dL range was significantly greater than the 2% decrease observed in either the 6–6.99 g/dL (P=0.0017 or 8–8.99 g/dL (P≤0.0001 range. Cost savings of up to $700,000/year were extrapolated from our results showing 491 fewer units of red blood cells transfused during the 5-month post change. These cost

  8. The feasibility and physiological aspects of anesthesia and surgery without homologous blood transfusion

    NARCIS (Netherlands)

    R. Lapin (Ronny)

    1983-01-01

    textabstractThe modern practice of medicine has an ever-increasing dependency on the blood bank industry. Indeed, on many occasions there is an unwarranted and inappropriate use of hemotherapy. The first recorded blood transfusion was given to Pope Innocent VIII in 1492 (Narengo-Rowe, 1982). three b

  9. Improving health profile of blood donors as a consequence of transfusion safety efforts

    DEFF Research Database (Denmark)

    Edgren, Gustaf; Tran, Trung Nam; Hjalgrim, Henrik;

    2007-01-01

    BACKGROUND: Transfusion safety rests heavily on the health of blood donors. Although they are perceived as being healthier than average, little is known about their long-term disease patterns and to which extent the blood banks' continuous efforts to optimize donor selection has resulted in impro...

  10. Washing older blood units before transfusion reduces plasma iron and improves outcomes in experimental canine pneumonia.

    Science.gov (United States)

    Cortés-Puch, Irene; Wang, Dong; Sun, Junfeng; Solomon, Steven B; Remy, Kenneth E; Fernandez, Melinda; Feng, Jing; Kanias, Tamir; Bellavia, Landon; Sinchar, Derek; Perlegas, Andreas; Solomon, Michael A; Kelley, Walter E; Popovsky, Mark A; Gladwin, Mark T; Kim-Shapiro, Daniel B; Klein, Harvey G; Natanson, Charles

    2014-02-27

    In a randomized controlled blinded trial, 2-year-old purpose-bred beagles (n = 24), with Staphylococcus aureus pneumonia, were exchanged-transfused with either 7- or 42-day-old washed or unwashed canine universal donor blood (80 mL/kg in 4 divided doses). Washing red cells (RBC) before transfusion had a significantly different effect on canine survival, multiple organ injury, plasma iron, and cell-free hemoglobin (CFH) levels depending on the age of stored blood (all, P blood improved survival rates, shock score, lung injury, cardiac performance and liver function, and reduced levels of non-transferrin bound iron and plasma labile iron. In contrast, washing fresh blood worsened all these same clinical parameters and increased CFH levels. Our data indicate that transfusion of fresh blood, which results in less hemolysis, CFH, and iron release, is less toxic than transfusion of older blood in critically ill infected subjects. However, washing older blood prevented elevations in plasma circulating iron and improved survival and multiple organ injury in animals with an established pulmonary infection. Our data suggest that fresh blood should not be washed routinely because, in a setting of established infection, washed RBC are prone to release CFH and result in worsened clinical outcomes.

  11. Haemolysis following rapid experimental red blood cell transfusion--an evaluation of two infusion pumps

    DEFF Research Database (Denmark)

    Hansen, Tom Giedsing; Sprogøe-Jakobsen, U; Pedersen, C M;

    1998-01-01

    The vast majority of infusion pumps used for rapid transfusion of large amounts of blood have never been properly examined regarding their influence on the quality of the red blood cells (RBCs) infused. In this study, we evaluated the effect of two different infusion pumps on the degree of RBC...

  12. The EASTR Study: indications for transfusion and estimates of transfusion recipient numbers in hospitals supplied by the National Blood Service.

    Science.gov (United States)

    Wells, A W; Llewelyn, C A; Casbard, A; Johnson, A J; Amin, M; Ballard, S; Buck, J; Malfroy, M; Murphy, M F; Williamson, L M

    2009-12-01

    This study provides data on National Blood Service (NBS) red blood cell (RBC, n = 9142), platelet (PLT, n = 4232) and fresh frozen plasma (FFP, n = 3584) recipients independently sampled by monthly quota from 29 representative hospitals over 12 months in 2001-2002. Hospitals were stratified by size according to total yearly RBC issues. Transfusion indications were chosen from diagnostic and procedural codes, and recipients grouped into Epidemiology and Survival of Transfusion Recipients Case-mix Groups (E-CMGs). The main E-CMGs were digestive [19% of RBC recipients; including 5% gastrointestinal (GI) bleeds and 3% colorectal surgery], musculoskeletal (15%; 12% hip and knee replacement), haematology (13%) and obstetrics and gynaecology (10%). Renal failure, fractured neck of femur, cardiac artery by-pass grafting (CABG) and paediatrics, each accounted for 3-4% recipients. FFP recipients: the main E-CMGs were digestive (21% of FFP recipients; including 7% GI bleeds and 3% colorectal surgery), hepatobiliary (15%; 7% liver disease and 2% liver transplant), cardiac (12%) and paediatrics (9%) The renal, paediatrics, vascular and haematology E-CMGs each had 6-7% of recipients. PLT recipients: the main E-CMGs were haematology (27% of PLT recipients; including 9% lymphoma and 8% acute leukaemia), cardiac (17%), paediatrics (13%), hepatobiliary (10%) and digestive (9%). Back-weighting gave national estimates of 433 000 RBC, 57 500 FFP and 41 500 PLT recipients/year in England and North Wales, median age 69, 64 and 59 years, respectively. Digestive and hepatobiliary indications emerged as the top reason for transfusion in RBC and FFP recipients, and was also a frequent indication in PLT recipients.

  13. Metabolic pathways that correlate with post-transfusion circulation of stored murine red blood cells.

    Science.gov (United States)

    de Wolski, Karen; Fu, Xiaoyoun; Dumont, Larry J; Roback, John D; Waterman, Hayley; Odem-Davis, Katherine; Howie, Heather L; Zimring, James C

    2016-05-01

    Transfusion of red blood cells is a very common inpatient procedure, with more than 1 in 70 people in the USA receiving a red blood cell transfusion annually. However, stored red blood cells are a non-uniform product, based upon donor-to-donor variation in red blood cell storage biology. While thousands of biological parameters change in red blood cells over storage, it has remained unclear which changes correlate with function of the red blood cells, as opposed to being co-incidental changes. In the current report, a murine model of red blood cell storage/transfusion is applied across 13 genetically distinct mouse strains and combined with high resolution metabolomics to identify metabolic changes that correlated with red blood cell circulation post storage. Oxidation in general, and peroxidation of lipids in particular, emerged as changes that correlated with extreme statistical significance, including generation of dicarboxylic acids and monohydroxy fatty acids. In addition, differences in anti-oxidant pathways known to regulate oxidative stress on lipid membranes were identified. Finally, metabolites were identified that differed at the time the blood was harvested, and predict how the red blood cells perform after storage, allowing the potential to screen donors at time of collection. Together, these findings map out a new landscape in understanding metabolic changes during red blood cell storage as they relate to red blood cell circulation.

  14. A comparative assessment of nursing students' cognitive knowledge of blood transfusion using lecture and simulation.

    Science.gov (United States)

    Flood, Lisa S; Higbie, Julie

    2016-01-01

    Professional nurses must have the knowledge and skills to safely administer blood products and monitor for life-threatening complications. Nurse educators should ensure that student nurses also learn how to safely administer blood products; however students rarely have the opportunity to witness and manage adverse transfusion reactions. Despite the low incidence of rare adverse transfusion reactions, nursing students must be able to immediately recognize transfusion reactions, implement appropriate interventions, and communicate effectively with health care providers. To reinforce blood transfusion knowledge, practice technical skills, and promote management of adverse reactions, a human patient simulation experience was created for baccalaureate nursing students to provide application of related classroom content. Using a quasi-experimental design, students who received a related didactic lecture preceding the simulation were compared with students who did not receive the lecture. The lecture group's pre/posttest mean scores (n = 42) were significantly higher than the no lecture group's mean scores (n = 44). This simulation design included proper blood administration procedures, patient monitoring, management of transfusion reactions, and practice with interdisciplinary communication. Participation in a human patient simulation following a related didactic lecture may be useful to strengthen cognitive learning and help bridge the didactic-clinic gap.

  15. How do we transfuse blood components in cirrhotic patients undergoing gastrointestinal procedures?

    Science.gov (United States)

    Yates, Sean G; Gavva, Chakri; Agrawal, Deepak; Sarode, Ravi

    2016-04-01

    The liver plays a pivotal role in hemostasis. Consequently, patients with cirrhosis frequently demonstrate abnormal coagulation profiles on routine laboratory tests. These tests mainly reflect decreased procoagulant proteins. However, in cirrhosis, complex changes also occur in anticoagulant and fibrinolytic pathways. Recent evidence demonstrates that patients with cirrhosis exist in a state of hemostatic rebalance. Accordingly, routine tests inadequately represent hemostatic alterations in these patients. Unfortunately, these tests are regularly used to guide the transfusion of blood components with the assumption that they will correct laboratory abnormalities and improve hemostasis in a bleeding patient or prevent excessive bleeding following a procedure. With an absence of both accurate laboratory testing to assess hemostasis and evidence-based guidelines to direct the transfusion of blood components, management of patients with cirrhosis poses a significant challenge to clinicians. Therefore, we developed multidisciplinary guidelines for the periprocedural transfusion of blood components in patients with cirrhosis based on concurrent evidence and personal experience at our medical center.

  16. Circulating microRNAs as biomarkers for detection of autologous blood transfusion.

    Directory of Open Access Journals (Sweden)

    Nicolas Leuenberger

    Full Text Available MicroRNAs (miRNAs are small non-coding RNAs that regulate various biological processes. Cell-free miRNAs measured in blood plasma have emerged as specific and sensitive markers of physiological processes and disease. In this study, we investigated whether circulating miRNAs can serve as biomarkers for the detection of autologous blood transfusion, a major doping technique that is still undetectable. Plasma miRNA levels were analyzed using high-throughput quantitative real-time PCR. Plasma samples were obtained before and at several time points after autologous blood transfusion (blood bag storage time 42 days in 10 healthy subjects and 10 controls without transfusion. Other serum markers of erythropoiesis were determined in the same samples. Our results revealed a distinct change in the pattern of circulating miRNAs. Ten miRNAs were upregulated in transfusion samples compared with control samples. Among these, miR-30b, miR-30c, and miR-26b increased significantly and showed a 3.9-, 4.0-, and 3.0-fold change, respectively. The origin of these miRNAs was related to pulmonary and liver tissues. Erythropoietin (EPO concentration decreased after blood reinfusion. A combination of miRNAs and EPO measurement in a mathematical model enhanced the efficiency of autologous transfusion detection through miRNA analysis. Therefore, our results lay the foundation for the development of miRNAs as novel blood-based biomarkers to detect autologous transfusion.

  17. Blood transfusion to regulate the management of clinical transfusion affect behavior%输血管理对规范临床输血行为的影响

    Institute of Scientific and Technical Information of China (English)

    龙芸

    2013-01-01

      目的探讨输血管理对规范临床输血行为的影响。方法随机抽取我院2008年1月—10月(对照组)及2009年1月—6月(试验组)输血病历各200份,结合输血科登记及回收的资料,对比分析2组病历输血行为规范的情况。结果试验组在合理用血、输血申请、患者知情同意、输血前传染病筛查、医嘱、输血护理操作程序、不良反应回报及血袋回收等行为均明显较对照组规范,差异有统计学意义(P<0.01)。结论进行输血管理可以减少临床不规范行为,从而降低医疗风险,保证患者输血安全。%Objective to explore the clinical transfusion of blood transfusion management standard of the role. Methods random blood transfusions medical records from January 2008 to October 2009 (control group)and in January to June (group) the 200 copies,and,with a blood transfusion registration and recovery of material, the two groups were retrospectively analysis medical records and code of blood transfusion.Results the blood,blood transfusion in reasonable application,informed consent,patients before a blood transfusion infectious disease screening, and doctor's advice,blood transfusion nursing procedures,adverse reactions and return the department recycling and behavior are obvious standard than the control group,the difference was statistically significant(P<0.01).Conclusion blood transfusion management can reduce clinical irregularities,so as to reduce the risk on medical treatment,ensure patients'blood transfusion safety.

  18. Anti-Toxoplasma gondii Antibody Levels in Blood Supply of Shiraz Blood Transfusion Institute, Iran.

    Directory of Open Access Journals (Sweden)

    Minoo Shaddel

    2014-03-01

    Full Text Available The prevalence of Toxoplasma gondii infection in the blood donors has been poorly studied. The aim of this study was to assess the prevalence of acute and chronic toxoplasmosis in blood products.A total of 250 blood products (112 fresh frozen plasma and 138 packed cells in the Blood Transfusion Institute, Shiraz, Iran were tested for specific T. gondii antibodies (IgG and IgM by ELISA method in 2013. Positive IgG anti-T. gondii samples were further tested for IgM anti-T. gondii antibody. A positive IgG test with the negative and positive IgM test was interpreted as a chronic and acute toxoplasmosis, respectively. The relationship of jobs, blood types, sex, marital status and residency of participants with chronic toxoplasmosis prevalence were statistically analyzed by χ(2.Of 250 samples, 58 (23.2% and one were positive for IgG anti-T. T. gondii (chronic and IgM anti-T. T. gondii (acute antibodies levels, respectively. Twenty nine (25.9% of fresh frozen plasma (FFP samples were positive for IgG anti-T. gondiiiand 1(0.89% of them was positive for IgM anti-T. gondiii antibody. Thirty (21.74% of packed cell samples were positive for IgG anti-T. gondii antibody. The prevalence of chronic toxoplasmosis was significantly higher in workers, farmers, house wives, unemployed and free jobs (P=0.007, people with low education levels (P=0.035 and B type of blood ABO system (P=0.0001. However, there were no significant differences regarding to age, sex, marital status, residency and type of blood products.There were chronic and acute toxoplasmosis in blood products and the prevalence of toxoplasmosis especially chronic form was high. Therefore screening of blood for T. gondii antibodies may be considered.

  19. Jehovah's Witness parents' refusal of blood transfusions: Ethical considerations for psychologists.

    Science.gov (United States)

    Hoffman, Anna

    2016-08-01

    Psychologists in medical settings may be confronted with Jehovah's Witness parents refusing blood transfusions for their children as an ethical dilemma. The purpose of this discussion is to help psychologists provide informed, ethical consultations and support by investigating the values of the Jehovah's Witness community and the origin of the blood transfusion taboo, how medical and legal professionals have approached this dilemma, exploring relevant ethical principles and standards for psychologists, and suggestions for how to move toward a better understanding of harm with Jehovah's Witness families.

  20. Blood Trials: Transfusions, Injections, and Experiments in Africa, 1890-1920.

    Science.gov (United States)

    Sunseri, Thaddeus

    2016-07-01

    From about 1880 to 1920, a culture of medical experimentation promoted blood transfusion as a therapy for severe anemia in Europe, which was applied in German East Africa in 1892 for a case of blackwater fever, a complication of malaria afflicting mainly Europeans. This first case of blood transfusion in Africa, in which an African's blood was transfused into a German official, complicates the dominant narrative that blood transfusions in Africa came only after World War I. Medical researchers moreover experimented with blood serum therapies on human and animal subjects in Europe and Africa, injecting blood of different species, "races" and ethnicities into others to demonstrate parasite transmissibility and to discover vaccines for diseases such as malaria, sleeping sickness, and yellow fever. While research in German colonies is highlighted here, this was a transnational medical culture that crossed borders and oceans. This research is of interest as a possible early pathway for the epidemic spread of HIV and other zoonoses in Africa and the world, which biomedical researchers have identified as emerging in West-Central Africa sometime around the turn of the twentieth century.

  1. Alloimmunization is associated with older age of transfused red blood cells in sickle cell disease.

    Science.gov (United States)

    Desai, Payal C; Deal, Allison M; Pfaff, Emily R; Qaqish, Bahjat; Hebden, Leyna M; Park, Yara A; Ataga, Kenneth I

    2015-08-01

    Red blood cell (RBC) alloimmunization is a significant clinical complication of sickle cell disease (SCD). It can lead to difficulty with cross-matching for future transfusions and may sometimes trigger life-threatening delayed hemolytic transfusion reactions. We conducted a retrospective study to explore the association of clinical complications and age of RBC with alloimmunization in patients with SCD followed at a single institution from 2005 to 2012. One hundred and sixty six patients with a total of 488 RBC transfusions were evaluated. Nineteen patients (11%) developed new alloantibodies following blood transfusions during the period of review. The median age of RBC units was 20 days (interquartile range: 14-27 days). RBC antibody formation was significantly associated with the age of RBC units (P = 0.002), with a hazard ratio of 3.5 (95% CI: 1.71-7.11) for a RBC unit that was 7 days old and 9.8 (95% CI: 2.66-35.97) for a unit that was 35 days old, 28 days after the blood transfusion. No association was observed between RBC alloimmunization and acute vaso-occlusive complications. Although increased echocardiography-derived tricuspid regurgitant jet velocity (TRV) was associated with the presence of RBC alloantibodies (P = 0.02), TRV was not significantly associated with alloimmunization when adjusted for patient age and number of transfused RBC units. Our study suggests that RBC antibody formation is significantly associated with older age of RBCs at the time of transfusion. Prospective studies in patients with SCD are required to confirm this finding.

  2. Potential for Zika virus transmission through blood transfusion demonstrated during an outbreak in French Polynesia, November 2013 to February 2014.

    Science.gov (United States)

    Musso, D; Nhan, T; Robin, E; Roche, C; Bierlaire, D; Zisou, K; Shan Yan, A; Cao-Lormeau, V M; Broult, J

    2014-04-10

    Since October 2013, French Polynesia has experienced the largest documented outbreak of Zika virus (ZIKAV) infection. To prevent transmission of ZIKAV by blood transfusion, specific nucleic acid testing of blood donors was implemented. From November 2013 to February 2014: 42 (3%) of 1,505 blood donors, although asymptomatic at the time of blood donation, were found positive for ZIKAV by PCR. Our results serve to alert blood safety authorities about the risk of post-transfusion Zika fever.

  3. Nurses’ knowledge of blood transfusion in medical training centers of Shahrekord University of Medical Science in 2004

    OpenAIRE

    Aslani, Yosef; Etemadyfar, Shahram; Noryan, Kobra

    2010-01-01

    BACKGROUND: Using blood and blood components is a common therapeutic procedure in hospitals. Nurses have an important role in a safe blood transfusion. Therefore, it is crucial for nurses to have sufficient knowledge of situations, amount and methods of using blood components, possible side effects and necessary cares. This study investigated nurses’ knowledge of blood transfusion. METHODS: This was a cross-sectional descriptive study on 117 nurses in medical training hospitals of Shahrekord ...

  4. Blood transfusion improves renal oxygenation and renal function in sepsis-induced acute kidney injury in rats

    NARCIS (Netherlands)

    L. Zafrani (Lara); B. Ergin (Bulent); Kapucu, A. (Aysegul); C. Ince (Can)

    2016-01-01

    textabstractBackground: The effects of blood transfusion on renal microcirculation during sepsis are unknown. This study aimed to investigate the effect of blood transfusion on renal microvascular oxygenation and renal function during sepsis-induced acute kidney injury. Methods: Twenty-seven Wistar

  5. Transfusion of leukocyte-depleted red blood cells is not a risk factor for nosocomial infections in critically ill children

    NARCIS (Netherlands)

    van der Wal, Judith; van Heerde, Marc; Markhorst, Dick G.; Kneyber, Martin C. J.

    2011-01-01

    Objectives: Transfusion of red blood cells is increasingly linked with adverse outcomes in critically ill children. We tested the hypothesis that leukocyte-depleted red blood cell transfusions were independently associated with increased development of bloodstream infections, ventilator-associated p

  6. Influence of curve magnitude and other variables on operative time, blood loss and transfusion requirements in adolescent idiopathic scoliosis.

    LENUS (Irish Health Repository)

    Nugent, M

    2015-05-03

    Posterior spinal instrumentation and fusion for correction of adolescent idiopathic scoliosis (AIS) typically requires lengthy operating time and may be associated with significant blood loss and subsequent transfusion. This study aimed to identify factors predictive of duration of surgery, intraoperative blood loss and transfusion requirements in an Irish AIS cohort.

  7. The effect of blood transfusion and immunosuppression on organ graft survival : a study in dogs and rats

    NARCIS (Netherlands)

    G.J.C.M. Niessen

    1982-01-01

    textabstractSince the first preliminary report by Opelz et al. (1973a) on the beneficial effect of blood transfusions, it has gradually become evident that blood transfusions do have such an effect on renal allograft survival. Nevertheless, some physicians are still reluctant to adopt a deliberate b

  8. Postoperative autologous blood transfusion drain or no drain in primary total hip arthroplasty? A randomised controlled trial

    NARCIS (Netherlands)

    Horstmann, Wieger G.; Kuipers, Bart M.; Slappendel, Rob; Castelein, Rene M.; Kollen, Boudewijn J.; Verheyen, Cees C. P. M.

    2012-01-01

    Postoperative maintenance of high haemoglobin (Hb) levels and avoidance of homologous blood transfusions is important in total hip arthroplasty (THA). The introduction of a postoperative drainage autologous blood transfusion (ABT) system or no drainage following THA has resulted in reduction of homo

  9. Transfusion rate and prevalence of unexpected red blood cell alloantibodies in women undergoing hysterectomy for benign disease

    DEFF Research Database (Denmark)

    Thoestesen, Lisbeth M; Rasmussen, Kjeld L; Lauszus, Finn F;

    2011-01-01

    To determine transfusion rates, risk factors for transfusion and the prevalence of unexpected red blood cell alloantibodies in women undergoing hysterectomy for benign disease. In addition, we aimed to evaluate the necessity of the pretransfusion testing for red blood cell alloantibodies....

  10. Effect of Body Mass Index on Blood Transfusion in Total Hip and Knee Arthroplasty.

    Science.gov (United States)

    Frisch, Nicholas; Wessell, Nolan M; Charters, Michael; Peterson, Ed; Cann, Brett; Greenstein, Alex; Silverton, Craig D

    2016-09-01

    Perioperative blood management remains a challenge during total hip arthroplasty (THA) and total knee arthroplasty (TKA). The purpose of this study was to systematically examine the relationship between body mass index (BMI) and perioperative blood transfusion during THA and TKA while attempting to resolve conflicting results in previously published studies. The authors retrospectively evaluated 2399 patients, 896 of whom underwent THA and 1503 of whom underwent TKA. Various outcome variables were assessed for their relationship to BMI, which was stratified using the World Health Organization classification scheme (normal, 30 kg/m(2)). Among patients undergoing THA, transfusion rates were 34.8%, 27.6%, and 21.9% for normal, overweight, and obese patients, respectively (P=.002). Among patients undergoing TKA, transfusion rates were 17.3%, 11.4%, and 8.3% for normal, overweight, and obese patients, respectively (P=.002). Patients with an elevated BMI have decreased rates of blood transfusion following both THA and TKA. This same cohort also loses a significantly decreased percentage of estimated blood volume. No trends were identified for a relationship between BMI and deep venous thrombosis, pulmonary embolism, myocardial infarction, discharge location, length of stay, 30-day readmission rate, and preoperative hemoglobin level. Elevated BMI was significantly associated with increased estimated blood loss in patients undergoing THA and those undergoing TKA. There was a statistically significant trend toward increased deep surgical-site infection in patients undergoing THA (P=.043). Patients with increased BMI have lower rates of blood transfusion and lose a significantly smaller percentage of estimated blood volume following THA and TKA. [Orthopedics.2016; 39(5):e844-e849.].

  11. Immunomodulating effect of blood transfusion: is storage time important?

    DEFF Research Database (Denmark)

    Mynster, T; Dybkjoer, E; Kronborg, Gitte;

    1998-01-01

    in stimulating TNF-alpha and IL-2 release in an ex vivo assay. METHODS: Supernatants of 10 units of whole blood and 10 units of SAGM blood were collected after 1, 21 and 35 days of standard blood bank storage. Heparinized blood from 20 healthy volunteers (as 'recipients'), corresponding in ABO and Rh type...... to the stored blood, were used in a culture system with LPS and PHA as stimulators of TNF-alpha and IL-2 release. The effect of added supernatants, from either stored whole blood or SAGM blood, on cytokine release was evaluated compared to saline as control. TNF-alpha concentration was analyzed by ELISA after...

  12. Impact of Early Blood Transfusion After Kidney Transplantation on the Incidence of Donor-Specific Anti-HLA Antibodies.

    Science.gov (United States)

    Ferrandiz, I; Congy-Jolivet, N; Del Bello, A; Debiol, B; Trébern-Launay, K; Esposito, L; Milongo, D; Dörr, G; Rostaing, L; Kamar, N

    2016-09-01

    Little is known about the impact of posttransplant blood transfusion on the sensitization of anti-HLA antibodies and the formation of donor-specific antibodies (DSAs). The aims of our study were to determine the 1-year incidence of DSAs (assessed using a solid-phase assay) and antibody-mediated rejection (AMR) in kidney transplant patients who had or had not received a blood transfusion during the first year after transplantation. Included were 390 non-HLA-sensitized patients who had received an ABO-compatible kidney transplant and had not previously or simultaneously received a nonkidney transplant. Overall, 64% of patients received a red blood cell transfusion within the first year after transplantation, most within the first month. The overall 1-year incidence of DSAs was significantly higher in patients that had undergone transfusion (7.2% vs. 0.7% in patients with no transfusion, p transfusion group (n = 15, 6%) compared with the nontransfusion group (n = 2, 1.4%; p = 0.04). Blood transfusion was an independent predictive factor for de novo DSA formation but not for AMR. Patients who had a transfusion and developed DSAs were more often treated with cyclosporin A (n = 10, 55.5%) rather than tacrolimus (n = 45, 19.4%; p = 0.0001). In conclusion, early posttransplant blood transfusion may increase immunological risk, especially in underimmunosuppressed patients.

  13. Risk of cancer after blood transfusion from donors with subclinical cancer: a retrospective cohort study

    DEFF Research Database (Denmark)

    Edgren, Gustaf; Hjalgrim, Henrik; Reilly, Marie

    2007-01-01

    BACKGROUND: Although mechanisms for detection of short-term complications after blood transfusions are well developed, complications with delayed onset, notably transmission of chronic diseases such as cancer, have been difficult to assess. Our aim was to investigate the possible risk of cancer...... transmission from blood donors to recipients through blood transfusion. METHODS: We did a register-based retrospective cohort study of cancer incidence among patients who received blood from donors deemed to have a subclinical cancer at the time of donation. These precancerous donors were diagnosed...... with a cancer within 5 years of the donation. Data from all computerised blood bank registers in Sweden and Denmark gathered between 1968 and 2002 were merged into a common database. Demographic and medical data, including mortality and cancer incidence, were ascertained through linkages with nationwide...

  14. The Nlrp3 Inflammasome Does Not Regulate Alloimmunization to Transfused Red Blood Cells in Mice

    Directory of Open Access Journals (Sweden)

    David R. Gibb

    2016-07-01

    Full Text Available Red blood cell (RBC transfusions are essential for patients with hematological disorders and bone marrow failure syndromes. Despite ABO matching, RBC transfusions can lead to production of alloantibodies against “minor” blood group antigens. Non-ABO alloimmunization is a leading cause of transfusion-associated mortality in the U.S. Despite its clinical importance, little is known about the immunological factors that promote alloimmunization. Prior studies indicate that inflammatory conditions place patients at higher risk for alloimmunization. Additionally, co-exposure to pro-inflammatory pathogen associated molecular patterns (PAMPs promotes alloimmunization in animal models, suggesting that RBC alloimmunization depends on innate immune cell activation. However, the specific innate immune stimuli and sensors that induce a T cell-dependent alloantibody response to transfused RBCs have not been identified. The NLRP3 inflammasome senses chemically diverse PAMPs and damage associated molecular patterns (DAMPs, including extracellular ATP and iron-containing heme. We hypothesized that activation of the NLRP3 inflammasome by endogenous DAMPs from RBCs promotes the alloimmune response to a sterile RBC transfusion. Using genetically modified mice lacking either NLRP3 or multiple downstream inflammasome response elements, we ruled out a role for the NLRP3 inflammasome or any Caspase-1 or -11 dependent inflammasome in regulating RBC alloantibody production to a model antigen.

  15. Immunomodulating effect of blood transfusion: is storage time important?

    DEFF Research Database (Denmark)

    Mynster, T; Dybkjoer, E; Kronborg, Gitte;

    1998-01-01

    in stimulating TNF-alpha and IL-2 release in an ex vivo assay. METHODS: Supernatants of 10 units of whole blood and 10 units of SAGM blood were collected after 1, 21 and 35 days of standard blood bank storage. Heparinized blood from 20 healthy volunteers (as 'recipients'), corresponding in ABO and Rh type......OBJECTIVES: TNF-alpha and IL-2 are important cytokines in macrophage and T-lymphocyte activity against infection and dissemination of malignant cells. We studied the influence of supernatants from stored whole blood and buffy-coat-depleted SAGM (saline, adenine, glucose and mannitol) blood...... to the stored blood, were used in a culture system with LPS and PHA as stimulators of TNF-alpha and IL-2 release. The effect of added supernatants, from either stored whole blood or SAGM blood, on cytokine release was evaluated compared to saline as control. TNF-alpha concentration was analyzed by ELISA after...

  16. Sero - Prevalence of Viral Transfusion-transmissible Infections amongst voluntary Blood donors

    Directory of Open Access Journals (Sweden)

    Rashida Elrashid Mohamed Ali

    2016-02-01

    Full Text Available This study aimed to determine the Sero-prevalence of viral transfusion-transmissible Infectious diseases among blood donors, namely immunodeficiency virus, hepatitis B and C transmissible infections (TTIs like HBV, HCV. HIV (Human immune viruses.. sero-prevalence of viral transmissible infections. The donated blood for specific antibodies for infections agents. Can largely reduce the risk of TTIs, virus among blood donors. The study was carried out in the blood bank at Khartoum Teaching Hospital, centre, Sudan. Screening of blood samples for hepatitis B surface Antigen (HBsAg, Human immunodeficiency virus (HIV and hepatitis C virus (HCV Antibodies were done using (ELISA enzyme link immunoassay. The study included (1184 voluntary Blood donors, all were males. The overall prevalence of viral transfusion transmissible Infections were (11.84%. The sero-prevalence for antibody against HIV (6 and hepatitis C Virus was positive in 8 (0.06 and (0.08% donors respectively while HBsAg was detected in 98 (9.8% donors.  situation that need for strict criteria for selection of blood donors and also methods of laboratory assays. Services are high in Sudan due to the endemicity of infections like malaria, nutritional problem and obstetrical emergencies associated with blood loss. Little is known about the level of these infections in Sudan so; this study was conducted to investigate the sero-prevalence of transfusion transmissible viral infectious diseases in particular human B and hepatitis Immunodeficiency, hepatitis C viruses. The mode of transmission for HIV, HBV and HCV is the same and includes unsafe Sexual sharp materials Contact, using contaminated with body fluid, mother to Child and transfusion of blood and blood Products.

  17. Transfusion-associated hepatitis before the screening of blood for hepatitis risk factors

    DEFF Research Database (Denmark)

    Engle, Ronald E; Bukh, Jens; Alter, Harvey J

    2014-01-01

    from 66 patients undergoing open heart surgery in the 1960s were reevaluated with modern diagnostic tests to determine the incidence of TAH and its virologic causes. RESULTS: In this heavily transfused population receiving a mean of 20 units per patient of predominantly paid-donor blood, 30 of 66 (45...

  18. Two decades of risk factors and transfusion-transmissible infections in Dutch blood donors

    NARCIS (Netherlands)

    Slot, Ed; Janssen, Mart P.; Marijt-Van Der Kreek, Tanneke; Zaaijer, Hans L.; Van De Laar, Thijs J.

    2016-01-01

    BACKGROUND Risk behavior-based donor selection procedures are widely used to mitigate the risk of transfusion-transmissible infections (TTIs), but their effectiveness is disputed in countries with low residual risks of TTIs. STUDY DESIGN AND METHODS In 1995 to 2014, Dutch blood donors infected with

  19. Well being of obstetric patients on minimal blood transfusions (WOMB trial)

    NARCIS (Netherlands)

    B.W. Prick (Babette); E.A.P. Steegers (Eric); A.G. Jansen (Gerard); W.C.J. Hop (Wim); M.L.E. Essink-Bot (Marie-Louise); N.C.J. Peters; C.A. Uyl-de Groot (Carin); D.N.M. Papatsonis (Dimitri); B.M.C. Akerboom (Bettina); G.C.H. Metz (Godfried); H.A. Bremer (Henk); A.J. van Loon (Aren); R.H. Stigter (Rob); J.A.M. van der Post (Joris); M. van Alphen (Marcel); M. Porath (Martina); R.J.P. Rijnders (Robbert); M.E.A. Spaanderman; D.H. Schippers (Daniela); K.W.M. Bloemenkamp (Kitty); K.E. Boers (Kim); H.C.J. Scheepers; F.J.M.E. Roumen (Frans); A. Kwee (Anneke); N.W.E. Schuitemaker (Nico); B.W.J. Mol (Ben); D.J. van Rhenen (Dirk Jan); J.J. Duvekot (Johannes)

    2010-01-01

    textabstractBackground: Primary postpartum haemorrhage is an obstetrical emergency often causing acute anaemia that may require immediate red blood cell (RBC) transfusion. This anaemia results in symptoms such as fatigue, which may have major impact on the health-related quality of life. RBC transfu

  20. Utilization and quality of cryopreserved red blood cells in transfusion medicine.

    Science.gov (United States)

    Henkelman, S; Noorman, F; Badloe, J F; Lagerberg, J W M

    2015-02-01

    Cryopreserved (frozen) red blood cells have been used in transfusion medicine since the Vietnam war. The main method to freeze the red blood cells is by usage of glycerol. Although the usage of cryopreserved red blood cells was promising due to the prolonged storage time and the limited cellular deterioration at subzero temperatures, its usage have been hampered due to the more complex and labour intensive procedure and the limited shelf life of thawed products. Since the FDA approval of a closed (de) glycerolization procedure in 2002, allowing a prolonged postthaw storage of red blood cells up to 21 days at 2-6°C, cryopreserved red blood cells have become a more utilized blood product. Currently, cryopreserved red blood cells are mainly used in military operations and to stock red blood cells with rare phenotypes. Yet, cryopreserved red blood cells could also be useful to replenish temporary blood shortages, to prolong storage time before autologous transfusion and for IgA-deficient patients. This review describes the main methods to cryopreserve red blood cells, explores the quality of this blood product and highlights clinical settings in which cryopreserved red blood cells are or could be utilized.

  1. The Lost Art of Whole Blood Transfusion in Austere Environments

    Science.gov (United States)

    2015-04-01

    use of antiplatelet agents or blood thinners taken for underlying cardiovascu- lar conditions. It is just this patient subgroup, patients with... antiplatelet agents and blood thinners, helping promote clotting (Fig. 1). Practical Approach V How to Prepare the Expedition for a WFWB Backup As mentioned... anticoagulants and red cell additive solutions. Whole blood (approximately 450 mL of blood + 63 mL of preservation solution) has an average hematocrit

  2. Trends of transfusion transmissible diseases among blood donors at Uttarakhand, India

    Directory of Open Access Journals (Sweden)

    Gita Negi

    2014-01-01

    Full Text Available Context: Blood can save lives; however, it can be a source of transfusion transmitted diseases if proper screening of donated blood is not done. It is now mandatory to screen all donated blood units, whether replacement or voluntary for five transfusion transmitted diseases-namely human immunodeficiency virus (HIV, hepatitis B and C, syphilis, and malaria. Aims: The present study was done to study the prevalence of infectious disease markers among donors at the blood bank of a tertiary care center. Settings and Design: A total of 53,069 donors donated blood over 11 years. The number of replacement and voluntary donors was 41,710 and 11,359, respectively. Materials and Methods: Screening of blood units was done by enzyme-linked immunosorbent assay (ELISA method for HIV and hepatitis B and C. HIV testing was done using fourth generation ELISA kits. Syphilis was tested by latex agglutination assay and malaria was tested using slide method up to the year 2008-2009 and by rapid immunochromatographic assay after that. Results: The mean percentage of these infections per year was found to be 0.2, 1.2, 0.9, 0.3, and 0.002% for HIV, hepatitis B surface antigen (HBsAg, hepatitis C virus (HCV, syphilis, and malarial parasite (MP, respectively. Conclusions: The risk of transfusion transmissible infection (TTI today is low but supply of safe blood depends on proper donor selection and sensitive screening tests.

  3. Clinicians' satisfaction with a hospital blood transfusion service: a marketing analysis of a monopoly supplier.

    Science.gov (United States)

    Pennington, S J; McClelland, D B; Murphy, W G

    1993-12-01

    One of the objectives of the NHS reforms is to improve customer focus within the health service. In a study to assess the quality of customer service provided by the Edinburgh and South East Scotland Blood Transfusion Service a 19 item questionnaire survey of the main clinical users of the service was performed to ascertain their satisfaction, measured on a 5 point anchored scale, with important aspects of the service, including medical consultation, diagnostic services, blood and blood components or products and their delivery, and general satisfaction with the service. Of 122 clinicians in medical and surgical disciplines in five hospitals in Edinburgh, 72 (59%) replied. Fourteen (22%) indicated dissatisfaction with any aspect of the medical consultation service, owing to inadequate follow up of clinical contacts and unsatisfactory routing of incoming calls. Diagnostic services were criticised for the presentation, communication, and interpretation of results. The restricted availability of whole blood, the necessity to order platelets and plasma through the duty blood transfusion service doctor, and the use of a group and screen policy, attracted criticism from a small number of clinicians. Ten of 68 respondents expressed dissatisfaction with delivery of blood and components to the wards and theatres. The findings indicate that the clinicians served by this blood transfusion service are largely satisfied with the service. Changes are being implemented to improve reporting of laboratory results and measures taken to improve liaison with clinicians.

  4. Clinicians' satisfaction with a hospital blood transfusion service: a marketing analysis of a monopoly supplier.

    Science.gov (United States)

    Pennington, S J; McClelland, D B; Murphy, W G

    1993-01-01

    One of the objectives of the NHS reforms is to improve customer focus within the health service. In a study to assess the quality of customer service provided by the Edinburgh and South East Scotland Blood Transfusion Service a 19 item questionnaire survey of the main clinical users of the service was performed to ascertain their satisfaction, measured on a 5 point anchored scale, with important aspects of the service, including medical consultation, diagnostic services, blood and blood components or products and their delivery, and general satisfaction with the service. Of 122 clinicians in medical and surgical disciplines in five hospitals in Edinburgh, 72 (59%) replied. Fourteen (22%) indicated dissatisfaction with any aspect of the medical consultation service, owing to inadequate follow up of clinical contacts and unsatisfactory routing of incoming calls. Diagnostic services were criticised for the presentation, communication, and interpretation of results. The restricted availability of whole blood, the necessity to order platelets and plasma through the duty blood transfusion service doctor, and the use of a group and screen policy, attracted criticism from a small number of clinicians. Ten of 68 respondents expressed dissatisfaction with delivery of blood and components to the wards and theatres. The findings indicate that the clinicians served by this blood transfusion service are largely satisfied with the service. Changes are being implemented to improve reporting of laboratory results and measures taken to improve liaison with clinicians. PMID:10132458

  5. Hyperkalemia after irradiation of packed red blood cells: Possible effects with intravascular fetal transfusion

    Energy Technology Data Exchange (ETDEWEB)

    Thorp, J.A.; Plapp, F.V.; Cohen, G.R.; Yeast, J.D.; O' Kell, R.T.; Stephenson, S. (St. Luke' s Perinatal Center, Kansas City, MO (USA))

    1990-08-01

    Plasma potassium, calcium, and albumin concentrations in irradiated blood, and in fetal blood before and after transfusion, were measured. Dangerously high plasma potassium levels were observed in some units of irradiated packed red blood cells (range, 13.9 to 66.5 mEq/L; mean, 44.7 mEq/L) and could be one possible explanation for the high incidence of fetal arrhythmia associated with fetal intravascular transfusion. There are many factors operative in the preparation of irradiated packed red blood cells that may predispose to high potassium levels: the age of the red blood cells, the number of procedures used to concentrate the blood, the duration of time elapsed from concentration, the duration of time elapsed from irradiation, and the hematocrit. Use of fresh blood, avoidance of multiple packing procedures, limiting the hematocrit in the donor unit to less than or equal to 80%, and minimizing the time between concentration, irradiation and transfusion may minimize the potassium levels, and therefore making an additional washing procedure unnecessary.

  6. [Allogenic hematopoietic stem cell transplantation with unrelated cord blood: report of three cases from the Chilean cord blood bank].

    Science.gov (United States)

    Barriga, Francisco; Wietstruck, Angélica; Rojas, Nicolás; Bertin, Pablo; Pizarro, Isabel; Carmona, Amanda; Guilof, Alejandro; Rojas, Iván; Oyarzún, Enrique

    2013-08-01

    Public cord blood banks are a source of hematopoietic stem cells for patients with hematological diseases who lack a family donor and need allogeneic transplantation. In June 2007 we started a cord blood bank with units donated in three maternity wards in Santiago, Chile. We report the first three transplants done with cord blood units form this bank. Cord blood units were obtained by intrauterine collection at delivery. They were depleted of plasma and red cells and frozen in liquid nitrogen. Tests for total nucleated cells, CD34 cell content, viral serology, bacterial cultures and HLA A, B and DRB1 were done. Six hundred cord blood units were stored by March 2012. Three patients received allogeneic transplant with cord blood from our bank, two with high risk lymphoblastic leukemia and one with severe congenital anemia. They received conditioning regimens according to their disease and usual supportive care for unrelated donor transplantation until full hematopoietic and immune reconstitution was achieved. The three patients had early engraftment of neutrophils and platelets. The child corrected his anemia and the leukemia patients remain in complete remission. The post-transplant course was complicated with Epstein Barr virus, cytomegalovirus and BK virus infection. Two patients are fully functional 24 and 33 months after transplant, the third is still receiving immunosuppression.

  7. Storage time of transfused blood and disease recurrence after colorectal cancer surgery

    DEFF Research Database (Denmark)

    Mynster, T; Nielsen, Hans Jørgen

    2001-01-01

    of buffy-coat-depleted red cells suspended in saline, adenine, glucose, and mannitol blood for 21 days was used as cut-off point. RESULTS: Median follow-up was 6.8 years (range, 5.4 years to 7.9 years), and median overall survival was 4.6 years for 288 nontransfused patients and 3.0 years for 452...... complications. CONCLUSION: Transfusion of buffy-coat-depleted red cells suspended in saline, adenine, glucose, and mannitol blood stored for ... of the transfused blood. Therefore, we studied the relationship between blood storage time and the development of disease recurrence and long-term survival after colorectal cancer surgery. METHODS: Preoperative and postoperative data were prospectively recorded in 740 patients undergoing elective resection...

  8. Transfusão de sangue em terapia intensiva: um estudo epidemiológico observacional Blood transfusion in intensive care: an epidemiological observational study

    Directory of Open Access Journals (Sweden)

    José Rodolfo Rocco

    2006-09-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: A transfusão de concentrado de hemácias (CHA é muito freqüente no centro de tratamento intensivo (CTI, mas as conseqüências da anemia nos pacientes gravemente enfermos ainda são obscuras. Os objetivos desse estudo foram avaliar a freqüência, as indicações, os limiares transfusionais e o prognóstico dos pacientes criticamente enfermos que receberam CHA. MÉTODO: Estudo prospectivo de coorte realizado no CTI médico-cirúrgico de um Hospital Universitário durante 16 meses. Foram coletados dados demográficos, clínicos e os relacionados a transfusão de CHA. Regressão logística binária foi utilizada após as análises univariadas. RESULTADOS: Dos 698 pacientes internados, 244 (35% foram transfundidos com CHA. Os pacientes clínicos e em pós-operatório de urgência foram mais transfundidos. Os limiares transfusionais foram: hematócrito = 22,8% ± 4,5% e hemoglobina = 7,9 ± 1,4 g/dL. Os pacientes transfundidos receberam em média 4,4 ± 3,7 CHA e apresentaram maior letalidade no CTI (39,8% versus 13,2%; p 5 unidades e escore SAPS II. CONCLUSÕES: A transfusão de CHA é freqüente no CTI, particularmente nos pacientes internados por problemas clínicos e após cirurgias de emergência, com internação prolongada, em VM e com cirrose hepática. O limiar transfusional observado foi mais baixo que aquele assinalado pela literatura. A transfusão de CHA foi associada com maior letalidade.BACKGROUND AND OBJECTIVES: Packed red blood cell (PRBC transfusion is frequent in intensive care unit (ICU. However, the consequences of anemia in ICU patients are poorly understood. Our aim was to evaluate the prevalence, indications, pre-transfusion hematocrit and hemoglobin levels, and outcomes of ICU patients transfused with PRBC. METHODS: Prospective cohort study conducted at a medical-surgical ICU of a teaching hospital during a 16-month period. Patients' demographic, clinical, laboratory and transfusion-related data

  9. Extracellular vesicles in transfusion-related immunomodulation and the role of blood component manufacturing.

    Science.gov (United States)

    Almizraq, Ruqayyah J; Seghatchian, Jerard; Acker, Jason P

    2016-12-01

    There is an emerging interest in the risks posed by the ability of blood transfusion to modulate the immune system of recipients. Observational trials suggest that RBC transfusions may be associated with increased morbidity and mortality, however studies demonstrating the deleterious consequences of transfusion-related immunomodulation have had conflicting results. Efforts to understand the biological mechanisms responsible for TRIM are under way, and are focusing on the role that the extracellular vesicles (EVs) that accumulate in a red cell concentrate (RCC) during storage may play. EVs are heterogeneous submicron-sized vesicles that vary in size, composition and surface biomarkers. The biophysical and biochemical parameters of EVs reflect their mechanism of formation and cell sources. RCCs have been shown to contain a mixed population of EVs and not all EVs in RCC are solely from the constituent RBCs. The concentration of the different EVs (the RBC EVs and the non-RBC EVs), their composition, as well as their effects on the quality of the blood product vary depending on the manufacturing methods used to produce the RCC units. This article will review current evidence of the role of extracellular vesicles in transfusion-related immunomodulation and will discuss the impact that different methods used to collect, manufacture and store blood have on the composition and characteristics of EVs in RCCs.

  10. No major change in vCJD agent strain after secondary transmission via blood transfusion.

    Directory of Open Access Journals (Sweden)

    Matthew T Bishop

    Full Text Available BACKGROUND: The identification of transmission of variant Creutzfeldt-Jakob disease (vCJD by blood transfusion has prompted investigation to establish whether there has been any alteration in the vCJD agent following this route of secondary transmission. Any increase in virulence or host adaptation would require a reassessment of the risk analyses relating to the possibility of a significant secondary outbreak of vCJD. Since there are likely to be carriers of the vCJD agent in the general population, there is a potential for further infection by routes such as blood transfusion or contaminated surgical instruments. METHODOLOGY: We inoculated both wild-type and transgenic mice with material from the first case of transfusion associated vCJD infection. PRINCIPAL FINDINGS: The strain transmission properties of blood transfusion associated vCJD infection show remarkable similarities to the strain of vCJD associated with transmission from bovine spongiform encephalopathy (BSE. CONCLUSIONS: Although it has been hypothesized that adaptation of the BSE agent through secondary passage in humans may result in a greater risk of onward transmission due to an increased virulence of the agent for humans, our data presented here in two murine models suggest no significant alterations to transmission efficiency of the agent following human-to-human transmission of vCJD.

  11. Red Blood Cell Antigen Genotyping for Sickle Cell Disease, Thalassemia, and Other Transfusion Complications.

    Science.gov (United States)

    Fasano, Ross M; Chou, Stella T

    2016-10-01

    Since the discovery of the ABO blood group in the early 20th century, more than 300 blood group antigens have been categorized among 35 blood group systems. The molecular basis for most blood group antigens has been determined and demonstrates tremendous genetic diversity, particularly in the ABO and Rh systems. Several blood group genotyping assays have been developed, and 1 platform has been approved by the Food and Drug Administration as a "test of record," such that no phenotype confirmation with antisera is required. DNA-based red blood cell (RBC) phenotyping can overcome certain limitations of hemagglutination assays and is beneficial in many transfusion settings. Genotyping can be used to determine RBC antigen phenotypes in patients recently transfused or with interfering allo- or autoantibodies, to resolve discrepant serologic typing, and/or when typing antisera are not readily available. Molecular RBC antigen typing can facilitate complex antibody evaluations and guide RBC selection for patients with sickle cell disease (SCD), thalassemia, and autoimmune hemolytic anemia. High-resolution RH genotyping can identify variant RHD and RHCE in patients with SCD, which have been associated with alloimmunization. In the future, broader access to cost-efficient, high-resolution RBC genotyping technology for both patient and donor populations may be transformative for the field of transfusion medicine.

  12. Health-related quality of life in children with sickle cell anemia: impact of blood transfusion therapy.

    Science.gov (United States)

    Beverung, Lauren M; Strouse, John J; Hulbert, Monica L; Neville, Kathleen; Liem, Robert I; Inusa, Baba; Fuh, Beng; King, Allison; Meier, Emily Riehm; Casella, James; DeBaun, Michael R; Panepinto, Julie A

    2015-02-01

    The completion of the Multicenter Silent Infarct Transfusion Trial demonstrated that children with pre-existing silent cerebral infarct and sickle cell anemia (SCA) who received regular blood transfusion therapy had a 58% relative risk reduction of infarct recurrence when compared to observation. However, the total benefit of blood transfusion therapy, as assessed by the parents, was not measured against the burden of monthly blood transfusion therapy. In this planned ancillary study, we tested the hypothesis that a patient centered outcome, health-related quality of life (HRQL), would be greater in participants randomly assigned to the blood transfusion therapy group than the observation group. A total of 89% (175 of 196) of the randomly allocated participants had evaluable entry and exit HRQL evaluations. The increase in Change in Health, measured as the child's health being better, was significantly greater for the transfusion group than the observation group (difference estimate = -0.54, P ≤ 0.001). This study provides the first evidence that children with SCA who received regular blood transfusion therapy felt better and had better overall HRQL than those who did not receive transfusion therapy.

  13. Red blood transfusion in preterm infants: changes in glucose, electrolytes and acid base balance

    Directory of Open Access Journals (Sweden)

    Shereen Abdelghaffar

    2012-01-01

    Full Text Available Background: Preterm neonates comprise the most heavily transfused group of patients, and about 85% of extremely low birth weight newborns receive a transfusion by the end of their hospital stay. The aim of this study was to assess the possible metabolic effects of RBC transfusion on preterm infants, especially during the first 2 weeks of life, and its relation to blood volume. Materials and Methods: This study was conducted on 40 preterm neonates with gestational age of less than or equal to 34 weeks. They received RBCs transfusion during first 2 weeks of life. Venous blood samples of infants were collected 2 to 4 hours before and 1 hour after the end of transfusion to evaluate hemoglobin (Hb level, hematocrit, acid-base, electrolytes, and glucose status. Then, infants were classified into two main groups: those who received RBCs volume less than or 20 ml/kg and those who received RBCs volume more than 20 ml/kg. Results: Infants received a mean volume of 20.38 ± 3.2 ml/kg RBCs (range, 10.9 - 26.6 ml/kg at a median age of 9.8 ± 3.6 days. After transfusion, a significant increase of mean Hb (P<0.001, mean Hct (P<0.001, pH (P<0.001, pO 2 (P<0.05, and a significant decrease of the pCO2 (41.46 ± 8.8torr vs 35.4 ± 9.34 torr; P<0.001 were observed. In addition, there was a significant increase of serum K + (P<0.001, and a significant decrease of Ca +2 (P<0.001. A positive correlation was found between the K + intake and the changes of kalemia (r = 0.99; P = 0.00. Furthermore, we observed an inverse correlation between the patients′ calcium intake and the changes of calcemia (r = -0.35; P = 0.02. On comparing the changes in clinical and biochemical variables between two groups after transfusion, we observed a significant increase in mean Hb and Hct associated with a significant decrease in mean serum Ca +2 (P<0.001 in the group receiving the larger blood volume. Conclusion: RBC transfusion was effective in improving anemia, oxygenation, increasing

  14. Long term follow up of patients after allogeneic stem cell transplantation and transfusion of HSV-Tk transduced T-cells.

    Directory of Open Access Journals (Sweden)

    Eva Maria Weissinger

    2015-04-01

    Full Text Available Allogeneic stem cell transplantation (allo-HSCT is one of the curative treatments for hematologic malignancies, but is hampered by severe complications, such as acute or chronic graft-versus-host-disease (aGvHD; cGvHD and infections. CD34-selcetion of stem cells reduces the risk of aGvHD, but also leads to increased infectious complications and relapse. Thus, we studied the efficacy, safety and feasibility of transfer of gene modified donor T-cells shortly after allo-HSCT in two clinical trials between 2002 and 2007 and here we compare the results to unmodified donor leukocyte transfusion (DLI. The aim of these trials was to provide patients with the protection of T-cells after T-cell-depleted allo-HSCT in the matched or mismatched donor setting with an option to delete transduced T-cells, if severe aGvHD occurred within the trial period. Donor-T-cells were transduced with the replication-deficient retrovirus SFCMM-3, expressing HSV-Tk and the truncated LNGFR for selection of transduced cells. Transduced cells were transfused either after day +60 (matched donors or on day +42 (haploidentical donors.Nine patients were included in the first trial (MHH; 2002 until 2007 2 were included in TK007 (2005-2009 and 6 serve as a control group for outcome after haploidentical transplantation without HSV-TK-transduced DLI. Three patients developed acute GvHD, two had grade I of the skin, one had aGvHD on day +131 (post-HSCT; +89 post-HSV-Tk DLI grade II, which was successfully controlled by ganciclovir (GCV. Donor chimerism was stabilized after transfusion of the transduced cells in all patients treated. Functionality of HSV-Tk gene expressing T-cells was shown by loss of bcr-abl gene expression as well as by control of cytomegalovirus-reactivation. To date, 6patients have relapsed and died, 2 after a second HSCT without T-cell depletion or administration of unmodified T-cells. Eleven patients (7 post-HSV-Tk DLI are alive and well to date.

  15. Can inter-professional simulation training influence the frequency of blood transfusions after birth?

    Science.gov (United States)

    Egenberg, Signe; Øian, Pål; Bru, Lars Edvin; Sautter, Michael; Kristoffersen, Gunn; Eggebø, Torbjørn Moe

    2015-01-01

    Objective To investigate whether inter-professional simulation training influenced the rate of red blood cell (RBC) transfusions after birth. Design Two cohorts were compared retrospectively using a pre–post design. Setting Norwegian university hospital with 4800 deliveries annually. Population Women with estimated blood loss >500 mL within 24 h after birth in 2009 and 2011. Methods In 2010, all maternity staff attended a 6-h, scenario-based training on emergency obstetrics including postpartum hemorrhage, using a birthing simulator. The simulation focused on prevention, identification, and treatment of postpartum hemorrhage and on communication and leadership. Debrief immediately after the scenarios involved reflection and self-assessment. Main outcome measures The frequency of women receiving RBC transfusions as a marker for blood loss. Secondary outcome was the frequency of surgical procedures in the management of postpartum hemorrhage. Results In 2009, 111/534 (20.8%) women with estimated blood loss >500 mL after birth received RBC transfusions vs. 67/546 (12.3%) in 2011 (p < 0.01). The adjusted odds ratio for women receiving RBC transfusions in 2011 vs. 2009 was 0.53 (95% CI 0.38–0.74). Parity, oxytocin augmentation, duration of second stage, episiotomy, operative vaginal delivery, and sphincter injury were included in the final model. The odds ratio was stable in all combinations of possible confounders. We observed a significant reduction in the frequencies of curettage (p < 0.01) and uterine artery embolizations (p = 0.01). Conclusion We found a significant reduction in RBC transfusions after birth, which might be associated with mandatory simulation training. A causal link cannot be documented because of complex interactions of several variables. PMID:25545119

  16. [Blood Safety in the XXI century. Transfusion transmitted infectious diseases. International and Mexican view].

    Science.gov (United States)

    Rojo Medina, Julieta

    2014-01-01

    Currently worldwide, the transfusion of blood components cannot be done without residual risks, as compared to those countries with a high human development index, mostly in Europe, that have blood donation systems based on 100% repeat volunteer donors and use molecular biology techniques in screening for infectious diseases. In Latin America and the Caribbean countries, prevention of transfusion-transmissible diseases requires special and different strategies due to several factors: the high prevalence of replacement donors, their specific geographical location, climate, genetic, and sociocultural status of the population make them vulnerable to endemic diseases such as dengue, malaria, and Chagas disease. Thus it is necessary to create local approaches to increase blood safety and achieve the goals set by the Pan American Health Organization.

  17. Predicting Blood Transfusion Factors in Coronary Artery Bypass Surgery

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    L. Kasraian

    2007-04-01

    Full Text Available Introduction & Objective: The ability to predict the use of blood components during bypass surgery will improve the blood banks ability to provide efficient service.Materials and Methods: This is a retrospective cross-sectional study that was carried out on patients that underwent CABG in Shiraz Namazi hospital in 2004. The sample size was 480 and we did systematic random sampling, and a questionnaire contained factors that effect on blood need was filling out. Independent t-test, multivariate logistic regression and Poason correlation were used for data analysis.Results: The average age of patients was 59.15±10.6 years, 69.2% were male and the mean Hct before surgery was 39.86±6.38% and after operation was 32.68±5.84% and the duration of surgery was 2 hours and 48 minutes. The average of pack cell was 5.76±1.52 unit and average of FFP was 2.82±7.72 unit. There was not significant correlation between ages, weighs, Hct before and after, sex and pack cell use (P> 0.05. The use of pack cell and FFP were more in urgent surgery in diabetic patients and vascular disease (P< 0.05.Conclusion: It seems that the rate of blood demanding in proportion to blood use is logical but the rate of blood usage is more than blood usage in other countries with considering of immunological and non-immunological complication of blood products, the heart surgeons must do special concern about the making decision for blood use.

  18. The Prevalence of Transfusion Transmitted Infections in ABO Blood Groups and Rh Type System

    Science.gov (United States)

    Nigam, Jitendra Singh; Singh, Savitri; Kaur, Viplesh; Giri, Sumit; Kaushal, Ravi Prakash

    2014-01-01

    Screening of blood and blood products is important to reduce the risk of transfusion transmitted infections (TTIs). The transfusion of unscreened or inadequately screened blood and blood products are the major source of TTIs. The aim of this paper is to find out the prevalence of TTIs in ABO blood groups and Rh type system. A total of 4128 blood donors were screened from January 2010 to April 2014. Serological tests were performed for hepatitis B surface antigen (HBsAg), anti hepatitis C virus (Anti-HCV), anti HIV-1 and 2, venereal disease research Laboratory test (VDRL) and malaria parasite (MP) antigen. In seroreactive donors, HBsAg, Anti-HCV, VDRL, MP antigen and anti HIV were positive in 40 cases, 26 cases, 19 cases, 6 cases and 2 cases, respectively. Highest percentage of HBsAg, Anti HCV, VDRL, MP antigen and anti HIV was observed in blood group A negative (2/50), O negative (1/66), B negative (1/91), AB positive (2/377) blood group respectively. In the present study, the total number of Rhnegative donors is lower when compared to Rh-positive blood donors, but Rh-negative blood donors show higher percentages of seroreactivity for TTIs. Larger scale studies at molecular level are required to improve the knowledge of this aspect. PMID:25568761

  19. The prevalence of transfusion transmitted infections in ABO blood groups and Rh type system

    Directory of Open Access Journals (Sweden)

    Jitendra Singh Nigam

    2014-12-01

    Full Text Available Screening of blood and blood products is important to reduce the risk of transfusion transmitted infections (TTIs. The transfusion of unscreened or inadequately screened blood and blood products are the major source of TTIs. The aim of this paper is to find out the prevalence of TTIs in ABO blood groups and Rh type system. A total of 4128 blood donors were screened from January 2010 to April 2014. Serological tests were performed for hepatitis B surface antigen (HBsAg, anti hepatitis C virus (Anti-HCV, anti HIV-1 and 2, venereal disease research laboratory test (VDRL and malaria parasite (MP antigen. In seroreactive donors, HBsAg, Anti-HCV, VDRL, MP antigen and anti HIV were positive in 40 cases, 26 cases, 19 cases, 6 cases and 2 cases, respectively. Highest percentage of HBsAg, Anti HCV, VDRL, MP antigen and anti HIV was observed in blood group A negative (2/50, O negative (1/66, B negative (1/91, AB positive (2/377 blood group respectively. In the present study, the total number of Rh-negative donors is lower when compared to Rh-positive blood donors, but Rh-negative blood donors show higher percentages of seroreactivity for TTIs. Larger scale studies at molecular level are required to improve the knowledge of this aspect.

  20. Total knee arthroplasty: indication of blood transfusion according to hematimetric variation and clinical symptoms of hypoperfusion,

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    Rodrigo Tavares Cardozo

    2014-10-01

    Full Text Available Objective:To analyze the relationship between hematimetric variation and the presence of clinical symptoms of hypoperfusion for indicating blood transfusion in patients undergoing total knee arthroplasty.Methods:A retrospective analysis was conducted on data gathered from the medical files of 55 patients with a diagnosis of gonarthrosis, who underwent total knee arthroplasty at a hospital orthopedics and traumatology service between February 2011 and December 2012. The patients studied presented unilateral joint degeneration and fitted into the indications for surgical treatment. All the patients underwent a preoperative cardiological evaluation, presenting a pattern of ASA I–III and absence of blood dyscrasia, and preoperative hemoglobin measurements were made. However, no minimum hematimetric value was established for the surgical treatment; there were only clinical criteria for blood perfusion.Results:Among the 55 patients, 35 were female and 20 were male, and the mean age was 68 years. Six patients underwent homologous blood transfusion, because of their clinical condition of tissue hypoperfusion, persistent hypotension, loss of consciousness, sweating and coercible vomiting. They presented postoperative hemoglobin of 7.5–8.8 g/dL.Conclusion:For patients with falls in hemoglobin counts greater than 20% and values lower than 9 g/dL after the surgery, there is a possible need for blood transfusion, which should only be indicated when accompanied by major symptoms of tissue hypoperfusion.

  1. Lung function, transfusion, pulmonary capillary blood volume and sickle cell disease.

    Science.gov (United States)

    Lunt, Alan; McGhee, Emily; Robinson, Polly; Rees, David; Height, Susan; Greenough, Anne

    2016-02-01

    Lung function abnormalities occur in children with sickle cell disease (SCD) and may be associated with elevated pulmonary blood volume. To investigate that association, we determined whether blood transfusion in SCD children acutely increased pulmonary capillary blood volume (PCBV) and increased respiratory system resistance (Rrs5). Measurements of Rrs5 and spirometry were made before and after blood transfusion in 18 children, median age 14.2 (6.6-18.5) years. Diffusing capacity for carbon monoxide and nitric oxide were assessed to calculate the PCBV. Post transfusion, the median Rrs5 had increased from 127.4 to 141.3% predicted (pvolume from 39.7 to 64.1 ml/m2 (pvolume in one second (p=0.0056) and vital capacity (p=0.0008) decreased. The increase in Rrs5 correlated with the increase in PCBV (r=0.50, p=0.0493). Increased pulmonary capillary blood volume may at least partially explain the lung function abnormalities in SCD children.

  2. Nonpharmacological, blood conservation techniques for preventing neonatal anemia--effective and promising strategies for reducing transfusion.

    Science.gov (United States)

    Carroll, Patrick D; Widness, John A

    2012-08-01

    The development of anemia after birth in very premature, critically ill newborn infants is a universal well-described phenomenon. Although preventing anemia in this population, along with efforts to establish optimal red blood cell (RBC) transfusion and pharmacologic therapy continue to be actively investigated, the present review focuses exclusively on nonpharmacological approaches to the prevention and treatment of neonatal anemia. We begin with an overview of topics relevant to nonpharmacological techniques. These topics include neonatal and fetoplacental hemoglobin levels and blood volumes, clinical and laboratory practices applied in critically ill neonates, and current RBC transfusion practice guidelines. This is followed by a discussion of the most effective and promising nonpharmacological blood conservation strategies and techniques. Fortunately, many of these techniques are feasible in most neonatal intensive care units. When applied together, these techniques are more effective than existing pharmacotherapies in significantly decreasing neonatal RBC transfusions. They include increasing hemoglobin endowment and circulating blood volume at birth; removing less blood for laboratory testing; and optimizing nutrition.

  3. The effect of aspirin on blood loss and transfusion requirements in patients with femoral neck fractures.

    LENUS (Irish Health Repository)

    Manning, Brian J

    2012-02-03

    Although it is widely accepted that aspirin will increase the risk of intra- and post-operative bleeding, clinical studies have not consistently supported this assumption. We aimed to assess the effect of pre-operative aspirin on blood loss and transfusion requirements in patients undergoing emergency fixation of femoral neck fractures. A prospective case-control study was undertaken in patients presenting with femoral neck fractures. Parameters recorded included intra-operative blood loss, post-operative blood loss, transfusion requirements and peri-operative reduction in haemoglobin concentration. Of 89 patients presenting with femoral neck fractures 32 were on long-term aspirin therapy. Pre-operative aspirin ingestion did not significantly affect peri-operative blood loss, or change in haemoglobin concentration or haematocrit. However those patients taking aspirin pre-operatively had a significantly lower haemoglobin concentration and haematocrit and were more likely to be anaemic at presentation than those who were not receiving aspirin. Patients taking aspirin were also more likely to receive blood transfusion post-operatively.

  4. In-vitro stem cell derived red blood cells for transfusion: are we there yet?

    Science.gov (United States)

    Kim, Hyun Ok

    2014-03-01

    To date, the use of red blood cells (RBCs) produced from stem cells in vitro has not proved practical for routine transfusion. However, the perpetual and widespread shortage of blood products, problems related to transfusion-transmitted infections, and new emerging pathogens elicit an increasing demand for artificial blood. Worldwide efforts to achieve the goal of RBC production through stem cell research have received vast attention; however, problems with large-scale production and cost effectiveness have yet to prove practical usefulness. Some progress has been made, though, as cord blood stem cells and embryonic stem cells have shown an ability to differentiate and proliferate, and induced pluripotent stem cells have been shown to be an unlimited source for RBC production. However, transfusion of stem cell-derived RBCs still presents a number of challenges to overcome. This paper will summarize an up to date account of research and advances in stem cell-derived RBCs, delineate our laboratory protocol in producing RBCs from cord blood, and introduce the technological developments and limitations to current RBC production practices.

  5. Influence of antiplatelet-anticoagulant drugs on the need of blood components transfusion after vesical transurethral resection

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    Alvaro Julio Virseda-Rodríguez

    2015-07-01

    Full Text Available Aims: The effect of the antithrombotic preventive therapy on haemorrhage keeps uncertain. We investigate the influence of the antiplatelet and anticoagulant drugs (AP/AC drugs on the transfusion requirement after vesical transurethral resection (VTUR. We also describe the epidemiology of the blood components transfusion in our department. Materials and Methods: Retrospective observational study of a series of patients needing blood transfusion at the Urology Department between June 2010 and June 2013. Selection of 100 consecutive patients who were transfused after VTUR due to bladder transitional cell carcinoma (BTCC (group A = GA. Control group: 100 consecutive patients who underwent VTUR due to BTCC and were not transfused (group B = GB. Transfusion criteria: Haemoglobin < 8 g/dl + anaemia symptoms. Age, gender, associated AP/AC treatment, secondary diagnoses, toxics, tumour stage and grade were analysed. Results: 212 patients required transfusion of a blood component. 169 were men (79% and 43 women (21%. Median age 77.59 years (SD 9.42, range 50-92. Secondary diagnoses: Diabetes Mellitus 64%, high blood pressure 77%, dyslipidemia 52%. 60% of patients were previously treated with AP/AC drugs. Average Haemoglobin pre-transfusion values: 7.4 g/dl (DE ± 0.7. Average Haemoglobin post-transfusion values: 8.9 g/Dl (DE ± 0.72. Most frequent transfusion indications were bladder cancer (37%, kidney cancer (11%, prostate cancer (8%, benign prostatic hyperplasia (BHP (8%, other urological diagnoses (36%. Intraoperative transfusions indicated by the anaesthesiologist: kidney cancer (33%, BPH (28%. Patients who underwent VTUR due to BTCC were older in GA (77.59 years SD 9.42 than in GB (68.98 years SD 11.78 (p = 0.0001. Similar gender distribution (15 women in GA and 24 in GB. Less patients were asked to keep their treatment with ASA 100mg (AcetylSalicylicAcid in GA (25.64% than in GB (50% (p = 0.0330. More aggressive tumour grade in GA (p = 0.0003 and

  6. PHYSIOLOGIC TRANSFUSION TRIGGERS AND MASSIVE TRANSFUSION

    OpenAIRE

    Tánczos Krisztián; Molnár Zsolt

    2013-01-01

    Blood transfusion is often a life saving intervention, but can also be harmful. Restrictive transfusion protocols have recently been developed with a post transfusion target haemoglobin level of 70–100 g/l. Whether haemoglobin level on its own is enough to guide our transfusion policy is an important issue. This review was aimed to look at other possible, so called physiological indicators of blood transfusion what clinicians can be used in addition to haemoglobin during their everyday practi...

  7. Transfusion of platelets, but not of red blood cells, is independently associated with nosocomial infections in the critically ill

    NARCIS (Netherlands)

    Engele, Leo J.; Straat, Marleen; van Rooijen, Ingeborg H M; de Vooght, Karen M K; Cremer, Olaf L.; Schultz, Marcus J.; Bos, Lieuwe D J; Juffermans, Nicole P.

    2016-01-01

    Background: Red blood cell (RBC) transfusion has been associated with nosocomial infection in the critically ill patients. However, this association may be confounded by length of stay, as prolonged intensive care unit (ICU stay) increases both risk of infection and risk of transfusion. Also, it is

  8. Interventions to reduce wrong blood in tube errors in transfusion: a systematic review.

    Science.gov (United States)

    Cottrell, Susan; Watson, Douglas; Eyre, Toby A; Brunskill, Susan J; Dorée, Carolyn; Murphy, Michael F

    2013-10-01

    This systematic review addresses the issue of wrong blood in tube (WBIT). The objective was to identify interventions that have been implemented and the effectiveness of these interventions to reduce WBIT incidence in red blood cell transfusion. Eligible articles were identified through a comprehensive search of The Cochrane Library, MEDLINE, EMBASE, Cinahl, BNID, and the Transfusion Evidence Library to April 2013. Initial search criteria were wide including primary intervention or observational studies, case reports, expert opinion, and guidelines. There was no restriction by study type, language, or status. Publications before 1995, reviews or reports of a secondary nature, studies of sampling errors outwith transfusion, and articles involving animals were excluded. The primary outcome was a reduction in errors. Study characteristics, outcomes measured, and methodological quality were extracted by 2 authors independently. The principal method of analysis was descriptive. A total of 12,703 references were initially identified. Preliminary secondary screening by 2 reviewers reduced articles for detailed screening to 128 articles. Eleven articles were eventually identified as eligible, resulting in 9 independent studies being included in the review. The overall finding was that all the identified interventions reduced WBIT incidence. Five studies measured the effect of a single intervention, for example, changes to blood sample labeling, weekly feedback, handwritten transfusion requests, and an electronic transfusion system. Four studies reported multiple interventions including education, second check of ID at sampling, and confirmatory sampling. It was not clear which intervention was the most effective. Sustainability of the effectiveness of interventions was also unclear. Targeted interventions, either single or multiple, can lead to a reduction in WBIT; but the sustainability of effectiveness is uncertain. Data on the pre- and postimplementation of

  9. Non Infectious Complications Related to Blood Transfusion: An 11 year Retrospective Analysis in a Tertiary Care Hospital.

    Science.gov (United States)

    Philip, J; Pawar, A; Chatterjee, T; Mallhi, R S; Biswas, A K; Dimri, U

    2016-09-01

    In India transmission of transfusion transmissible infections (TTI) has shown a relative decrease as a result of mandatory screening of donated blood for TTI's. However, reducing the incidence of non infectious complications poses a major challenge, mainly due to the fact that a number of adverse reactions go unreported. Blood transfusion reaction, can be categorized based on the time interval between transfusion of blood products and the presentation of adverse reactions as acute i.e. those presenting during or within 24 h and as delayed i.e. those presenting anytime after 24 h. Transfusion reactions can further be classified as immune and non immune or infectious and non infectious based on the pathophysiology. In this retrospective study which was undertaken with an aim to determine the type and frequency of non infectious complications due to transfusion of blood and blood products recorded the incidence of febrile non hemolytic transfusion reactions (FNHTR) 51.40 %, allergic reactions 40.14 %, non immune hemolytic reactions 4.22 %, hypothermia 2.81 %, anaphylaxis 0.70 % and iron overload 0.70 %. FNHTR which was found to be the most common complication in this study can certainly be minimized, if not completely eliminated by adopting a policy of universal leucodepletion, the implementation of which solely depends on the financial and infrastructure resources available. This study also reiterates the importance of hemovigilance as a tool to improve the safety of blood transfusion.

  10. Contribution of the Retrovirus Epidemiology Donor Study (REDS to research on blood transfusion safety in Brazil

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    Paula Loureiro

    2014-04-01

    Full Text Available The Retrovirus Epidemiology Donor Study (REDS program was established in the United States in 1989 with the purpose of increasing blood transfusion safety in the context of the HIV/AIDS and human T-lymphotropic virus epidemics. REDS and its successor, REDS-II were at first conducted in the US, then expanded in 2006 to include international partnerships with Brazil and China. In 2011, a third wave of REDS renamed the Recipient Epidemiology and Donor Evaluation Study-III (REDS-III was launched. This seven-year research program focuses on both blood banking and transfusion medicine research in the United States of America, Brazil, China, and South Africa. The main goal of the international programs is to reduce and prevent the transmission of HIV/AIDS and other known and emerging infectious agents through transfusion, and to address research questions aimed at understanding global issues related to the availability of safe blood. This article describes the contribution of REDS-II to transfusion safety in Brazil. Articles published from 2010 to 2013 are summarized, including database analyses to characterize blood donors, deferral rates, and prevalence, incidence and residual risk of the main blood-borne infections. Specific studies were developed to understand donor motivation, the impact of the deferral questions, risk factors and molecular surveillance among HIV-positive donors, and the natural history of Chagas disease. The purpose of this review is to disseminate the acquired knowledge and briefly summarize the findings of the REDS-II studies conducted in Brazil as well as to introduce the scope of the REDS-III program that is now in progress and will continue through 2018.

  11. Blood transfusion practice in obstetric and gynecology: impact of educational programs to create awareness for judicious use of blood components.

    Science.gov (United States)

    Gupte, Snehalata C; Patel, Pratima N

    2014-09-01

    The study presents the data analysis (1) To find out the trend of blood component use during the period 2003-2010 and to determine impact of component awareness programs on reduction in whole blood (WB) and single unit transfusions. (2) To determine Hb trigger. The details about blood units issued were entered in the integrated blood bank management software as well as in Microsoft Excel. The data of 4,838 cases of pregnancy anemia; 2,244 receiving blood for obstetric (Ob) hemorrhage including 270 cases of disseminated intravascular coagulation; 1,413 women having Gynecological (Gy) bleeding; 911 Ob, 2,032 Gy and 740 surgeries for Gy malignancy were analyzed. During the years 2003-2010 there was gradual increase in component utilization for pregnancy anemia, Ob/Gy surgeries and Ob/Gy bleeding and significant reduction in WB transfusions due to component awareness programs. But single unit transfusions showed comparatively lower trend of reduction. The mean Hb was 6.4 g/dL for pregnancy anemia, 8.1 g/dL for surgeries and 7.3 g/dL for Ob/Gy bleeding.

  12. Transfusion transmittable infections - Seroprevalence among blood donors in a tertiary care hospital of Delhi

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    Sangeeta Pathak

    2013-01-01

    Full Text Available Context: Transfusion transmittable infections (TTI continue to be a major threat to safe transfusion practices. Blood is one of the major sources of transmission of infectious diseases viz. human immunodeficiency virus (HIV, hepatitis B virus (HBV, hepatitis C virus (HCV, syphilis, malaria, and many other infections in India. Screening assays for the infectious diseases with excellent sensitivity and specificity helps to enhance the safety of the blood transfusions reducing the diagnostic window period as much as possible. Aims: The present study was designed to determine the seroprevalence of TTIs viz., HIV, HCV, and HBV, among the blood donors in Max Super Specialty Hospital, New Delhi, India based on dual testing strategy using high sensitive screening assays such as enhanced chemiluminescence assay and nucleic acid testing (NAT. Materials and Methods: A total of 41207 blood units collected from the donors (both voluntary and replacement donors were screened for the TTI s, viz., anti HIV 1 and 2 antibody, anti HCV antibody, anti HBcore antibody, and HBsAg by enhanced chemiluminescence assay on VITROS ® ECiQ immunodiagnostics system. NAT was performed using Roche Cobas ® TaqScreen MPX assay, which can detect simultaneously HIV 1 (groups M and O, HIV-2, HCV, and HBV on Roche Cobas ® s201 system. Results: The seroprevalence of HIV, HBsAg, anti HBcore antibody, and HCV based on enhanced chemiluminescence assay was found to be 0.25, 0.2, 7.06, and 0.7%, respectively. A total number of 6587 samples from July 2010 to December 2010 were tested on NAT, of which 3 samples were reactive for HBV in NAT; this was missed by enhanced chemiluminescence assay. Conclusions: Based on the seroprevalence study of infectious diseases viz., HIV, HBV, and HCV, we conclude that screening of blood and blood components by dual testing strategy using high sensitivity serological assay like enhanced chemiluminescence technology and NAT helps in detecting the

  13. The role of comprehensive check at the blood bank reception on blood requisitions in detecting potential transfusion errors.

    Science.gov (United States)

    Jain, Ashish; Kumari, Sonam; Marwaha, Neelam; Sharma, Ratti Ram

    2015-06-01

    Pre-transfusion testing includes proper requisitions, compatibility testing and pre-release checks. Proper labelling of samples and blood units and accurate patient details check helps to minimize the risk of errors in transfusion. This study was aimed to identify requisition errors before compatibility testing. The study was conducted in the blood bank of a tertiary care hospital in north India over a period of 3 months. The requisitions were screened at the reception counter and inside the pre-transfusion testing laboratory for errors. This included checking the Central Registration number (C.R. No.) and name of patient on the requisition form and the sample label; appropriateness of sample container and sample label; incomplete requisitions; blood group discrepancy. Out of the 17,148 blood requisitions, 474 (2.76 %) requisition errors were detected before the compatibility testing. There were 192 (1.11 %) requisitions where the C.R. No. on the form and the sample were not tallying and in 70 (0.40 %) requisitions patient's name on the requisition form and the sample were different. Highest number of requisitions errors were observed in those received from the Emergency and Trauma services (27.38 %) followed by Medical wards (15.82 %) and the lowest number (3.16 %) of requisition errors were observed from Hematology and Oncology wards. C.R. No. error was the most common error observed in our study. Thus a careful check of the blood requisitions at the blood bank reception counter helps in identifying the potential transfusion errors.

  14. Red blood cells intended for transfusion : quality criteria revisited

    NARCIS (Netherlands)

    Hogman, CF; Meryman, HT

    2006-01-01

    Great variation exists with respect to viability and function of fresh and stored red blood cells (RBCs) as well as of the contents of RBC hemoglobin (Hb) in individual units. Improved technology is available for the preparation as well as the storage of RBCs. The authors raise the question whether

  15. Plasma free hemoglobin and microcirculatory response to fresh or old blood transfusions in sepsis.

    Directory of Open Access Journals (Sweden)

    Elisa Damiani

    Full Text Available Free hemoglobin (fHb may induce vasoconstriction by scavenging nitric oxide. It may increase in older blood units due to storage lesions. This study evaluated whether old red blood cell transfusion increases plasma fHb in sepsis and how the microvascular response may be affected.This is a secondary analysis of a randomized study. Twenty adult septic patients received either fresh or old (15 days storage, respectively RBC transfusions. fHb was measured in RBC units and in the plasma before and 1 hour after transfusion. Simultaneously, the sublingual microcirculation was assessed with sidestream-dark field imaging. The perfused boundary region was calculated as an index of glycocalyx damage. Tissue oxygen saturation (StO2 and Hb index (THI were measured with near-infrared spectroscopy and a vascular occlusion test was performed.Similar fHb levels were found in the supernatant of fresh and old RBC units. Despite this, plasma fHb increased in the old RBC group after transfusion (from 0.125 [0.098-0.219] mg/mL to 0.238 [0.163-0.369] mg/mL, p = 0.006. The sublingual microcirculation was unaltered in both groups, while THI increased. The change in plasma fHb was inversely correlated with the changes in total vessel density (r = -0.57 [95% confidence interval -0.82, -0.16], p = 0.008, De Backer score (r = -0.63 [95% confidence interval -0.84, -0.25], p = 0.003 and THI (r = -0.72 [95% confidence interval -0.88, -0.39], p = 0.0003.Old RBC transfusion was associated with an increase in plasma fHb in septic patients. Increasing plasma fHb levels were associated with decreased microvascular density.ClinicalTrials.gov NCT01584999.

  16. Thrombotic thrombocytopenic purpura secondary to ABO group incompatible blood transfusion in a patient after cardiac surgery

    Directory of Open Access Journals (Sweden)

    Yalcin Solak

    2013-01-01

    Full Text Available The triggers of secondary thrombotic thrombopcytopenic purpura (TTP include drug toxicity, radiation and high-dose chemotherapy, angioinvasive infections, surgery and acute graft versus host disease. TTP secondary to surgery have been reported in a number of cases. Most of the cases have been occurred after open heart surgery. Extensive endothelial damage is held responsible as the initiating mechanism in postoperative TTP cases. However, there is no report of secondary TTP describing development owing to ABO incompatible blood transfusion. Here, we describe a patient who developed TTP after transfusion of ABO incompatible blood during hospitalization for bypass surgery. We also propose a hypothesis which may account for the possible underlying mechanism.

  17. Accuracy of continuous noninvasive hemoglobin monitoring for the prediction of blood transfusions in trauma patients.

    Science.gov (United States)

    Galvagno, Samuel M; Hu, Peter; Yang, Shiming; Gao, Cheng; Hanna, David; Shackelford, Stacy; Mackenzie, Colin

    2015-12-01

    Early detection of hemorrhagic shock is required to facilitate prompt coordination of blood component therapy delivery to the bedside and to expedite performance of lifesaving interventions. Standard physical findings and vital signs are difficult to measure during the acute resuscitation stage, and these measures are often inaccurate until patients deteriorate to a state of decompensated shock. The aim of this study is to examine a severely injured trauma patient population to determine whether a noninvasive SpHb monitor can predict the need for urgent blood transfusion (universal donor or additional urgent blood transfusion) during the first 12 h of trauma patient resuscitation. We hypothesize that trends in continuous SpHb, combined with easily derived patient-specific factors, can identify the immediate need for transfusion in trauma patients. Subjects were enrolled if directly admitted to the trauma center, >17 years of age, and with a shock index (heart rate/systolic blood pressure) >0.62. Upon admission, a Masimo Radical-7 co-oximeter sensor (Masimo Corporation, Irvine, CA) was applied, providing measurement of continuous non-invasive hemoglobin (SpHb) levels. Blood was drawn and hemoglobin concentration analyzed and conventional pulse oximetry photopletysmograph signals were continuously recorded. Demographic information and both prehospital and admission vital signs were collected. The primary outcome was transfusion of at least one unit of packed red blood cells within 24 h of admission. Eight regression models (C1-C8) were evaluated for the prediction of blood use by comparing area under receiver operating curve (AUROC) at different time intervals after admission. 711 subjects had continuous vital signs waveforms available, to include heart rate (HR), SpHb and SpO2 trends. When SpHb was monitored for 15 min, SpHb did not increase AUROC for prediction of transfusion. The highest ROC was recorded for model C8 (age, sex, prehospital shock index, admission

  18. [Perioperative risk factors associated with allogeneic blood transfusion in patients with hip fracture surgery].

    Science.gov (United States)

    Durán-Nah, Jaime Jesús; Pastelín-Ruiz, Sofía Elisa; Miam-Viana, Emilio de Jesús

    2015-01-01

    Introducción: el objetivo es identificar los factores de riesgo asociados a la hemotransfusión alogénica en pacientes con cirugía de cadera realizada en un hospital general citadino, durante 2008 y 2009. Métodos: fueron considerados como casos 118 pacientes que recibieron sangre alogénica en el pre, el trans o en el postquirúrgico inmediato, y como controles 138 pacientes que tuvieron el mismo tipo de cirugía, pero no fueron hemotransfundidos. La relación entre variables se investigó utilizando un modelo de regresión logística del que se obtuvieron la razón de momios (RM) y los intervalos de confianza (IC) de 95 %. Resultados: se identificaron como factores de riesgo: el sangrado transquirúrgico mayor o igual a 400 ml (frente a < 400 ml, RM 5.68, IC 95 % 2.5 a 12.9, p = 0.007) y la concentración prequirúrgica de hemoglobina < 11 g/dL (frente a = 11 g/dL, RM 2.86, IC 95 % 1.5 a 5.6; p = 0.001); pero no la duración de la cirugía, el segmento femoral intervenido, la técnica quirúrgica ni la Hb postquirúrgica. Conclusiones: el sangrado transquirúrgico mayor o igual a 400 ml y la Hb prequirúrgica < 11 g/dL incrementaron el riesgo de hemotransfusión alogénica.

  19. Blood transfusion and the anaesthetist: management of massive haemorrhage

    Science.gov (United States)

    Thomas, D; Wee, M; Clyburn, P; Walker, I; Brohi, K; Collins, P; Doughty, H; Isaac, J; Mahoney, PF; Shewry, L

    2010-01-01

    Hospitals must have a major haemorrhage protocol in place and this should include clinical, laboratory and logistic responses. Immediate control of obvious bleeding is of paramount importance (pressure, tourniquet, haemostatic dressings). The major haemorrhage protocol must be mobilised immediately when a massive haemorrhage situation is declared. A fibrinogen 1.5 times normal represents established haemostatic failure and is predictive of microvascular bleeding. Early infusion of fresh frozen plasma (FFP; 15 ml.kg−1) should be used to prevent this occurring if a senior clinician anticipates a massive haemorrhage. Established coagulopathy will require more than 15 ml.kg−1 of FFP to correct. The most effective way to achieve fibrinogen replacement rapidly is by giving fibrinogen concentrate or cryoprecipitate if fibrinogen is unavailable. 1:1:1 red cell:FFP:platelet regimens, as used by the military, are reserved for the most severely traumatised patients. A minimum target platelet count of 75 × 109.l−1 is appropriate in this clinical situation. Group-specific blood can be issued without performing an antibody screen because patients will have minimal circulating antibodies. O negative blood should only be used if blood is needed immediately. In hospitals where the need to treat massive haemorrhage is frequent, the use of locally developed shock packs may be helpful. Standard venous thromboprophylaxis should be commenced as soon as possible after haemostasis has been secured as patients develop a prothrombotic state following massive haemorrhage. PMID:20963925

  20. No evidence of transmission of chronic lymphocytic leukemia through blood transfusion

    DEFF Research Database (Denmark)

    Hjalgrim, Henrik; Rostgaard, Klaus; Vasan, Senthil K;

    2015-01-01

    Monoclonal B-cell lymphocytosis (MBL) is a precursor of chronic lymphocytic leukemia (CLL). Observations of MBL in blood donors raise concern that transmitted MBL may cause recipient CLL. Using a database with health information on 1.5 million donors and 2.1 million recipients, we compared CLL oc...... transfusion experience over more than 30 years indicate that MBL/CLL transmission does not contribute importantly to recipient CLL risk....

  1. Automated Prediction of Early Blood Transfusion and Mortality in Trauma Patients

    Science.gov (United States)

    2014-09-24

    have recently been reviewed.29 Advanced radiologic tools such as CT scan and Focused As- sessment with Sonography in Trauma ( FAST ) scans and labo- ratory... trauma patients 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) Colin F. Mackenzie, MBChB, Yulei Wang, MS, Peter...13. SUPPLEMENTARY NOTES 14. ABSTRACT Prediction of blood transfusion needs and mortality for trauma patients in near real time is an unrealized goal

  2. Does a liberal national transfusion law assure blood safety? A survey of blood bank directors' perspectives in Lebanon.

    Science.gov (United States)

    Haddad, Antoine; Bou Assi, Tarek; Ammar, Walid; Baz, Elizabeth

    2013-11-01

    In transfusion medicine today, 'zero risk' has become a universal objective. Thus, we investigated whether the level of blood safety as defined by Lebanese legislation is satisfactory. Our work covered the period from September 2008 to June 2012. First, we studied each chapter in law and regulations, and compared them with the latest French regulations. The standards of Good Manufacturing Practice, characteristics of blood products and their storage, and the overall organization and haemovigilance for recipients and donors are not defined. Our analysis revealed numerous problems in today's blood safety situation. There is, for example, no clear definition or identification of the different blood safety components. Then, we conducted a national survey of blood bank directors to assess their perception of blood safety in Lebanon. Our survey revealed a negative perception (52.4 per cent) of the current blood safety situation, with more than 90 per cent of respondents in favor of national regulatory improvements.

  3. Effect of Plasma and Red Blood Cell Transfusions on Survival in Patients with Combat Related Traumatic Injuries

    Science.gov (United States)

    2007-10-01

    2006;46:2014–2027. 21. Vincent JL, Baron JF, Reinhart K, et al. Anemia and blood transfusion in critically ill patients. JAMA. 2002;288:1499–1507. 22...N, Moore EE, Sauaia A, Kenny -Moynihan M, Burch JM, Galloway B. Predicting life-threatening coagulopathy in the massively transfused trauma patient...is on acute mortality and does not represent effects on causes of mortality that occur beyond that point. We agree that the total amount of blood

  4. Successful implementation of a packed red blood cell and fresh frozen plasma transfusion protocol in the surgical intensive care unit.

    Directory of Open Access Journals (Sweden)

    Benjamin E Szpila

    Full Text Available Blood product transfusions are associated with increased morbidity and mortality. The purpose of this study was to determine if implementation of a restrictive protocol for packed red blood cell (PRBC and fresh frozen plasma (FFP transfusion safely reduces blood product utilization and costs in a surgical intensive care unit (SICU.We performed a retrospective, historical control analysis comparing before (PRE and after (POST implementation of a restrictive PRBC/FFP transfusion protocol for SICU patients. Univariate analysis was utilized to compare patient demographics and blood product transfusion totals between the PRE and POST cohorts. Multivariate logistic regression models were developed to determine if implementation of the restrictive transfusion protocol is an independent predictor of adverse outcomes after controlling for age, illness severity, and total blood products received.829 total patients were included in the analysis (PRE, n=372; POST, n=457. Despite higher mean age (56 vs. 52 years, p=0.01 and APACHE II scores (12.5 vs. 11.2, p=0.006, mean units transfused per patient were lower for both packed red blood cells (0.7 vs. 1.2, p=0.03 and fresh frozen plasma (0.3 vs. 1.2, p=0.007 in the POST compared to the PRE cohort, respectively. There was no difference in inpatient mortality between the PRE and POST cohorts (7.5% vs. 9.2%, p=0.39. There was a decreased risk of urinary tract infections (OR 0.47, 95%CI 0.28-0.80 in the POST cohort after controlling for age, illness severity and amount of blood products transfused.Implementation of a restrictive transfusion protocol can effectively reduce blood product utilization in critically ill surgical patients with no increase in morbidity or mortality.

  5. Dengue viremia in blood donors in Northern India: Challenges of emerging dengue outbreaks to blood transfusion safety

    Directory of Open Access Journals (Sweden)

    Sadhana Mangwana

    2015-01-01

    Full Text Available Backdround: Emerging infectious diseases pose threats to the general human population; including recipients of blood transfusions. Dengue is spreading rapidly to new areas and with increasing frequency of major outbreaks. Screening blood for dengue antigens in dengue-endemic countries would be costly and should, therefore, be recommended only after careful assessment of risk for infection and cost. Aim: A prospective study was conducted to establish the magnitude of the threat that dengue poses to blood safety where it is sporadic with seasonal variations, to quantify risk and to assess that whether screening is feasible and cost-effective. Materials and Methods: Nonstructural protein 1 (NS1 antigen test was done on 1709 donations during dengue outbreak in the months August to November 2013 as an additional test using Bio-Rad Platelia Dengue NS1AG test kit which is one step sandwich format microplate enzyme immunoassay using murine monoclonal antibodies for capture and revelation. Chi-square test was used to find statistical significance. Results and Conclusions: Majority cases were whole blood, replacement, male donors with 76.10% donors in <35 years age group. About 17.85% were single donor platelet donations. NS1 antigen in all donors was negative. In the past, dengue affected mainly children who do not donate blood. With the changing trend, mean age of infection increased affecting the population that does donate blood, further reducing blood donation pool. Further studies need to be done in different geographic regions of the country during dengue transmission season to establish maximum incidence of viremic donations, rates of transfusion transmission and clinical consequences in recipients. If risk is found to be substantial, decision will be taken by the policymakers at what threshold screening should be instituted to ensure safe blood transfusion.

  6. Solid-phase techniques in blood transfusion serology.

    Science.gov (United States)

    Beck, M L; Plapp, F V; Sinor, L T; Rachel, J M

    1986-01-01

    For nearly a century, erythrocyte agglutination has persisted as the most widely used method for the demonstration of antigen-antibody reaction in immunohematology. So far, no other system has been developed which can match its simplicity, versatility, and general reliability. The major disadvantage of agglutination reactions is the lack of an objective endpoint, which has severely hindered attempts to automate routine pretransfusion tests. To overcome this problem, we have designed a series of solid-phase assays for ABO and Rh grouping, antibody screening, compatibility, and hepatitis tests. Each of these solid-phase assays shares a common endpoint of red cell adherence, which is easily interpreted visually or spectrophotometrically. Computer interface permits the automatic interpretation and recording of results. We believe this solid-phase system should finally bring the blood bank laboratory into the age of automation.

  7. No Effect of a Bipolar Sealer on Total Blood Loss or Blood Transfusion in Nonseptic Revision Knee Arthroplasty-A Prospective Study With Matched Retrospective Controls

    DEFF Research Database (Denmark)

    Nielsen, Christian Skovgaard; Gromov, Kirill; Jans, Øivind;

    2017-01-01

    BACKGROUND: Postoperative anemia is frequent after revision of total knee arthroplasty (TKA) with reported transfusion rates up to 83%. Despite increased efforts of reducing blood loss and enhancing fast recovery within the fast-track setup, a considerable transfusion rate is still evident. The a...

  8. Red blood cell alloimmunization is influenced by the delay between Toll-like receptor agonist injection and transfusion.

    Science.gov (United States)

    Elayeb, Rahma; Tamagne, Marie; Bierling, Philippe; Noizat-Pirenne, France; Vingert, Benoît

    2016-02-01

    Murine models of red blood cell transfusion show that inflammation associated with viruses or methylated DNA promotes red blood cell alloimmunization. In vaccination studies, the intensity of antigen-specific responses depends on the delay between antigen and adjuvant administration, with a short delay limiting immune responses. In mouse models of alloimmunization, the delay between the injection of Toll-like receptor agonists and transfusion is usually short. In this study, we hypothesized that the timing of Toll-like receptor 3 agonist administration affects red blood cell alloimmunization. Poly(I:C), a Toll-like receptor 3 agonist, was administered to B10BR mice at various time points before the transfusion of HEL-expressing red blood cells. For each time point, we measured the activation of splenic HEL-presenting dendritic cells, HEL-specific CD4(+) T cells and anti-HEL antibodies in serum. The phenotype of activated immune cells depended on the delay between transfusion and Toll-like receptor-dependent inflammation. The production of anti-HEL antibodies was highest when transfusion occurred 7 days after agonist injection. The proportion of HEL-presenting CD8α(+) dendritic cells producing interleukin-12 was highest in mice injected with poly(I:C) 3 days before transfusion. Although the number of early-induced HEL-specific CD4(+) T cells was similar between groups, a high proportion of these cells expressed CD134, CD40 and CD44 in mice injected with poly(I:C) 7 days before transfusion. This study clearly shows that the delay between transfusion and Toll-like receptor-induced inflammation influences the immune response to transfused red blood cells.

  9. Platelet concentrates for topical use: bedside device and blood transfusion technology. Quality and versatility.

    Science.gov (United States)

    Borzini, Piero; Balbo, Valeria; Mazzucco, Laura

    2012-06-01

    More or less after a decade of experimental and pioneering manual procedures to prepare platelet-rich plasma (PRP) for topical use, several portable and bedside devices were made available to prepare the PRP at the point-of-care. This technical opportunity increased the number of patients who got access to the treatment with autologous PRP and PRP-gel. Since topical treatment of tissue with PRP and PRP-gel was restricted to autologous preparation, blood transfusion centers that professionally prepare donor-derived platelet concentrates were not able to cover the overwhelming request for autologous PRP supply. Principally for logistic and organization reasons blood transfusion centers usually fail the challenge of prompt delivery of PRP to the physician over large territory. Nevertheless the blood bank production of platelet concentrates is associated with high standardization and quality controls not achievable from bedside and portable devices. Furthermore it easy to demonstrate that high-volume blood bank-produced platelet concentrates are less expensive than low-volume PRP produced by portable and bedside devices. Taking also in consideration the ever-increasing safety of the blood components, the relationship between bedside device-produced and blood-bank-produced PRP might be reconsidered. Here we discuss this topic concluding that the variety of sources of PRP production is an opportunity for versatility and that, ultimately, versatility is an opportunity for the patient's care.

  10. HLA Chimerism in allogenic haplo-identical peripheral blood stem cell transplant

    Directory of Open Access Journals (Sweden)

    Chhaya Sonal

    2004-01-01

    Full Text Available HLA antigens were used as markers to establish the presence of chimerism (i.e. simultaneous presence of two lymphocyte populations from recipient as well as donor in a patient with chronic granulomatous disease treated with one haplotype matched stem cell transplant. Neutrophil engraftment occurred on Day 6 post peripheral blood stem cell transplant (PBSCT. Platelet counts were maintained above 20x10[9]/L. Six months after the allogenic PBSCT, lymphocyte population was chimeric and cells of both donor (father and host HLA type were present. The patient revealed a shift in his HLA antigen profile and there was evidence of donor cell engraftment. The HLA phenotype A26,CwXX,B8,DRB1FNx0103//A32,Cw4,B35,DRB1FNx0116// represented his true phenotype whereas A11,Cw7,B62,DRB1FNx0114 represented donor (father origin.. HLA system as a genetic marker is a useful additional approach to determine engraftment following an allogenic haplo-identical stem cell transplantation.

  11. All clinically-relevant blood components transmit prion disease following a single blood transfusion: a sheep model of vCJD.

    Directory of Open Access Journals (Sweden)

    Sandra McCutcheon

    Full Text Available Variant CJD (vCJD is an incurable, infectious human disease, likely arising from the consumption of BSE-contaminated meat products. Whilst the epidemic appears to be waning, there is much concern that vCJD infection may be perpetuated in humans by the transfusion of contaminated blood products. Since 2004, several cases of transfusion-associated vCJD transmission have been reported and linked to blood collected from pre-clinically affected donors. Using an animal model in which the disease manifested resembles that of humans affected with vCJD, we examined which blood components used in human medicine are likely to pose the greatest risk of transmitting vCJD via transfusion. We collected two full units of blood from BSE-infected donor animals during the pre-clinical phase of infection. Using methods employed by transfusion services we prepared red cell concentrates, plasma and platelets units (including leucoreduced equivalents. Following transfusion, we showed that all components contain sufficient levels of infectivity to cause disease following only a single transfusion and also that leucoreduction did not prevent disease transmission. These data suggest that all blood components are vectors for prion disease transmission, and highlight the importance of multiple control measures to minimise the risk of human to human transmission of vCJD by blood transfusion.

  12. Clinical assessment of quality of life of the patients with chronic blood transfusion and chelation therapy

    Directory of Open Access Journals (Sweden)

    Tamil Selvan

    2014-01-01

    Full Text Available Background: The patient with hemoglobinopathy like thalassemia major (TM, bone marrow dysfunction, and sickle cell disease are requiring chronic blood transfusion for their life time to survive. Among these, TM is one of the most common hemoglobinopathy worldwide. Objective: This study is done to assess the quality of life (QOL of the patients with chronic blood transfusion and chelation therapy. Materials and Methods: The QOL scores were obtained through the self-administered SF-36 questionnaire. The study subjects were asked to answer the SF-36 questionnaire once every 3 months. Results: After 6 months, the SF 36 general health mean score was 63.58 ± 12.98 (P < 0.05. The highest mean score was 69.37 ± 11.61. The mean difference after the final reviews was statistically significant. Conclusion: The preponderance of scores used to assess QOL suggests that there is a direct and independent effect on QOL when treated with transfusion and iron-chelation therapy.

  13. No early effect of storage time of transfused red blood cells on fatigue and plasma cytokines in patients with anaemia from non-acute gastrointestinal bleeding

    DEFF Research Database (Denmark)

    Mynster, Tommie; Dziegiel, Morten H; Kofoed, Kristian

    2007-01-01

    Background: Fatigue in anaemia is empirically reduced by blood transfusion. Long storage time of red cells may be associated with immunomodulatory effects, and blood stored for a long time may cause tissue hypoxia upon transfusion. Patients and Methods: 22 patients admitted with haemoglobin ... (nsSL). Beside increase in haemoglobin the only significant change in blood parameters after transfusion was a decrease in thrombocyte count (nsSL). No significant differences were seen in concentrations of cytokines before and after transfusion. Conclusion: Transfusion of two units of red cells...... relieved self-estimated fatigue, independent of blood storage time. Thrombocyte count decreased after transfusion, probably due to dilution by transfused blood. Aged red cells may not, or only sparsely, directly trigger the interleukin cascade....

  14. Impact of hemoglobin nitrite to nitric oxide reductase on blood transfusion for resuscitation from hemorrhagic shock

    Directory of Open Access Journals (Sweden)

    Chad Brouse

    2015-01-01

    Full Text Available Background: Transfusion of blood remains the gold standard for fluid resuscitation from hemorrhagic shock. Hemoglobin (Hb within the red blood cell transports oxygen and modulates nitric oxide (NO through NO scavenging and nitrite reductase. Aims: This study was designed to examine the effects of incorporating a novel NO modulator, RRx-001, on systemic and microvascular hemodynamic response after blood transfusion for resuscitation from hemorrhagic shock in a hamster window chamber model. In addition, to RRx-001 the role of low dose of nitrite (1 × 10−9 moles per animal supplementation after resuscitation was studied. Materials and Methods: Severe hemorrhage was induced by arterial controlled bleeding of 50% of the blood volume (BV and the hypovolemic state was maintained for 1 h. The animals received volume resuscitation by an infusion of 25% of BV using fresh blood alone or with added nitrite, or fresh blood treated with RRx-001 (140 mg/kg or RRx-001 (140 mg/kg with added nitrite. Systemic and microvascular hemodynamics were followed at baseline and at different time points during the entire study. Tissue apoptosis and necrosis were measured 8 h after resuscitation to correlate hemodynamic changes with tissue viability. Results: Compared to resuscitation with blood alone, blood treated with RRx-001 decreased vascular resistance, increased blood flow and functional capillary density immediately after resuscitation and preserved tissue viability. Furthermore, in RRx-001 treated animals, both mean arterial pressure (MAP and met Hb were maintained within normal levels after resuscitation (MAP >90 mmHg and metHb <2%. The addition of nitrite to RRx-001 did not significantly improve the effects of RRx-001, as it increased methemoglobinemia and lower MAP. Conclusion: RRx-001 alone enhanced perfusion and reduced tissue damage as compared to blood; it may serve as an adjunct therapy to the current gold standard treatment for resuscitation from

  15. Role of National Accreditation Board of Hospitals and Healthcare Providers (NABH core indicators monitoring in quality and safety of blood transfusion

    Directory of Open Access Journals (Sweden)

    Anshu Gupta

    2016-01-01

    Full Text Available Context: Certain quality indicators are mandatory in the maintenance and improvement of quality in blood transfusion. Monitoring of such indicators should be done regularly and deficiencies are to be corrected for effective blood transfusion services. Aims: To study the usefulness of monitoring of the National Accreditation Board for Hospitals and Healthcare Providers (NABH core indicators in blood transfusion and in the maintenance of hemovigilance. Settings and Design: Hemovigilance is a "quality process" to improve quality and increase the safety of blood transfusion. It covers and surveys all activities of the blood transfusion chain from donors to recipients. Core indicators′ monitoring is a part of the hemovigilance process. Materials and Methods: A 2-year retrospective study was conducted in a blood storage unit of a NABH accredited tertiary care hospital of a metropolitan city. Four NABH core indicators in blood transfusion were observed and monitored by the clinical and blood storage unit staff of different levels. Results: It was observed that there was an improvement in quality by core indicators monitoring with decreased wastage of blood and blood components, decreased average turnaround time for issue of blood and blood components, and lesser number of transfusion reactions. Conclusion: This study demonstrated that monitoring of NABH core indicators results in the enhancement of quality and safety in blood transfusion services, reducing the incidence of transfusion reactions.

  16. Transfusion strategy

    DEFF Research Database (Denmark)

    Jakobsen, Carl-Johan

    2014-01-01

    Blood transfusion is associated with increased morbidity and mortality and numerous reports have emphasised the need for reduction. Following this there is increased attention to the concept of patient blood management. However, bleeding is relatively common following cardiac surgery and is furth....... In conclusion the evidence supports that each institution establishes its own patient blood management strategy to both conserve blood products and maximise outcome.......Blood transfusion is associated with increased morbidity and mortality and numerous reports have emphasised the need for reduction. Following this there is increased attention to the concept of patient blood management. However, bleeding is relatively common following cardiac surgery and is further...

  17. Tattoos and transfusion-transmitted disease risk: implications for the screening of blood donors in Brazil

    Directory of Open Access Journals (Sweden)

    Sérgio de A. Nishioka

    2002-08-01

    Full Text Available Having a tattoo has been associated with serological evidence of hepatitis B and C viruses, as well as human immunodeficiency virus infections and syphilis; all of these are known to be transmissible by blood transfusion. These associations are of higher magnitude for individuals with nonprofessionally-applied tattoos and with two or more tattoos. Tattoos are common among drug addicts and prisoners, conditions that are also associated with transfusion-transmitted diseases. We examined the implications of these associations for the screening of blood donors in Brazil. Numbers of individuals who would be correctly or unnecessarily deferred from blood donation on the basis of the presence of tattoos, and on their number and type, were calculated for different prevalence situations based on published odds ratios. If having a tattoo was made a deferral criterion, cost savings (due to a reduced need for laboratory testing and subsequent follow-up would accrue at the expense of the deferral of appropriate donors. Restricting deferral to more `at-risk' sub-groups of tattooed individuals would correctly defer less individuals and would also reduce the numbers of potential donors unnecessarily deferred. Key factors in balancing cost savings and unnecessary deferrals include the magnitude of the pool of blood donors in the population, the prevalence of individuals with tattoos and the `culture' of tattoos in the population. Tattoos can therefore be an efficient criterion for the screening of blood donors in certain settings, a finding that requires corroboration from larger population-based studies.

  18. Transfusão de concentrado de hemácias na unidade de terapia intensiva Red blood cells transfusion in intensive care unit

    Directory of Open Access Journals (Sweden)

    Solange Emanuelle Volpato

    2009-12-01

    Full Text Available INTRODUÇÃO: A anemia é um problema comum na admissão dos pacientes nas unidades de terapia intensiva, sendo a prática de transfusão de concentrado de hemácias uma terapêutica freqüente. As causas de anemia em pacientes críticos que realizam transfusão de concentrado de hemácias são várias: perda aguda de sangue após trauma, hemorragia gastrointestinal, cirurgia, dentre outras. Atualmente, poucos estudos são disponibilizados sobre o uso de hemocomponentes em pacientes sob cuidados intensivos. Embora as transfusões sangüíneas sejam freqüentes em unidades de terapia intensiva, os critérios de manejo otimizados não são claramente definidos, não existindo, inclusive, guidelines específicos. OBJETIVOS: Analisar as indicações clínicas do uso do concentrado hemácia na unidade de terapia intensiva. MÉTODOS: Foram analisados os prontuários dos pacientes internados na unidade de terapia intensiva que realizaram transfusão de concentrado de hemácias no período de 1º de janeiro de 2005 a 31 de dezembro de 2005. O trabalho foi aceito pelo Comitê de Ética em Pesquisa da Universidade do Sul de Santa Catarina (UNISUL. RESULTADOS: A taxa de transfusão foi de 19,33%, tendo predomínio do gênero masculino. Prevalência de paciente com idade superior ou igual a 60 anos. A taxa de óbitos nos pacientes transfundidos com concentrado de hemácias foi de 38,22%. O critério de indicação de transfusão mais freqüente foi por baixa concentração de hemoglobina (78% com média da hemoglobina pré-transfusional de 8,11g/dl. CONCLUSÕES: Os diagnósticos pré-transfusão mais frequentes são politrauma e sepse/choque séptico. Baixa concentração de hemoglobina é o principal critério clínico com média pré-transfusional de 8,11g/dl.BACKGROUND: The anemia is a common problem upon admission of the patients in the intensive care unit being the red blood cell transfusion a frequent therapeutic. The causes of anemia in critical

  19. Barriers to Timely and Safe Blood Transfusion for PPH Patients: Evidence from a Qualitative Study in Dhaka, Bangladesh

    Science.gov (United States)

    Akhter, Sadika; Anwar, Iqbal; Akter, Rashida; Kumkum, Feroza Akhter; Nisha, Monjura Khatun; Ashraf, Fatema; Islam, Ferdousi; Begum, Nazneen; Chowdhury, Mahbub Elahi; Austin, Anne; Islam, Syed Shariful; Rahman, Aminur

    2016-01-01

    Background and Objectives In Bangladesh, postpartum hemorrhage (PPH) is the leading cause of maternal mortality accounting for 31% of all blood transfusions in the country. Although safe blood transfusion is one of the 8 signal functions of Comprehensive Emergency Obstetric Care (CEmOC) strategy, most of the designated public sector CEmOC facilities do not have on-site blood storage system. Emergent blood is mainly available from external blood banks. As a result, emergent patients are to rely on an unregulated network of brokers for blood which may raise question about blood safety. This study explored lived experiences of patients’ attendants, managers, providers, and blood brokers before and after the implementation of an on-line Blood Information and Management Application (BIMA) in regards to barriers and facilitators of blood transfusion for emergent patients. Methods Data were collected at Dhaka Medical College Hospital (DMCH), a tertiary-level teaching hospital before (January 2014) and after (March 2015) the introduction of an online BIMA system. Data collection methods included 24 key informant interviews (KIIs) and 40 in-depth interviews (IDIs). KIIs were conducted with formal health service providers, health managers and unlicensed blood brokers. IDIs were conducted with the relatives and husbands of women who suffered PPH, and needed emergency blood. Results Patients’ attendants were unaware of patients’ blood type and availability of blood in emergency situation. Newly introduced online BIMA system could facilitate blood transfusion process for poor patients at lower cost and during any time of day and night. However, service providers and service recipients were heavily dependent on a network of unlicensed blood brokers for required blood for emergent PPH patients. Blood collected through unlicensed blood brokers is un-screened, unregulated and probably unsafe. Blood brokers feel that they are providing a needed service, acknowledged a

  20. Blood transfusion for preventing primary and secondary stroke in people with sickle cell disease

    Science.gov (United States)

    Estcourt, Lise J; Fortin, Patricia M; Hopewell, Sally; Trivella, Marialena; Wang, Winfred C

    2017-01-01

    Background Sickle cell disease is one of the commonest severe monogenic disorders in the world, due to the inheritance of two abnormal haemoglobin (beta globin) genes. Sickle cell disease can cause severe pain, significant end-organ damage, pulmonary complications, and premature death. Stroke affects around 10% of children with sickle cell anaemia (HbSS). Chronic blood transfusions may reduce the risk of vaso-occlusion and stroke by diluting the proportion of sickled cells in the circulation. This is an update of a Cochrane Review first published in 2002, and last updated in 2013. Objectives To assess risks and benefits of chronic blood transfusion regimens in people with sickle cell disease for primary and secondary stroke prevention (excluding silent cerebral infarcts). Search methods We searched for relevant trials in the Cochrane Library, MEDLINE (from 1946), Embase (from 1974), the Transfusion Evidence Library (from 1980), and ongoing trial databases; all searches current to 04 April 2016. We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group Haemoglobinopathies Trials Register: 25 April 2016. Selection criteria Randomised controlled trials comparing red blood cell transfusions as prophylaxis for stroke in people with sickle cell disease to alternative or standard treatment. There were no restrictions by outcomes examined, language or publication status. Data collection and analysis Two authors independently assessed trial eligibility and the risk of bias and extracted data. Main results We included five trials (660 participants) published between 1998 and 2016. Four of these trials were terminated early. The vast majority of participants had the haemoglobin (Hb)SS form of sickle cell disease. Three trials compared regular red cell transfusions to standard care in primary prevention of stroke: two in children with no previous long-term transfusions; and one in children and adolescents on long-term transfusion. Two trials compared the drug

  1. ROLE OF PLATELET TRANSFUSIONS IN DENGUE HEMORRHAGIC FEVER- 6 MONTHS REPORT

    Directory of Open Access Journals (Sweden)

    Geeta

    2012-08-01

    Full Text Available ABSTRACT: BACKGROUND: Allogenic platelet transfusion plays a major role in the management of thrombocytopenia. The study includes details of pla telet transfusion over a period of 6 months from January-2011 to June-2011 at blood bank of Gan dhi Hospital. Total number of patients who received were 487 and proportionate use of total un its of RDP (Random Donor Platelets issued from blood bank were as follows; dengue hemorrhagic fever (38% and remaining for acute leukemia (12%, Aplastic anemia (10%, sepsis (10% , DIC (Disseminated Intravascular Coagulation (10%, cardiac surgery (10%. In dengu e hemorrhagic fever, correlation of platelet count with platelet transfusion and platelet increm ent have been evaluated.

  2. [Voluntariness and blood donation: Proceedings of an ethics seminar held at the National Institute for Blood Transfusion].

    Science.gov (United States)

    Garraud, O; Danic, B; Cartron, J-P; Chiaroni, J; Clavier, B; Cuneo, B; Guimelchain-Bonnet, M; Hermitte, M-A; Mackowiak, S; Monsellier, M; Moreau, S; Papa, K; Pelletier, B; Pottier, R; Praile, R; Saillol, A; Tissot, J-D; Vernant, J-P; Hervé, C

    2016-09-01

    Voluntariness stands for one of the four pillars of ethics in blood donation; it is, however, more related to tradition than to legislation. Because it seems necessary to apply "marketing" techniques to blood collection in order to meet the needs in blood components, both in terms of quantity and quality, one wonders if this may be at the expense of this principle of voluntariness. This seminar-belonging actually to a series of seminars in Ethics in Transfusion Medicine-aimed at questioning the possible weakness of voluntariness in the field of blood donation. To achieve this goal, specialists of numerous disciplines in medical sciences, law and humanities gathered to discuss all related issues to voluntariness in blood donation.

  3. Red blood cell alloimmunization is influenced by recipient inflammatory state at time of transfusion in patients with sickle cell disease.

    Science.gov (United States)

    Fasano, Ross M; Booth, Garrett S; Miles, Megan; Du, Liping; Koyama, Tatsuki; Meier, Emily Riehm; Luban, Naomi L C

    2015-01-01

    Sickle cell disease (SCD) patients are at increased risk of red blood cell (RBC) alloimmunization. Recipient inflammatory state at time of transfusion has been shown to regulate alloimmunization in murine models, but evidence is lacking in SCD patients. We retrospectively studied a cohort of alloimmunized SCD patients to determine the influence of pro-inflammatory SCD-related complications at time of transfusion on alloimmunization. For each transfusion, the presence of pro-inflammatory state, degree of RBC antigen matching, unit age, storage solution and alloantibody detection date were ascertained. Transfusion-associated pro-inflammatory events were compared between transfusions resulting and not resulting in new alloantibodies. Univariate analysis and multivariate logistic regression were performed. Fifty-two patients received 3166 pre-storage leuco-reduced transfusions of which 128 resulted in alloantibodies. Transfusions during inflammatory events were associated with increased alloantibody risk on univariate and multivariate analysis; acute chest syndrome and vaso-occlusive crisis showed strongest associations with alloimmunization. Increased antigen matching demonstrated a protective effect on alloimmunization (univariate and multivariate analysis). Although an association was seen between citrate-phosphate-dextrose (adenine) stored units and alloimmunization on univariate analysis, no effect was found on multivariate analysis. Identifying recipient pro-inflammatory states at time of transfusion that promote alloimmunization can impact RBC unit selection decisions for SCD patients at risk for alloimmunization.

  4. Comparison of the effects of SAG-M and whole-blood transfusions on postoperative suppression of delayed hypersensitivity

    DEFF Research Database (Denmark)

    Nielsen, Hans Jørgen; Hammer, J H; Moesgaard, F;

    1991-01-01

    pre- and postoperatively by skin testing with seven common delayed-type hypersensitivity (DTH) antigens. The postoperative skin-test response decreased more in the patients who received whole blood (15 patients) than in those who received SAG-M blood (16 patients) (60% versus 42%, p less than 0......The influence of perioperative whole-blood transfusion and transfusion with erythrocyte suspension (SAG-M blood) on postoperative depression of cell-mediated immunity (CMI) was investigated in 67 patients who underwent elective resection for colorectal cancer. Cell-mediated immunity was assessed...

  5. [Joint application of mathematic models in assessing the residual risk of hepatitis C virus transmitted through blood transfusion].

    Science.gov (United States)

    Wang, Xun; Jia, Yao; Xie, Yun-zheng; Li, Xiu-mei; Liu, Xiao-ying; Wu, Xiao-fei

    2011-09-01

    The practicable and effective methods for residual risk assessment on transfusion-transmitted disease was to establish the mathematic models. Based on the characteristics of the repeat donors which donated their blood on a regular base, a model of sero-conversion during the interval of donations was established to assess the incidence of the repeat donors. Based on the characteristics of the prevalence in the population, a model of 'prevalence increased with the age of the donor' was established to assess the incidence of those first-time donors. And based on the impact of the windows period through blood screening program, a model of residual risk associated with the incidence and the length of the windows period was established to assess the residual risk of blood transfusion. In this paper, above said 3 kinds of mathematic models were jointly applied to assess the residual risk of hepatitis C virus (HCV) which was transmitted through blood transfusion in Shanghai, based on data from the routine blood collection and screening program. All the anti-HCV unqualified blood donations were confirmed before assessment. Results showed that the residual risk of HCV transmitted through blood transfusion during Jan. 1(st), 2007 to Dec. 31(st), 2008 in Shanghai was 1:101 000. Data showed that the results of residual risk assessment with mathematic models was valuable. The residual risk of transfusion-transmitted HCV in Shanghai was at a safe level, according to the results in this paper.

  6. Prevention of post-transfusion hepatitis c transmission through donor blood and its components

    Directory of Open Access Journals (Sweden)

    A. V. Chechetkin

    2015-01-01

    Full Text Available The aim of organizational aspects of preventing the transmission of hepatitis C virus with donor blood and its components.Materials and methods. An activity of the blood service establishments in Russia for the prevention of HCV infection through transfusion of blood and its components on the basis of the analysis of sectoral statistical surveys was studied.Results. The frequency of detection of antibodies to hepatitis C virus in blood donors and its components during 2009–2013 decreased by more than 1,5 times. The percentage of donors who have identified markers of hepatitis C virus was significantly different in different regions: from 0,51% to 1,36%. The activity of the blood service implemented method of plasma quarantine resulting annually rejected from 0,32% to 0,23% as a result of the identified markers of HCV. Pathogen inactivated plasma volume increased in 3 times, the platelet concentrate in 3,2 times.Conclusion. To ensure the safety of donated blood and its components in the blood service effectively the modern technology use for to prevention transmission of the HCV: quarantine of plasma, donor selection and development, inactivation of pathogens. The degree of implementation in practice of nonpaid voluntary blood transfusions significantly increased and is characterized by regional features in recent years .

  7. Recruitment of prospective donors: what do they expect from a homepage of a blood transfusion service?

    Science.gov (United States)

    Moog, R; Fourné, K

    2007-08-01

    In times of shrinking donor population, the recruitment of donors is of utmost importance. Recruitment can be done by personal communication, advertisement/information, classical mass media (newspaper, radio, TV) or new computerized media. The aim of this study was to gain information about the donors' demands of an Internet presentation of a blood transfusion service. Between October and December 2004 inclusive, prospective donors were asked to complete a survey about the impact of Internet information for blood donors. The survey contained questions measuring demographics, education and motivation for blood donation. In addition, the survey included questions that measured Internet access, duration of online time and donors' demands for an Internet presentation of a blood transfusion service. Donors were asked to tick a box with predefined answers. In cases where no options were applied, donors were requested to specify their answers. One hundred and fourteen prospective donors (71 female, 43 male) with a median age of 25 years (range 18-57 years) completed the survey. Most donors (57.9%) were 18-30 years old. Forty-two (36.8%) of the surveyed donors were repeat donors, whereas 72 (63.2%) were first-time donors. The majority of donors were informed about blood donation from relatives or friends (70.7% repeat donors and 67.7% first-time donors). Most of them had Internet access (85.7% repeat donors and 90.3% first-time donors). Exclusive use of private access was more often reported in repeat donors (77.8%), whereas both private and professional access was more frequently used in first-time donors (32.3%). Most donors used the Internet access daily, followed by weekly and monthly use. Multiple answers were given about the importance of desired information about the topic 'blood donation'. Both first-time and repeat donors wanted to be informed about organizational details of blood donation such as opening times, eligibility criteria, donation process and the kind

  8. Autotransfusión sanguínea en cirugía ortognática: necesario Autologous blood transfusions in orthognathic surgery: a necessity

    Directory of Open Access Journals (Sweden)

    L. Naval

    2006-12-01

    Full Text Available El ahorro de sangre es un asunto que puede simplificar la asistencia médica diaria y mejorar su calidad tanto desde el punto de vista de morbilidad, seguridad y coste económico y social para los pacientes, profesionales de la salud como anestesistas, cirujanos, banco de sangre y de los equipos de dirección de hospitales públicos y privados. Inicialmente el interés por evitar los efectos adversos secundarios a la transfusión alogénica (TAL (transmisión de enfermedades infecciosas, reacciones transfusionales, como el Distress Respiratorio Agudo asociado a transfusión, costes, sensibilizaciones… y posteriormente el ahorro de recursos limitados hacen que múltiples grupos de trabajo desarrollen nuevas estrategias frente a un problema común: la reposición o el ahorro de la sangre perdida durante las intervenciones quirúrgicas y el postoperatorio inmediato. Asistimos en los últimos años a un menor uso durante las cirugías de cualquier tipo de sangre, especialmente la alogénica, gracias a la mejora de las técnicas quirúrgicas y anestésicas. Entre ellas la utilización de sangre del propio paciente (autóloga o autotransfusión (AUT en sus distintas modalidades. ¹ Llevamos a cabo una revisión de las distintas modalidades de AUT mostrando la experiencia de nuestro Servicio en el que se lleva practicando desde finales de los años 80.²Daily medical care can be simplified by saving blood, and the quality of care improved from the point of view of morbidity and safety. The economic and social cost can be reduced for patients and for health professionals such as anesthetists, surgeons, and for the blood banks and teams directing private and public hospitals. Initially the interest in avoiding the adverse secondary effects of allogenic transfusion (ALT (infectious disease transmission, transfusion reactions, such as Acute Respiratory Distress associated with transfusion, cost, sensitivity... followed by the desire to save limited

  9. Transfusion Medicine

    Directory of Open Access Journals (Sweden)

    Smit Sibinga CT

    2013-07-01

    Full Text Available Cees Th. Smit Sibinga ID Consulting, Zuidhorn, The NetherlandsTransfusion Medicine is a bridging science, spanning the evidence-based practice at the bedside with the social sciences in the community.     Transfusion Medicine starts at the bedside. Surprisingly, only recently that has become rediscovered with the development of ‘patient blood management’ and ‘patient centered’ approaches to allow the growth of an optimal and rational patient care through supportive hemotherapy – safe and effective, affordable and accessible.1    Where transfusion of blood found its origin in the need of a patient, it has drifted away for a long period of time from the bedside and has been dominated for almost a century by laboratory sciences. At least the first ten editions of the famous and well reputed textbook Mollison’s Blood Transfusion in Clinical Medicine contained only a fraction on the actual bedside practice of transfusion medicine and did not focus at all on patient blood management.2    This journal will focus on all aspects of the transfusion chain that immediately relate to the bedside practice and clinical use of blood and its components, and plasma derivatives as integral elements of a human transplant tissue. That includes legal and regulatory aspects, medical, ethical and cultural aspects, pure science and pathophysiology of disease and the impact of transfusion of blood, as well as aspects of the epidemiology of blood transfusion and clinical indications, and cost-effectiveness. Education through timely and continued transfer of up to date knowledge and the application of knowledge in clinical practice to develop and maintain clinical skills and competence, with the extension of current educational approaches through e-learning and accessible ‘apps’ will be given a prominent place.

  10. Burden of transfusion transmissible viral infections among blood donors at a tertiary care referral teaching hospital in South India

    Directory of Open Access Journals (Sweden)

    Suresh B

    2016-07-01

    Full Text Available Background: Blood serves as a vehicle for transmission of blood-borne pathogens including human immunodeficiency virus (HIV, hepatitis B virus (HBV and hepatitis C virus (HCV. The present study was conducted to estimate the prevalence of these transfusion transmitted infections (TTIs in blood donors. Methods: All blood donors presenting to the blood bank at our tertiary care teaching hospital were screened for HIV, HBV and HCV by using enzyme-linked immunosorbent assay (ELISA method. Results: During the period January to December 2014, 9958 blood donors were screened for viral markers. The prevalence of HIV, HBsAg and HCV was 0.36%, 1.67%, and 0.56% respectively. Conclusions: Although multiple critical steps are taken to minimize the risk of infection from transfusion of blood or blood products, this risk can never be entirely eliminated. Stringent donor selection, proper counseling and deferral/ self exclusion may reduce the seroreactivity in donated blood and wastage of resources.

  11. [Risk of transmission of Trypanosoma cruzi by blood transfusion in Mexico].

    Science.gov (United States)

    Guzmán Bracho, C; García García, L; Floriani Verdugo, J; Guerrero Martínez, S; Torres Cosme, M; Ramírez Melgar, C; Velasco Castrejón, O

    1998-08-01

    Data from the late eighties indicate that 1.6% of the Mexican population was infected with Chagas' disease and that transmission by way of blood transfusion was taking place in nearly every state, in areas of different sizes. The risk of transmission via that route has seldom been documented in Mexico, and for this reason a sentinel survey was conducted in 1994 in 18 blood banks belonging to the Ministry of Health and located in various states. The purpose of the study was to determine the risk of transmission via blood transfusion and to calculate the national prevalence of infection among potential donors, so as to have a set of general indicators of the prevailing disease burden and of the importance of this transmission route. Participants were selected on the basis of operating criteria: all government-run transfusion centers with the capacity to screen blood donors for at least one year and persons seeking to donate blood (n = 64,969) who satisfied the Official Mexican Standards (Norma Official Mexicana) for the therapeutic use of human blood and blood products. For the analysis of the results the centers were grouped according to migration flow in order to detect any possible influence the latter may have had on Chagas' disease transmission within the country. Screening was done with indirect hemagglutination using a reagent produced by the Instituto Nacional de Diagnóstico y Referencia Epidemiológicos and donated to the blood banks. Positive cases were confirmed by indirect immunofluorescence. Positive results were detected in 996 persons, for a prevalence of 1.5% (95% CI: 1.44 to 1.63). Concordance between the final results obtained by local labs and by the central lab was given by a kappa index of 0.87 (95% CI: 0.862 to 0.877). Cities having the highest emigration rates had three times the risk of transmission as compared to cities that drew immigrants (odds ratio = 2.82; 95% CI: 2.18 to 3.65). We recommend that mandatory serologic screening be enforced

  12. Seroprevalence of transfusion transmissible infections among blood donors at the blood bank of a Medical College of Kolkata

    Directory of Open Access Journals (Sweden)

    Prasanta Ray Karmakar

    2014-01-01

    Full Text Available Seroprevalence of transfusion transmissible infections (TTIs among blood donors can be used to monitor the prevalence among apparently healthy adult population. The present study was conducted to determine the profile of blood donors and seroprevalence of TTI among them. Retrospective analysis of the donors of a blood bank attached with a tertiary care hospital of Kolkata in 2011 was carried out. Data were analyzed with SPSS version 17. Majority (85% of the donors were male, two-third in the age group of 21-40 years. Among the donors 2.79% were positive for any of the screened TTIs. Seroprevalence was highest for hepatitis B (1.41% followed by human immunodeficiency virus (0.60% and hepatitis C (0.59% and least for syphilis (0.23%. Seropositivity increased with age up to 50 years. There was no significant difference in seropositivity between male and female. Highly sensitive donor screening and public awareness program can make transfusion of blood products safe.

  13. Seroprevalence of transfusion transmissible infections among blood donors at the blood bank of a Medical College of Kolkata.

    Science.gov (United States)

    Karmakar, Prasanta Ray; Shrivastava, Prabha; Ray, Tapobrata Guha

    2014-01-01

    Seroprevalence of transfusion transmissible infections (TTIs) among blood donors can be used to monitor the prevalence among apparently healthy adult population. The present study was conducted to determine the profile of blood donors and seroprevalence of TTI among them. Retrospective analysis of the donors of a blood bank attached with a tertiary care hospital of Kolkata in 2011 was carried out. Data were analyzed with SPSS version 17. Majority (85%) of the donors were male, two-third in the age group of 21-40 years. Among the donors 2.79% were positive for any of the screened TTIs. Seroprevalence was highest for hepatitis B (1.41%) followed by human immunodeficiency virus (0.60%) and hepatitis C (0.59%) and least for syphilis (0.23%). Seropositivity increased with age up to 50 years. There was no significant difference in seropositivity between male and female. Highly sensitive donor screening and public awareness program can make transfusion of blood products safe.

  14. Prevalence of antibodies to hepatitis C virus after blood transfusion in heart surgery.

    OpenAIRE

    Barcena, R.; A. Gonzalez; Martin-de-Argila, C.; Ulibarrena, C.; J. Graus; Grande, L. A.

    1994-01-01

    We studied the frequency and time of appearance of antibodies to the hepatitis C virus (HCV) retrospectively in the sera of 127 patients who underwent heart surgery between 1983 and 1986. They received blood from volunteer donors hepatitis B surface antigen (HBsAg) negative with normal serum alanine-aminotransferase levels. A prospective follow-up was carried out every 15 days for at least 6 months from the moment of the transfusion. Of the ten patients who developed biochemical criteria of p...

  15. Major surgery in an osteosarcoma patient refusing blood transfusion: case report

    Directory of Open Access Journals (Sweden)

    Shanmugam Rukmanikanthan

    2010-11-01

    Full Text Available Abstract We describe an unusual case of osteosarcoma in a Jehovah's Witness patient who underwent chemotherapy and major surgery without the need for blood transfusion. This 16-year-old girl presented with osteosarcoma of the right proximal tibia requiring proximal tibia resection, followed by endoprosthesis replacement. She was successfully treated with neoadjuvant chemotherapy and surgery with the support of haematinics, granulocyte colony-stimulating factor, recombinant erythropoietin and intraoperative normovolaemic haemodilution. This case illustrates the importance of maintaining effective, open communication and exploring acceptable therapeutic alternative in the management of these patients, whilst still respecting their beliefs.

  16. 输血科信息化建设在优化输血管理中的作用%Function of Blood Transfusion Department Informationization Construction in Optimizing Blood Transfusion Management

    Institute of Scientific and Technical Information of China (English)

    米运强; 董梅; 王迪

    2011-01-01

    目的:研究探讨输血信息管理系统在输血科管理和日常工作中的积极作用.方法:通过输血信息管理系统的管理规则来规范输血工作,同时根据工作需求来优化软件操作.结果:通过信息系统控制和规范管理工作流程,输血科的管理工作不仅按规定的质量标准运行,而且提高了工作效率,绝对避免了错写血型、字迹误差和发放错误造成的医疗纠纷.做到了成分输血、节约用血、合理用血.%Objective To discuss the positive effect of information management system for clinical blood transfusion on the administration and daily works of transfusion department. Method clinical Blood transfusion was normalized by the management rules of information system,and the software operation was optimized with the work requirements. Conclusion By controlling and normalizing the administration work procedure through the information management system of blood transfusion, the management works of transfusion department not only run the required quality standards but also improved efficiency.Whereas the medical disputes were avoided absolutely such as wrong blood type by typo,writing errors and incorect delivery.As a result, ingredient blood transfusion, blood conservation and rational usage of blood were realized.

  17. Favourable results of a new intraoperative and postoperative filtered autologous blood re-transfusion system in total hip arthroplasty : A randomised controlled trial

    NARCIS (Netherlands)

    Horstmann, Wieger G.; Swierstra, Martzen J.; Ohanis, David; Rolink, Rob; Kollen, Boudewijn J.; Verheyen, Cees C. P. M.

    2014-01-01

    A new intraoperative filtered salvaged blood re-transfusion system has been developed for primary total hip arthroplasty (THA) that filters and re-transfuses the blood that is lost during THA. This system is intended to increase postoperative haemoglobin (Hb) levels, reduce perioperative net blood l

  18. Statewide collaboration to evaluate the effects of blood loss and transfusion on surgical site infection after hysterectomy.

    Science.gov (United States)

    Young, Heather; Berumen, Crystal; Knepper, Bryan; Miller, Amber; Silverman, Morgan; Gilmartin, Heather; Wodrich, Elizabeth; Alexander, Sandy; Price, Connie S

    2012-01-01

    We used mandatory public reporting as an impetus to perform a statewide study to define risk factors for surgical site infection. Among women who underwent abdominal hysterectomy, blood transfusion was a significant risk factor for surgical site infection in patients who experienced blood loss of less than 500 mL.

  19. A successful experience of the Iranian blood transfusion organization in improving accessibility and affordability of plasma derived medicine.

    Science.gov (United States)

    Chegini, Azita; Torab, Seyed Ardeshir; Pourfatollah, Ali Akbar

    2017-02-01

    Plasma is the liquid part of blood. It is estimated 21.6 million liters of plasma collect from Whole blood annually. From these plasma, 4.2 million liters transfuse, 8.1 million liters fractionate, 9.3 million liters waste. Nowadays, blood products and PDM (plasma derived medicine) consider as essential medicine in modern health care and transfusion medicine. Iranian blood transfusion organization as a non-profit organization was established in 1974 in order to centralize all blood transfusion activities from donor recruitment to distribution of blood components to hospitals. Iran is the only country in EMR region with the rate of 20-29.9 blood donations per 1000 population and reached 100% voluntary non-remunerated blood donation in 2007. RBCs and platelets demand are much more than FFPs so the IBTO was faced the surplus plasma that could cause surplus plasma wastage. Simultaneously, hospitals need more plasma derived medicine especially albumin, IVIG, factor VIII, factor IX. IBTO was faced the challenges such as Fractionators selection, Plasma volume shipment, Contract duration, Product profile, Multiple External audits, Cold chain maintenance, Transporting plasma across international borders, NAT test. To overcome plasma wastage and storage of PDM. IBTO involved toll manufacturing in 2005 and not only prevents plasma wastage but also save MOH (ministry of health) budget.

  20. DEL RBC transfusion should be avoided in particular blood recipient in East Asia due to allosensitization and ineffectiveness

    Institute of Scientific and Technical Information of China (English)

    Chao-peng SHAO; Bao-yan WANG; Shi-hui YE; Wen-li ZHANG; Hua XU; Nai-bao ZHUANG; Xiao-ying WU; Heng-gui XU

    2012-01-01

    Previously,both primary and secondary anti-D alloimmunizations induced by “Asian type" DEL (RHD1227A allele) were observed in two incidents.We investigated how often these alloimmunization events occur.The transfusions of any D-negative patients were investigated in the First Affiliated Hospital of Xi'an Jiaotong University Medical College,China,during the entire 2009.The antigens of D,C,c,E,and e were routinely serotyped.The "Asian type" DEL variant was genotyped and the RHD heterozygote was determined through two published methods.The changes in anti-D levels were monitored by the indirect antiglobulin test (IAT) and flow cytometry.Thirty D-negative transfused patients were included in the study.We focused on 11 recipients who were transfused with packed red blood cells (RBCs) from DEL donors at least one time.Of those 11 recipients,seven were anti-D negative before transfusion and four were anti-D positive (one patient with an autoantibody).One of the seven pre-transfusion anti-D negative patients produced a primary-response anti-D after being transfused with 400 ml of DEL blood twice.All four pre-transfusion antibody positive patients were not observed hemoglobin (Hb) levels increased,as expected after transfusions.Two patients had an increase in anti-D from 1∶8 to 1∶64 by IAT,which was also shown by flow cytometry.None of the patients experienced an acute hemolytic episode.Our data indicated that the primary anti-D induced by DEL transfusion or the secondary anti-D elevated by DEL in a truly D-negative patient might not be unusual.We suggest that a truly D-negative childbearing-aged woman should avoid DEL transfusion to protect her from primary anti-D allosensitization.In addition,anti-D positive recipients should also avoid DEL red cell transfusion due to the delayed hemolytic transfusion reaction (DHTR).

  1. Low immunogenicity of allogeneic human umbilical cord blood-derived mesenchymal stem cells in vitro and in vivo

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Miyoung; Jeong, Sang Young; Ha, Jueun; Kim, Miyeon; Jin, Hye Jin; Kwon, Soon-Jae [Biomedical Research Institute, MEDIPOST Co., Ltd, Seoul 137-874 (Korea, Republic of); Chang, Jong Wook [Research Institute for Future Medicine Stem Cell and Regenerative Medicine Center, Samsung Medical Center, Seoul 137-710 (Korea, Republic of); Choi, Soo Jin; Oh, Wonil; Yang, Yoon Sun [Biomedical Research Institute, MEDIPOST Co., Ltd, Seoul 137-874 (Korea, Republic of); Kim, Jae-Sung [Division of Radiation Cancer Research, Korea Institute of Radiological and Medical Sciences, Seoul 139-709 (Korea, Republic of); Jeon, Hong Bae, E-mail: jhb@medi-post.co.kr [Biomedical Research Institute, MEDIPOST Co., Ltd, Seoul 137-874 (Korea, Republic of)

    2014-04-18

    Highlights: • hUCB-MSCs maintained low immunogenicity even after immune challenge in vitro. • Humanized NSG mice were established using human UCB CD34+ cells. • Repeated intravenous hUCB-MSC injection into mice did not lead to immune responses and adverse events. • Allogeneic hUCB-MSCs maintained low immunogenicity in vitro and in vivo. - Abstract: Evaluation of the immunogenicity of human mesenchymal stem cells (MSCs) in an allogeneic setting during therapy has been hampered by lack of suitable models due to technical and ethical limitations. Here, we show that allogeneic human umbilical cord blood derived-MSCs (hUCB-MSCs) maintained low immunogenicity even after immune challenge in vitro. To confirm these properties in vivo, a humanized mouse model was established by injecting isolated hUCB-derived CD34+ cells intravenously into immunocompromised NOD/SCID IL2γnull (NSG) mice. After repeated intravenous injection of human peripheral blood mononuclear cells (hPBMCs) or MRC5 cells into these mice, immunological alterations including T cell proliferation and increased IFN-γ, TNF-α, and human IgG levels, were observed. In contrast, hUCB-MSC injection did not elicit these responses. While lymphocyte infiltration in the lung and small intestine and reduced survival rates were observed after hPBMC or MRC5 transplantation, no adverse events were observed following hUCB-MSC introduction. In conclusion, our data suggest that allogeneic hUCB-MSCs have low immunogenicity in vitro and in vivo, and are therefore “immunologically safe” for use in allogeneic clinical applications.

  2. Evaluation of Stem Cell-Derived Red Blood Cells as a Transfusion Product Using a Novel Animal Model.

    Science.gov (United States)

    Shah, Sandeep N; Gelderman, Monique P; Lewis, Emily M A; Farrel, John; Wood, Francine; Strader, Michael Brad; Alayash, Abdu I; Vostal, Jaroslav G

    2016-01-01

    Reliance on volunteer blood donors can lead to transfusion product shortages, and current liquid storage of red blood cells (RBCs) is associated with biochemical changes over time, known as 'the storage lesion'. Thus, there is a need for alternative sources of transfusable RBCs to supplement conventional blood donations. Extracorporeal production of stem cell-derived RBCs (stemRBCs) is a potential and yet untapped source of fresh, transfusable RBCs. A number of groups have attempted RBC differentiation from CD34+ cells. However, it is still unclear whether these stemRBCs could eventually be effective substitutes for traditional RBCs due to potential differences in oxygen carrying capacity, viability, deformability, and other critical parameters. We have generated ex vivo stemRBCs from primary human cord blood CD34+ cells and compared them to donor-derived RBCs based on a number of in vitro parameters. In vivo, we assessed stemRBC circulation kinetics in an animal model of transfusion and oxygen delivery in a mouse model of exercise performance. Our novel, chronically anemic, SCID mouse model can evaluate the potential of stemRBCs to deliver oxygen to tissues (muscle) under resting and exercise-induced hypoxic conditions. Based on our data, stem cell-derived RBCs have a similar biochemical profile compared to donor-derived RBCs. While certain key differences remain between donor-derived RBCs and stemRBCs, the ability of stemRBCs to deliver oxygen in a living organism provides support for further development as a transfusion product.

  3. SEROPREVALENCE OF TRANSFUSION TRANSMITTED INFECTIONS IN A TEACHING HOSPITAL BLOOD BANK

    Directory of Open Access Journals (Sweden)

    Shariff

    2014-02-01

    Full Text Available BACKGROUND: Blood transfusion is a life - saving procedure. However , the recipient has the potential risk of acquiring transfusion - transmissible infections (TTI , important infectious agents being Human Immunodeficiency Virus (HIV , Hepatitis B & C viruses , and Treponema pallidum. AIM: This study was undertaken to know the prev alence of TTI in our hospital blood bank and hence evaluate the safety of the blood units . MATERIAL AND METHOD: The present study was conducted at the Blood Bank of our Medical College Hospital. Data was collected retrospectively for a 4.5 - year period from January 2008 to June 2012. Donor data including demographic details and results of the screening tests were recorded. RESULTS: In the 4.5 - year period , there were 7128 donors – both voluntary and replacement donors. The donors were in the age group 18 to 5 0 years. Out of the 116 donors tested positive for any test , there were 5 female donors and the 111 male donors. The donors who tested positive formed 1.6% of the total number of donors. The maximum number of donors were positive for HBsAg (n=47 , followed by positivity for HCV (n=45. The seroprevalence of HBsAg , HCV , HIV and Syphilis was 0.66% , 0.63% , 0.25% and 0.1% respectively. There was no case with smear positive for malaria parasite. CONCLUSION: The seroprevalence of TTI is minimal in our set up. The risk can be kept to a minimum by proper donor selection and testing of the collected units

  4. Critical analysis of the indications for blood transfusions in surgery Análise crítica das indicações de transfusões sangüíneas em cirurgias

    Directory of Open Access Journals (Sweden)

    José D’Oliveira Couto

    2005-10-01

    Full Text Available The several factors which precipitate blood transfusion in hospitals are called “transfusion trigger”. The goal of perioperative blood replacement is to maintain satisfactory levels of haemoglobin and blood volume in order to have a better tissue oxygenation. The coagulation factors are used in the coagulations dysfunctions. The ideal is to avoid or to carry out a better blood transfusion in small quantities at a lower risk. Recent reports question the standards previously considered acceptable for blood transfusion. Blood substitute products for the treatment of haemorrhagic shock, blood bioproducts, and the indications for transfusions based on laboratory and clinical parameters, are analysed and discussed in this review.   Os vários fatores que precipitam uma transfusão sanguínea nos hospitais são chamados de “gatilho da transfusão”. O objetivo da reposição de sangue no perioperatório é manter níveis satisfatórios de hemoglobina e de volume sanguíneo para uma adequada oxigenação tecidual. Os fatores de coagulação são importantes nas disfunções de coagulação. O ideal é evitar-se ou promover-se uma melhor transfusão em pequenas quantidades e com menor risco. Trabalhos recentes questionam os padrões previamente considerados aceitáveis para a transfusão sanguínea. Produtos substitutivos para o tratamento do choque hemorrágico, bioprodutos do sangue e as indicações baseadas em parâmetros laboratoriais e clínicos são analisadas e discutidas nesta revisão.

  5. 犬血型与安全输血研究进展%Research Advance in Canine Blood Group and Safe Blood Transfusion

    Institute of Scientific and Technical Information of China (English)

    丁晓麟; 温海; 贺星亮; 张汇东

    2011-01-01

    This paper reviews the research progress in the safe blood transfusion of dog, including canine blood group system, identification of blood group, cross matching, selection of the donor, transfusion reaction and so on, systematically explores how to conduct the safe and effective blood transfusion of dog, and discusses the current existent problems.%综述了犬血型系统、血型鉴定、交叉配血、供血犬选择以及输血反应等与安全输血相关的各方面的研究进展,系统探讨了临床上如何对犬进行安全、有效输血以及当前存在问题.

  6. Storage time of red blood cells and mortality of transfusion recipients.

    Science.gov (United States)

    Middelburg, Rutger A; van de Watering, Leo M G; Briët, Ernest; van der Bom, Johanna G

    2013-01-01

    Storage of red cells and the associated storage lesion have been suggested to contribute to adverse clinical outcomes. The aim of this study was to investigate whether increasing storage time of red cells is associated with mortality of recipients. From all patients who received red cell transfusions between January 2005 and May 2009, in the Leiden University Medical Center, we selected those who received only-young or only-old red cells, defined as below or above the median storage time. Mortality was compared in a Cox regression model. Subsequently, similar comparisons were made between subgroups with increasing contrast between old and young red cells. Among adult patients, after correction for potential confounders, the hazard ratio of death within 1 year after receiving red cells stored for more than 17 days compared with 17 days or less was 0.98 (95% confidence interval, 0.83-1.2). With increasing contrast, the hazard ratio decreased to 0.56 (95% confidence interval, 0.32-0.97) for red cells stored for more than 24 days compared with less than 10 days. In contrast to what has previously been suggested, we find an almost 2-fold increase in mortality rate after the transfusion of fresh red cells compared with old red cells. Results dependent on analyses chosen and previous studies may not have used optimal analyses. The tendency to demand ever-fresher blood could actually be detrimental for at least some patient groups.

  7. Prevalence of antibodies to hepatitis C virus after blood transfusion in heart surgery.

    Science.gov (United States)

    Barcena, R; Gonzalez, A; Martin-de-Argila, C; Ulibarrena, C; Graus, J; Grande, L A

    1994-08-01

    We studied the frequency and time of appearance of antibodies to the hepatitis C virus (HCV) retrospectively in the sera of 127 patients who underwent heart surgery between 1983 and 1986. They received blood from volunteer donors hepatitis B surface antigen (HBsAg) negative with normal serum alanine-aminotransferase levels. A prospective follow-up was carried out every 15 days for at least 6 months from the moment of the transfusion. Of the ten patients who developed biochemical criteria of post-transfusional non-A non-B hepatitis, six seroconverted to anti-HCV (60%). Of the other 117, two were already positive before transfusion (1.51%), one patient showed antibodies only in the first post-transfusional serum (passive transfer), and another two patients with no evidence of post-transfusional hepatitis developed HCV antibodies on the 90th day, remaining indefinitely (afterwards seroconversion without hepatitis); both patients' earlier sera were anti-HCV negative. Four (40%) of the ten patients with post-transfusional hepatitis did not develop any serum markers to known hepatotropic agents. Although these findings do not exclude a viral infection by these viruses, they are consistent with the involvement of an unidentified non-A, non-B, non-C agent.

  8. Preoperative predictors of blood component transfusion in living donor liver transplantation

    Directory of Open Access Journals (Sweden)

    R N Makroo

    2013-01-01

    Full Text Available Context: Extensive bleeding associated with liver transplantation is a major challenge faced by transplant surgeons, worldwide. Aims: To evaluate the blood component consumption and determine preoperative factors that predict the same in living donor liver transplantation (LDLT. Settings and Design: This prospective study was performed for a 1 year period, from March 2010 to February 2011. Materials and Methods: Intra- and postoperative utilization of blood components in 152 patients undergoing LDLT was evaluated and preoperative patient parameters like age, gender, height, weight, disease etiology, hemoglobin (Hb, hematocrit (Hct, platelet count (Plt, total leukocyte count (TLC, activated partial thromboplastin time (aPTT, international normalized ratio (INR, serum bilirubin (T. bilirubin, total proteins (T. proteins, albumin to globulin ratio (A/G ratio, serum creatinine (S. creatinine, blood urea (B. urea, and serum electrolytes were assessed to determine their predictive values. Univariate and stepwise discriminant analysis identified those factors, which could predict the consumption of each blood component. Results: The average utilization of packed red cells (PRCs, cryoprecipitates (cryo, apheresis platelets, and fresh frozen plasma was 8.48 units, 2.19 units, 0.93 units, and 2,025 ml, respectively. Disease etiology and blood component consumption were significantly correlated. Separate prediction models which could predict consumption of each blood component in intra and postoperative phase of LDLT were derived from among the preoperative Hb, Hct, model for end-stage liver disease (MELD score, body surface area (BSA, Plt, T. proteins, S. creatinine, B. urea, INR, and serum sodium and chloride. Conclusions: Preoperative variables can effectively predict the blood component requirements during liver transplantation, thereby allowing blood transfusion services in being better prepared for surgical procedure.

  9. Tranexamic acid reduces blood loss and blood transfusions in primary total hip arthroplasty: a prospective randomized double-blind study in 40 patients

    DEFF Research Database (Denmark)

    Husted, Henrik; Blønd, Lars; Sonne-Holm, Stig;

    2003-01-01

    INTRODUCTION: We performed a prospective, randomized, double-blind study on 40 patients scheduled for primary total hip arthroplasty due to arthrosis or osteonecrosis to determine the effect of tranexamic acid on per- and postoperative blood losses and on the number of blood transfusions needed...

  10. Tranexamic acid reduces blood loss and blood transfusions in primary total hip arthroplasty: a prospective randomized double-blind study in 40 patients

    DEFF Research Database (Denmark)

    Husted, Henrik; Blønd, Lars; Sonne-Holm, Stig;

    2003-01-01

    = 0.001), a total blood loss of 814 mL versus 1231 mL (p = 0.001) and a total need for 4 blood transfusions versus 25 (p = 0.04). No patient in either group had symptoms of deep venous thrombosis, pulmonary embolism or prolonged wound drainage. INTERPRETATION: Transemic acid is effective in reducing...

  11. Autologous re-transfusion drain compared with no drain in total knee arthroplasty : a randomised controlled trial

    NARCIS (Netherlands)

    Horstmann, Wieger; Kuipers, Bart; Ohanis, David; Slappendel, Robert; Kollen, Boudewijn; Verheyen, Cees

    2014-01-01

    Background. Post-operative anaemia following total knee arthroplasty is reported to impede functional mobility in the early period following surgery, whereas allogeneic blood transfusions, used to correct low post-operative haemoglobin levels, have concomitant disadvantages. The use of a post-operat

  12. Effects of the combination of blood transfusion and postoperative infectious complications on prognosis after surgery for colorectal cancer. Danish RANX05 Colorectal Cancer Study Group

    DEFF Research Database (Denmark)

    Mynster, T; Christensen, Ib Jarle; Moesgaard, F

    2000-01-01

    BACKGROUND: The frequency of postoperative infectious complications is significantly increased in patients with colorectal cancer receiving perioperative blood transfusion. It is still debated, however, whether perioperative blood transfusion alters the incidence of disease recurrence or otherwise...... affects the prognosis. METHODS: Patient risk variables, variables related to operation technique, blood transfusion and the development of infectious complications were recorded prospectively in 740 patients undergoing elective resection for primary colorectal cancer. Endpoints were overall survival (n.......13-2.82)), localization of cancer in the rectum and Dukes classification were independent risk factors. CONCLUSION: Blood transfusion per se may not be a risk factor for poor prognosis after colorectal cancer surgery. However, the combination of perioperative blood transfusion and subsequent development of postoperative...

  13. The association between preoperative concentration of soluble vascular endothelial growth factor, perioperative blood transfusion, and survival in patients with primary colorectal cancer

    DEFF Research Database (Denmark)

    Werther, K; Christensen, Ib Jarle; Nielsen, Hans Jørgen

    2001-01-01

    OBJECTIVE: To investigate a possible association between the preoperative concentration of soluble vascular endothelial growth factor (sVEGF), perioperative blood transfusion, and survival in patients operated on for colorectal cancer. DESIGN: Retrospective study. SETTING: University hospital......, Denmark. SUBJECTS: 614 patients operated on for primary colorectal cancer. MAIN OUTCOME MEASURES: Association between preoperative blood transfusion and preoperative concentration of sVEGF. Association between perioperative blood transfusion and survival. RESULTS: Blood transfused up to one month before...... preoperative serum samples were obtained was significantly (p = 0.02) associated with high preoperative concentrations of sVEGF. The frequency of perioperative blood transfusion was significantly (p = 0.0007) higher in patients with rectal cancer than in patients with colon cancer. A multivariate analysis...

  14. Role of Medical Social Workers in Management of Anxiety and Stress Among Blood Donors with Transfusion Transmissible Infections

    Directory of Open Access Journals (Sweden)

    Umakanth Siromani

    2014-02-01

    Full Text Available Blood transfusion is a life-saving intervention and millions of lives are saved each year globally through this procedure. Unsafe transfusion practices put millions of people at risk of transfusion-transmissible infections (TTIs and it is mandatory to test the donated blood for blood borne infectious diseases. This is an alarming situation requiring immediate action in appropriate counseling of donors before and after testing of their blood. It is really a challenge for blood banks and motivators if a blood donor is positive for infectious diseases. What is the role of blood bank in helping or guiding the donors to overcome their anxiety and stress? How a medical social worker could psychologically support and guide them to act as cause ambassadors for voluntary blood donation? Guidance and counseling would help them to live positively. Health education, compassionate care and teaching coping mechanisms would encourage them in overcoming their stress and anxiety. [Natl J Med Res 2014; 4(1.000: 87-88

  15. Cryopreserved red blood cells for pediatric transfusion. Frozen storage of small aliquots in polyvinyl chloride (PVC) plastic bags.

    Science.gov (United States)

    Valeri, C R; Valeri, D A; Gray, A; Melaragno, A J; Vecchione, J J; Dennis, R C; Emerson, C P

    1981-01-01

    Human nonrejuvenated and rejuvenated red bood cells were prepared for cryopreservation and subsequent pediatric transfusion. Glycerol was added to the red blood cells in the primary polyvinyl chloride plastic collection bag to achieve a concentration of 40 per cent W/V. The red blood cells were concentrated by centrifugation, and the supernatant glycerol was discarded. Each glycerolized unit was divided into four equal aliquots in the individual 600-ml bags of a dry quadruple polyvinyl chloride plastic system, and each aliquot was frozen and stored at -80 C. After thawing, sodium chloride solutions were used to wash the aliquots in the IBM Blood Processor 2991-1 or 2991-2 or the Haemonetics Blood Processor 115, and the washed aliquots were stored in a sodium chloride-glucose-phosphate solution at 4 C for 24 hours. Freeze-thaw recovery of the red blood cells was about 97 per cent, and freeze-thaw-wash recovery was about 84 per cent. Twenty-four-hour posttransfusion survival values were about 92 per cent for both nonrejuvenated and indated-rejuvenated red blood cells. Nonrejuvenated red blood cells, those frozen within three to five days of collection without biochemical modification, had normal oxygen transport function at the time of transfusion; rejuvenated red blood cells, those biochemically treated with PIGPA Solution A after three to five days of storage at 4 C, had improved oxygen transport function at the time of transfusion.

  16. Transfusion transmitted infections in thalassaemics: need for reappraisal of blood screening strategy in India.

    Science.gov (United States)

    Shyamala, V

    2014-04-01

    The aim of the study was to assess the blood safety in India through prevalence in thalassaemic population. Safety of the blood supply is a subject of great concern for all recipients. This review attempts to assess the relevance and format of tests for viruses in the context of transfusion transmitted infection (TTI) prevalence in India. Serological marker testing for human immunodeficiency virus-1/2 (HIV-1/2), hepatitis C virus (HCV) and hepatitis B virus (HBV) is mandatory in India. Numerous TTI incidents in the repeat recipients supported by results from nucleic acid technology (NAT) testing indicate the deficiencies in blood safety. The β-thalassaemic population (3-17%) in India has been used to reflect on blood safety. The prevalence of HIV-1/2, HCV and HBV in the Indian donor population, the limitations in accessing safe donors, quality of serological tests and the impact on repeat recipients is evaluated. The reports point to prevalence of ˜2% of viral diseases in the blood donor population, and the insufficiency of serology testing resulting in up to 45% TTIs in thalassaemics. The revelation by individual donation (ID) NAT testing, of 1 per 310 units being serology negative-NAT reactive is alarming. Extrapolating the serology negative NAT reactive yields, for an annual blood supply of 7.9 million units, 23,700 units or nearly 100,000 blood components are likely to be infectious. Though the cost for ID-NAT testing is considered unaffordable for a medium development country such as India, the enormity of TTIs will place an unmanageable cost burden on the society.

  17. Impact of autologous blood transfusion on the use of pack of red blood cells in coronary artery bypass grafting surgery

    Directory of Open Access Journals (Sweden)

    Leonardo Leiria de Moura da Silva

    2013-06-01

    Full Text Available OBJECTIVE: To evaluate the impact of Cell Saver autologous blood transfusion system (CS on the use of packed red blood cells (pRBC in coronary artery bypass grafting (CABG surgery. METHODS: We carried out a retrospective cross-sectional study in 87 patients undergoing primary elective CABG with miniaturized cardiopulmonary bypass (miniCPB, divided in two groups: 44 without-CS and 43 with-CS. We investigated the necessity of absolute use and the volume of packed red blood cells (pRBC in each group, as well as cardiovascular risk factors, presurgical variables and intraoperative surgical parameters. All data were collected from medical records and there was no randomization or intervention on group selection. Statistical analysis was performed with Student t-test, Mann-Whitney U-test and χ² test, with a 5% significance level. RESULTS: There were no significant differences between the two groups in terms of cardiovascular risk factors and pre and intraoperative variables. Evaluating the absolute use of pRBC during surgery, there was a statistically significant difference (P=0.00008 between the groups without-CS (21/44 cases; 47.7% and with-CS (4/43 cases; 9.3%. There was also a statistically significant difference (P=0.000117 in the volumes of pRBC between the groups without-CS (198.651258.65ml and with-CS (35.061125.67ml. On the other hand, in the early postoperative period (up to 24h there was no difference regarding either the absolute use or the volumes of pRBC between both studied groups. CONCLUSION: Autologous erythrocyte transfusion with CS use reduces the use of intraoperative homologous pRBC in coronary artery bypass grafting surgeries associated with miniCPB.

  18. [Satisfaction survey in general hospital personnel involved in blood transfusion: implementation of the ISO 9001: 2000 standard].

    Science.gov (United States)

    Chord-Auger, S; de Bouchony, E Tron; Moll, M-C; Boudart, D; Folléa, G

    2004-07-01

    As part of its policy of constant quality improvement, Etablissement Français du Sang (EFS) des Pays de la Loire (Pays de la Loire Regional blood transfusion institution) carried out a satisfaction survey among the hospital personnel involved in prescribing and using immuno-hematological tests and labile blood products. The polling tool selected by agreement between the hospital management and quality assurance department was a questionnaire that permitted item rating and free commentary. It addressed the personnel's perception of the quality of erythrocyte immuno-hematological (EIH) testing and of the products administered, as well as their perception of the quality of communications with the local EFS. The questionnaire was sent to 26 physicians and 32 senior nurses in 15 hospital departments. The reply rate was 60% and expressed a 85% overall satisfaction level. Dissatisfaction causes were more specifically analysed, the main one involving labile blood product distribution in emergency situations. A joint undertaking by the EFS and the hospital led to the implementation of corrective measures, including the writing and implementation of a common standard operating procedure for emergency transfusion management. The results obtained demonstrated the feasibility of this type of survey and the interest, to a blood transfusion centre and the hospital personnel involved in transfusion, of assessing their very own perception of service quality.

  19. Prediction of escape red blood cell transfusion in expectantly managed women with acute anaemia after postpartum haemorrhage

    NARCIS (Netherlands)

    Prick, B. W.; Schuit, E.; Mignini, L.; Jansen, A. J. G.; van Rhenen, D. J.; Steegers, E. A. P.; Mol, B. W.; Duvekot, J. J.

    2015-01-01

    ObjectiveTo determine clinical predictors of escape red blood cell (RBC) transfusion in postpartum anaemic women, initially managed expectantly, and the additional predictive value of health-related quality of life (HRQoL) measures. DesignSecondary analysis of women after postpartum haemorrhage, eit

  20. Revisiting transfusion safety and alternatives to transfusion.

    Science.gov (United States)

    Schoettker, Patrick; Marcucci, Carlos E; Casso, Gabriele; Heim, Catherine

    2016-01-01

    Transfusion of blood products can be life saving when used appropriately. It carries however at the same time a potential for morbidity and mortality, depending on the patient, the product or the setting. Numerous strategies have been elaborated to minimize these risks, and in recent years, transfusion has no longer been regarded as essential for the management of a wide range of diseases. Uncomplicated surgeries in well-prepared patients can now be conducted without the use of transfusions. Questions about transfusion safety and shortage have led to extensive research on alternatives to blood transfusion, ranging from non-pharmacological to pharmacological solutions. Restrictive transfusion therapies, preoperative autologous blood donations, perioperative red cell salvage, acute normovolaemic haemodilution techniques or patient blood management are potential solutions where prothrombin complex or fibrinogen concentrates, synthetic anti-fibrinolytic agents, desmopressin, rFVIIa, or erythropoiesis stimulating agents may play a complementary pharmacologic role.

  1. Seroprevalence and trends in transfusion transmitted infections among blood donors in a university hospital blood bank: a 5 year study.

    Science.gov (United States)

    Pallavi, P; Ganesh, C K; Jayashree, K; Manjunath, G V

    2011-03-01

    Blood is life. Transfusion of blood and blood components, as a specialized modality of patient management saves millions of lives worldwide each year and reduce morbidity. It is well known that blood transfusion is associated with a large number of complications, some are only trivial and others are potentially life threatening, demanding for meticulous pretransfusion testing and screening particularly for transfusion transmissible infections (TTI). These TTI are a threat to blood safety. The priority objective of BTS is thus to ensure safety, adequacy, accessibility and efficiency of blood supply at all levels. The objective of the present study was to assess the prevalence and trend of transfusion transmitted infections (TTI) among voluntary and replacement donors in the Department of Blood bank and transfusion Medicine of JSS College Hospital, a teaching hospital of Mysore during the period from 2004 to 2008. A retrospective review of donors record covering the period between 2004 and 2008 at the blood bank, JSS Hospital, Mysore was carried out. All samples were screened for HIV, HBsAg, HCV, syphilis and malaria. Of the 39,060, 25,303 (64.78%) were voluntary donors and the remaining 13,757 (35.22%) were replacement donors. The overall prevalence of HIV, HbsAg, HCV and syphilis were 0.44, 1.27, 0.23 and 0.28%, respectively. No blood donor tested showed positivity for malarial parasite. Majority were voluntary donors with male preponderance. In all the markers tested there was increased prevalence of TTI among the replacement donors as compared to voluntary donors. With the implementation of strict donor criteria and use of sensitive screening tests, it may be possible to reduce the incidence of TTI in the Indian scenario.

  2. Rh阴性患者输血策略%The transfusion strategy for patients with Rh negative blood

    Institute of Scientific and Technical Information of China (English)

    兰炯采

    2015-01-01

    近年来,有关Rh阴性患者的输血问题由于媒体炒作而变得复杂化,不利于临床对患者的生命抢救。政府已对Rh阴性患者的输血颁布了有关法规,以指导临床安全、有效和科学的输血。对于体内无抗-D抗体的Rh阴性患者,在血资源紧急情况下可以输配血相合的Rh阳性血,而对于有抗-D抗体者则应尽量输注Rh阴性血。本文阐述Rh阴性患者安全、有效、科学的输血策略。%In recent years, the blood transfusion in Rh negative patients has been complicated due to media hype, which hampers the patients’ life in clinical emergency treatment. The government has already issued the relevant laws and regulations for Rh negative blood transfusion in order to guide the safe, effective and scientiifc blood transfusion. When the blood resources are insuifcent in an emergency situation, the Rh negative patients without anti-D antibody can receive Rh D-positive blood, while those with anti-D antibody must infuse Rh D negative blood as possible. This paper states the strategy for safe, scientiifc and reasonable blood transfusion in patients with Rh negative blood.

  3. In-flight transfusion of packed red blood cells on a combat search and rescue mission: a case report from operation enduring freedom.

    Science.gov (United States)

    West, Brad C; Bentley, Richard; Place, Ronald J

    2004-03-01

    Injuries on the battlefield can occur far from the nearest medical treatment facility. This is especially likely for downed pilots and special operations personnel. Some of these injuries lead to significant blood loss requiring transfusion. We present two cases of injured coalition force members during Operation Enduring Freedom that illustrate the potential need for a transfusion capability at the site of injury to prevent death. Consideration should be given to augmenting transfusion capabilities in military environments with predictably long evacuation times.

  4. Satisfaction survey in general hospital personnel involved in blood transfusion: implementation of the ISO 9001: 2000 standard.

    Science.gov (United States)

    Chord-Auger, S; Tron de Bouchony, E; Moll, M C; Boudart, D; Folléa, G

    2004-10-01

    As part of its policy of constant quality improvement, Etablissement francais du sang (EFS) des pays de la Loire (Pays de la Loire Regional Blood Transfusion Centre) carried out a satisfaction survey among the hospital personnel involved in prescribing and using immunohaematological tests and labile blood products (LBP). The polling tool selected by agreement between the Saint Nazaire's hospital management and Quality Assurance (QA) Department was a questionnaire that permitted item rating and free commentary. It addressed the personnel's perception of the quality of erythrocyte immunohaematological (EIH) testing and of the products administered, as well as their perception of the quality of communications with the local EFS. The questionnaire was sent to 26 physicians and 32 senior nurses in 15 hospital departments. The reply rate was 60% and expressed an 85% overall satisfaction level. Dissatisfaction causes were more specifically analysed, the main one involving LBP distribution in emergency situations. A joint undertaking by the EFS and the hospital led to the implementation of corrective measures, including the writing and implementation of a common standard operating procedure for emergency transfusion management. The results obtained demonstrated the feasibility of this type of survey and the interest, to a blood transfusion centre and the hospital personnel involved in transfusion, of assessing their very own perception of service quality.

  5. Bacterial contamination of blood components: Norwegian strategies in identifying donors with higher risk of inducing septic transfusion reactions in recipients.

    Science.gov (United States)

    Klausen, Sofie Strand; Hervig, Tor; Seghatchian, Jerard; Reikvam, Håkon

    2014-10-01

    Bacterial contamination of blood and its cellular components remains the most common microbiological cause of transfusion associated morbidity and mortality, even in developed countries. This yet unresolved complication is seen more often in platelet transfusions, as platelet concentrates are stored at room temperature, in gas permeable containers with constant agitation, which support bacterial proliferation from relatively low undetectable levels, at the beginning of storage time, to relatively high virulent bacteria titers and endotoxin generation, at the end of shelf life. Accordingly, several combined strategies are introduced and implemented to at least reduce the potential risk of bacterial contaminated products for transfusion. These embody: improved donors arms cleaning; bacterial avoidance by diversion of the first portion of collection; reducing bacterial growth through development of newer storage media for longer platelet shelf life; bacterial load reduction by leucoreduction/viral inactivation, in some countries and eliminating the use potentially contaminated units through screening, through current available testing procedures, though none are not yet fully secure. We have not seen the same reduction in bacterial associated transfusion infections as we have observed for the sharp drop in transfusion associated transmission rates of HIV and hepatitis B and C. This great viral reduction is not only caused by the introduction of newer and more sensitive and specific detection methods for different viruses, but also the identification of donor risk groups through questionnaires and personal interviews. While search for more efficient methods for identifying potential blood donors with asymptomatic bacteremia, as well as a better way for detecting bacteria in stored blood components will be continuing, it is necessary to establish more standardized guidelines for the recognition the adverse reactions in recipients of potentially contaminated units

  6. Analysis of component blood transfusion in certain hospital from 2008 to 2010%某院2008~2010年成分输血分析

    Institute of Scientific and Technical Information of China (English)

    董立君

    2012-01-01

    目的 分析该院过去三年成分输血情况,指导临床科学、合理用血.方法 对该院2008~2010年用血量进行统计,计算出各种成分输血率.结果 成分输血使用量逐年增加,以红细胞、血浆为主,血浆的应用比例逐年下降.结论 该院成分输血率已达较高水平(≥99.9%),但是临床血浆的滥用情况应该得到进一步遏制,仍需继续加强对成分输血的监督管理,强调血小板和冷沉淀的配合使用,以便节约有限的血液资源.%Objective To analyze the state of component blood transfusion in certain hospital during 2008 and 2010 and to guide reasonable and effective blood transfusion. Methods The mount of blood for clinical transfusion and the rate of different component blood transfusion were statistically analyzed. Results The mount of component blood transfusion increased gradually. Red blood cells and plasma transfusion were the most common blood component for clinical transfusion, but the proportion of plasma decreased gradually. Conclusion The percentage of component blood transfusion had attained a relatively advanced level (≥99. 9%), but the abuse of plasma should be reduced further. More effective managing and supervising of component blood transfusion should be strengthened, combined usage of platelet and cryoprecipitate should be further utilized to save the limited blood resources.

  7. Prevention of non-immune mediated transfusion-related acute lung injury; from blood bank to patient.

    Science.gov (United States)

    van Bruggen, Robin; de Korte, Dirk

    2012-01-01

    Transfusion-related acute lung injury (TRALI) is a severe form of pulmonary insufficiency induced by transfusion. TRALI is the leading cause of transfusion-related death, and is caused by the infusion of either anti-leukocyte antibodies in plasma containing blood products or neutrophil priming substances that accumulate during storage of cellular blood products. Among these neutrophil priming substances are bioactive lipids, such as lyso-phosphatidylcholines (lysoPCs) and arachidonic acid, soluble CD40L (sCD40L) and possibly other, as yet unidentified substances. The accumulation of these substances during cellular blood product storage and their role in the induction of "non-immune mediated" TRALI pathogenesis are highly relevant for the current debate of the use of longer vs. shorter stored blood products. In this review, the accumulation of these different substances during storage, as well as their mode of action in inducing TRALI are discussed. In addition, different improvements in current blood banking procedures to prevent TRALI due to these non-immune mediators will be proposed.

  8. Impairment of recovery of muscle function by residual rocuronium after re-transfusion of intraoperative salvaged blood

    Institute of Scientific and Technical Information of China (English)

    Wang Geng; Wang Jia; Zhou Haibin; Zhao Xia; Wu Xinmin

    2014-01-01

    Background Recurarization has previously been described in the context of acute normovolemic hemodilution.The aim of this study was to investigate the impairment of recovery of neuromuscular function after re-transfusion of intraoperative salvaged blood in patients treated with rocuronium.Methods We enrolled 50 patients undergoing general anesthesia for lumbar surgery.Intraoperative blood salvage (IBS) was used in 30 patients (group Ⅰ); the remaining 20 comprised a control group (group C).Anesthesia was induced with fentanyl,midazolam,propofol and rocuronium.Rocuronium was infused to maintain neuromuscular blockade during surgery.Blood was collected from the operative field and re-transfused in the post-anesthesia care unit (PACU).Neuromuscular function was monitored using the train-of-four ratio (TOFr).Once the train-of-four ratio exceeded 90 in the PACU,neuromuscular function was evaluated every 5 minutes for 30 minutes.The TOFr and incremental recovery of TOFr from baseline were recorded.Salvaged blood was re-transfused at the beginning of the evaluation for patients in group Ⅰ,and afterwards for patients in group C.Blood gas analysis was assessed before anesthesia and in the PACU.Results Incremental recovery of TOFr from baseline was significantly less in group Ⅰ than controls at 25 minutes (6.1±3.2vs.9.1±3.2,respectively; P=0.001) and 30 minutes (7.1±3.2 vs.10.0±2.2,respectively; P=-0.001).There were no significant differences in gas exchange between the groups.Conclusions In patients who had received a rocuronium infusion during anesthesia,re-transfusion of salvaged blood significantly impaired recovery of neuromuscular function recovery in the PACU,but without significant impairment of respiratory function.

  9. Quantification of Transfusion Recipients at Risk of Receiving Hepatitis B Virus-Contaminated Blood Components: A Korean Study.

    Science.gov (United States)

    Lee, Kunsei; Kim, Hyeongsu; Chang, Sounghoon; Hur, Mina; Kim, Vitna; Jeong, Hyoseon; Seo, Dong Hee; Lee, SangWon; Kim, Eun Jung; Shin, Eunyoung; Kim, Young Tack

    2016-09-01

    Although there are lots of studies about the risk for the hepatitis B virus infection such as the residual risk for donated blood, there is no research on the risk of HBV infection, from the viewpoint of recipients in Korea. Using the data about HBsAg status of donated blood in 2008 and 2009, the distribution of blood components from the claim data of health insurance in 2009, the distribution of HBsAg and HBsAb of recipients, and some assumptions, we quantified the number of recipients in Korea that might be expected to receive HBV-contaminated blood components, as a proxy index for HBV infection by transfusion in 2009. Of the 376,211 recipients, the number who might be expected to receive blood components with HBV in 2009 was 23.2 (95 % CI 13.6, 36.8) in the basic model, 43.2 (95 % CI 25.4, 68.7) in extended model I, 55.2 (95 % CI 32.5, 87.7) in extended model II and 101.6 (95 % CI 59.8, 161.4) in extended model III. The number of HBV-positive samples per 100,000 transfused units was 0.6 in the basic model (95 % CI 0.3, 0.9), 1.1 in extended model I (95 % CI 0.6, 1.8), 1.4 in extended model II (95 % CI 0.8, 2.2), and 2.6 in extended model III (95 % CI 1.5, 4.1). This study showed that a few recipients might receive HBV-contaminated blood component by transfusion. These results could be used as a scientific evidence for health policy on HBV transfusion infection.

  10. Net haemoglobin increase from reinfusion of refrigerated vs. frozen red blood cells after autologous blood transfusions

    DEFF Research Database (Denmark)

    Ashenden, M; Mørkeberg, Jakob Sehested

    2011-01-01

    objective was to examine which storage procedure yielded the largest increase in circulating haemoglobin after reinfusion compared to baseline. MATERIALS AND METHODS  Equal volumes of blood from 15 men were withdrawn and stored either frozen or refrigerated as packed red blood cells. Serial measures...... freezing. Nevertheless, frozen storage allowed haemoglobin to fully recover before reinfusion, while the haemoglobin was 10% lower in the refrigerated group compared with baseline. After reinfusion, the haemoglobin levels were 11·5% higher than the baseline values in the group reinfused with frozen blood......, while for the refrigerated group, haemoglobin levels were only 5·2% higher than baseline. CONCLUSION  The relatively larger recovery from anaemia in the frozen group during storage more than compensated for the larger loss of haemoglobin during freezing and resulted in a larger net gain in haemoglobin...

  11. Infusion pumps and red blood cell damage in transfusion therapy: an integrative revision of the academic literature 1

    Science.gov (United States)

    Wilson, Ana Maria Miranda Martins; Peterlini, Maria Angélica Sorgini; Pedreira, Mavilde da Luz Gonçalves

    2016-01-01

    ABSTRACT Objectives: to obtain information from scientific literature concerning infusion pumps used in administering erythrocyte (red blood cells) and to evaluate the implications in the practical use of this equipment by nurses when conducting transfusions. Method: an integrative revision of the following scientific databases: Pubmed/Medline, Scopus, the Virtual Library for Health, SciELO, Web of Science and Cochrane. The following descriptors were used: "infusion pumps", "blood transfusion", "transfused erythrocyte" and "hemolyis". There were no restrictions on the scope of the initial data and it was finalized in December 2014. 17 articles were identified in accordance with the inclusion and exclusion criteria. Results: all of the publications included in the studies were experimental in vitro and covered the use of infusion pumps in transfusion therapy. A summary of the data was presented in a synoptic chart and an analysis of it generated the following categories: cellular damage and the infusion mechanism. Conclusion: infusion pumps can be harmful to erythrocytes based on the infusion mechanism that is used, as the linear peristaltic pump is more likely to cause hemolysis. Cellular damage is related to the plasmatic liberation of markers that largely dominate free hemoglobin and potassium. We reiterate the need for further research and technological investments to guide the development of protocols that promote safe practices and that can contribute to future clinical studies. PMID:27533272

  12. Infusion pumps and red blood cell damage in transfusion therapy: an integrative revision of the academic literature

    Directory of Open Access Journals (Sweden)

    Ana Maria Miranda Martins Wilson

    Full Text Available ABSTRACT Objectives: to obtain information from scientific literature concerning infusion pumps used in administering erythrocyte (red blood cells and to evaluate the implications in the practical use of this equipment by nurses when conducting transfusions. Method: an integrative revision of the following scientific databases: Pubmed/Medline, Scopus, the Virtual Library for Health, SciELO, Web of Science and Cochrane. The following descriptors were used: "infusion pumps", "blood transfusion", "transfused erythrocyte" and "hemolyis". There were no restrictions on the scope of the initial data and it was finalized in December 2014. 17 articles were identified in accordance with the inclusion and exclusion criteria. Results: all of the publications included in the studies were experimental in vitro and covered the use of infusion pumps in transfusion therapy. A summary of the data was presented in a synoptic chart and an analysis of it generated the following categories: cellular damage and the infusion mechanism. Conclusion: infusion pumps can be harmful to erythrocytes based on the infusion mechanism that is used, as the linear peristaltic pump is more likely to cause hemolysis. Cellular damage is related to the plasmatic liberation of markers that largely dominate free hemoglobin and potassium. We reiterate the need for further research and technological investments to guide the development of protocols that promote safe practices and that can contribute to future clinical studies.

  13. Effects of preoperative β-blocker on blood loss and blood transfusion during spinal surgeries with sodium nitroprusside-controlled hypotension

    Directory of Open Access Journals (Sweden)

    Yasser Mohamed Amr

    2012-01-01

    Full Text Available Background: The present study sought to determine whether premedication with oral β-blocker before hypotensive anesthesia with sodium nitroprusside could improve the quality of surgical field, decrease the blood loss, and decrease the need for homologous blood transfusion and duration of surgery. Methods: Eighty patients scheduled for spinal fixation surgery were included in a prospective, randomized, double-blinded study. Patients were classified into two groups: Group I received oral atenolol 50 mg twice one day before surgery; and Group II received placebo tablets identical in appearance to atenolol tablets for the same period and interval. All patients in both the groups received intraoperative sodium nitroprusside (SNP as a hypotensive agent. Hemodynamic variables, amount of sodium nitroprusside used, quality of surgical field, and the amount of homologous blood transfusion and blood loss were compared between groups. Results: Heart rate and amount of SNP used were significantly less (P<0.0001 in the atenolol group, but no significant difference was found in intraoperative mean arterial blood pressure (MABP between the two groups. The time of surgeries was significantly shorter in Group I than in Group II (185±15.21 vs 225±12.61 min, P<0.0001. The quality of surgical field was better in Group I than in Group II in all times of measurements, P<0.0001. The amount of blood loss and the amount of packed red blood cells transfused were significantly less in Group I than in Group II, P<0.0001. No clinically significant complications were observed in either group. Conclusion: Premedication with oral atenolol 50 mg twice/day for one day before hypotensive anesthesia with SNP during spinal surgeries seems to be clinically safe and effective to reduce heart rate, amount of SNP used, amount of blood loss, and amount of blood transfused with better quality of surgical field.

  14. Targeting Continuing Medical Education on Decision Makers: Who Decides to Transfuse Blood?

    Science.gov (United States)

    Goodnough, Lawrence T.; And Others

    1992-01-01

    Staff communication patterns were observed during 13 open-heart surgeries to identify the transfusion decision makers. It was determined that targeting decision makers for continuing medical education would improve the quality of transfusion practice and increase the efficiency of continuing education. (SK)

  15. [Applications in gynecology-obstetrics of the first legal cases concerning HIV transmission by blood transfusion and errors in screening].

    Science.gov (United States)

    Pierre, F; Soutoul, J H

    1991-01-01

    The intention of the authors in this paper is to provide a preliminary report on what is going on in order to inform gynaecologists and obstetricians of the initial legal steps concerning the transmission of HIV by blood transfusion and the defects in screening for the infection which could have been caught by a pregnant woman; where there was a possibility of a false-positive diagnosis from the serum which could have brought about a termination of pregnancy unnecessarily. Two decisions have been analysed, the one according to the old administrative law and the other according to the more recent judgement, involving pregnancy and other decisions which were not directly concerned with the specialty. These can be instructive for practitioners because these circumstance may come up again. It is worth looking at the case papers where medical responsibility can be invoked involving the professional insurance agencies. These cases will increase in numbers in the future. The authors analysed in the light of the decisions that had been made, possible penal, civil and administrative liabilities that could threaten gynaecologists and obstetricians in this field. The study ends by pointing out what can be done to lessen these medico-legal risks by avoiding blood loss in operations, by finding other ways than blood transfusions towards the end of pregnancy, but above all, by reducing and controlling the number of blood transfusions carefully. This has to be done in collaboration with the transfusion centres and the laboratories where the blood is tested. Judges will have to work out where the responsibility lies if the cases come before them.

  16. The effects of aprotinin on blood product transfusion associated with thoracic aortic surgery requiring deep hypothermic circulatory arrest.

    LENUS (Irish Health Repository)

    Seigne, P W

    2012-02-03

    OBJECTIVE: To compare the effects of aprotinin on blood product use and postoperative complications in patients undergoing thoracic aortic surgery requiring deep hypothermic circulatory arrest. DESIGN: A retrospective study. SETTING: A university hospital. PARTICIPANTS: Nineteen patients who underwent elective or urgent thoracic aortic surgery. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: The total number of units of packed red blood cells, fresh frozen plasma, and platelets was significantly less in the group that received aprotinin (p = 0.01, 0.04, and 0.01). The intraoperative transfusion of packed red blood cells and platelets, collection and retransfusion of cell saver, and postoperative transfusion of fresh frozen plasma were also significantly less in the aprotinin group (p = 0.01, 0.02, 0.01, and 0.05). No patient in either group sustained renal dysfunction or a myocardial infarction. Two patients who had not received aprotinin suffered from chronic postoperative seizures, and one patient who had received aprotinin sustained a perioperative stroke. CONCLUSIONS: Low-dose aprotinin administration significantly decreases blood product transfusion requirements in the setting of thoracic aortic surgery requiring deep hypothermic circulatory arrest, and it does not appear to be associated with renal or myocardial dysfunction.

  17. [Contributions of the Council of Europe's Blood Transfusion Steering Committee to the determination of rules for the selection of donors of blood and blood components and the study of sexual behaviors having an impact on blood safety].

    Science.gov (United States)

    Behr-Gross, M-E; Heiden, M; Norda, R

    2013-05-01

    In November 2009, the Council of Europe's Blood Transfusion Steering Committee created a group of experts to explore the problem of behaviors having an impact on the management of donors of blood and blood components and on blood transfusion safety in Europe. This ad hoc group sought a harmonised interpretation of temporary exclusion (or temporary deferral), as opposed to permanent exclusion (or permanent deferral), in the context of the selection of donors of blood and blood components. It was also given the mandate to assess, on the basis of available data, the possibility of differentiating "at risk" behaviours from behaviours "at high risk" of contamination by serious infectious diseases transmitted by blood, blood components or derived therapeutic products. The primary objective of this work was to ensure the safety of blood, blood components and derived therapeutic products for future recipients by promoting a risk analysis-based approach, given that some countries envisaged amending their provisions for donor selection. However, a risk analysis can only be performed on groups, not individuals, which may give the impression of a discriminatory approach, so it needed to be justified in the context of transfusion safety. A collaborative project, which included an investigation phase, led to the drafting of a technical memorandum that summarised the data collected in ten Council of Europe member states on the selection criteria for blood donors and the epidemiology of infectious diseases (with a focus on human immunodeficiency virus) in the general population and among blood donors. The technical memorandum was published in 2011 on the European Directorate for the Quality of Medicines and Healthcare website dedicated to this project. A draft resolution of the Committee of Ministers of the Council of Europe was then developed by the Council of Europe's Blood Transfusion Steering Committee. This text was circulated among member and observer states of the Council

  18. Concentrating on links of blood transfusion in clinical departments%医院临床科室输血应注重环节管理

    Institute of Scientific and Technical Information of China (English)

    朱晨光

    2011-01-01

    目的 规范临床科室输血工作程序,避免相关环节差错发生.方法 把握临床科室输血科学评估内容、指征和知情告询杠杆,临床科室输血文书信息质量,输血技术操作标准及输血网络化管理,监测通报(通讯)和院、科、个人培训机制控制点.结果 注重临床科室输血环节控制,可帮助临床科室医务人员重温(或更新)输血知识,熟知法律(规)、标准,规范文书信息质量和操作标准行为,提升科学合理、循征输血理念,促进输血管理和技术要素优化,减少临床输血反应、事故和纠纷发生.结论临床科室输血是临床输血工作的关键环节之一,其质量控制程度好坏是输血科学合理、安全有效根本保证.%OBJECTIVE To standardize the clinical departments blood transfusion procedures, to avoid the errors occurred in related links. METHODS The content of scientific assessment of blood transfusion in clinical departments, divisions and informed consultation indication lever, the quality of documents information in clinical blood transfusion instruments were educated, blood transfusion optional behavior and blood transfusion network operating standards and management were grasped through, monitoring the communications and the hospital,scientific, personal training system control points. RESULTS Focusing process control of blood transfusion in clinical departments can help medical personnel review (or renew) transfusion knowledge; to familiarize with the law (regulations), standards, regulations information quality and operating standards behavior acted to enhance the scientific and rational, evidence blood transfusion ideas, promote blood transfusion management and technical elements of optimization, reduce clinical transfusion reactions, accidents and disputes occur. CONCLUSION The blood transfusion in clinical departments is one of the key links, the quality control of which is the fundamental guarantee not only for the

  19. Predictors of red blood cell transfusion after cardiac surgery: a prospective cohort study

    Directory of Open Access Journals (Sweden)

    Camila Takao Lopes

    2015-12-01

    Full Text Available Abstract OBJECTIVE To identify predictors of red blood cell transfusion (RBCT after cardiac surgery. METHOD A prospective cohort study performed with 323 adults after cardiac surgery, from April to December of 2013. A data collection instrument was constructed by the researchers containing factors associated with excessive bleeding after cardiac surgery, as found in the literature, for investigation in the immediate postoperative period. The relationship between risk factors and the outcome was assessed by univariate analysis and logistic regression. RESULTS The factors associated with RBCT in the immediate postoperative period included lower height and weight, decreased platelet count, lower hemoglobin level, higher prevalence of platelet count <150x10 3/mm3, lower volume of protamine, longer duration of anesthesia, higher prevalence of intraoperative RBCT, lower body temperature, higher heart rate and higher positive end-expiratory pressure. The independent predictor was weight <66.5Kg. CONCLUSION Factors associated with RBCT in the immediate postoperative period of cardiac surgery were found. The independent predictor was weight.

  20. Insight into "Calculated Risk": An Application to the Prioritization of Emerging Infectious Diseases for Blood Transfusion Safety.

    Science.gov (United States)

    Neslo, R E J; Oei, W; Janssen, M P

    2017-02-23

    Increasing identification of transmissions of emerging infectious diseases (EIDs) by blood transfusion raised the question which of these EIDs poses the highest risk to blood safety. For a number of the EIDs that are perceived to be a threat to blood safety, evidence on actual disease or transmission characteristics is lacking, which might render measures against such EIDs disputable. On the other hand, the fact that we call them "emerging" implies almost by definition that we are uncertain about at least some of their characteristics. So what is the relative importance of various disease and transmission characteristics, and how are these influenced by the degree of uncertainty associated with their actual values? We identified the likelihood of transmission by blood transfusion, the presence of an asymptomatic phase of infection, prevalence of infection, and the disease impact as the main characteristics of the perceived risk of disease transmission by blood transfusion. A group of experts in the field of infectious diseases and blood transfusion ranked sets of (hypothetical) diseases with varying degrees of uncertainty associated with their disease characteristics, and used probabilistic inversion to obtain probability distributions for the weight of each of these risk characteristics. These distribution weights can be used to rank both existing and newly emerging infectious diseases with (partially) known characteristics. Analyses show that in case there is a lack of data concerning disease characteristics, it is the uncertainty concerning the asymptomatic phase and the disease impact that are the most important drivers of the perceived risk. On the other hand, if disease characteristics are well established, it is the prevalence of infection and the transmissibility of the disease by blood transfusion that will drive the perceived risk. The risk prioritization model derived provides an easy to obtain and rational expert assessment of the relative importance of

  1. Phenotypic differences of CD4(+) T cells in response to red blood cell immunization in transfused sickle cell disease patients.

    Science.gov (United States)

    Vingert, Benoît; Tamagne, Marie; Habibi, Anoosha; Pakdaman, Sadaf; Ripa, Julie; Elayeb, Rahma; Galacteros, Frédéric; Bierling, Philippe; Ansart-Pirenne, Hélène; Bartolucci, Pablo; Noizat-Pirenne, France

    2015-06-01

    Alloimmunization against red blood cells (RBCs) is the main immunological risk associated with transfusion in patients with sickle cell disease (SCD). However, about 50-70% of SCD patients never get immunized despite frequent transfusion. In murine models, CD4(+) T cells play a key role in RBC alloimmunization. We therefore explored and compared the CD4(+) T-cell phenotypes and functions between a group of SCD patients (n = 11) who never became immunized despite a high transfusion regimen and a group of SCD patients (n = 10) who had become immunized (at least against Kidd antigen b) after a low transfusion regimen. We studied markers of CD4(+) T-cell function, including TLR, that directly control lymphocyte function, and their spontaneous cytokine production. We also tested responders for the cytokine profile in response to Kidd antigen b peptides. Low TLR2/TLR3 expression and, unexpectedly, strong expression of CD40 on CD4(+) T cells were associated with the nonresponder status, whereas spontaneous expression of IL-10 by CD4(+) T cells and weak Tbet expression were associated with the responder status. A Th17 profile was predominant in responders when stimulated by Jb(k) . These findings implicate CD4(+) T cells in alloimmunization in humans and suggest that they may be exploited to differentiate responders from nonresponders.

  2. Effects of the combination of blood transfusion and postoperative infectious complications on prognosis after surgery for colorectal cancer. Danish RANX05 Colorectal Cancer Study Group

    DEFF Research Database (Denmark)

    Mynster, T; Christensen, Ib Jarle; Moesgaard, F;

    2000-01-01

    = 740) and time to diagnosis of recurrent disease in the subgroup of patients operated on with curative intention (n = 532). The patients were analysed in four groups divided with respect to administration or not of perioperative blood transfusion and development or non-development of postoperative......BACKGROUND: The frequency of postoperative infectious complications is significantly increased in patients with colorectal cancer receiving perioperative blood transfusion. It is still debated, however, whether perioperative blood transfusion alters the incidence of disease recurrence or otherwise...... affects the prognosis. METHODS: Patient risk variables, variables related to operation technique, blood transfusion and the development of infectious complications were recorded prospectively in 740 patients undergoing elective resection for primary colorectal cancer. Endpoints were overall survival (n...

  3. Leukodepleted blood components do not remove the potential for long-term transfusion-associated microchimerism in Australian major trauma patients.

    Science.gov (United States)

    Hirani, Rena; Balogh, Zsolt J; Lott, Natalie J; Hsu, Jeremy M; Irving, David O

    2014-01-01

    Despite the introduction of leukodepleted blood components, it has been shown that donor leukocyte engraftment (microchimerism) remains a long-term consequence of red blood cell (RBC) transfusion. The incidence of microchimerism may be affected by international disparities in blood processing methods or variations in transfusion practices. This study was conducted to determine the prevalence of microchimerism in Australian trauma patients. A secondary aim was to examine whether any patient complications correlated to the incidence of microchimerism. Australian trauma patients (n = 86) who had been transfused with red blood cell (RBC) units between 2000 and 2012 with an injury severity score (ISS) of greater than 15 were recruited. The prevalence of microchimerism was determined using genetic screening with a panel of insertion/deletion biallelic polymorphisms. The mean storage age of the transfused RBC units was 20 ± 8 days and the mean length of stay (LOS) in hospital was 40 ± 39 days. There were no significant associations in this study sample to bias for patient age, gender, number of transfused RBC units or ISS. Nine of the 55 (16.3%) patients transfused with non-leukodepleted blood components displayed an incidence of microchimerism. Of the 31 patients transfused with leukodepleted RBC units, 3 (9.6%) displayed an incidence of microchimerism. Therefore, despite the universal introduction of leukodepleted blood components in Australia, the prevalence of transfusion-associated microchimerism was found to be unchanged. Furthermore, half of the patients exhibiting microchimerism were recorded to have had splenic injury or required splenectomy at the time of transfusion.

  4. Transfusion medicine in the Formosa Fun Coast water park explosion: The role of combined tissue and blood banking.

    Science.gov (United States)

    Chang, Chih-Chun; Yeh, Chin-Chuan; Chu, Fang-Yeh

    2016-10-01

    The Formosa Fun Coast explosion, occurring in a recreational water park located in the Northern Taiwan on 27 June 2015, made 499 people burn-injured. For those who had severe burn trauma, surgical intervention and fluid resuscitation were necessary, and potential blood transfusion therapy could be initiated, especially during and after broad escharotomy. Here, we reviewed the literature regarding transfusion medicine and skin grafting as well as described the practicing experience of combined tissue and blood bank in the burn disaster in Taiwan. It was reported that patients who were severely burn-injured could receive multiple blood transfusions during hospitalization. Since the use of skin graft became a mainstay alternative for wound coverage after the early debridement of burn wounds at the beginning of the 20th century, the development of tissue banking program was initiated. In Taiwan, the tissue banking program was started in 2006. And the first combined tissue and blood bank was established in Far Eastern Memorial Hospital in 2010, equipped with the non-sterile, clean and sterile zones distinctly segregated with a unidirectional movement in the sterile area. The sterile zone was a class 10000 clean room equipped with high efficiency particulate air filter (HEPAF) and positive air pressure ventilation. The combined tissue and blood bank has been able to provide the assigned blood products and tissue graft timely and accurately, with the concepts of centralized management. In the future, the training of tissue and blood bank technicians would be continued and fortified, particularly on the regulation and quality control for further bio- and hemovigilance.

  5. Ammonia concentration and bacterial evaluation of feline whole blood and packed red blood cell units stored for transfusion

    Directory of Open Access Journals (Sweden)

    Eva Spada

    2014-10-01

    Full Text Available Ammonia concentrations increase in human, canine and equine WB and PRBC units during storage. The aim of this study was to determine the effect of storage on ammonia concentration in feline WB and PRBC units stored in a veterinary blood bank and to evaluate possible correlations with bacterial contamination. Ammonia concentration was evaluated in 15 WB units and 2 PRBC units on day 1 and at the end of storage after 35 and 42 days, respectively. In an additional 5 WB units and 4 PRBC units ammonia concentrations were determined daily until the day the normal reference range was exceeded and then weekly to the end of storage. All units were evaluated for bacterial contamination. Ammonia increased markedly during storage as a linear function over time. On the 35th and 42th day of storage at 4±2°C mean±SD ammonia concentration reached 909±158 µg/dl and 1058±212 µg/dl in WB and PRBC units, respectively. Bacterial culture was negative in all units. High ammonia concentrations in stored WB and PRBC units could result in toxicity, particularly in feline recipients with liver failure, portosystemic shunts or those receiving large transfusion volumes. Clinical in vivo studies evaluating the effects on recipients should be performed.

  6. Endovascular Treatment of Aortic Aneurysms and Blood Transfusion. What do We Need?

    Science.gov (United States)

    Machado, Rui; Loureiro, Luís; Antunes, Inês; Coutinho, Jorge; Almeida, Rui

    2016-05-01

    Introdução: O tratamento endovascular dos aneurismas da aorta reduziu as taxas de transfusão. Não existem recomendações relativamente às unidades de glóbulos vermelhos a serem tipadas por crossmatch pré-operatoriamente. O nosso objetivo é contribuir para a análise das unidades de glóbulos vermelhos necessárias no tratamento endovascular dos aneurismas da aorta e na cirurgia híbrida de aneurismas da aorta e definir um protocolo do Maximum Surgical Blood Orders Schedule. Material e Métodos: Analisámos retrospetivamente a base de dados prospectiva dos doentes tratados eletivamente por tratamento endovascular dos aneurismas da aorta, entre 2001 e 2012. Analisamos idade, género, classe ASA, Maximum Surgical Blood Orders Schedule, unidades de glóbulos vermelhos transfundidas e tempos, endoprótese, relação unidades de glóbulos vermelhos consumidas/endoprótese, relação unidades crossmatched/transfundidas, conversão para cirurgia convencional, hemoglobina pré-operatória e na alta. Resultados: Selecionamos para análise 187 doentes, 90% homens, idade média 73,1, classe ASA III mais frequente. Usamos próteses aorto-bi-iliaca em 71%, aorto-uni-iliaca 23% e torácica 6%. Não necessitaram transfusão 72,6%. Transfundimos 171 unidades de glóbulos vermelhos. A relação unidades crossmatched/transfundidas foi 10,1 até 2010 e 7,3 após. A relação unidades de glóbulos vermelhos consumidas/endoprótese nas primeiras 24 horas foi 0,21 unidades de glóbulos vermelhos/aorto-bi-iliaca, 0,46 unidades de glóbulos vermelhos/aorto-uni-iliaca, 0,8 unidades de glóbulos vermelhos/torácica, 1,3 unidades de glóbulos vermelhos/híbrida-torácica e duas unidades de glóbulos vermelhos/híbrida-aorto-bi-iliaca. Obtivemos relação estatisticamente significativa entre unidades de glóbulos vermelhos transfundidas/endoprótese (p < 0,001) e entre classificação ASA e unidades de glóbulos vermelhos transfundidas após 24 h (p < 0,01). Discussão: As recomenda

  7. Effect of autologous blood donation on the central venous pressure, blood loss and blood transfusion during living donor left hepatectomy

    Institute of Scientific and Technical Information of China (English)

    Bruno Jawan; Shih-Hor Wang; Chih-Che Lin; Tsan-Shiun Lin; Yueh-Wei Liu; Chao-Long Chen; Yu-Fan Cheng; Chia-Chi Tseng; Yaw-Sen Chen; Chih-Chi Wang; Tung-Liang Huang; Hock-Liew Eng; Po-Ping Liu; King-Wah Chiu

    2005-01-01

    AIM: Autologous blood donation (ABD) is mainly used to reduce the use of banked blood. In fact, ABD can be regarded as acute blood loss. Would ABD 2-3 d before operation affect the CVP level and subsequently result in less blood loss during liver resection was to be determined.METHODS: Eighty-four patients undergoing living donor left hepatectomy were retrospectively divided as group Ⅰ (GⅠ)and group Ⅱ (GⅡ) according to have donated 250-300 mL blood 2-3 d before living donor hepatectomy or not. The changes of the intraoperative CVP, surgical blood loss,blood products used and the changes of perioperative hemoglobin (Hb) between groups were analyzed and compared by using Mann-Whitney Utest.RESULTS: The results show that the intraoperative CVP changes between GⅠ (n = 35) and GⅡ (n = 49) up to graft procurement were the same, subsequently the blood loss,but ABD resulted in significantly lower perioperative Hb levels in GⅠ.CONCLUSION: Since none of the patients required any blood products perioperatively, all the predonated bloods were discarded after the patients were discharged from the hospital, It indicates that ABD in current series had no any beneficial effects, in term of cost, lowering the CVP, blood loss and reduce the use of banked blood products, but resulted in significant lower Hb in perioperative period.

  8. 儿童围手术期的成分输血%Perioperative transfusion of blood components in pediatric patients

    Institute of Scientific and Technical Information of China (English)

    向波; 陈祖德; 赵一洋

    2014-01-01

    儿童在围手术期的循环和代谢稳定性较成人更加脆弱,大量输血时尤其需要非常警惕不良后果.在同等失血情况下,年龄因素是儿童输血治疗评估时重要参考指标之一.目前,成分输血法已得到认可,将血液中各种有效成分分离提纯后依据病情需要针对性地输注有效的血液成分,更科学地利用极为有限的血液资源.现就儿童围手术期成分输血中各主要制品输注的输血指征、输血剂量及管理等实际问题进行讨论.%Circulatory state and metabolic homeostasis could be more easily disturbed during perioperative periods for children compared with those of adults especially when receiving massive transfusions.Patient's age would be an important factor for clinical evaluation if certain amount of blood was lost.Component transfusions have now gained wide recognitions.Specific blood components should be considered according to different diseases,which would make transfusion more accurate and blood resources used more efficiently.This article focused on the indications,doses and several specific issues for perioperative component transfusions among pediatric patients.

  9. Geographic Variability in Potentially Discretionary Red Blood Cell Transfusions After Coronary Artery Bypass Grafting Surgery

    Science.gov (United States)

    Likosky, Donald S.; Al-Attar, Paul M.; Malenka, David J.; Furnary, Anthony P.; Lehr, Eric J.; Paone, Gaetano; Kommareddi, Mallika; Helm, Robert; Jin, Ruyun; Maynard, Chuck; Hanson, Eric C.; Olmstead, Elaine M.; Mackenzie, Todd A.; Ross, Cathy S.; Zhang, Min

    2016-01-01

    We assessed regional differences in potentially discretionary [coronary artery bypass (CABG) surgery. Regional variation in overall RBC rates remained after risk adjustment, perhaps due to differences in regional practice environments. Objective A number of established regional quality improvement collaboratives have partnered to assess and improve care across their regions under the umbrella of the “Cardiac Surgery Quality IMPROVEment (IMPROVE) Network”. The first effort of the IMPROVE Network has been to assess regional differences in potentially discretionary [coronary artery bypass (CABG) surgery across 56 medical centers in four IMPROVE Network regions between January 2008 and June 2012. Each center submitted the most recent 200 patients who received 0, 1, or 2 units of RBC transfusion during the index admission. Patient and disease characteristics, intra-operative practices, and percentage of cases receiving RBC transfusions were collected. Region-specific transfusion rates were calculated, after adjusting for pre- and intra-operative factors among region-specific centers. Results There were small, but significant, differences in patient case mix across regions. RBC transfusions of 1 or 2 units occurred among 25.2% (2,826/11,200) of CABG procedures. Significant variation in use and number of RBCs existed across regions [None: 74.8% (min:max 70.0%, 84.1%), 1 unit: 9.7% (5.1%, 11.8%), 2 units: 15.5% (9.1%, 18.2%)], p<0.001. Variation in overall transfusion rates remained after adjustment (9.1% – 31.7%, p<0.001). Conclusions Delivery of small volumes of RBC transfusions was common, yet varied across geographic regions. These data suggest that differences in regional practice environments, including transfusion triggers and anemia management, may contribute to variability in RBC transfusion rates. PMID:25227699

  10. The History of the Foundation of the Iranian National Blood Transfusion Service in 1974 and the Biography of its Founder; Professor Fereydoun Ala.

    Science.gov (United States)

    Azizi, Mohammad Hossein; Nayernouri, Touraj; Bahadori, Moslem

    2015-06-01

    The history of early attempts of blood transfusion in Iran traces back to the 1940s; however, around three decades later in 1974, the Iranian National Blood Transfusion Service (Sazeman-e Melli-e Enteqal-e Khun-e Iran) was founded by the outstanding hematologist, Professor Fereydoun Ala. The main goals of this centralized organization were to collect blood from healthy voluntary donors, to screen the donated blood and to provide various safe blood products based on scientific and ethical standards. In due course, a new era of blood transfusion service in Iran had begun to such a degree that after more than four decades of its activity, it is now considered the best-developed blood service in the eastern Mediterranean region. Here, a brief historical account of the early blood transfusion efforts and the establishment of the modern Iranian National Blood Transfusion Service in Iran is discussed in addition to the life and career of its founder and first director, Professor Fereydoun Ala.

  11. Effectiveness of blood donor questionnaire directed at risk factor for transfusion transmitted infections in Pakistani population

    Directory of Open Access Journals (Sweden)

    Nuzhat Salamat

    2012-01-01

    Full Text Available Background: Deferring blood donors who admit to high-risk behavior on questioning are likely to eliminate those in window period for transfusion transmitted infections (TTI. However, many questions have been implemented in some countries as part of donor history questionnaire, based on precautionary principle and not on evidence, and can result in increased donor losses. This study aims to identify effective risk-directed questions having high predictive value, in local context which can form part of blood donor deferral policies. For this, a case control study in a hospital blood bank having donation services was carried out prospectively over a period of three years. Materials and Methods: Two hundred and twenty donors, who were repeatedly reactive for HBsAg, anti-HCV, anti-HIV with EIA, and syphilis with TPHA, were the cases. Eight hundred and eighty four controls were the donors who tested negative for all TTI test. All donors answered seven hepatitis risk directed questions and their responses and reactivity status for TTI were used for statistical analysis with SPSS ver. 15. Results: Positive predictive value for history of jaundice at any age for HBsAg was 20%, while PPV for history of surgery in previous six months for both HBsAg and anti-HCVHCV was also around 20%, based on pretest probability of 7%. The post-test probability for these questions was around 30%. Odds ratios with 95% CI did not reveal any significant association of hepatitis with any of seven questions. Donor losses after deferring on basis of two questions were 5.3% per year, while deferral rate after all seven questions was 20%. Conclusions: Donors should be permanently deferred if there is history of jaundice at any age, while deferral period after surgery should be one year. Other risk-directed questions should not be used to defer donors. Donor deferral policies should be evidence based and questions with proven efficacy should be made part of donor history

  12. Malaria and blood transfusion: major issues of blood safety in malaria-endemic countries and strategies for mitigating the risk of Plasmodium parasites.

    Science.gov (United States)

    Abdullah, Saleh; Karunamoorthi, Kaliyaperumal

    2016-01-01

    Malaria inflicts humankind over centuries, and it remains as a major threat to both clinical medicine and public health worldwide. Though hemotherapy is a life-sustaining modality, it continues to be a possible source of disease transmission. Hence, hemovigilance is a matter of grave concern in the malaria-prone third-world countries. In order to pursue an effective research on hemovigilance, a comprehensive search has been conducted by using the premier academic-scientific databases, WHO documents, and English-language search engines. One hundred two appropriate articles were chosen for data extraction, with a particular reference to emerging pathogens transmitted through blood transfusion, specifically malaria. Blood donation screening is done through microscopic examination and immunological assays to improve the safety of blood products by detection major blood-borne pathogens, viz., HIV, HBV, HCV, syphilis, and malarial parasites. Transfusion therapy significantly dwindles the preventable morbidity and mortality attributed to various illnesses and diseases, particularly AIDS, tuberculosis, and malaria. Examination of thick and thin blood smears are performed to detect positivity and to identify the Plasmodium species, respectively. However, all of these existing diagnostic tools have their own limitations in terms of sensitivity, specificity, cost-effectiveness, and lack of resources and skilled personnel. Globally, despite the mandate need of screening blood and its components according to the blood-establishment protocols, it is seldom practiced in the low-income/poverty-stricken settings. In addition, each and every single phase of transfusion chain carries sizable inherent risks from donors to recipients. Interestingly, opportunities also lie ahead to enhance the safety of blood-supply chain and patients. It can be achieved through sustainable blood-management strategies like (1) appropriate usage of precise diagnostic tools/techniques, (2) promoting

  13. ROLE OF TRANEXAMIC ACID IN REDUCING POSTOPERATIVE BLOOD LOSS AND TRANSFUSION REQUIREMENT IN PATIENTS UNDERGOING LOWER LIMB ORTHOPEDIC SURGERIES

    Directory of Open Access Journals (Sweden)

    Yashwant

    2014-09-01

    Full Text Available AIM: Aim of our study to assess the effects of tranexamic acid (TA in patients undergoing lower limb orthopedic surgeries. OBJECTIVE: Assess the effects of tranexamic acid on prevention of bleeding and requirement of blood transfusion after major lower limb orthopedic surgeries. MATERIAL AND METHOD: 90 patients ASA grade I & II undergoing elective surgery for femoral fracture like open reduction internal fixation, hemiarthroplasty, total hip replacement (THR under anaesthesia were taken. Patients were classified randomly into 2 groups (forty five patients in each group. Group T: Patients received inj. TA 10 mg/kg body weight. Group P: Patients received normal saline 1 ml/kg body weight 15 min before surgery. Postoperative hemoglobin concentration (on day 0 and day 2 and volume of blood in the drain were measured. The number of units of packed red cells transfused during the hospital stay was recorded and any thromboembolic and other complications were documented. RESULT: Analysis revealed that there were no significant differences between the patients with respect to age, sex, duration and type of surgery and preoperative mean hemoglobin concentration. Neither heart rate nor MABP has statistically significant difference or results (P>0.05. The drains were removed in the evening of the first postoperative day. Mean volume of blood in the drain compared to placebo group showing a highly significant reduction in postoperative blood loss (P=0.01. Mean fall in hemoglobin at day 0 and day 2 was 2 less in the study group as compared to the placebo that has P value 0.01 making it significant finding. CONCLUSION: the present paired study demonstrated that the administration of TA given preoperatively reduces the blood loss in the first 24 h by a highly significant degree as well it causes a significant reduction in postoperative anemia and need for transfusion among these patients.

  14. An Experimental Study on RBC Count and Serum Potassium Concentration Changes During Compres-sion Transfusion of WBC-removal Whole Blood

    Institute of Scientific and Technical Information of China (English)

    Jin-Lian Cheng; Shi-Fan Han; Ya-Qin Li; Yin-Ping Chu; Yu-Mei Sun; Jin-Feng Guo

    2015-01-01

    Objective: To observe changes in RBC count, changes, RBC morphology, and serum potassium during compressed transfusion of WBC-removal whole blood. Methods: Prepared human WBC-removal whole blood and connected transfusion apparatus with different sizes of intravenous detaining needles ( 18G, 20G, 22G and 24G) . Observed RBC count and serum potassium concentration under different pressures ( 100 mmHg, 200 mmHg, and 300 mmHg) as blood flowed out of the pinhead end of the intravenous detaining needle. Samples ob-tained with the 20G needle were smeared on glass slides, and RBC morphologic changes were ob-served under an oil immersion lens. Results: RBC count and serum potassium changed slightly under different pressures with differ-ent sizes of intravenous detaining needles as blood flowed through the transfusion apparatus. In ad-dition, the observation of blood samples under a common light microscope revealed that coarse-prick, oblong, and spindle cell counts in the visual fields increased gradually as the pressure in-creased. Additionally, a portion of cells had undergone splintering. Conclusions: While applying 18G, 20G, 22G and 24G intravenous detaining needles for blood transfusion under less than 300 mmHg of pressure, no significant RBC count change was found in blood samples in the short term. However, there were significant RBC morphologic changes. The results could offer more basis to ensure the clinical safety of patients undergoing blood transfusion.

  15. Transfusion medicine

    Energy Technology Data Exchange (ETDEWEB)

    Murawski, K.; Peetoom, F.

    1986-01-01

    These proceedings contain 24 selections, including papers presented at the conference of American Red Cross held in May 1985, on the Subject of transfusion medicine. Some of the titles are: Fluosol/sup R/-DA in Radiation Therapy; Expression of Cloned Human Factor VIII and the Molecular Basis of Gene Defects that Cause Hemophilia; DNA-Probing Assay in the Detection of Hepatitis B Virus Genome in Human Peripheral Blood Cells; and Monoclonal Antibodies: Convergence of Technology and Application.

  16. Fate in humans of the plasticizer, DI (2-ethylhexyl) phthalate, arising from transfusion of platelets stored in vinyl plastic bags. [plasticizer migration into human blood from vinyl plastic bags during transfusion

    Science.gov (United States)

    Rubin, R. J.; Schiffer, C. A.

    1975-01-01

    Platelet concentrates were shown to contain 18-38 mg/100 ml of a phthalate plasticizer (DEHP) which arose by migration from the vinyl plastic packs in which the plateletes were prepared and stored. Transfusion of these platelets into 6 adult patients with leukemia resulted in peak blood plasma levels of DEHP ranging from 0.34 - 0.83 mg/100 ml. The blood levels fell mono-exponentially with a mean rate of 2.83 percent per minute and a half-life of 28.0 minutes. Urine was assayed by a method that would measure unchanged DEHP as well as all phthalic acid-containing metabolities. In two patients, at most 60 and 90% of the infused dose, respectively, was excreted in the urine collected for 24 hours post-transfusion. These estimates, however, could be high due to the simultaneous excretion of DEHP remaining from previous transfusions or arising from uncontrolled environmental exposures.

  17. Platelet transfusion refractoriness attributable to HLA antibodies produced by donor-derived cells after allogeneic bone marrow transplantation from one HLA-antigen-mismatched mother.

    Science.gov (United States)

    Hatakeyama, Naoki; Hori, Tsukasa; Yamamoto, Masaki; Inazawa, Natsuko; Iesato, Kotoe; Miyazaki, Toru; Ikeda, Hisami; Tsutsumi, Hiroyuki; Suzuki, Nobuhiro

    2011-12-01

    PTR is a serious problem in patients being treated for hematologic disorders. Two patients with acute leukemia developed PTR after allogeneic BMT from one HLA-antigen-mismatched mother attributable to HLA antibodies, which could not be detected in their serum before BMT. HLA antibodies, whose specificity resembled that of each patient, were detected in each donor's serum. Each donor had probably been immunized during pregnancy by their partner's HLA antigens expressed by the fetus, consequently, transplanted donor-derived cells provoked HLA antibodies in each recipient early after BMT, and those HLA antibodies induced PTR. If the mothers are selected as donors for their children, they should be tested for the presence of HLA antibodies.

  18. Hemolysis is associated with low reticulocyte production index and predicts blood transfusion in severe malarial anemia.

    Directory of Open Access Journals (Sweden)

    Rolf Fendel

    Full Text Available BACKGROUND: Falciparum Malaria, an infectious disease caused by the apicomplexan parasite Plasmodium falciparum, is among the leading causes of death and morbidity attributable to infectious diseases worldwide. In Gabon, Central Africa, one out of four inpatients have severe malarial anemia (SMA, a life-threatening complication if left untreated. Emerging drug resistant parasites might aggravate the situation. This case control study investigates biomarkers of enhanced hemolysis in hospitalized children with either SMA or mild malaria (MM. METHODS AND FINDINGS: Ninety-one children were included, thereof 39 SMA patients. Strict inclusion criteria were chosen to exclude other causes of anemia. At diagnosis, erythrophagocytosis (a direct marker for extravascular hemolysis, EVH was enhanced in SMA compared to MM patients (5.0 arbitrary units (AU (interquartile range (IR: 2.2-9.6 vs. 2.1 AU (IR: 1.3-3.9, p<0.01. Furthermore, indirect markers for EVH, (i.e. serum neopterin levels, spleen size enlargement and monocyte pigment were significantly increased in SMA patients. Markers for erythrocyte ageing, such as CD35 (complement receptor 1, CD55 (decay acceleration factor and phosphatidylserine exposure (annexin-V-binding were investigated by flow cytometry. In SMA patients, levels of CD35 and CD55 on the red blood cell surface were decreased and erythrocyte removal markers were increased when compared to MM or reconvalescent patients. Additionally, intravascular hemolysis (IVH was quantified using several indirect markers (LDH, alpha-HBDH, haptoglobin and hemopexin, which all showed elevated IVH in SMA. The presence of both IVH and EVH predicted the need for blood transfusion during antimalarial treatment (odds ratio 61.5, 95% confidence interval (CI: 8.9-427. Interestingly, this subpopulation is characterized by a significantly lowered reticulocyte production index (RPI, p<0.05. CONCLUSIONS: Our results show the multifactorial pathophysiology of SMA

  19. [Allergic reactions to transfusion].

    Science.gov (United States)

    Hergon, E; Paitre, M L; Coeffic, B; Piard, N; Bidet, J M

    1987-04-01

    Frequent allergic reactions following transfusion are observed. Usually, they are benign but sometimes we observe severe allergic reactions. Adverse reactions may be brought about by least two mechanisms. First, immediate-type hypersensibility reactions due to IgE. Secondly, anaphylactic-type reactions due to interaction between transfused IgA and class specific anti IgA in the recipient's plasma. They are characterized by their severest form (anaphylactic shock). The frequency of severe reactions following the transfusion blood plasma is very low. These transfusion reactions are complement-mediated and kinins-mediated. Prevention of allergic reactions is necessary among blood donors and recipients.

  20. Rare myeloid sarcoma/acute myeloid leukemia with adrenal mass after allogeneic mobilization peripheral blood stem cell transplantation

    Institute of Scientific and Technical Information of China (English)

    Ya-Fei Wang; Qian Li; Wen-Gui Xu; Jian-Yu Xiao; Qing-Song Pang; Qing Yang; Yi-Zuo Zhang

    2013-01-01

    Myeloid sarcoma (MS) is a rare hematological neoplasm that develops either de novo or concurrently with acute myeloid leukemia (AML). This neoplasm can also be an initial manifestation of relapse in a previously treated AML that is in remission. A 44-year-old male patient was diagnosed with testis MS in a local hospital in August 2010. Atfer one month, bone marrow biopsy and aspiration conifrmed the diagnosis of AML. Allogeneic mobilization peripheral blood stem cell transplantation was performed, with the sister of the patient as donor, after complete remission (CR) was achieved by chemotherapy. Five months after treatment, an adrenal mass was detected by positron emission tomography-computed tomography (PET-CT). Radiotherapy was performed for the localized mass after a multidisciplinary team (MDT) discussion. hTe patient is still alive as of May 2013, with no evidence of recurrent MS or leukemia.

  1. Low transfusion transmission of hepatitis E among 25,637 single-donation, nucleic acid-tested blood donors

    DEFF Research Database (Denmark)

    Harritshøj, Lene H.; Holm, Dorte K.; Sækmose, Susanne G.;

    2016-01-01

    nucleic acid test with a 95% detection probability of 7.9 IU/mL. HEV-positive samples were quantified by real-time polymerase chain reaction and genotyped. Transmission was evaluated among recipients of HEV RNA-positive blood components. Phylogenetic analyses compared HEV sequences from blood donors...... was investigated among Danish blood donors, and the prevalence of HEV transfusion-transmitted infection (TTI) was investigated among recipients. STUDY DESIGN AND METHODS: Samples from 25,637 consenting donors collected during 1 month in 2015 were screened retrospectively using an individual-donation HEV RNA...... immune response could not be excluded. Phylogenetic analysis showed relatively large sequence differences between HEV from donors, symptomatic patients, and swine. CONCLUSIONS: Despite an HEV RNA prevalence of 0.04% in Danish blood donations, all HEV-positive donations carried low viral loads...

  2. Factors affecting invalid red blood cell transfusion and countermeasures%红细胞输注无效的影响因素及对策

    Institute of Scientific and Technical Information of China (English)

    刘默; 杜瑜; 周宏伟; 刘芳; 彭朝津

    2012-01-01

    目的 探讨影响临床红细胞输注无效的因素,并就红细胞输注无效影响因素提出相应的临床对策.方法 采用回顾性分析的方法对2009年9月至2011年9月在解放军总医院第一附属医院血液科926份红细胞输注病例的临床资料进行整理和分析,分析临床红细胞输注无效的影响因素.结果 926份红细胞输注病例共输注红细胞1289次,194次为无效输注,无效输注率达到15.05%;而二分类Logistic回归分析发现:多次输血、多次妊娠、患有2种以上自身免疫系统疾病及红细胞制品的贮存时间长是影响红细胞输注效果的因素.结论 红细胞输注无效率较高,在临床工作中,严格掌握红细胞输注适应症,并采取针对性预防措施,可有效避免红细胞输注无效的发生.%Objective To investigate the clinical factors affecting RBC transfusion,and invalid red blood cell transfusion corresponding clinical counter measures. Methods A retrospective analysis of September 2009 - September 2011 Department of Hematology in our hospital 926 cases of red blood cell transfusion clinical data collation, analysis of clinical factors affecting red blood cell transfusion. Results A total of 926 patients were given red blood cell transfusion 1289 times, 194 times invalid infusion, invalid infusion rate 15.05% ;And two Logistic Regression analysis;multiple transfusions, multiple pregnancies,with 2 or more autoimmune diseases and red blood cell products storation time are factors affecting red blood cell transfusion. Conclusions Invalid red blood cell transfusion rate is high, in clinical work,strict control of red blood cell transfusion indications and take appropriate preventive measures can effectively prevent the occurrence of red blood cell transfusion.

  3. Influence of detection of infection indicators before blood transfusion on blood transfusion infections%输血前感染性指标检测对患者输血感染的影响研究

    Institute of Scientific and Technical Information of China (English)

    郁玲; 俞北伟; 刘秋菊; 李月; 郑琳; 程涛

    2016-01-01

    目的:探讨输血前感染性指标检测对输血感染的影响,为临床血液病感染的预防控制及减少医疗纠纷提供参考。方法选择2012年6月-2015年6月于医院拟接受输血1300例患者进行输血前感染性指标检测,包括乙型肝炎病毒五项标志物、丙型肝炎病毒(HCV)、苍白密螺旋体(抗‐TP)、人类免疫缺陷病毒(HIV);采用酶免疫分析法对所有患者进行输血前8项检测,以了解患者输血前的感染情况。结果在输血感染性指标检测中HBsAb的阳性率最高占21.69%,其次为 HBsAg占10.85%。患者存在2种或3种重叠感染模式,其中以 HB‐sAb+ HBeAb的重叠感染模式所占比例最高共26例占2.00%,其次为HBsAg+ HBsAb+ HBcAb的重叠感染模式,共24例占1.85%。不同年龄段患者 HBsAg 、HBsAb、HBeAg、HBeAb、HBcAb阳性率比较差异有统计学意义(P<0.05)。结论加强对输血前7项感染性指标的检测不仅提高患者的输血安全性、发现潜在疾病,还能降低院内交叉感染以及医疗纠纷的发生,在临床上具有重要意义。%OBJECTIVE To explore the influence of detection of infection indicators before blood transfusion on blood transfusion infection so as to provide guidance for clinical prevention and control of the blood infection and reduce medical disputes .METHODS The pre‐transfusion infection indicators were detected for 1 300 patients who were supposed to receive the blood transfusion in the hospital from Jun 2012 to Jun 2015 ,including five markers of hepatitis B virus ,hepatitis C virus (HCV) ,total protein (TP) ,and human immunodeficiency virus (HIV) .The 8 indicators were detected for all the patients before blood transfusion by using enzyme immunoassay so as to un‐derstand the incidence of infection before the blood transfusion .RESULTS Among the infection indicators that were detected before the blood transfusion ,the positive rate

  4. Alloimmunization screening after transfusion of red blood cells in a prospective study Pesquisa de aloimunização após transfusão de concentrados de hemácias em um estudo prospectivo

    Directory of Open Access Journals (Sweden)

    Vitor Mendonça Alves

    2012-01-01

    Full Text Available BACKGROUND: Several irregular red blood cell alloantibodies, produced by alloimmunization of antigens in transfusions or pregnancies, have clinical importance because they cause hemolysis in the fetus and newborn and in transfused patients. OBJECTIVE: a prospective analysis of patients treated by the surgical and clinical emergency services of Hospital de Clínicas of the Universidade Federal do Triângulo Mineiro (HC/UFTM, Brazil was performed to correlate alloimmunization to clinical and epidemiological data. METHODS: Blood samples of 143 patients with initial negative antibody screening were collected at intervals for up to 15 months after the transfusion of packed red blood cells. Samples were submitted to irregular antibody testing and, when positive, to the identification and serial titration of alloantibodies. The Fisher Exact test and Odds Ratio were employed to compare proportions. RESULTS: Fifteen (10.49% patients produced antibodies within six months of transfusion. However, for 60% of these individuals, the titers decreased and disappeared by 15 months after transfusion. Anti-K antibodies and alloantibodies against antigens of the Rh system were the most common; the highest titer was 1:32 (anti-K. There was an evident correlation with the number of transfusions. CONCLUSIONS: Given the high incidence of clinically important red blood cell alloantibodies in patients transfused in surgical and clinical emergency services, we suggest that phenotyping and pre-transfusion compatibilization for C, c, E, e (Rh system and K (Kell system antigens should be extended to all patients with programmed surgeries or acute clinical events that do not need emergency transfusions.OBJETIVO: Vários aloanticorpos irregulares antieritrocitários, produzidos por sensibilizações a antígenos estranhos durante gestações ou transfusões, possuem importância clínica por provocarem hemólise no feto ou recém-nascido e/ou no receptor de sangue. Diante

  5. The causes analysis of clinical blood transfusion adverse reactions and counteractions%临床输血不良反应原因分析及对策

    Institute of Scientific and Technical Information of China (English)

    常洪劲; 许静静; 李岩

    2016-01-01

    Objective To analyze the possible reasons of blood transfusion adverse reactions and consti-tute the counteractions for further reducing or preventing similar blood transfusion adverse reactions.Methods The fifty-nine cases of blood transfusion adverse reactions and all the 44983 person-time of blood transfu-sion were collected between January 2013 and December 2014.And then we analyzed the time-lag,the inci-dence rate of BTAR in different blood products,the harm of the body from BTAR,department and patients’ outcome.Results All the BTAR occurred in the 6 hours in the beginning of blood transfusion, which were called acute transfusion reactions.Skin allergy and fervescence were the major symptoms of acute transfusion reaction.The blood products of blood transfusion adverse reactions included virus inactivated frozen plasma, platelets,cryoprecipitate, and suspended leukocyte reduced red blood cells.Among the blood products of transfusion adverse reactions,the BTAR incidence rate of plasma occupy the multiple.The ICU were the ma-jor department.After treatment, the damage caused by adverse reactions were recovered.Conclusion The occurrence of blood transfusion adverse reactions were mainly patients themselves allergic to immunoglobu-lin within the plasma,or the patients had produced leucocyte antibody.By symptomatic treatment,it was to give antiallergic drug and febrifuge before blood transfusion routinely and the antigen in coordination with each other and leukocyte reduced blood products which could reduce or avoid the occurrence of blood trans-fusion adverse reactions.%目的:分析发生输血不良反应( blood transfusion adverse reactions,BTAR)的可能原因并制订应对措施,进一步减少或避免类似BTAR的发生。方法收集2013年1月至2014年12月期间发生的BTAR 59例及所有输血人次44983人次,分析发生BTAR的时滞、不同血制品的不良反应发生率、不良反应对机体的危害、科室分布及患者预

  6. Use of Esophageal Hemoximetry to Assess the Effect of Packed Red Blood Cell Transfusion on Gastrointestinal Oxygenation in Newborn Infants.

    Science.gov (United States)

    Vora, Farha M; Gates, Judy; Gerard, Kimberley; Hanson, Shawn; Applegate, Richard L; Blood, Arlin B

    2017-01-18

    Objectives There are no widely accepted methods of continuously monitoring gut oxygenation in the newborn during packed red blood cell transfusion. We investigated the use of an orally inserted light spectroscopy probe to measure lower esophageal oxyhemoglobin saturations (eStO2) before, during, and after transfusion and made comparisons with abdominal near-infrared spectroscopy (NIRS) and superior mesenteric artery (SMA) flow. Study Design Thirteen neonates with corrected gestational ages ranging from 22 weeks, 0 day to 37 weeks, 5 days were enrolled. eStO2 and NIRS measurements were recorded continuously for a 25-hour period starting 1 hour prior to starting the 4-hour transfusion. Transabdominal ultrasound was used to measure SMA flow prior to, upon completion, and 20 hours after the transfusion. Results Twelve infants completed the study. eStO2 was well-tolerated and was weakly (r = 0.06) correlated (p < 0.001) with NIRS. Compared with NIRS, eStO2 demonstrated a markedly greater variation in oxyhemoglobin values. NIRS and SMA flow measurements did not change, while eStO2 increased from 48 ± 5% and 45 ± 5% in the pre- and intratransfusion periods to 57 ± 4% in the posttransfusion period (p = 0.03). Conclusion Measurement of eStO2 is feasible in neonates and may provide a continuous and sensitive index of rapid changes in mesenteric oxygenation in this patient population.

  7. DISTRIBUTION OF ABO AND RH-D BLOOD GROUPS IN THE CACHAR DISTRICT OF BARAK VALLEY OF ASSAM: IMPLICATION FOR REGIONAL BLOOD TRANSFUSION SERVICE

    Directory of Open Access Journals (Sweden)

    Dharmakanta Kumbhakar

    2016-07-01

    Full Text Available BACKGROUND ABO and Rhesus (Rh-D blood group antigens are integrated parts of the red blood cell membranes. They are hereditary characters and are useful in population genetic studies, in resolving medico-legal issues and more importantly in compatibility test in blood transfusion and organ transplant practices. They show a wide geographical and racial variation. The knowledge of the distribution of ABO and Rh-D blood groups among different population is essential in health care and transfusion practices. AIMS AND OBJECTIVES To study the distribution of ABO and Rh-D blood groups amongst the population of Cachar district of Barak valley of Assam. MATERIALS AND METHODS We did a retrospective analysis of records of 1,60,500 blood samples grouped for ABO and Rh-D typing at Silchar Medical College and Hospital Blood Bank, Silchar, over a period of 10 years from 1st January 1999 to 31st December 2008. RESULTS AND OBSERVATIONS Out of total 1,60,500 blood samples grouped for ABO and Rh-D typing during the period in the centre, the distribution of phenotype A, B, AB and O were 24.80% (39,804, 32.00% (51,360, 5.60% (8,986 and 37.60% (60,350 respectively. The Rh-D positive phenotype was 95.40% (1, 53,117 and remaining 4.60% (7,383 was Rh-D negative. The frequency of Rh-D phenotypes in the various ABO blood groups was as - A Positive 23.70% (38,039, A Negative 1.10% (1,765, B Positive 30.80% (49,433, B Negative 1.20% (1,927, AB Positive 5.40% (8,665, AB Negative 0.20% (321, O Positive 35.50% (56,980 and O Negative 2.10% (3,370 respectively. DISCUSSION Silchar Medical College and Hospital Blood Bank receives blood samples for grouping of almost all population of Cachar district. Hence, the data revealed in the present study fairly reflects the prevalence of ABO and Rh-D groups distribution in the Cachar district in Barak valley of Assam. CONCLUSION The present study provide information on the status of ABO and Rh-D blood groups distribution of the region and

  8. Bioactive substance accumulation and septic complications in a burn trauma patient: effect of perioperative blood transfusion?

    DEFF Research Database (Denmark)

    Nielsen, H J; Reimert, C M; Dybkjaer, E;

    1997-01-01

    cationic protein (ECP), eosinophil protein X (EPX), neutrophil myeloperoxidase (MPO) and interleukin 6 (IL-6) were drawn frequently from the patient before, during and after the operations, and from all transfused red cell, platelet and fresh frozen plasma units. Urine was sampled every hour during...

  9. ACUTE LUNG INJURY COMPLICATING BLOOD TRANSFUSION IN POST-PARTUM HEMORRHAGE: INCIDENCE AND RISK FACTORS.

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    Luciana Teofili

    2014-10-01

    Conclusions. Patients suffering from PPH represent a high-risk population for TRALI. In particular, patients with gestational hypertension and pre-eclampsia   have the highest risk, particularly if they are not receiving anti-hypertensive therapy. A careful monitoring of these patients after transfusions is therefore recommended.

  10. Fluid shift from intravascular compartment during fetal red blood cell transfusion

    NARCIS (Netherlands)

    Kamping, M.A.; Pasman, S.A.; Bil-van den Brink, C.P.; Oepkes, D.; Adama van Scheltema, P.N.; Vandenbussche, F.P.H.A.

    2013-01-01

    OBJECTIVES: Intrauterine transfusion imposes a considerable burden on the fetal circulation by increasing volume and pressure, and a fluid shift from the fetal circulation occurs even during the procedure. The aim of this study was to quantify the intraprocedural fluid shift and to investigate the e

  11. Surgical technique for allogeneic uterus transplantation in macaques

    Science.gov (United States)

    Obara, Hideaki; Kisu, Iori; Kato, Yojiro; Yamada, Yohei; Matsubara, Kentaro; Emoto, Katsura; Adachi, Masataka; Matoba, Yusuke; Umene, Kiyoko; Nogami, Yuya; Banno, Kouji; Tsuchiya, Hideaki; Itagaki, Iori; Kawamoto, Ikuo; Nakagawa, Takahiro; Ishigaki, Hirohito; Itoh, Yasushi; Ogasawara, Kazumasa; Saiki, Yoko; Sato, Shin-ichi; Nakagawa, Kenshi; Shiina, Takashi; Aoki, Daisuke; Kitagawa, Yuko

    2016-01-01

    No study has reported an animal model of uterus transplantation (UTx) using cynomolgus macaques. We aimed to establish a surgical technique of allogeneic UTx assuming the recovery of a uterus from a deceased donor in cynomolgus macaques. Four allogeneic UTxs were performed in female cynomolgus macaques. Donor surgeries comprised en bloc recovery of organs with iliac vessels on both sides, and/or abdominal aorta/vena cava after sufficient perfusion from one femoral artery or external iliac artery. Before perfusion, 150 mL of whole blood was obtained from the donor for subsequent blood transfusion to the recipient. Four uterine grafts were orthotopically transplanted to recipients. End-to-side anastomosis was performed to the iliac vessels on one side in case 1 and iliac vessels on both sides in case 2; aorto-aorto/cavo-caval anastomosis was performed in cases 3 and 4. Arterial blood flow of the uterine grafts was determined by intraoperative indocyanine green (ICG) angiography. ICG angiography results showed sufficient blood flow to all uterine grafts, and anaemia did not progress. Under appropriate immune suppression, all recipients survived for more than 90 days post-transplantation, without any surgical complications. We describe a surgical technique for allogeneic UTx in cynomolgus macaques. PMID:27786258

  12. Effect of blood transfusion, dopamine, or normal saline on neurogenic shock secondary to acutely raised intracranial pressure.

    Science.gov (United States)

    Rahimifar, M; Tator, C H; Shanlin, R J; Sole, M J

    1989-06-01

    An experimental model to simulate acutely raised intracranial pressure due to a rapidly expanding intracranial space-occupying lesion was used to produce neurogenic shock. Forty-one rats in neurogenic shock (defined as a mean systemic arterial pressure (SAP) of less than 60 mm Hg) were subjected to various treatments to increase the mean SAP to a level of more than 80 mm Hg. The control group with neurogenic shock received no treatment, and the six treatment groups received infusions of: whole blood, packed cells, plasma, normal saline, dopamine, or a combination of dopamine and saline. Detrimental effects were observed after transfusion of packed cells or whole blood, which caused further deterioration of mean SAP. Although dopamine or the combination of dopamine and saline were both effective (p = 0.0001) for reversing hypotension, the combination was the most effective. If this rat paradigm correlates with human disease, these results indicate that, in the absence of hypovolemia, neurogenic shock due to acute intracranial hypertension should be treated with a combined transfusion of dopamine and normal saline, but not blood since the latter could have a detrimental effect.

  13. 1601例外科输血患者红细胞输注量与死亡率相关性分析%Correlation analysis of 1601 surgical transfusion and mortality in patients with red blood cell transfusions

    Institute of Scientific and Technical Information of China (English)

    李荣芳; 陈家茂; 杨江存

    2015-01-01

    Objective To explore the relationship between red blood cell transfusion volume and patients' mortality in mas-sive blood transfusion. Methods Multicenter retrospective research was carried out on 1601 surgical inpatients who receiving massive blood transfusion in 20 large comprehensive hospitals in China. According to red blood cell transfusion volume within 24 hours or 72 hours, they are divided into 8 groups: 0-4U, 5-9U, 10-14U, 15-19U, 20-24U, 25-29U, 30-39U, 40U-. The status of patients' death with different red blood cell transfusion volume was analyzed. Results Patients' mortality increases with the in-crease of red blood cell transfusion when total red blood cell transfusion volume ≥10U within 24 or 72 hours. Survival analysis based on different red blood cell transfusion volume was of statistical significance (χ2=72.857, P<0.001). Logistic regression analy-sis reveals that red blood cell transfusion volume was an independent risk factor (OR=0.52;CI:0.43-0.64; P<0.01) for death of pa-tients in massive blood transfusion. When red blood cells were transfused at 5U-9U volume within 24 and 72 hours, mortality is the lowest, which was 3.7% and 2.3% respectively. Conclusions During massive blood transfusion for surgical inpatients, there is some correlation between red blood cell transfusion volume within 24 or 72 hours and mortality of patients. Patients' mortality in-creases with the increase of red blood cell transfusion. Red blood cell transfusion volume, length of stay at hospital and intensive care unit constitute the independent risk factors for patients' death.%目的:联合国内20家大型综合医院多中心回顾性调研外科住院患者大量输血病历1601例,分析探讨红细胞输注量与患者死亡率的关联性。方法联合全国20家三级综合医院进行多中心回顾性分析大量输血病例资料,根据24h内或72h内红细胞输注量分为:0~4U、5~9U、10~14U、15~19U、20~24U、25~29U、30~39U、40~U,8个组

  14. Duration of deep hypothermia during aortic surgery and the risk of perioperative blood transfusion

    Directory of Open Access Journals (Sweden)

    Michael Mazzeffi

    2012-01-01

    Full Text Available Deep hypothermia, which is used during thoracic aortic surgery for neuroprotection, is associated with coagulation abnormalities in animal and in vitro models. However, there is a paucity of data regarding the impact of deep hypothermia duration on perioperative bleeding. The objective of the current study was to examine the relationship between the duration of deep hypothermia and perioperative bleeding. A retrospective review of 507 consecutive thoracic aortic surgery patients who had surgery with deep hypothermic circulatory arrest was performed. The degree of bleeding and coagulopathy was estimated using perioperative transfusion. Log linear modeling with Poisson regression was used to analyze the relationship between deep hypothermia duration and perioperative bleeding, while controlling for other preselected variables. There was a significant association between deep hypothermia duration and RBC transfusion (P = 0.001. There was no significant association between deep hypothermia duration and FFP and platelet transfusion (P = 0.18 and P = 0.06. The association between deep hypothermia duration and the amount of bleeding (RBC transfusion was dependent on total CPB time. In general, for shorter CPB times (approximately 120 to 180 minutes there was an upward sloping line or positive relationship between deep hypothermia duration and bleeding. However, for cases with longer CPB times (300 to 360 minutes, there was no such relationship. The relationship between deep hypothermia duration and perioperative bleeding is dependent on CPB time. For surgeries with short CPB times (120 to 180 minutes, prolonged deep hypothermia is associated with increased post-operative bleeding, as estimated by RBC transfusion. For cases with longer CPB times (300 to 360 minutes, there appears to be no relationship.

  15. Normative evaluation of blood banks in the Brazilian Amazon region in respect to the prevention of transfusion-transmitted malaria

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    Daniel Roberto Coradi Freitas

    2014-12-01

    Full Text Available Objective:To evaluate blood banks in the Brazilian Amazon region with regard to structure and procedures directed toward the prevention of transfusion-transmitted malaria (TTM.Methods:This was a normative evaluation based on the Brazilian National Health Surveillance Agency (ANVISA Resolution RDC No. 153/2004. Ten blood banks were included in the study and classified as 'adequate' (≥80 points, 'partially adequate' (from 50 to 80 points, or 'inadequate' (<50 points. The following components were evaluated: 'donor education' (5 points, 'clinical screening' (40 points, 'laboratory screening' (40 points and 'hemovigilance' (15 points.Results:The overall median score was 49.8 (minimum = 16; maximum = 78. Five blood banks were classified as 'inadequate' and five as 'partially adequate'. The median clinical screening score was 26 (minimum = 16; maximum = 32. The median laboratory screening score was 20 (minimum = 0; maximum = 32. Eight blood banks performed laboratory tests for malaria; six tested all donations. Seven used thick smears, but only one performed this procedure in accordance with Ministry of Health requirements. One service had a Program of External Quality Evaluation for malaria testing. With regard to hemovigilance, two institutions reported having procedures to detect cases of transfusion-transmitted malaria.Conclusion:Malaria is neglected as a blood–borne disease in the blood banks of the Brazilian Amazon region. None of the institutions were classified as 'adequate' in the overall classification or with regard to clinical screening and laboratory screening. Blood bank professionals, the Ministry of Health and Health Surveillance service managers need to pay more attention to this matter so that the safety procedures required by law are complied with.

  16. Durable Red Blood Cell Transfusion Independence in a Patient with an MDS/MPN Overlap Syndrome Following Discontinuation of Iron Chelation Therapy

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    Harpreet Kochhar

    2015-01-01

    Full Text Available Background. Hematologic improvement (HI occurs in some patients with acquired anemias and transfusional iron overload receiving iron chelation therapy (ICT but there is little information on transfusion status after stopping chelation. Case Report. A patient with low IPSS risk RARS-T evolved to myelofibrosis developed a regular red blood cell (RBC transfusion requirement. There was no response to a six-month course of study medication or to erythropoietin for three months. At 27 months of transfusion dependence, she started deferasirox and within 6 weeks became RBC transfusion independent, with the hemoglobin normalizing by 10 weeks of chelation. After 12 months of chelation, deferasirox was stopped; she remains RBC transfusion independent with a normal hemoglobin 17 months later. We report the patient’s course in detail and review the literature on HI with chelation. Discussion. There are reports of transfusion independence with ICT, but that transfusion independence may be sustained long term after stopping chelation deserves emphasis. This observation suggests that reduction of iron overload may have a lasting favorable effect on bone marrow failure in at least some patients with acquired anemias.

  17. [Transfusions in geriatrics].

    Science.gov (United States)

    Moulias, Sophie; Lesure, Christine

    2015-01-01

    Elderly people are Darticularlv Drone to anaemia and the need for transfusions. However, in response to the known adverse effects of red blood cell transfusions, particularly in the context of chronic anaemia, new recommendations have been issued. it is always necessary to consider this procedure on a case-by-case basis, analysing the risk-benefit ratio.

  18. Platelet alloimmunization after transfusion

    DEFF Research Database (Denmark)

    Taaning, E; Simonsen, A C; Hjelms, E;

    1997-01-01

    BACKGROUND AND OBJECTIVES: The frequency of platelet-specific antibodies after one series of blood transfusions has not been reported, and in multiply transfused patients is controversial. MATERIALS AND METHODS: We studied the frequency of alloimmunization against platelet antigens in 117 patient...

  19. 成分输血对急性失血患者酸碱平衡的影响%The acid-base balance influence of blood component transfusion on acute blood loss patients

    Institute of Scientific and Technical Information of China (English)

    吴胜楠; 洪澄英; 温隽珉; 周志强; 赖旭春

    2009-01-01

    目的:探讨成分输血对急性失血患者酸碱平衡的影响.方法:对88例急性失血患者进行输血前及输血后定时血气分析监测,根据血气监测结果分析成分输血对酸碱平衡的影响.结果:观察期间14例患者存在其他影响酸碱平衡因素退出.纳入分析的74例中,44例输血前存在不同程度代谢性酸中毒的患者输血后26例酸中毒消失,17例减轻,1例略加重.74例患者中输血后发生输血相关性碱中毒24例,其24 h内新鲜冰冻血浆(FFP)平均用量2 063 ml,明显高于非碱中毒患者.输血相关性碱中毒的病例未使用酸性药物进行治疗,停止输血后13~48 h自动恢复.结论:急性失血患者输血前大部分存在程度不同的代谢性酸中毒,经有效止血、输血后多能缓解.成分输血对急性失血患者酸碱平衡的影响主要表现为代谢性碱中毒,代谢性酸中毒罕见.输血相关性碱中毒一般为自限性,停止输血后可自行恢复.%Objective:To investigate the acid-base balance influence of blood component transfusion on acute blood loss patients. Methods:We detected the blood gas analysis of 88 acute blood loss patients before and after blood component transfusion, to analyze the acid-base balance influence of blood component transfusion according to the blood gas analysis. Results:Fourteen patients were quit for the acid-base balance influence of other factors during the observation, Seventy-four patients were bring into the acid-base balance analysis; Among the forty-four patients with different degree acidosis before, Twenty-six patient's acidosis vanished after blood component transfusion,Seventeen patient's acidosis alleviated af-ter blood componenttransfusion, One patient's acidosis aggravated slightly after blood component transfusion;Twenty-four patients had blood transfusion relevent alkalosis in all seventy-four patients after transfusion, And their average usage amount of fresh frozen plasma (FFP) was 2 063

  20. Analysis on the status of clinical blood transfusion from 2008 to 2014%某院2008~2014年临床输血调查分析

    Institute of Scientific and Technical Information of China (English)

    廖悦婷; 郭玉嵩; 林天平; 杨芳年

    2016-01-01

    目的:分析该院2008~2014年临床输血现状,规范输血管理,提高合理使用血液。方法对各种成分输血用量、人均用血量、各血型使用量及不同科室的红细胞、血小板用量进行统计并分析作比较。结果2008~2014年完全采用成分输血,2010年后血小板使用量最大,其次是红细胞、血浆,冷沉淀凝血因子用量最少。用血量呈逐年增加趋势,人均用血量逐年下降,不同血型使用量比较,差异有统计学意义(P<0.05),各科室用血量有所不同,对输血成分的需求也不同。结论该院2008~2014年临床输血较为科学合理,但仍有改进空间。%Objective To investigate the status of clinical blood transfusion from 2008 to 2014 in order to standardize clinical transfusion management and improve the clinical rational usage of various blood components .Methods By various blood compo‐nents transfusion ,the average quantity of clinical blood transfusion ,4 common blood types and the usage of red blood cells and platelet in different departments were analyzed and compared .Results The rate of blood component transfusion remained at 100%over the 2008 - 2014 year .The utilization of platelet was the highest ,followed by red blood cells and plasma ,and the amount of cryoprecipitate was the least from 2010 .The total consumption of blood was increasing each year ,but there was a downward trend at the average usage of clinical blood ,and also there were significant differences among 4 common blood types ,and the blood compo‐nent transfusion rate was different in different departments in hospital .Conclusion From 2008 to 2014 ,the blood transfusion is ap‐propriate and reasonable ,but still can be improved by effective means .

  1. [Giving blood: an individual right or the expression of a social responsibility? The donors' position in the debates on blood transfusion].

    Science.gov (United States)

    Bastard, B

    2006-09-01

    This debate questions the donor's position within the transfusional framework. How are blood donation regulations initiated and implemented? Experts called upon this question insist on the necessity to better inform about such regulations so that they can be rapidly approved and in order to keep donors from adverse reactions linked to blood donations. How to make donors' rejections more tolerable? Contra-indications are a source of anxiety for the person whose blood sample is not accepted. While blood transfusion has never been safer in the past than it is today in wealthy countries, one should ask the question whether the donor is or not the victim of doubts still weighing down on this activity. Implementing the precautionary principle may indeed lead transfusion supervisors to take brutal decisions detrimental to the donor, seeming rather inspired by political or media pressures than calling on scientific or economic rigorous principles. What does the donor selection aim at in terms of prevention and public health? What about the renewal of donor associations' directors? Where are we at with the homosexual rejection trends? Such are the issues as those induced by the current debate.

  2. Blood transfusion and iatrogenic risks in Mexico city: anti-Trypanosoma cruzi seroprevalence in 43,048 blood donors, evaluation of parasitemia, and electrocardiogram findings in seropositive

    Directory of Open Access Journals (Sweden)

    Nidia Hernández-Becerril

    2005-04-01

    Full Text Available Iatrogenous transmission of Trypanosoma cruziby blood transfusion was suggested as a potential risk by Pellegrino (1949. Seropositive blood donors in Mexico were first reported in 1978, however, limited information is available due to small sampling, the use of heterogeneous serologic assays, and geographically limited studies. A wide survey carried out in 18 out of the 32 states of Mexico, showed a national mean of 1.6% seropositive among 64,969 donors, ranging from 0.2 to 2.8%. In the present study, we have screened 43,048 voluntary blood donors in a period of five years at the Instituto Nacional de Cardiología I. Chávez, a concentration hospital located in Mexico city which serves mainly the metropolitan area and accepts from all over the country. Standardized ELISA and IIF were used to identify seropositive individuals in addition to hemoculture, PCR and standard 12 lead ECG tests that were applied to a group of seropositive patients (29/161. The result showed a seropositivity of 0.37% (161/43,048. From the group of seropositive individuals 40% (12/29 were potential carriers of T. cruzi at the donation time and 5/29 had subclinical ECG abnormalities. Parasitological tests performed in 70 erythrocyte and platelet fractions from seropositive units (70/161 showed negative results. Our findings strongly support T. cruzi screening in the transfusion medicine practice and identify subclinical heart disease among seropositive blood donors.

  3. Blood component use in a sub-Saharan African country: results of a 4-year evaluation of diagnoses associated with transfusion orders in Namibia.

    Science.gov (United States)

    Pitman, John P; Wilkinson, Robert; Liu, Yang; von Finckenstein, Bjorn; Smit Sibinga, Cees Th; Lowrance, David W; Marfin, Anthony A; Postma, Maarten J; Mataranyika, Mary; Basavaraju, Sridhar V

    2015-01-01

    National blood use patterns in sub-Saharan Africa are poorly described. Although malaria and maternal hemorrhage remain important drivers of blood demand across Africa, economic growth and changes in malaria, HIV/AIDS, and noncommunicable disease epidemiology may contribute to changes in blood demand. We evaluated indications for blood use in Namibia, a country in southern Africa, using a nationally representative sample and discuss implications for the region. Clinical and demographic data related to the issuance of blood component units in Namibia were reviewed for a 4-year period (August 1, 2007-July 31, 2011). Variables included blood component type, recipient age and sex, and diagnosis. Diagnoses reported by clinicians were reclassified into International Statistical Classification of Diseases, 10th Revision categories. Multiple imputation methods were used to complete a data set missing age, sex or diagnosis data. Descriptive analyses were conducted to describe indications for transfusions and use of red blood cells (RBCs), platelets, and plasma. A total of 39,313 records accounting for 91,207 blood component units were analyzed. The median age of Namibian transfusion recipients was 45 years (SD, ±19). A total of 78,660 RBC units were issued in Namibia during the study period. Red blood cells transfused for "unspecified anemia" accounted for the single largest category of blood issued (24,798 units). Of the overall total, 38.9% were for diseases of the blood and blood-forming organs (D50-D89). Infectious disease (A00-B99), pregnancy (O00-O99), and gastrointestinal (K20-K93) accounted for 14.8%, 11.1%, and 6.1% of RBC units issued, respectively. Although a specific diagnosis of malaria accounted for only 2.7% of pediatric transfusions, an unknown number of additional transfusions for malaria may have been categorized by requesting physicians as unspecified anemia and counted under diseases of blood forming organs. During the study period, 9751 units of fresh

  4. Transfusão de hemácias em terapia intensiva: controvérsias entre evidências Red blood cell transfusion in the intensive care setting: controversies amongst evidence

    Directory of Open Access Journals (Sweden)

    Rubens Carmo Costa Filho

    2009-08-01

    com hemoglobina superiores a 7 g/dL. Não existe um consenso sobre o limiar transfusional em pacientes críticos. Os pacientes com doença cardiovascular parecem apresentar um maior risco de morte do que aqueles sem doença cardiovascular, para qualquer nível de hemoglobina. A transfusão guiada por níveis de hemoglobina e parâmetros fisiológicos, oxi-hemodinâmicos individualizados e contexto clínico parece ser atualmente estratégia mais aceita do que a correção arbitrária e isolada da hemoglobina.Anemia is a prevalent issue in intensive care units. It appears in the first days, and may continue or worsen during hospital stay. Its etiology is generally multifactorial. Red blood cell transfusion is the most common intervention for treating anemia. Approximately 12 million blood units are used for transfusions in the United States, 25% to 30% in the intensive care units. Due to reduction of transfusion infections the increased safety has allowed an expansion of clinical indications. However, transfusion therapy is associated with other adverse effects such as nosocomial infections, immunological impairment, lung injury, hemolytic reactions and higher cancer incidence. Various papers have tried to show an association between correction of anemia and mortality-morbidity, but no consensus has been reached in literature. One of the current World Health Organization's proposals is to reduce potentially unnecessary transfusions, promoting a rational transfusion attitude. The primary objective of this narrative review is to approach controversies regarding the transfusion threshold according to recent studies, and as a secondary objective, it aims to discuss iatrogenic anemia aspects and the different behaviors among intensivists on the best practices for implementation of transfusion practices. It is not within our objectives to discuss transfusion complications, although they are mentioned. A search was conducted on electronic literature databases (Pub

  5. [Blood transfusion and viral diseases. Recent acquisitions concerning viral hepatitis viruses, cytomegaloviruses and Epstein-Barr virus].

    Science.gov (United States)

    Spanò, C

    1979-02-11

    In recent years, an increasingly clear picture has been formed of the virus-induced syndromes that may follow a blood transfusion or the use of blood derivatives. Up to about 10 years ago, post-infusion infection was predominantly due to serum hepatitis. Blumberg's discovery of HBsAg (formerly known as Australia antigen) has made it possible to check and prevent viral hepatitis, type B, and to recognise such distinct forms as the mononucleosis-like syndrome caused by cytomegalic virus, infectious mononucleosis caused by EB virus, and so-called non A/non B hepatitis. A brief account of recent advances with respect to the biological features of the viruses responsible for type A and type B hepatitis, CMV and EB virus, and their behaviour in man is followed by an examination of the transfusional aspects, the methods used in their study, and the difficulties involved. The soundness of existing methods and the need for their standardisation are discussed.

  6. Blood tranfusion in critically ill patients: state of the art Transfusão de sangue em pacientes críticos: estado da arte

    Directory of Open Access Journals (Sweden)

    Ludhmila Abrahão Hajjar

    2007-01-01

    Full Text Available Anemia is one of the most common abnormal findings in critically ill patients, and many of these patients will receive a blood transfusion during their intensive care unit stay. However, the determinants of exactly which patients do receive transfusions remains to be defined and have been the subject of considerable debate in recent years. Concerns and doubts have emerged regarding the benefits and safety of blood transfusion, in part due to the lack of evidence of better outcomes resulting from randomized studies and in part related to the observations that transfusion may increase the risk of infection. As a result of these concerns and of several studies suggesting better or similar outcomes with a lower transfusion trigger, there has been a general tendency to decrease the transfusion threshold from the classic 10 g/dL to lower values. In this review, we focus on some of the key studies providing insight into current transfusion practices and fueling the current debate on the ideal transfusion trigger.A transfusão no paciente crítico vem sendo alvo de discussões recentes considerando seus reais benefícios na redução de morbi-mortalidade e os riscos associados ao procedimento. Nos últimos anos, alguns estudos controlados e randomizados tiveram como objetivo comparar desfechos clínicos entre pacientes que receberam transfusão de maneira mais liberal (hemoglobina alvo em torno de 9 g/dL e transfusão de maneira mais restritiva (hemoglobina em torno de 7 g/dL. Os resultados demonstram a não superioridade da estratégia liberal comparada com a restritiva. Além disso, em alguns subgrupos de pacientes menos graves ou de menor idade, a transfusão foi associada com piores desfechos clínicos. Os riscos da transfusão de sangue no paciente crítico incluem desde incidência maior de infecções bacterianas, infecções virais, imunodepressão, reações hemolíticas e lesões teciduais inflamatórias, dentre outros. Algumas estratégias v

  7. Postoperative red blood cell transfusion strategy in frail anemic elderly with hip fracture. A randomized controlled trial.

    Science.gov (United States)

    Gregersen, Merete

    2016-04-01

    Hip fracture in the elderly is associated with poor recovery from physical disability and mortality. Perioperative blood loss is common, and anemia might be fatal in the frail elderly. Red blood cell transfusions might increase the risk of infection. In an observational study, a liberal transfusion strategy with hemoglobin (Hb) target of 7 mmol/l (11.3 g/dl) seemed to improve survival in nursing home residents with hip fracture compared to the recommended restrictive strategy with a Hb target of 6 mmol/l (9.7 g/dl) according to the Danish Health Authority. Our aim was to compare these two strategies in the frail elderly in a randomized controlled trial on the outcomes: recovery from physical disabilities, mortality, infection, infection biomarkers, and overall Quality of Life (OQoL). We included 284 elderly admitted to hospital for surgical hip fracture repair from nursing homes or sheltered housing facilities. The anemic patients were assigned postoperatively to the liberal or the restrictive transfusion strategy. Randomization divided each transfusion group into two equal blocks with regard to type of the residence. Hb was measured daily during the first three postoperative days, at least once during the following 4-6 days, then at least once a week during the subsequent three weeks. The transfusions were administered according to group assignments, but no later than 24 hours after the Hb determination, one unit at a time, and no more than two units per day. The intervention lasted for 30 days after surgery. Outcome measurements were performed on days 10, 30, 90, and 365. Blinded assessors evaluated physical performance and OQoL. The liberal transfusion strategy did not improve recovery from physical disabilities, mortality, infection rate, or OQoL compared to the restrictive strategy. However, in nursing home residents, 90-day mortality rate (20%) following the liberal strategy was statistically significantly lower than that (36%) after the restrictive strategy

  8. ABO血型不合异基因造血干细胞移植后血型转换期的输血策略%Transfusion strategy to ABO-incompatible grafts in allogeneic hematopoietic stem cell transplantation

    Institute of Scientific and Technical Information of China (English)

    许金华; 李晓丰

    2015-01-01

    BACKGROUND:Hematopoietic stem cel transplantation is an important means for clinical cure of hematologic malignancies, congenital hereditary diseases and autoimmune diseases. Although ABO-incompatibility has no effects on the survival of transplanted hematopoietic stem cels, the transfusion strategy to ABO-incompatible grafts in alogeneic hematopoietic stem cel transplantation is worth studying. OBJECTIVE:To explore the antigen-antibody changes during blood conversion after ABO-incompatible hematopoietic stem cel transplantation as wel as transfusion strategies. METHODS:Blood grouping, antibody detection, antibody titer determination, cross-match test were employed for antigen-antibody monitoring during blood conversion and pre-transfusion compatibility detection in 24 cases undergoing ABO-incompatible alogeneic hematopoietic stem cel transplantation. Another 30 cases undergoing ABO-compatible alogeneic hematopoietic stem cel transplantation were enroled as controls to select the appropriate blood. RESULTS AND CONCLUSION:Al of the 24 ABO-incompatible patients developed the hematopoietic reconstitution after transplantation, but both major and major-minor ABO incompatibility were different from ABO compatibility in the time of erythrocytic recovery (P < 0.05). According to the changes of ABO antigen and antibody during the blood conversion, the patients of major ABO incompatibility were selected the red blood cels of their own type, the patients of minor ABO incompatibility were selected the red blood cels of the blood group from patients to donors gradualy, and the patients of major-minor ABO incompatibility were selected the red blood cels from O-type blood to donor’s type gradualy. None of the 24 recipients presented hemolytic reaction during transplantation and after transfusion. Therefore, the transfusion strategy to ABO-incompatible grafts in alogeneic hematopoietic stem cel transplantation is dynamicaly varied according to the changes of patient’s ABO

  9. 犬贫血性疾病输血疗法的疗效观察%The Blood Transfusion Treatment of Canine Anemia Disease

    Institute of Scientific and Technical Information of China (English)

    郭延敏; 任艳艳

    2012-01-01

    输血疗法是救治动物的一项重要措施.为了验证输血疗法的作用,对数十例贫血病病犬进行输血疗法治疗,通过血常规检查、血液生化学检查等发现患犬均患有不同程度的贫血,红细胞数、血红蛋白含量、红细胞压积均明显低于正常值,在治疗原发病的同时配合了输血疗法.经过一段时间的治疗,发现应用输血疗法治疗的患犬痊愈快,患犬的红细胞数、血红蛋白含量、红细胞压积均逐渐升高接近正常值.由此可见,输血疗法对犬贫血病的治疗效果较好.%Blood transfusion is an important method for remedying animals. In order to verify the effect of blood transfusion therapy, the experiment used symptomatic treatment combing blood transfusion therapy to cure the troubled canines. Blood routine examination, blood biochemical analysis and other examination were done and found that those canines were troubled with different degrees of anemia, with lower red cells, heamoglobin and volume packed red cells. The diseased canines were treated with blood transfusion. Some time later after the therapy,the sick canines were healed quicker. At the same time,the blood routine examination and biochemical analysis were done to the cured canines,the results showed that the red cells,heamoglobin and volume packed red cells were heighten obviously to the range of normal values. Therefore, the blood transfusion therapy got better effect than traditional therapy.

  10. Rh阴性血型患者输血相关问题探讨%Discussion on the issues related to Rh-negative blood transfusion

    Institute of Scientific and Technical Information of China (English)

    韩艳秋

    2016-01-01

    Rh血型系统是重要的红细胞血型系统,目前临床输血治疗对于Rh阴性血液的需求仍处于紧张状态.实际临床工作中,通过典型案例分析总结针对Rh阴性血型患者输血的临床经验,建立规范化的血库管理模式,分析Rh阴性血型患者的输血类型,并且积极普及Rh阴性血型的相关知识,尽力减少临床输血过程中导致的输血反应等问题,从而达到安全、合理输血的目的.%Rh blood group system is very important for red blood cell blood group system,the supply of Rh-negative blood have been remained on edge in clinical blood transfusions.During clinical practice,we should learn experience of blood transfusion in patients with Rh-negative blood type from clinical typical cases,establish a standardized blood bank management model,analyze the types of blood transfusion of Rh-negative patients,and popularize knowledge of Rh-negative rare blood type,try our best to reduce the probability of transfusion reaction,in order to ensure the clinical blood supply,and the blood quality and safety.

  11. The Coagulative Profile of Cyanotic Children Undergoing Cardiac Surgery: The Role of Whole Blood Preoperative Thromboelastometry on Postoperative Transfusion Requirement.

    Science.gov (United States)

    Vida, Vladimiro L; Spiezia, Luca; Bortolussi, Giacomo; Marchetti, Marta E; Campello, Elena; Pittarello, Demetrio; Gregori, Dario; Stellin, Giovanni; Simioni, Paolo

    2016-07-01

    The objective of this study is to evaluate the preoperative coagulation pattern and its association to postoperative blood products transfusion in children with congenital heart disease (CHD), focusing on cyanotic patients (oxygen saturation, SATO 2  < 85%). From January to August 2014, preoperative standard coagulation tests and rotational thromboelastometry assays were performed on 81 pediatric patients (<16 years old) who underwent surgery for CHD with the aid of cardiopulmonary bypass. Sixty patients (74%) were acyanotic and 21 (26%) cyanotic. Mean age at time of surgery was 7.9 months (interquartile range 2.9-43.6 months). Cyanotic patients had a significantly higher hematocrit (P < 0.001), a reduced prothrombin activity (PT) (P = 0.01) level, and a lower platelet count (P = 0.02) than acyanotic patients. An inverse linear association was found between patient's SATO2 and clot formation time (CFT) (INTEM, P = 0.001, and EXTEM, P < 0.0001). A direct linear association was found between patient's SATO2 and maximum clot firmness (MCF) (INTEM, P = 0.04, and EXTEM, P = 0.05). Preoperative cyanosis was also associated with a lower median MCF in FIBTEM (P = 0.02). Cyanotic patients required more frequent postoperative transfusions of fibrinogen (7/21 patients, 33% vs. 4/60 patients, 6.7%, P = 0.01) and fresh frozen plasma (14/21, 67% vs. 25/60, 42%, P = 0.08). Patients with a lower presurgery PT and platelet count subsequently required more fibrinogen transfusion P = 0.02 and P = 0.003, respectively); the same goes for patients with a longer CFT (INTEM, P = 0.01 and EXTEM, P = 0.03) and a reduced MCF (INTEM, P = 0.02 and FIBTEM, P = 0.01) as well. Cyanotic patients showed significant preoperative coagulation anomalies and required a higher postoperative fibrinogen supplementation. The preoperative MCF FIBTEM has become an important factor in our postoperative thromboelastometry-guided transfusion

  12. [Respiratory complications after transfusion].

    Science.gov (United States)

    Bernasinski, M; Mertes, P-M; Carlier, M; Dupont, H; Girard, M; Gette, S; Just, B; Malinovsky, J-M

    2014-05-01

    Respiratory complications of blood transfusion have several possible causes. Transfusion-Associated Circulatory Overload (TACO) is often the first mentioned. Transfusion-Related Acute Lung Injury (TRALI), better defined since the consensus conference of Toronto in 2004, is rarely mentioned. French incidence is low. Non-hemolytic febrile reactions, allergies, infections and pulmonary embolism are also reported. The objective of this work was to determine the statistical importance of the different respiratory complications of blood transfusion. This work was conducted retrospectively on transfusion accidents in six health centers in Champagne-Ardenne, reported to Hemovigilance between 2000 and 2009 and having respiratory symptoms. The analysis of data was conducted by an expert committee. Eighty-three cases of respiratory complications are found (316,864 blood products). We have counted 26 TACO, 12 TRALI (only 6 cases were identified in the original investigation of Hemovigilance), 18 non-hemolytic febrile reactions, 16 cases of allergies, 5 transfusions transmitted bacterial infections and 2 pulmonary embolisms. Six new TRALI were diagnosed previously labeled TACO for 2 of them, allergy and infection in 2 other cases and diagnosis considered unknown for the last 2. Our study found an incidence of TRALI 2 times higher than that reported previously. Interpretation of the data by a multidisciplinary committee amended 20% of diagnoses. This study shows the imperfections of our system for reporting accidents of blood transfusion when a single observer analyses the medical records.

  13. Does blood transfusion affect pituitary gonadal axis and sperm parameters in young males with sickle cell disease?

    Directory of Open Access Journals (Sweden)

    Ashraf T Soliman

    2013-01-01

    Full Text Available Objective: We evaluated the effect of packed red cell transfusion (PCTx on serum concentrations of gonadotropins luteinizing hormone and follicle-stimulating hormone (LH and FSH and testosterone (T levels and measured sperm parameters in young adults with sickle cell disease (SCD on top-up transfusion (TTx and those on exchange transfusion (ETx regimen. Materials and Methods: Basal serum concentrations of FSH, LH, and T and semen parameters were evaluated before and 7 days after PCTx in 18 young adults with transfusion-dependent SCD, aged 20.7 ± 2.88 years. They had full pubertal development (Tanner′s stage 5, and capacity to ejaculate. They were regularly transfused since early childhood. Chelation therapy was started early during the first 2 years of life using desferrioxamine and was replaced by deferasirox for the last 4-5 years. Ten patients were on TTx and eight were on ETx regimen. Results: PCTx significantly increased hemoglobin (Hb from 8.5 ± 1.17 g/dl to 10.5 ± 0.4 g/dl, T from 12.3 ± 1.24 nmol/L to 14.23 ± 1.22 nmol/L and gonadotropins′ concentrations. Sperm parameters improved significantly after PCTx including: total sperm count from 87.4 ± 24.6 million/ml to 146.2 ± 51.25 million/ml, total progressive sperm motility (TPM from 40.8 ± 11.1 million/ml to 93.4 ± 38.3 million/ml, rapid progressive sperm motility (RPM progressive motility from 29.26 ± 8.75 million/ml to 67.4 ± 29 million/ml. After PCTx the total sperm count, TPM and RPM were significantly better in the ETx group versus the TTx group. Before and after PCTx, T concentrations were correlated significantly with sperm total count, volume, TPM and RPM (r = 0.53, 0.55, 0.42, and 0.38, respectively, P < 0.01. Hb concentrations were correlated significantly with sperm count, TPM, RPM, and % of sperms with normal morphology (r = 0.60, 0.69, 0.66, and 0.86, respectively, P < 0.001. Conclusion: Our study suggests that in males with SCD blood transfusion is associated

  14. Transfusion practices in trauma

    Directory of Open Access Journals (Sweden)

    V Trichur Ramakrishnan

    2014-01-01

    Full Text Available Resuscitation of a severely traumatised patient with the administration of crystalloids, or colloids along with blood products is a common transfusion practice in trauma patients. The determination of this review article is to update on current transfusion practices in trauma. A search of PubMed, Google Scholar, and bibliographies of published studies were conducted using a combination of key-words. Recent articles addressing the transfusion practises in trauma from 2000 to 2014 were identified and reviewed. Trauma induced consumption and dilution of clotting factors, acidosis and hypothermia in a severely injured patient commonly causes trauma-induced coagulopathy. Early infusion of blood products and early control of bleeding decreases trauma-induced coagulopathy. Hypothermia and dilutional coagulopathy are associated with infusion of large volumes of crystalloids. Hence, the predominant focus is on damage control resuscitation, which is a combination of permissive hypotension, haemorrhage control and haemostatic resuscitation. Massive transfusion protocols improve survival in severely injured patients. Early recognition that the patient will need massive blood transfusion will limit the use of crystalloids. Initially during resuscitation, fresh frozen plasma, packed red blood cells (PRBCs and platelets should be transfused in the ratio of 1:1:1 in severely injured patients. Fresh whole blood can be an alternative in patients who need a transfusion of 1:1:1 thawed plasma, PRBCs and platelets. Close monitoring of bleeding and point of care coagulation tests are employed, to allow goal-directed plasma, PRBCs and platelets transfusions, in order to decrease the risk of transfusion-related acute lung injury.

  15. Incidence, Predictors, and Postoperative Complications of Blood Transfusion in Thoracic and Lumbar Fusion Surgery: An Analysis of 13,695 Patients from the American College of Surgeons National Surgical Quality Improvement Program Database.

    Science.gov (United States)

    Aoude, Ahmed; Nooh, Anas; Fortin, Maryse; Aldebeyan, Sultan; Jarzem, Peter; Ouellet, Jean; Weber, Michael H

    2016-12-01

    Study Design Retrospective cohort study. Objective To identify predictive factors for blood transfusion and associated complications in lumbar and thoracic fusion surgeries. Methods The American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database was used to identify patients who underwent lumbar or thoracic fusion from 2010 to 2013. Multivariate analysis was used to determine predictive factors and postoperative complications associated with transfusion. Results Out of 13,695 patients, 13,170 had lumbar fusion and 525 had thoracic fusion. The prevalence of transfusion was 31.8% for thoracic and 17.0% for lumbar fusion. The multivariate analysis showed that age between 50 and 60, age between 61 and 70, age > 70, dyspnea, American Society of Anesthesiologists class 3, bleeding disease, multilevel surgery, extended surgical time, return to operation room, and higher preoperative blood urea nitrogen (BUN) were predictors of blood transfusion for lumbar fusion. Multilevel surgery, preoperative BUN, and extended surgical time were predictors of transfusion for thoracic fusion. Patients receiving transfusions who underwent lumbar fusion were more likely to develop wound infection, venous thromboembolism, pulmonary embolism, and myocardial infarction and had longer hospital stay. Patients receiving transfusions who underwent thoracic fusion were more likely to have extended hospital stay. Conclusion This study characterizes incidence, predictors, and postoperative complications associated with blood transfusion in thoracic and lumbar fusion. Pre- and postoperative planning for patients deemed to be at high risk of requiring blood transfusion might reduce postoperative complications in this population.

  16. A method to collect, store and issue multiple aliquots of packed red blood cells for neonatal transfusions.

    Science.gov (United States)

    Strauss, R G; Villhauer, P J; Cordle, D G

    1995-01-01

    Premature neonates require multiple red blood cell (RBC) transfusions. Single-donor programs have been proposed as a means to limit donor exposures, but methods must be developed to collect, store long-term and issue multiple aliquots of RBCs from a single donor. We evaluated a method by which RBCs could be collected, leukocyte depleted, repeatedly centrifuged for issuance as multiple small aliquots of high-hematocrit cells and then resuspended for continued storage throughout 42 days. The quality of RBCs handled by the method were compared to cells stored in standard fashion. Leakage of intracellular potassium, hemoglobin and lactic dehydrogenase into the extracellular fluid from RBCs processed by either method was comparable-indicating maintenance of RBC integrity. Multiple cultures, taken throughout the period of storage, were sterile to document that extensive handling did not introduce contamination. This new method appears promising as a means to provide RBCs for neonates.

  17. Perioperative Blood Transfusion Promotes Worse Outcomes of Bladder Cancer after Radical Cystectomy: A Systematic Review and Meta-Analysis.

    Directory of Open Access Journals (Sweden)

    You-Lin Wang

    Full Text Available Multiple studies have investigated the effect of perioperative blood transfusion (PBT for patients with radical cystectomy (RC, but the results have been inconsistent. We conducted a systematic review and meta-analysis to investigate the relationship between PBT and the clinical outcomes of RC patients.We searched MEDLINE, EMBASE, the Cochrane library and BIOSIS previews to identify relevant literature for studies that focused on the relationship of PBT and outcomes of patients undergoing RC. A fixed or random effects model was used in this meta-analysis to calculate the pooled hazard ratio (HR with 95% confidence intervals (CIs.A total of 7080 patients in 6 studies matched the selection criteria. Aggregation of the data suggested that PBT in patients who underwent RC correlated with increased all-cause mortality, cancer-specific mortality and cancer recurrence. The combined HRs were 1.19 (n = 6 studies, 95% CI: 1.11-1.27, Z = 4.71, P<0.00001, 1.17 (n = 4 studies, 95% CI: 1.06-1.30, Z = 3.06, P = 0.002, 1.14 (n = 3 studies, 95% CI: 1.03-1.27, Z = 2.50, P = 0.01, respectively. The all-cause mortality associated with PBT did not vary by the characteristics of the study, including number of study participants, follow-up period and the median blood transfusion ratio of the study.Our data showed that PBT significantly increased the risks of all-cause mortality, cancer-specific mortality and cancer recurrence in patients undergoing RC for bladder cancer.

  18. Risk factors of infections induced by blood transfusion and prevention measures%输血感染的危险因素分析及防范

    Institute of Scientific and Technical Information of China (English)

    潘晓红

    2013-01-01

    OBJECTIVE To analyze the related risk factors and causes of the infections induced by the blood transfusion in the blood transfusion department and discuss the prevention countermeasures so as to ensure the safety of the clinical blood transfusion and improve the quality of the medical service.METHODS The medical records of 72 cases of patients who underwent blood transfusion from Jun 2009 to Jun 2011 were retrospectively analyzed,and the risk factors of the blood transfusion infections were analyzed.RESULTS Of 72 cases with the blood transfusion -associated diseases,there were 54 cases with hepatitis B,12 cases with hepatitis C,4 cases with mixed hepatitis B and hepatitis C,and 2 cases with syphilis infections,the incidence of the hepatitis B was the highest (75.00%),followed by the hepatitis C (16.67%),the mixed hepatitis B and hepatitis C (5.55%),and syphilis infection (2.78%) ; the incidence of the blood transfusion-associate diseases varied in the risk factors,the difference was statistically significant (P<0.05),the incidence of the blood transfusion-associated diseases induced by the window period was the highest (84.72%).CONCLUSION Only when fully understand the risk factors of the blood transfusion infections can we take the effective prevention measures and reasonably use blood so as to ensure the safety of the blood transfusion.%目的 分析医院输血科发生输血感染的相关危险因素及其原因,并探讨其防范对策,确保临床输血的安全,提高医疗服务质量.方法 采用病历信息回顾性分析2009年6月-2011年6月医院72例输血感染以及不同危险因素导致输血感染相关性疾病的分布.结果 72例输血感染相关性疾病,其中感染乙型肝炎54例,丙型肝炎12例,同时感染乙型肝炎和丙型肝炎4例,感染梅毒2例,感染乙型肝炎的发生率最高为75.00%,其次感染丙型肝炎发生率为16.67%,同时感染乙型肝炎和丙型肝炎发生率为5.55

  19. Blockade of CD40-CD154 at the time of donor-specific blood transfusion does not lead to prolonged kidney allograft survival in nonhuman primates

    NARCIS (Netherlands)

    Ringers, J; Haanstra, KG; Kroczek, RA; Kliem, K; Kuhn, EM; Wubben, J; Ossevoort, MA; Volk, HD; Jonker, M

    2002-01-01

    Background. In rodents it has been demonstrated that blockade of the CD40-CD154 (CD40L) pathway at the time of donor-specific blood transfusion (DST) can result in indefinite graft survival. Because it has been reported in the past that DST in monkeys can have a favorable effect on graft outcome and

  20. The influence and impact of the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) on blood transfusion services in Africa : Case studies from Namibia

    NARCIS (Netherlands)

    Pitman, John Patton

    2015-01-01

    The questions addressed by this thesis were born from an interest in the relationship between international development projects and the impact external funds had on technical issues of importance to blood transfusion services. Specifically, I was interested in how the rapid injection of massive fun

  1. Multiple utilization of energy in buildings. Utilization of waste heat at the Blood Transfusion Service; Energie im Gebaeude mehrfach nutzen. Abwaermenutzung beim Blutspendedienst Nord

    Energy Technology Data Exchange (ETDEWEB)

    Gaigalat, Jens

    2012-11-01

    For the Blood Transfusion Service North the German Red Cross (Berlin, Federal Republic of Germany) utilizes the waste heat from production facilities and laboratories for heating offices. By doing this, the VRV technology for the realization of this solution was used.

  2. Response to intravenous allogeneic equine cord-blood-derived mesenchymal stromal cells administered from chilled or frozen state in serum and protein free media

    Directory of Open Access Journals (Sweden)

    Lynn Brandon Williams

    2016-07-01

    Full Text Available Equine Mesenchymal stromal cells (MSC are commonly transported, chilled or frozen, to veterinary clinics. These MSC must remain viable and minimally affected by culture, transport, or injection processes. The safety of two carrier solutions developed for optimal viability and excipient use were evaluated in ponies, with and without allogeneic cord blood-derived (CB MSC. We hypothesized that neither the carrier solutions nor CB-MSC would elicit measurable changes in clinical, hematological, or biochemical parameters. In 9 ponies (study 1 a bolus of HypoThermosol® FRS (HTS-FRS, CryoStor® CS10 (CS10 or saline was injected IV (n=3/treatment. Study 2, following a one week washout period 5x107 pooled allogeneic CB-MSC were administered IV in HTS-FRS following 24h simulated chilled transport. Study 3, following another one week washout period 5x107 pooled allogeneic CB-MSC were administered IV in CS10 immediately after thawing. Nine ponies received CB-MSCs in study 2 and 3 and three ponies received the cell carrier media without cells. CB-MSCs were pooled in equal numbers from five unrelated donors. In all studies ponies were monitored with physical examination, and blood collection for 7 days following injection. CD4 and CD8 lymphocyte populations were also evaluated in each blood sample.In all three studies, physical exam, complete blood cell count, serum biochemistry, and coagulation panel did not deviate from established normal ranges. Proportions of CD4+ and CD8+ lymphocytes increased at 168h post injection in CB-MSC treatment groups regardless of the carrier solution. Decreases in CD4+/CD8+ double positive populations were observed at 24 h and 72 h in CB-MSC treated animals. There was no difference in viability between CB-MSC suspended in HTS-FRS or CS10.HTS-FRS and CS10 used for low volume excipient injection of MSC suspensions was not associated with short-term adverse reactions. HTS-FRS and CS10 both adequately maintain CB-MSC viability

  3. Washing of stored red blood cells by an autotransfusion device before transfusion

    NARCIS (Netherlands)

    de Vroege, R.; Wildevuur, W. R.; Muradin, J. A. G.; Graves, D.; van Oeveren, W.

    2007-01-01

    Background and Objectives The use of an autotransfusion device to wash blood of the incision site is increasing. After washing, this blood is retransfused without side effects caused by activated plasma factors and cell release products. This procedure could be extended to washing of donor blood, wh

  4. Romiplostim in thrombocytopenia treatment after allogeneic bone marrow transplantation

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    I. A. Lisukov

    2014-07-01

    Full Text Available Persistent thrombocytopenia is a frequent complication after allogeneic bone marrow transplantation (BMT. The major causes of thrombocytopenia include accelerated platelet destruction by antiplatelet antibodies, microangiopathy, viral infection, drug toxicity,graft`s hypofunction with insufficient production of platelets from megakaryocytes. We have evaluated an efficacy of TPO-receptor agonistromiplostim in treatment of 3 patients with refractory thrombocytopenia after allogeneic BMT. The first 30 years old patient received haploidentical allogeneic stem cell transplantation for refractory AML relapse. He developed graft hypofunction due to CMV infection, acute GVHD and thrombotic thrombocytopenic purpura (TTP with platelet counts 5 × 109/l and bleeding complications. After bone marrow “boost” the patient received romiplostim 1 mkg/kg weekly during 2 weeks and 4 mkg/kg during another 2 weeks. Upon reaching platelet counts 50 × 109/l the romiplostim was stopped, but platelet count decreased to 5–7 × 109/l and romiplostim was administered in dose of 4 mkg/kg weekly during 5 weeks. Platelet counts have achieved 150 × 109/l and thrombocytopenia during further follow-up was not revealed. The second 19 years old AML patient received haploidentical allogeneic stem cell transplantation for second remission consolidation. He developed thrombocytopenia (10 × 109/l due to CMV infection and severe TTP. He received romiplostim 4 mkg/kg weekly and 5 weeks later platelet counts was 50 × 109/l. The administration of romiplostim was allowed to avoid bleeding complications and transfusion dependency. The third 18 years old ALL patient received MUD allogeneic stem cell transplantation for second remission consolidation. He developed profound thrombocytopenia (5 × 109/l with severe hemorrhagic complications and platelet transfusions refractory due to TTP and acute GVHD. He received one dose of romiplostim 1 mkg/kg and two doses of 3 mkg

  5. Romiplostim in thrombocytopenia treatment after allogeneic bone marrow transplantation

    Directory of Open Access Journals (Sweden)

    I. A. Lisukov

    2012-01-01

    Full Text Available Persistent thrombocytopenia is a frequent complication after allogeneic bone marrow transplantation (BMT. The major causes of thrombocytopenia include accelerated platelet destruction by antiplatelet antibodies, microangiopathy, viral infection, drug toxicity,graft`s hypofunction with insufficient production of platelets from megakaryocytes. We have evaluated an efficacy of TPO-receptor agonistromiplostim in treatment of 3 patients with refractory thrombocytopenia after allogeneic BMT. The first 30 years old patient received haploidentical allogeneic stem cell transplantation for refractory AML relapse. He developed graft hypofunction due to CMV infection, acute GVHD and thrombotic thrombocytopenic purpura (TTP with platelet counts 5 × 109/l and bleeding complications. After bone marrow “boost” the patient received romiplostim 1 mkg/kg weekly during 2 weeks and 4 mkg/kg during another 2 weeks. Upon reaching platelet counts 50 × 109/l the romiplostim was stopped, but platelet count decreased to 5–7 × 109/l and romiplostim was administered in dose of 4 mkg/kg weekly during 5 weeks. Platelet counts have achieved 150 × 109/l and thrombocytopenia during further follow-up was not revealed. The second 19 years old AML patient received haploidentical allogeneic stem cell transplantation for second remission consolidation. He developed thrombocytopenia (10 × 109/l due to CMV infection and severe TTP. He received romiplostim 4 mkg/kg weekly and 5 weeks later platelet counts was 50 × 109/l. The administration of romiplostim was allowed to avoid bleeding complications and transfusion dependency. The third 18 years old ALL patient received MUD allogeneic stem cell transplantation for second remission consolidation. He developed profound thrombocytopenia (5 × 109/l with severe hemorrhagic complications and platelet transfusions refractory due to TTP and acute GVHD. He received one dose of romiplostim 1 mkg/kg and two doses of 3 mkg

  6. HBV, HCV and HIV seroprevalence among blood donors in Istanbul, Turkey: how effective are the changes in the national blood transfusion policies?

    Directory of Open Access Journals (Sweden)

    Ali Acar

    2010-02-01

    Full Text Available The national blood transfusion policies have been changed significantly in recent years in Turkey. The purpose of this study was to determine the prevalence of HBV, HCV, and HIV in blood donors at the Red Crescent Center in Istanbul and to evaluate the effect of changes in the national blood transfusion policies on the prevalence of these infections. The screening results of 72695 blood donations at the Red Crescent Center in Istanbul between January and December 2007 were evaluated retrospectively. HBsAg, anti-HCV, and anti-HIV-1/2 were screened by microparticle enzyme immunoassay (MEIA method. Samples found to be positive for anti-HIV 1/2 and anti-HCV were confirmed by Inno-Lia HCV Ab III and Inno-Lia HIV I/II Score, respectively. The seropositivity rates for HBsAg, anti-HCV, and anti-HIV-1/2 were determined as 1.76%, 0.07%, and 0.008%, respectively. Compared to the previously published data from Red Crescent Centers in Turkey, it was found that HBV and HCV seroprevalances decreased and HIV seroprevalance increased in recent years. In conclusion, we believe that the drop in HBV and HCV prevalence rates are likely multifactorial and may have resulted from more diligent donor questioning upon screening, a higher level of public awareness on viral hepatitis as well as the expansion of HBV vaccination coverage in Turkey. Another factor to contribute to the decreased prevalence of HCV stems from the use of more sensitive confirmation testing on all reactive results, thereby eliminating a fair amount of false positive cases. Despite similar transmission routes, the increase in HIV prevalence in contrast to HBV and HCV may be linked to the increase in AIDS cases in Turkey in recent years.

  7. Analysis of the transfusion mode of rare blood patient in Beijing%北京市稀有血型患者输血途径探讨

    Institute of Scientific and Technical Information of China (English)

    许志远; 王涛

    2013-01-01

    目的 了解北京市稀有血型患者不同情况下输血途径,为相关政策制定提供依据.方法 回顾性分析2000-2011年北京市稀有血型患者血液标本抗体筛查、疑难配血情况,对稀有血型患者血型血清学结果、临床诊断、不同输血方法进行分析.结果 近11年来共发现7例罕见的稀有血型患者,检出率为9/10 000;其中3例为Fy(a-b+)存在抗-Fya抗体,2例为D--存在抗-Hr0抗体,1例为Jk(a-b-)存在抗-Jk3抗体,1例为OhB-分泌型存在抗-HI抗体.其中2例患者通过中国稀有血型库提供相合血液(1例同时自体备血),3例通过亲属互助献血(1例同时自身输血),2例自身输血.结论 稀有血型在输血人群中出现频率极低,此类患者相合性血液输注极为困难,制定稀有血型输血有关策略及建立和完善稀有血型库十分必要.%Objective To investigate the transfusion mode of rare blood groups in Beijing. Methods Retrospective analysis was carried out among rare blood patients in Beijing from 2000 to 2011, including their irregular antibody screening, difficult blood matching, clinical diagnosis and transfusion strategy. Results The rate of rare blood groups in Beijing was 7/7721 during 2000-2011. Seven patients were found with rare blood groups, three were Fy ( a-b+ ) with anti-Fya antibody, two were D- with anti-Hr0 antibody, one was Jk( a-b- ) with anti-Jk3 antibody, one was OhB- secretor with an-ti-HI antibody. For blood transfusion of the 7 patients, two found compatible blood in Chinese Bank of rare blood (one patient had preoperative autologous blood collectionat the same time), three were transfused by blood donation from patients' relatives (one had autologous blood transfusion at the same tinme), two had autologous blood transfusion. Conclusion The presence of rare blood group in Chinese population is rare, transfusion of compatible blood is very difficult. It is necessary to establish both the transfusion strategy of the rare

  8. Significant reduction in blood loss in patients undergoing minimal extracorporeal circulation

    NARCIS (Netherlands)

    Gerritsen, W. B.; van Boven, W. J.; Smelt, M.; Morshuis, W. J.; van Dongen, H. P.; Haas, F. J.; Aarts, L. P.

    2006-01-01

    Several recent studies have shown differences in blood loss and allogeneic transfusion requirements between on-pump and off-pump coronary artery bypass grafting (CABG). Recently a new concept, the mini-extracorporeal circulation, was introduced to minimize the side effects of extracorporeal circulat

  9. Treatment of immune thrombocytopenia after allogeneic cord blood stem cell transplantation with rituximab: a case report

    Institute of Scientific and Technical Information of China (English)

    Mengxing Li; Jishi Wang; Yan Zhang; Zhiqiang Sun; Yanju Li; Xiaoli Zhou

    2013-01-01

    Immune thrombocytopenia (ITP) is a chronic disease resulting from increased platelet destruction and impaired platelet production. Secondary ITP can be a manifestation of chronic graft-versus-host disease (GVHD) and represent a lymphoproliferative disorder. A boy with chronic graft-versus-host disease after cord blood stem cell transplantation who had severe refractory immune-mediated thrombocytopenia received infusion of rituximab weekly, 375 mg/m2, for 4 weeks. Platelets count of the patient was recovered, and rituximab was well tolerated with no severe toxicity observed during treatment.

  10. Mechanisms of severe transfusion reactions.

    Science.gov (United States)

    Kopko, P M; Holland, P V

    2001-06-01

    Serious adverse effects of transfusion may be immunologically or non-immunologically mediated. Currently, bacterial contamination of blood products, particularly platelets, is one of the most significant causes of transfusion-related morbidity and mortality. Septic transfusion reactions can present with clinical symptoms similar to immune-mediated hemolytic transfusion reactions and transfusion-related acute lung injury. Extremely high fever and/or gastrointestinal symptoms, in a transfusion recipient, may be indicative of sepsis. The diagnosis is based upon culturing the same organism from both the patient and the transfused blood component. Numerous organisms have been implicated as the cause of septic transfusion reactions. Due to different storage conditions, gram negative organisms are more often isolated from red blood cell components; gram positive organisms are more often isolated from platelets. Prevention of septic transfusion reactions is primarily dependent on an adequate donor history and meticulous preparation of the donor phlebotomy site. Visual inspection of blood components prior to transfusion is also vital to preventing these reactions. Several methods of detection of bacterial contamination and inactivation of pathogens are currently under active investigation.

  11. Implementation of the Continuous AutoTransfusion System (C.A.T.S) in open abdominal aortic aneurysm repair: an observational comparative cohort study.

    LENUS (Irish Health Repository)

    Tawfick, Wael A

    2008-01-01

    The use of the Continuous AutoTransfusion System (C.A.T.S; Fresenius Hemotechnology, Bad Homburg v.d.H., Germany), which conserves allogenic blood, is reported in 187 patients having abdominal aortic aneurysm repair during a 9-year period. Patients were allocated to C.A.T.S if a Haemovigilance technician was available. A mean of 685 mL of retrieved blood was reinfused in 101 patients receiving C.A.T.S; 61% required 2 U or less. All control patients required 3 U or more of allogenic blood. Allogenic transfusion in C.A.T.S patients decreased significantly (P < .0001). Mean intensive care unit stay was significantly reduced in C.A.T.S patients (P = .042). Mean postoperative hospital stay was 18 days for C.A.T.S group and 25 days in control patients (P = .014). The respective 30-day mortality was 12% versus 19% (P = .199). The C.A.T.S markedly reduced the amount of blood transfused, was associated with reduced intensive care unit and postoperative hospital stay, and was cost-effective.

  12. Effect of tranexamic acid on blood loss and transfusion requirement in total knee replacement in the Indian population: A case series

    Science.gov (United States)

    Gautam, Parshotam Lal; Katyal, Sunil; Yamin, Mohammad; Singh, Amandip

    2011-01-01

    Context: Total knee replacement (TKR) is often carried out using a tourniquet to minimize intraoperative blood loss. However, its application enhances local fibrinolysis, resulting in excessive blood loss during the post-operative period. Fibrinolytic profile varies in different regions and races. Tranexamic acid has been shown to reduce post-operative blood loss and the need for transfusion in TKR. However, there is paucity of literature from the Indian population and the efficacy of the agent has not been tested in Indian patients undergoing TKR. Aims: Effect of tranexamic acid on blood loss in TKR surgery in the Indian population. Setting and Design: In this double-blinded study, 40 patients undergoing unilateral TKR were randomly divided into two groups. Methods: All patients were conducted under spinal anaesthesia using injection bupivacaine 0.5% heavy 12-15 mg. The treatment group received 10 mg/kg tranexamic acid, intravenous (IV), half an hour before deflation of the tourniquet, with a second dose of 2 mg/kg administered 3 hours after the first dose. The exact protocol was followed for the placebo group, except that normal saline was used instead of tranexamic acid. Blood loss, blood transfusion details and change in haemoglobin levels were noted. Statistical Analysis: Student's paired ‘t’ test was used in statistical analysis. Results: The mean post-operative blood loss in the tranexamic acid group was 272.5±122.5 ml (mean±SD), and 685±118.2 ml in the placebo group (P<0.001). The total blood loss was lower in the tranexamic acid group than in the placebo group (427.6 ml vs. 911.6 ml; P<0.001). The absolute number of blood transfusions and the number of patients who required transfusions were lower in the tranexamic acid group than in the placebo group. None of the patients had any side or adverse effect. Conclusions: Tranexamic acid significantly decreases post-operative blood loss and reduces the need for blood transfusion in patients undergoing

  13. Effect of tranexamic acid on blood loss and transfusion requirement in total knee replacement in the Indian population: A case series

    Directory of Open Access Journals (Sweden)

    Parshotam Lal Gautam

    2011-01-01

    Full Text Available Context: Total knee replacement (TKR is often carried out using a tourniquet to minimize intraoperative blood loss. However, its application enhances local fibrinolysis, resulting in excessive blood loss during the post-operative period. Fibrinolytic profile varies in different regions and races. Tranexamic acid has been shown to reduce post-operative blood loss and the need for transfusion in TKR. However, there is paucity of literature from the Indian population and the efficacy of the agent has not been tested in Indian patients undergoing TKR. Aims: Effect of tranexamic acid on blood loss in TKR surgery in the Indian population. Setting and Design: In this double-blinded study, 40 patients undergoing unilateral TKR were randomly divided into two groups. Methods: All patients were conducted under spinal anaesthesia using injection bupivacaine 0.5% heavy 12-15 mg. The treatment group received 10 mg/kg tranexamic acid, intravenous (IV, half an hour before deflation of the tourniquet, with a second dose of 2 mg/kg administered 3 hours after the first dose. The exact protocol was followed for the placebo group, except that normal saline was used instead of tranexamic acid. Blood loss, blood transfusion details and change in haemoglobin levels were noted. Statistical Analysis: Student′s paired ′t′ test was used in statistical analysis. Results: The mean post-operative blood loss in the tranexamic acid group was 272.5±122.5 ml (mean±SD, and 685±118.2 ml in the placebo group (P<0.001. The total blood loss was lower in the tranexamic acid group than in the placebo group (427.6 ml vs. 911.6 ml; P<0.001. The absolute number of blood transfusions and the number of patients who required transfusions were lower in the tranexamic acid group than in the placebo group. None of the patients had any side or adverse effect. Conclusions: Tranexamic acid significantly decreases post-operative blood loss and reduces the need for blood transfusion in

  14. Transfusion requirements in patients with gastrointestinal bleeding: a study in a Blood Unit at a referral hospital

    Directory of Open Access Journals (Sweden)

    A. Garrido

    Full Text Available Objectives: 1. To study transfusion requirements in the Department of Gastroenterology of a Tertiary Referral Hospital, and their evolution over the last seven years. 2. To analyze risk factors associated with greater erythrocyte transfusion requirements. Patients and methods: erythrocyte transfusion requirements were compared for patients admitted to the Department of Gastroenterology at Hospital Virgen del Rocío, Seville, from 1999 to 2005. Clinical data of interest have been analyzed in order to determine factors associated with greater transfusion requirements. Results: 1,611 patients with a mean age of 60.45 years (59.7-61.2 were included in this study; 76.41% were males. Gastric ulcers were the cause of bleeding in 18.4% of cases (with 69% requiring transfusions; duodenal ulcers caused 22.2% of cases (with 52.9% requiring transfusions, and portal hypertension caused 33.6% of cases (with 90.2% requiring transfusions. Upper and lower gastrointestinal bleeding of unknown origin requires transfusions in 88.9 and 96.2% of cases, respectively. A multivariate logistic regression analysis showed that clinical presentations such as hematemesis (odds ratio = 3.12, hematochezia (odds ratio = 33.17, gastrointestinal hemorrhage of unknown origin (odds ratio = 6.57, and hemorrhage as a result of portal hypertension (odds ratio = 3.43 were associated with greater transfusion requirements for erythrocyte concentrates. No significant differences were observed between the percentages of patients who received transfusions from 1999 to 2005. Conclusions: 1. No differences have been observed between the percentages of patients who received transfusions over the last seven years at our Department of Gastroenterology. 2. Patients presenting with hematemesis or hematochezia, in addition to those with bleeding of unknown origin or from portal hypertension, are prone to have greater transfusion requirements.

  15. Prevalence and trend of major transfusion-transmissible infections among blood donors in Western China, 2005 through 2010.

    Directory of Open Access Journals (Sweden)

    Yan Song

    Full Text Available BACKGROUND: The prevalence of transfusion-transmissible infections (TTIs in blood donations is important for evaluating blood safety and potential risks to the population. This study investigated the prevalence of TTIs among blood donors in Western China and suggested measures for policy-makers. METHODS: The screening results of 66,311 donations between 2005 and 2010 from a central blood center in Western China were analyzed. The prevalence of hepatitis B virus (HBV, hepatitis C virus (HCV, human immunodeficiency virus (HIV, and syphilis infections were expressed in percentages for the entire study group as well as groups by demographic characteristics and donation frequency, with differences analyzed using Fisher's exact or Chi-square test. Logistic regression was performed to identify the influencing factors of the detected results. RESULTS: 1,769 (2.67%, 95% CI 2.55-2.79% of the donated blood had serological evidence of infection with at least one pathogen and 44 (0.07%, 95% CI 0.05-0.09% showed evidence of multiple infections. The seroprevalence of HBV, HCV, HIV, and syphilis infections was 0.87% (95% CI 0.80-0.94%, 0.86% (95% CI 0.79-0.93%, 0.31% (95% CI 0.26-0.35%, and 0.70% (95% CI 0.64-0.76% respectively. Trend analysis for the prevalence of TTIs showed a significant increase from 2.44% to 3.71% (χ2 = 100.72, p = 0.00 over this 6-year period. The positive rates for TTIs varied along demographic lines. The top three risk factors in test-positive donors were identified as age, education level and donation frequency. The older age group and lower educated group were linked to a higher prevalence of TTIs. A decreasing prevalence was associated with an increasing frequency of blood donations (χ2 = 562.78, p = 0.00. CONCLUSIONS: Hepatitis B and C were found most, and often in conjunction with syphilis. These were the primary threats to blood safety. The high positivity rate and the increasing prevalence of TTIs among blood

  16. Prevalence and Trend of Major Transfusion-Transmissible Infections among Blood Donors in Western China, 2005 through 2010

    Science.gov (United States)

    Song, Yan; Bian, Ying; Petzold, Max; Ung, Carolina Oi Lam

    2014-01-01

    Background The prevalence of transfusion-transmissible infections (TTIs) in blood donations is important for evaluating blood safety and potential risks to the population. This study investigated the prevalence of TTIs among blood donors in Western China and suggested measures for policy-makers. Methods The screening results of 66,311 donations between 2005 and 2010 from a central blood center in Western China were analyzed. The prevalence of hepatitis B virus (HBV), hepatitis C virus (HCV), human immunodeficiency virus (HIV), and syphilis infections were expressed in percentages for the entire study group as well as groups by demographic characteristics and donation frequency, with differences analyzed using Fisher's exact or Chi-square test. Logistic regression was performed to identify the influencing factors of the detected results. Results 1,769 (2.67%, 95% CI 2.55–2.79%) of the donated blood had serological evidence of infection with at least one pathogen and 44 (0.07%, 95% CI 0.05–0.09%) showed evidence of multiple infections. The seroprevalence of HBV, HCV, HIV, and syphilis infections was 0.87% (95% CI 0.80–0.94%), 0.86% (95% CI 0.79–0.93%), 0.31% (95% CI 0.26–0.35%), and 0.70% (95% CI 0.64–0.76%) respectively. Trend analysis for the prevalence of TTIs showed a significant increase from 2.44% to 3.71% (χ2 = 100.72, p = 0.00) over this 6-year period. The positive rates for TTIs varied along demographic lines. The top three risk factors in test-positive donors were identified as age, education level and donation frequency. The older age group and lower educated group were linked to a higher prevalence of TTIs. A decreasing prevalence was associated with an increasing frequency of blood donations (χ2 = 562.78, p = 0.00). Conclusions Hepatitis B and C were found most, and often in conjunction with syphilis. These were the primary threats to blood safety. The high positivity rate and the increasing prevalence of TTIs among blood

  17. Peripheral Blood WT1 Expression Predicts Relapse in AML Patients Undergoing Allogeneic Stem Cell Transplantation

    Directory of Open Access Journals (Sweden)

    Michele Malagola

    2014-01-01

    Full Text Available To evaluate if WT1 expression may predict relapse after allo-SCT, we analyzed WT1 levels on peripheral blood (PB and bone marrow (BM before and after allo-SCT in 24 AML patients with WT1 overexpression at diagnosis. Five copies of WT1/ABL × 104 from PB were identified as the threshold value that correlated with relapse after allo-SCT. The same correlation was not identified when WT1 expression was assessed from bone marrow (BM. Eight out of 11 (73% patients with a pre-allo-SCT PB-WT1 ≥ 5 and 4/13 (31% patients with a pre-allo-SCT PB-WT1 < 5 relapsed, respectively (P = 0.04. The incidence of relapse was higher in patients with PB-WT1 ≥ 5 measured after allo-SCT, at the 3rd (56% versus 38%; P = 0.43 and at the 6th month (71% versus 20%; P = 0.03. Patients with pretransplant PB-WT1 < 5 had significantly better 2-year OS and LFS than patients with a PB-WT1 ≥ 5 (81% versus 0% and 63% versus 20% (P = 0.02. Our data suggest the usefulness of WT1 monitoring from PB to predict the relapse in allotransplanted AML patients and to modulate the intensity of conditioning and/or the posttransplant immunosuppression in an attempt to reduce the posttransplant relapse risk.

  18. Mesenchymal stem cells derived from human placenta suppress allogeneic umbilical cord blood lymphocyte proliferation

    Institute of Scientific and Technical Information of China (English)

    Chang Dong LI; Wei Yuan ZHANG; He Lian LI; Xiao Xia JIANG; Yi ZHANG; Pei Hsien TANG; Ning MAO

    2005-01-01

    Human placenta-derived mononuclear cells (MNC) were isolated by a Percoll density gradient and cultured in mesenchymal stem cell (MSC) maintenance medium.The homogenous layer of adherent cells exhibited a typical fibroblastlike morphology,a large expansive potential,and cell cycle characteristics including a subset of quiescent cells.In vitro differentiation assays showed the tripotential differentiation capacity of these cells toward adipogenic,osteogenic and chondrogenic lineages.Flow cytometry analyses and immunocytochemistry stain showed that placental MSC was a homogeneous cell population devoid of hematopoietic cells,which uniformly expressed CD29,CD44,CD73,CD 105,CD166,laminin,fibronectin and vimentin while being negative for expression of CD31,CD34,CD45 and α-smooth muscle actin.Most importantly,immuno-phenotypic analyses demonstrated that these cells expressed class I major histocompatibility complex (MHC-Ⅰ),but they did not express MHC-Ⅱ molecules.Additionally these cells could suppress umbilical cord blood (UCB) lymphocytes proliferation induced by cellular or nonspecific mitogenic stimuli.This strongly implies that they may have potential application in allograft transplantation.Since placenta and UCB are homogeneous,the MSC derived from human placenta can be transplanted combined with hematopoietic stem cells (HSC) from UCB to reduce the potential graft-versus-host disease (GVHD) in recipients.

  19. 如何推行储血库、输血科全面质量控制管理%How to implement store blood bank, blood transfusion secco overall quality control management

    Institute of Scientific and Technical Information of China (English)

    郭天坤

    2012-01-01

    objective scientific and reasonable management store blood bank, blood transfusion families, make blood transfusion in clinical treatment can go smoothly, ensure transfusion safety, continue patients life. Method to establish and implement standardized management system, operation procedure, the responsibility to the people. The results through five years of standardization of scientific management, in YongXieLiang rising, by 2010, the whole store blood bank of blood has reached a considerable scale, but all kinds of records, operation since 2006 has not occurred for matching out and send the wrong blood transfusion errors and accident. Conclusion only establish and improve store blood bank, blood transfusion department each rules and regulations, operating procedures, to be effective in the prevention and control of store blood bank, blood transfusion in the branch happen various error accident, ensure the safe and effective treatment of clinical blood transfusion.%目的科学合理管理储血库、输血科,使输血在临床治疗中能顺利进行,保障输血安全,延续患者生命。方法建立和落实规范化管理制度、操作程序,责任到人。结果通过5年的规范化的科学管理,在用血量不断上升,到2010年,整个储血库的用血已达到相当大的规模,但各种记录、操作从2006年以来未发生过因配血不合和发血错误的输血差错及事故。结论只有建立健全储血库、输血科各项规章制度、操作规程,才能有效的防治储血库、输血科内发生的各种差错事故,保障临床安全有效的输血治疗。

  20. Smart blood cell and microvesicle-based Trojan horse drug delivery: Merging expertise in blood transfusion and biomedical engineering in the field of nanomedicine.

    Science.gov (United States)

    Wu, Yu-Wen; Goubran, Hadi; Seghatchian, Jerard; Burnouf, Thierry

    2016-04-01

    Therapeutic and diagnostic applications of nanomedicine are playing increasingly important roles in human health. Various types of synthetic nanoparticles, including liposomes, micelles, and other nanotherapeutic platforms and conjugates, are being engineered to encapsulate or carry drugs for treating diseases such as cancer, cardiovascular disorders, neurodegeneration, and inflammations. Nanocarriers are designed to increase the half-life of drugs, decrease their toxicity and, ideally, target pathological sites. Developing smart carriers with the capacity to deliver drugs specifically to the microenvironment of diseased cells with minimum systemic toxicity is the goal. Blood cells, and potentially also the liposome-like micro- and nano-vesicles they generate, may be regarded as ideally suited to perform such specific targeting with minimum immunogenic risks. Blood cell membranes are "decorated" with complex physiological receptors capable of targeting and communicating with other cells and tissues and delivering their content to the surrounding pathological microenvironment. Blood cells, such as erythrocytes, have been developed as permeable carriers to release drugs to diseased tissues or act as biofactory allowing enzymatic degradation of a pathological substrate. Interestingly, attempts are also being made to improve the targeting capacity of synthetic nanoparticles by "decorating" their surface with blood cell membrane receptor-like biochemical structures. Research is needed to further explore the benefits that blood cell-derived microvesicles, as a Trojan horse delivery systems, can bring to the arsenal of therapeutic micro- and nanotechnologies. This short review focuses on the therapeutic roles that red blood cells and platelets can play as smart drug-delivery systems, and highlights the benefits that blood transfusion expertise can bring to this exciting and novel biomedical engineering field.

  1. Emergency Whole Blood Use in the Field: A Simplified Protocol for Collection and Transfusion

    Science.gov (United States)

    2014-01-01

    system , military or civilian, is capable of providing RBC, plasma, and platelet units in a prehospital environment, especially in austere settings. As...colloids. Uncommonly, RBC and plasma units are avail- able in limited supply. No current evacuation system , military or civilian, is capable of providing...Personnel ABO blood type must be analyzed by a cer- tified laboratory routinely performing these tests. As an in- herent part of the blood type, persons

  2. Neonatal transfusion practices

    NARCIS (Netherlands)

    Lindern, Jeannette Susanne von

    2011-01-01

    Red blood cells (RBCs) are probably the most frequently used drug given to very preterm infants; more than 90% of infants with a birth weight <1000 grams receive one or more RBC transfusions. Except for reduction of the amount of blood drawn for laboratory tests and use of a single donor program, no

  3. Logistics of massive transfusions.

    Science.gov (United States)

    DeLoughery, Thomas G

    2010-01-01

    Care of the patient with massive bleeding involves more than aggressive surgery and infusion of large amounts of blood products. The proper management of massive transfusions-whether they are in trauma patients or other bleeding patients-requires coordination of the personnel in the surgical suite or the emergency department, the blood bank, and laboratory.

  4. Doença do enxerto contra hospedeiro pós-transfusional-guia para irradiação gama de hemocomponentes Transfusion-associated graft-versus-host disease-guideline on gamma irradiation of blood components

    Directory of Open Access Journals (Sweden)

    E.P. Landi

    1999-07-01

    syndrome. Clinical manifestations are fever, maculopapular skin rash, nausea, vomiting, diarrhea, hepatitis and pancytopenia owing to bone marrow hypoplasia. lt can occur in recipients with severe immunossuppression and in immunocompetent recipients after transfusion of ceillular components from HLA homozygous donor to recipients heterozygous for that HLA haplotype. The diagnosis is made by clinical manifestation and skin biopsy. Antithymocyte globulin and high dose systemic corticosteroids are both the most used therapy. The back of knowledge about this syndrome, the rapid evolution and the absence of treatement response are related to patients bad evolution. Gamma irradiation of blood products has been the mainstay of TA-GVHD prevention. Dose of 2500 cGy is required to completly inactivate T cells. lrradiation damage red cells membrane and the red celis units can not be storage for long time after irradiation. High potassium levels is the mainly change in red cells units.White cell-reduction filters do not prevent TA-GVHD and gamma irradiation does not prevent alloimmunization or blood reactions. Oniy cellular components like whole blood, red cells, platelets and granulocytes need be irradiated. Ali blood components should be irradiated to: first or second-degree relatives, patients need HLA-matched platelets, recipients of allogeneic or autologous bone marrow transplantation, patients with Hodgkin's disease, patients treated with purine analogue drugs, intrauterine transfusions, pre-term infants and when congenítal immunodeficiency states is suspected. lt is recomended irrradiated blood to patients with neoplastic disease when they receive intensive chemoterapy.

  5. SHOT conference report 2016: serious hazards of transfusion - human factors continue to cause most transfusion-related incidents.

    Science.gov (United States)

    Bolton-Maggs, P H B

    2016-12-01

    The Annual SHOT Report for incidents reported in 2015 was published on 7 July at the SHOT symposium. Once again, the majority of reports (77·7%) were associated with mistakes ('human factors'). Pressures and stress in the hospital environment contributed to several error reports. There were 26 deaths where transfusion played a part, one due to haemolysis from anti-Wr(a) (units issued electronically). The incidence of haemolysis due to this antibody has increased in recent years. Transfusion-associated circulatory overload is the most common contributor to death and major morbidity. Reports of delays to transfusion have increased, some caused by the failure of correct patient identification. There were seven ABO-incompatible red cell transfusions (one death) with an additional six to allogeneic stem cell transplant recipients. Near-miss reporting and analysis is useful and demonstrated nearly 300 instances of wrong blood in tube, which could have resulted in ABO-incompatible transfusion had the error not been detected. Errors with anti-D immunoglobulin continue, and preliminary data from the new survey of new anti-D found in pregnancy has shown that sensitisation occurs in some women even with apparently 'ideal' care. For the first time, the SHOT report now incorporates a chapter on donor events.

  6. [An a priori risk analysis study. Securisation of transfusion of blood product in a hospital: from the reception in the medical unit to its administration].

    Science.gov (United States)

    Bertrand, E; Lévy, R; Boyeldieu, D

    2013-12-01

    Following an ABO accident after transfusion of red blood cells, an a priori risk analysis study is being performed in a hospital. The scope of this analysis covers from the reception of the blood product in the medical unit to its administration. The risk analysis enables to identify the potentially dangerous situations and the evaluation of the risks in order to propose corrective measures (precautionary or protective) and bring the system back to an acceptable risk level. The innovative concept of an a priori risk analysis in the medical field allows the extension of the analysis of this transfusion risk to other hospitals. In addition, it allows the extension of the use of this approach to other medical fields.

  7. Short Communication: Investigating a Chain of HIV Transmission Events Due to Homosexual Exposure and Blood Transfusion Based on a Next Generation Sequencing Method.

    Science.gov (United States)

    Zhao, Qi; Zhang, Chen; Jiang, Yan; Wen, Yujie; Pan, Pinliang; Li, Yang; Zhang, Guiyun; Zhang, Lei; Qiu, Maofeng

    2015-12-01

    This study investigates a chain of HIV transmission events due to homosexual exposure and blood transfusion in China. The MiSeq platform, a next generation sequencing (NGS) system, was used to obtain genetic details of the HIV-1 env region (336 base pairs). Evolutionary analysis combined with epidemiologic evidence suggests a transmission chain from patient T3 to T2 through homosexual exposure and subsequently to T1 through blood transfusion. More importantly, a phylogenetic study suggested a likely genetic bottleneck for HIV in homosexual transmission from T3 to T2, while T1 inherited the majority of variants from T2. The result from the MiSeq platform is consistent with findings from the epidemiologic survey. The MiSeq platform is a powerful tool for tracing HIV transmissions and intrapersonal evolution.

  8. Postoperative blood loss prevention in total knee arthroplasty.

    Science.gov (United States)

    Banerjee, Samik; Kapadia, Bhaveen H; Issa, Kimona; McElroy, Mark J; Khanuja, Harpal S; Harwin, Steven F; Mont, Michael A

    2013-12-01

    Blood loss is a serious concern during lower extremity total joint arthroplasty with the estimated reduction in hemoglobin concentration known to vary between 2 and 4 g/dL after total knee arthroplasty (TKA). Allogeneic transfusions are commonly used to treat the acute blood loss and postoperative anemia to diminish the potential cardiovascular risks in up to 50% of such cases with a high volume of blood loss. However, these transfusions are associated with the risks of immunologic reactions, immunosuppression, and infection transmission. Multiple blood-saving strategies have been developed to minimize blood loss, to reduce transfusion rates, to decrease complications, and to improve outcomes in the postoperative period. Currently, there are no clear guidelines on the blood management strategies adopted to lessen the blood loss associated with TKA. The aim of this study was to review the literature and provide a broad summary of the efficacy and complications associated with several blood-saving measures that are currently used in the postoperative period. Evidence suggests that simple techniques such as limb elevation, cryotherapy, compression dressings, and drain clamping may reduce external drainage, however, whether these techniques lead to less allogeneic transfusions is currently debatable. Further research on using a combination of these strategies and their cost-effectiveness are needed.

  9. Enhancing Transfusion Safety: Nurse’s Role

    Directory of Open Access Journals (Sweden)

    Kyriazi Vasiliki

    2011-01-01

    Full Text Available Background: Despite strict clinical measures, there are distinct steps in transfusion process which require acute attention.The nurse is responsible for insuring that the right unit is administered to the right patient. Knowledge of risks is essential toadminister and monitor transfusions safely.Aim: This study summarizes the available data concerning transfusion adverse events and provides theoretical and technicalaspects for improving transfusion practice.Methodology: A systematic review in PubMed, MedLine and MDConsult database was conducted. The research limitsincluded English texts, referring to transfusion risks and technological means aiming at transfusion safety.Results: Blood transfusion is a medical intervention that saves lives and improves the quality of life. The regulations forensuring the availability and assuring the quality of the blood component cannot avoid transfusion errors, placing patients atrisk. Most frequent errors are attributed to practitioners involved in the clinical transfusion process. Based on reports toSerious Hazards of Transfusion (SHOT the risk of transfusion error is estimated at 1:16,500. Over the last years severalcommittees have recommended guidance for enhancing the safety of blood ordering and administration. Moreover, newtechnology like barcode on patient wristband manages to improve the performance in each step.Conclusion: Safe transfusion process depends on a series of linked processes and nurses should take specific measuresreferring to pre- and post-transfusion stage. Technological innovations could help patients in need of transfusion therapy.

  10. [Ischemic Changes in the Electrocardiogram and Circulatory Collapse Accompanied by Severe Anemia Owing to the Delay of Red Blood Cell Concentrate Transfusion in Two Patients with Intraoperative Massive Bleeding].

    Science.gov (United States)

    Horiuchi, Toshinori; Noguchi, Teruo; Kurita, Naoko; Yamaguchi, Ayako; Takeda, Masafumi; Sha, Keiichi; Nagahata, Toshihiro

    2016-01-01

    We present two patients developing intraoperative massive bleeding and showed ischemic changes in the electrocardiogram and circulatory collapse accompanied by severe anemia owing to the delay of red blood cell concentrate transfusion. One patient underwent hepatectomy and the other pancreaticoduodenectomy. Their lowest hemoglobin concentration was around 2 g x dl(-1), and they showed ischemic changes in the electrocardiogram and severe decreases in blood pressure. The former received compatible red blood cell concentrate and the latter received uncrossmatched same blood group red blood cell concentrate immediately, and their electrocardiogram and blood pressure quickly improved. To avoid life-threatening anemia, emergency red blood cell concentrate transfusion including compatible different blood group transfusion should be applied for intraoperative massive bleeding.

  11. Preoperative blood transfusion for gynecological operation of a patient with Bernard-Soulier syndrome: Case report

    OpenAIRE

    2011-01-01

    Bernard-Soulier syndrome belongs to congenital thrombocytopathic platelet disorders. There is a change of the structure of the glycoprotein in platelet membrane, causing the impair of platelet adherence on the blood vessel wall. This syndrome is clinically manifested by spontaneous bleeding in the skin and mucosa. The prognosis is usually good with an adequate support, but serious bleeding episodes occur during menstruation, trauma or surgery intervention. Treatment of bleeding or prophylaxis...

  12. Low-dose decitabine combined with fractional allogeneic hematopoietic stem cell transfusion for treatment of elderly patients with acute myeloid leukemia transformed from myelodysplastic syndrome:a report of 2 cases%小剂量地西他滨联合异基因造血干细胞分次输注治疗老年骨髓增生异常综合征转急性髓性白血病2例报告

    Institute of Scientific and Technical Information of China (English)

    李云双; 陈永升; 聂伟业; 黄琴; 孔祥敬; 尹晓林

    2015-01-01

    Objective To explore the efficay of low-dose decitabine combined with fractional allogeneic hematopoietic stem cell transfusion( micro transplantation) for treatment of elderly patients with acute myeloid leukemia transformed from myelodysplastic syndrome ( MDS-AML) .Methods Two patients diagnosed as MDS-AML were treated with chemotherapy regimen of low-dose decitabine or decitabine combined with CAG(cytosine arabinoside+aclacinomycin) and micro transplantation.The donors were children of patients with human leukocyte antigen semi-matched.Peripheral blood stem cells from the donors were mobilized with granulocyte colony-stimulating factor and then collected. Patients transfused PBSC about 36 hours after the chemotherapy finished.The disease status,platelet levels,survival timeand side effects were observed.Re sults Two cases did not achieve complete response.The survival times of Case 1 and Case 2 were 2 months and 4 months respectively. The platelet level in Case 1 increased remarkably after treatment,and reached to the maximal level of 59 ×109/L.No platelet transfusion was observed in Case 1.In Case 2,the interval of platelet transfusion was prolonged,and the patient was gradually independent on platelet transfusions. No graft-versus-host disease occurred in the two patients.Conclusion For elderly patients with MDS-AML,low-dose decitabine combined with micro transplantation can not cure the disease,but can prolong the survival time,increase the level of platelet and improve the quality of life.%目的 观察小剂量地西他滨联合异基因造血干细胞分次输注(微移植)治疗老年骨髓增生异常综合征转急性髓性白血病( MDS-AML)的疗效. 方法 对2例确诊为MDS-AML患者分别予小剂量地西他滨或地西他滨联合CAG方案(阿糖胞苷+阿克拉霉素)化疗加微移植治疗,供者为人类白细胞抗原半相合的患者子女,采集重组人粒细胞集落刺激因子动员后的供者外周血

  13. Efficacy and Safety of Antifibrinolytic Agents in Reducing Perioperative Blood Loss and Transfusion Requirements in Scoliosis Surgery: A Systematic Review and Meta-Analysis

    OpenAIRE

    Meng Wang; Xin-Feng Zheng; Lei-Sheng Jiang

    2015-01-01

    Background Routine use of antifibrinolytic agents in spine surgery is still an issue of debate. Objective To gather scientific evidence for the efficacy and safety of antifibrinolytic agents including aprotinin, tranexamic acid (TXA) and epsilon aminocaproic acid (EACA, traditionally known as Amicar) in reducing perioperative blood loss and transfusion requirements in scoliosis surgery. Methods We conducted a systematic review and meta-analysis for randomized controlled trials (RCTs), retrosp...

  14. Investigation of massive blood transfusion and its complications%大量输血及其并发症的探讨

    Institute of Scientific and Technical Information of China (English)

    任秀慧

    2015-01-01

    Objective To study the reason of massive blood transfusion, and to analyze the causes of its complications.Methods The clinical treatment data of 74 patients with massive blood transfusion were taken in a related analysis.Results There were 65 cases with complications among the 74 massive blood transfusion patients, and their complications mainly included circulatory overload, hemorrhagic tendency, hypothermia, and metabolic acidosis. Actively symptomatic treatment was given to the patients with good curative effect. Conclusion The medical staff should pay more attention to the changes of the massive bleeding patients’ conditions. A series of treatment measures ought to be taken timely for nursing when the complications in massive blood transfusion occurred.%目的:研究大量输血的原因,同时对其并发症的发生原因进行相关的分析。方法74例大量输血患者,对其临床救治的记录资料进行相关研究。结果74例大量输血患者中产生并发症者65例,主要包括:循环超负荷、出血倾向、低体温、代谢性酸中毒。均给予积极对症治疗,效果良好。结论医疗工作人员在护理和救治大量出血患者时应该密切观察患者的病情变化,一旦发现大量输血并发症,要及时地采取合适的治疗措施加以护理。

  15. Strategies for the transfusion of subjects with complex red cell immunisation: the Bank of rare blood donors of the Region of Lombardy

    Science.gov (United States)

    Morelati, Fernanda; Arnaboldi, Piera; Barocci, Fiorella; Bodini, Umberto; Boiani, Elisa; Bresciani, Susanna; Cambiè, Giuseppe; Cazzaniga, Giovanni; Cocco, Ernesto; Copeta, Alessandro; Crotti, Massimo; D’Agostino, Francesco; D’Agostino, Marco; Focchiatti, Valeria; Fonti, Elena; Galassi, Luigi; Gazzola, Giambattista; Gelpi, Luigi; Greppi, Noemi; Inghilleri, Giovanni Battista; Isernia, Paola; Manera, Maria Cristina; Marini, Mirella; Monti, Rosalia; Morales, Rino; Moroni, Gianalessandro; Morra, Enrica; Pau, Maria Paola; Paccapelo, Cinzia; Pagliaro, Pasqualepaolo; Prati, Daniele; Revelli, Nicoletta; Rinaldini, Claudia; Rossi, Davide; Rossi, Fabio; Salvaneschi, Laura; Sciariada, Luca; Sergiacomo, Pierluigi; Tiburzi, Alessandra; Trotti, Roberta; Turdo, Rosalia; Velati, Claudio; Villa, Maria Antonietta; Vismara, Giuseppina; Vitali, Elisabetta; Marconi, Maurizio

    2007-01-01

    Introduction Selecting units of rare blood for transfusion to patients with complex immunisation is one of the most critical processes of a Transfusion Centre. In January 2005 the ‘Rare Blood Components Bank – Reference Centre of the Region of Lombardy’ w as established with the following goals: 1) identifying regional rare blood donors; 2) creating a regional registry of rare donors; 3) organising a regional bank of liquid and frozen rare blood units; 4) setting up a regional Immunohaematology Reference Laboratory (IRL) to type donors and resolve complex cases. Methods The key elements in establishing the Bank were periodic meetings organised by the directors and representatives of the regional Departments of Transfusion Medicine and Haematology (DTMH) and the institution of three working groups (informatics, regulations, finance). Results The regional IRL was set up, the relevant operating procedures were distributed region-wide, software features were defined and later validated upon activation, and the funds assigned were allocated to various cost items. The number and characteristics of the donors to be typed were identified and 14 regional DTMHs started to send samples. Overall, 20,714 donors were typed, for a total of 258,003 typings, and 2,880 rare donors were identified. Of these, 97% were rare donors because of combinations of antigens (2,139 negative for the S antigen and 659 negative for the s antigen) and 3% (n=82) because they were negative for high-frequency antigens. In the first 2 years of activity, the IRL carried out investigations of 140 complex cases referred from other Centres and distributed 2,024 units with rare phenotypes to 142 patients. Conclusions The main goal achieved in the first 24 months from the start of the project was to set up a regional network able to meet the transfusion needs of patients with complex immunisation. PMID:19204778

  16. Influence of massive blood transfusion in 40 patients with severe trauma coagulation function%大量输血对40例严重创伤患者凝血功能的影响

    Institute of Scientific and Technical Information of China (English)

    王萍; 谢琦瑛; 朱莉君

    2015-01-01

    Objective:To discuss the influence of massive blood transfusion in 40 patients with severe trauma coagulation function. Methods:78 patients with requiring a lot of blood transfusion were selected.They were divided in two groups,40 patients required a large number of blood transfusion patients as the study group,38 patients with a small amount of blood transfusion for the control group.The difference of coagulation function between the two groups before and after blood transfusion was compared.Results:After 1 blood transfusion of 1 d,the TT,APTT and PT in the study group were significantly prolonged, and the FIB was decreased. A small amount of blood transfusion blood coagulation changed little.Conclusion:Severe trauma patients after a large number of blood transfusion and its co