Transfusion Medicine (TRANSFUSION MED)

Publications in this journal

• Article: Preliminary data for genotype distribution and epidemiological aspects of hepatitis C virus infection in blood donors from Yucatan, Mexico.

  B M García-Montalvo, M Macossay-Castillo
  Transfusion Medicine 01/2008; 17(6):488-90.
• Source

  Available from: ibto.ir

  Article: Transfusion-transmitted infections among multitransfused patients in Iran: a review.

  H Rezvan, H Abolghassemi, S Amini Kafiabad
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  ABSTRACT: Transfusion-transmitted infections (TTI) continue to be a major challenge for Blood transfusion organizations across the world. The problem is more serious in the developing countries with lower economic means. Multitransfused patients (MTPs) in these countries are at higher risk of infection, and studies of infection in these patients can be a useful index for examining the blood safety filters in place. The present article reviews the situation in Iran, where prevalence of the major viruses of concern, namely, hepatitis B virus, hepatitis C virus (HCV) and human immunodeficiency virus, studied in these patients is reported over a 9-year period. It is demonstrated that HCV is the most prevalent TTI and remains a major health problem for these patients.
  Transfusion Medicine 01/2008; 17(6):425-33.
• Source

  Available from: PubMed Central

  Article: Comparison of acute non-haemolytic transfusion reactions in female and male patients receiving female or male blood components.

  S Imoto, N Araki, E Shimada, K Saigo, K Nishimura, Y Nose, Y Bouike, M Hashimoto, H Mito, H Okazaki
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  ABSTRACT: To study the relationship between antibodies detected in patients' and/or donors' sera and the clinical features of acute non-haemolytic transfusion reactions (ANHTRs), and to determine any gender-related difference. ANHTRs range from urticaria to transfusion-related acute lung injury (TRALI). Antibodies to human leukocyte antigen (HLA), granulocytes, platelets, and/or plasma proteins are implicated in some of the ANHTRs. A higher antibody positivity is expected for females than for males. A comparative study of ANHTRs for antibody positivity and their clinical features between females and males for both patients and donors is helpful for characterizing ANHTRs including TRALI more clearly, but such studies are few and outdated. Two hundred and twenty-three ANHTR cases reported by 45 hospitals between October 2000 and July 2005 were analysed. The patients and 196 donors of suspect blood products were screened for antibodies to HLA Class I, HLA Class II, granulocytes, and platelets. The patients were also screened for anti-plasma protein antibodies. The types and severity of ANHTR did not differ significantly between female and male patients. The frequency of the anti-HLA antibodies, but not that of the non-HLA antibodies, was significantly higher in females. Non-HLA antibodies were significantly associated with severe reactions in females. All the TRALI cases had predisposing risk factors for acute lung injury, and 60% of the cases showed anti-leucocyte antibodies. Although the anti-HLA antibodies were detected more frequently in females than males, no significant association of ANHTRs including TRALI with gender, not only for patients, but also for donors, could be shown in this study.
  Transfusion Medicine 01/2008; 17(6):455-65.
• Article: Why don't women volunteer to give blood? A study of knowledge, attitude and practice of women about blood donation, Yazd, Iran, 2005.

  H Javadzadeh Shahshahani
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  ABSTRACT: The most important aim of all blood transfusion centres is to recruit blood donors from low-risk groups of society to donate blood voluntarily and regularly. In the city of Yazd, Iran, only 5% of blood donors are women. The aim of this study was to assess barriers of donation of blood by women and the level of knowledge, attitude and practice regarding blood donation. In this cross-sectional study, 1602 women were selected by cluster sampling method and asked to fill a specially formatted questionnaire. Data were analysed by ANOVA and the t-test. Levels of knowledge were different between the various groups. Illiterate women and housewives had the least levels of knowledge. Fifteen per cent of the women had donated blood at least once in the past. The most important motivational factor was sense of moral duty with a spiritual reward and the most important barriers for donating blood were anaemia, fear, lack of time and difficulty in access to donation sites. A significant percentage of women had false beliefs about blood donation. Increase in the level of knowledge of women and correction of false beliefs should be the topmost priority. Further studies are needed to determine whether addressing anaemia and women's health can tend to increase the number of female blood donors.
  Transfusion Medicine 01/2008; 17(6):451-4.
• Article: Assessment of corrected QT interval in sickle-cell disease patients who undergo erythroapheresis.

  C Boga, I Kozanoglu, M Yeral, C Bakar
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  ABSTRACT: Extension of the QT interval is characterized by syncope and cardiac arrest and often occurs in association with medical therapies and procedures. Whether erythroapheresis (EPH) could influence the QT interval duration in patients with sickle cell disease (SCD) is not known. We aimed to investigate the effects of EPH on the heart rate-corrected QT (QTc) interval. The study included 25 patients with SCD who underwent 34 EPH procedures. Two independent observers measured QTc interval duration from electrocardiograms performed continuously for 3 min at three different points during the EPH procedures (prior to EPH, after completion of 50% EPH and 15 min after EPH). Multiple regression analysis was used to determine if the ionized plasma calcium, the level of plasma magnesium, citrate infusion rate and painful crisis significantly contributed to the QTc interval. There was a non-significant trend (P = 0.184) towards increased QTc in sickle cell patients during EPH compared with pre-EPH values. QTc prolongation (>440 ms) occurred in 72% of the procedures. Fifty percent QTc values returned to baseline after the procedure. The independent variables were not significantly associated with QTc interval. Exchange procedures can induce QTc prolongation in patients with SCD.
  Transfusion Medicine 01/2008; 17(6):466-72.
• Article: Reducing replacement donors in Sub-Saharan Africa: challenges and affordability.

  I Bates, G Manyasi, A Medina Lara
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  ABSTRACT: In 1975, the World Health Assembly recommended that blood for transfusion should come from voluntary, non-remunerated donors; yet, in Africa, 75-80% of blood for transfusion still comes from hospital-based replacement donors. Although comprehensive economic data are scarce, evidence indicates that blood from voluntary donors recruited and screened at centralized transfusion centres, costs four to eight times as much as blood from a hospital-based, replacement donor system. Donor recruitment, quality assurance systems and distribution mechanisms in the centralized system are major reasons for the cost difference. There are concerns about the sustainability of centralized voluntary donor systems and their compatibility with the levels of health care that exist in many poor countries yet burdening patients' families with the responsibility of finding replacement blood donors will exacerbate poverty and reduce the safety of the blood supply. There are measures that can be introduced into hospital-based systems to improve safe blood supply in Africa but their effectiveness in different contexts needs to be evaluated.
  Transfusion Medicine 01/2008; 17(6):434-42.
• Source

  Available from: PubMed Central

  Article: Factors that motivate and hinder blood donation in Greece.

  O Marantidou, L Loukopoulou, E Zervou, G Martinis, A Egglezou, P Fountouli, P Dimoxenous, M Parara, M Gavalaki, A Maniatis
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  ABSTRACT: Donations in Greece are insufficient to cover the high transfusion needs arising from large numbers of thalassaemia and sickle cell anaemia patients and the implementation of new surgical techniques. Efforts to achieve self-sufficiency, and to render blood supplies safer and manageable must focus on recruiting and retaining more volunteer donors and on converting the large pool of replacement donors. The aim of the study was to gain insight into public perception regarding the risks of donation and transfusion and to identify the factors that would motivate more people in Greece to regularly donate blood. Questionnaires were distributed to 1,600 donors at the blood bank and visitors to hospitals at 11 locations across the country. Data on demographics, donation behaviour, incentives, risk perception and attitudes towards donation and transfusion were analysed separately for volunteer and replacement donors and non-donors. The results showed that women and young people donate the least in Greece. Also, many donors do not donate because they are not reminded to. A small percentage of donors confessed to having concealed part of the truth to background questions. Overall, incentives to donate were considered important and included future availability of blood for self or family, paid leave from work and free blood tests. Recruitment and retention efforts should include better communication with current donors, and raising awareness among eligible donors. Staff should be educated in soliciting information from potential donors, and incentives should be better aligned to avoid conflict with ethical values and ensure honesty in the prescreening process.
  Transfusion Medicine 01/2008; 17(6):443-50.
• Article: Gene frequencies of the HPA-1 platelet antigen alleles in the Lebanese population.

  A S Sabbagh, A T Taher, G S Zaatari, R A R Mahfouz
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  ABSTRACT: The objective was to study the gene frequencies of HPA-1 in the Lebanese population for the first time. The aims of this study were to assess the prevalence of 1a and 1b HPA-1 alleles in healthy Lebanese individuals and compare with the international literature. Human platelet antigen (HPA) systems are involved in alloimmunization, organ transplantation rejection and the development of cardiovascular disease. Of several classified HPA systems, HPA-1 specifically has been considered to be the most important antigenic system implicated in the Caucasian population. This specific gene has never been investigated in our population. DNA was extracted from specimens collected from 205 healthy unrelated Lebanese individuals and tested, using a reverse hybridization polymerase chain reaction (PCR) assay, for the prevalence of 1a and 1b HPA-1 alleles. Genotypes 1a/1a, 1a/1b, and 1b/1b were assigned accordingly. We observed that the 1a/1a genotype was the most prevalent (65.85%) followed by 1a/1b (30.24%) and 1b/1b (3.91%) with allelic frequencies for 1a and 1b of 0.81 and 0.19, respectively. As compared with other ethnic groups, the Lebanese population was found to have a relatively high prevalence of the HPA-1b, which may predispose to a higher risk of alloimmunization. This report is the first to study the prevalence of the HPA-1 system in the Lebanese population and serves as a template for future clinical research involving platelet disorders and cardiovascular diseases.
  Transfusion Medicine 01/2008; 17(6):473-8.
• Article: Feasibility and cost-benefit of implementing pooled screening for HCVAg in small blood bank settings.

  B Sarov, L Novack, N Beer, J Safi, H Soliman, J S Pliskin, E Litvak, A Yaari, E Shinar
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  ABSTRACT: To examine the accuracy, feasibility and benefits of screening for hepatitis C virus core antigen (HCVAg) using enzyme-linked immunosorbent assay (ELISA) test in pools. Many countries cannot afford to test blood donations for hepatitis C using molecular methods. Screening individual units using the ELISA HCVAg test is an acceptable, yet still expensive, alternative, especially for small blood bank settings. This study evaluated the option of screening for HCVAg in pools. The sensitivity (Se) and specificity (Sp) of HCVAg in pools of three and six antibody-negative samples were estimated and compared with polymerase chain reaction (PCR). The feasibility and cost-benefit of the assay was assessed on 960 routine samples collected at a hospital blood bank in Gaza. Based on results for 50 PCR-positive pools and 50 and 110 PCR-negative pools of three and six, the Se of testing in pools of three and six samples is 80-82% [95% confidence interval (CI): 66.3-91.4] and Sp >or=98% (95% CI: 89.4-100.0) compared with PCR. The incidence of antigen in donors in Gaza was 0.1% (95% CI: 0-0.56). Cost analyses suggested significant benefits from implementing screening blood donations for HCVAg when the incidence rate is >4.2/10,000, leading to reduction in the expenditures needed to treat patients infected with HCV. The risk of transfusion-transmitted hepatitis C in resource-deprived developing countries can be efficiently reduced by additional screening of antibody-negative blood donations for HCVAg in pools of six.
  Transfusion Medicine 12/2007; 17(6):479-87.
• Article: Predictable and avoidable human errors in phlebotomy area - an exclusive analysis from a tertiary health care system blood bank.

  P Pandey, R Chaudhary, R Tondon, D Khetan
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  ABSTRACT: Error is a direct reflection of system deficiency. Errors occurring in the phlebotomy area are grossly unreported. Though most of these errors does not lead to catastrophic outcome yet indicate system failure. The aim of the study was to identify errors that took place in phlebotomy area, analysing and classifying them. A prospective audit was conducted during an observational period of 8 months, in an overall cohort of 11 260 donors. The incidence of errors was 3.1%. Fifty-five percent errors were technical and remaining 44.9% were clerical. Of all the technical errors, 57.7% were classified as minor, whereas remaining 42.3% were of major category. Similarly, majority of clerical errors (89.9%) were of minor category. The trained staff accounted for all major events (27.8%). In the minor category, technical errors (73.2%) were more commonly done by trained staff, whereas for clerical errors (58.5%), newly recruited staff was responsible. Errors in phlebotomy area are benign but can compromise donor safety. The study helped to develop a consistent and straightforward classification system for errors and to reduce them by basic interventions. Errors committed mostly by our trained staff indicate the need of regular competency testing and an active system for detection of these deviations.
  Transfusion Medicine 11/2007; 17(5):375-8.
• Article: Nucleic acids amplification technique (NAT) screening for parvovirus B19: the first Italian routine experience.

  G Gessoni, P Barin, G Marchiori
  Transfusion Medicine 11/2007; 17(5):417-9.
• Article: Studies in animal model on the thrombogenicity of a new prothrombin complex concentrate from Argentina.

  M E Bernardi, M S Vitali, C Moya, H A Guglielmone, G R Cuadra
  Transfusion Medicine 11/2007; 17(5):420-2.
• Article: Net benefit of autologous compared with allogeneic blood transfusion.

  G Caspari, V Kiefel
  Transfusion Medicine 11/2007; 17(5):413-4.
• Article: A rapid gel agglutination test for the determination of fetomaternal haemorrhage.

  A Agaylan, O Meyer, N Ahrens, J Dudenhausen, S Bombard, A Salama
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  ABSTRACT: Determination of fetomaternal haemorrhage (FMH) remains an area of difficulty. In most cases, prophylactic Rh immunoglobulin is usually administered to affected women without testing for foetal red blood cells (RBC). Here, we describe a new particle gel immunoassay (PaGIA) for the determination FMH (FMH-PaGIA). Superparamagnetic particles were coated with monoclonal anti-D and mixed with ethylenediaminetetraacetic acid-anticoagulated blood samples from D-negative pregnant women. The particles were isolated using a magnetic particle concentrator and then placed into the reaction chamber of a gel card. Agglutinated particles on top or dispersed through the gel matrix indicated the presence of D-positive cells. After the test was adapted to detect >or=0.3% D-positive RBC, randomly selected postpartum samples from 208 women were analysed in parallel with the Kleihauer-Betke test (KBT). In addition, all discrepancies were further analysed by flow cytometry. A total of 203 of the 208 postpartum samples were negative in both tests. One sample reacted positive with both assays. Two samples were strongly positive in the new FMH-PaGIA, but negative in the KBT. A serological re-examination revealed that both women were D positive. The KBT gave a false-positive result in two cases because of hereditary persistence of haemoglobin F. The new test is specific, easy to perform and can be done at any time in all laboratories.
  Transfusion Medicine 11/2007; 17(5):395-8.
• Article: BCSH guidelines for policies on alternatives to allogeneic blood transfusion. 1. Predeposit autologous blood donation and transfusion, August 2006.

  T S Walsh, C Prowse
  Transfusion Medicine 11/2007; 17(5):353; discussion 366.
• Article: Transfusion-transmitted malaria: how vital is the need to screen in non-endemic countries?

  N Maalouf, M Naja, A R El Kinge, S Zein-El-Dine, A Taher
  Transfusion Medicine 11/2007; 17(5):415-6.
• Article: Routine antenatal anti-D prophylaxis and patient compliance with the two-dose regimen.

  B Chaffe, J Ford, V Bills
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  ABSTRACT: The aim of this study was to determine the compliance rates for women being offered routine antenatal anti-D prophylaxis in two obstetric units in the UK. Haemolytic disease of the newborn (HDN) is a potentially serious condition that can result in substantial morbidity and sometimes death. Current guidelines recommend that 500 IU anti-D immunoglobulin G (IgG) should be offered to all non-sensitized RhD-negative women at 28 and 34 weeks' gestation in order to prevent the risk of RhD sensitization in pregnancy. Implementing guidance, however, remains a challenge. We conducted a retrospective audit of 207 RhD-negative, non-sensitized pregnant women attending obstetric units during 2004 to assess compliance with national guidance on the provision of antenatal anti-D prophylaxis. Informed consent for routine antenatal anti-D prophylaxis was documented for 185 of these women. In total, 86.5% of women received the two doses of anti-D IgG. The majority of women received their first and second doses within 1 week of 28 and 34 weeks' gestation (87.0 and 86.0%, respectively). Accurate records of prophylactic anti-D IgG were maintained and updated. This audit demonstrates that the level of patient compliance with the two-dose regimen was high.
  Transfusion Medicine 11/2007; 17(5):399-403.
• Source

  Available from: bcshguidelines.com

  Article: Guidelines for policies on alternatives to allogeneic blood transfusion. 1. Predeposit autologous blood donation and transfusion.

  F E Boulton, V James
  Transfusion Medicine 11/2007; 17(5):354-65.
• Article: Production of soluble recombinant proteins with Kell, Duffy and Lutheran blood group antigen activity, and their use in screening human sera for Kell, Duffy and Lutheran antibodies.

  K Ridgwell, J Dixey, M L Scott
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  ABSTRACT: The aim of this study was to show that soluble recombinant (sr) proteins can mimic blood group antigens and be used to screen human sera for blood-group-specific antibodies. The blood of all pregnant women and pretransfusion patients should be screened for blood-group-specific antibodies to identify and monitor pregnancies at risk of haemolytic disease of the foetus and newborn (HDFN), and to prevent haemolytic transfusion reactions. Current antibody screening and identification methods use human red blood cell panels, which can complicate antibody identification if more than one antibody specificity is present. COS-7 cells were transfected to produce sr forms of the extracellular domains of the red blood cell membrane proteins that express Kell, Duffy or Lutheran blood group antigens. These sr proteins were used to screen for and identify anti-Kell, anti-Duffy or anti-Lutheran blood-group-specific allo-antibodies in human sera by haemagglutination inhibition and in solid-phase enzyme-linked immunosorbent assays (ELISAs). There is a positive correlation (correlation coefficient 0.605, P value 0.002) between antibody titre by standard indirect antiglobulin test (IAT) and signal intensity in the ELISA test. This work shows that sr proteins can mimic blood group antigens and react with human allogeneic antibodies, and that such proteins could be used to develop solid-phase, high-throughput blood group antibody screening and identification platforms.
  Transfusion Medicine 11/2007; 17(5):384-94.
• Article: The James Blundell Award Lecture 2006: transfusion and the treatment of haemorrhage: past, present and future.

  W H Dzik
  [show abstract] [hide abstract]
  ABSTRACT: In the early years of the 19th century, James Blundell reported in the Lancet the first clinical application of blood transfusion for the treatment of haemorrhage. Although these initial experiments may appear to us to have burst upon the medical world, Blundell had in fact done a decade of pre clinical research using animal models to establish principles to be brought to the clinic. His pivotal pre clinical experiments and the insights he gained are described in detail. Today, blood transfusion remains the cornerstone of treatment for serious bleeding - not only to restore oxygen carrying capacity but also to improve haemostasis, arrest and prevent bleeding. However, the indications for the use of blood components to treat bleeding remain ill-defined. In particular, despite the enormous volumes of fresh frozen plasma (FFP) transfused worldwide, the evidence that commonly used coagulation tests are reliable guides to transfusion with FFP is scant. Recent laboratory and clinical studies provide insight into the weaknesses of current coagulation tests as a guide to blood management. In the future, the application of genomics to haemostasis will uncover genetic polymorphisms leading to improved diagnostics and more tailored medical therapeutics. Examples of the emerging use of clinical genomics are presented. Ultimately, the application of widescale genomics testing will refresh our understanding of human physiology and will reassert the importance of the individual in patient care.
  Transfusion Medicine 11/2007; 17(5):367-74.