Federica Tomasella

Università degli Studi di Trieste, Trst, Friuli Venezia Giulia, Italy

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Publications (3)2.37 Total impact

  • Federica Tomasella · Luca G. Mascaretti
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    ABSTRACT: Although transfusion therapy in the past 30 years has achieved high levels of safety, severe adverse reactions can still complicate a red blood cell, plasma, or platelet transfusion. Adverse events can be either of infectious nature (Infectious Adverse Reactions to Transfusion–IARTs) or noninfectious (NIARTs). The former are due to viruses, bacteria, or protozoa present in the transfused component. Medical doctors faced with an infectious disease in a hospitalized patient should always collect an accurate clinical history that must include transfusion of blood components and take into consideration that the viral/bacterial/protozoan infection could be related to a transfusion event. If a transfusion-transmitted infection is suspected, the clinician must contact the transfusion center that will provide a look-back of the blood products and a follow-up of the involved donors. NIARTs may be of immunological and nonimmunological nature. This chapter provides an overview of pathogenesis, presentation, therapy, and prevention of the main NIARTs. Finally, organizational measures for the management of NIARTs are presented, in order to ensure the highest possible level of safety for the patients.
    No preview · Chapter · Jan 2015
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    ABSTRACT: The incidental finding of monoclonal immunoglobulin in the sera of healthy blood donors is a relatively frequent event and in such cases the subjects are commonly deferred permanently from donating blood. However, no follow-up studies of these cases have been published so far. Since 2000, all regular blood donors at Trieste Blood Bank have undergone annual screening by serum protein electrophoresis. Cases presenting with monoclonal gammopathy between January 2000 and December 2008 were registered and follow-up was performed until December 2010. Out of 8,197 regular blood donors, monoclonal gammopathy was detected in 104 subjects (1.3%). The median age at detection was 53 years, the median monoclonal protein concentration was 0.2 g/dL and the cumulative follow-up of these cases amounted to 763 person/years. In two cases asymptomatic multiple myeloma was diagnosed within 6 months of detection of the gammopathy and in 14 cases, the monoclonal gammopathy was transient. The remaining 88 cases were classified as having monoclonal gammopathy of undetermined significance (MGUS). Out of these, two events related to monoclonal gammopathy were observed during the follow up: one lymphoma and one light chain deposition nephropathy. According to current prognostic staging systems, the majority of blood donors with monoclonal gammopathy were classified as having low-risk MGUS and had a very low incidence of lymphoproliferative diseases. Permanent deferral of blood donors with stable MGUS causes about a 1% loss of potential blood donations and it represents a "precautionary measure" that needs to be substantiated and validated.
    Full-text · Article · Mar 2012 · Blood transfusion = Trasfusione del sangue
  • Paola Pradella · Federica Tomasella · Luca Mascaretti
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    ABSTRACT: This chapter describes one of the most remarkable characteristics of blood, its ability to clot. After a brief introduction relating to the history of blood coagulation research, which spans over 100 years, and the evolutionary mechanisms underlying coagulation systems, which indicate that some “ancestors” of coagulation factors were present over 400 million years ago, we discuss the two principal models of coagulation: cascade versus cell-based. Whereas the former has been the accepted model for over 30 years, the more recent cell-based model appears to be more applicable to in vivo blood coagulation. According to the latter model, platelet activation is a determinant event and can be induced either by thrombin produced as a consequence of the tissue factor/activated factor VII complex on cells bearing tissue factor, or by subendothelial collagen exposure. We then review the role played by endothelium and subendothelium structures in hemostasis and illustrate the relevance of tissue factor. The final sections are dedicated to platelet receptors and signaling pathways and to fibrinolysis, an important regulatory mechanism whose role is to start tissue damage repair, destroy the fibrin clot, restrain the clotting process, and prevent its extension into the vascular system.
    No preview · Chapter · Jan 2012