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Jacobs JW, Filkins L, Booth GS, Adkins BD. They come in threes: Marburg virus, emerging infectious diseases, and the blood supply. Transfus Apher Sci 2023; 62:103528. [PMID: 36038475 PMCID: PMC9417361 DOI: 10.1016/j.transci.2022.103528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Revised: 08/10/2022] [Accepted: 08/24/2022] [Indexed: 11/24/2022]
Affiliation(s)
- Jeremy W. Jacobs
- Department of Laboratory Medicine, Yale School of Medicine, New Haven, CT, USA,Correspondence to: 55 Park Street, New Haven, CT 06511, USA
| | - Laura Filkins
- Department of Pathology, University of Texas Southwestern, Dallas, TX, USA
| | - Garrett S. Booth
- Department of Pathology, Microbiology & Immunology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Brian D. Adkins
- Department of Pathology, University of Texas Southwestern, Dallas, TX, USA
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52
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Klei TRL, Begue S, Lotens A, Sigurjónsson ÓE, Wiltshire MD, George C, van den Burg PJM, Evans R, Larsson L, Thomas S, Najdovski T, Handke W, Eronen J, Mallas B, de Korte D. Recommendations for in vitro evaluation of blood components collected, prepared and stored in non-DEHP medical devices. Vox Sang 2023; 118:165-177. [PMID: 36510371 DOI: 10.1111/vox.13384] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 11/15/2022] [Accepted: 11/15/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND AND OBJECTIVES DEHP, di(2-ethylhexyl) phthalate, is the most common member of the class of ortho-phthalates, which are used as plasticizers. The Medical Device Regulation has restricted the use of phthalates in medical devices. Also DEHP has been added to the Annex XIV of REACH, "Registration, Evaluation, Authorisation and Restriction of Chemicals" due to its endocrine disrupting properties to the environment. As such, the sunset date for commercialisation of DEHP-containing blood bags is May 27th 2025. There are major concerns in meeting this deadline as these systems have not yet been fully validated and/or CE-marked. Also, since DEHP is known to affect red cell quality during storage, it is imperative to transit to non-DEHP without affecting blood product quality. Here, EBA members aim to establish common grounds on the evaluation and assessment of blood components collected, prepared and stored in non-DEHP devices. MATERIALS AND METHODS Based on data as well as the input of relevant stakeholders a rationale for the validation of each component was composed. RESULTS The red cell components will require the most extensive validation as their quality is directly affected by the absence of DEHP, as opposed to platelet and plasma components. CONCLUSION Studies in the scope of evaluating the quality of blood products obtained with non-DEHP devices, under the condition that they are carried out according to these recommendations, could be used by all members of the EBA to serve as scientific support in the authorization process specific to their jurisdiction or for their internal validation use.
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Affiliation(s)
- Thomas R L Klei
- Department of Product and Process Development, Sanquin Blood Supply, Amsterdam, The Netherlands
| | - Stephane Begue
- Etabissement Francais du Sang, Guadeloupe-Guyana et Martinique, Pointe-à-Pitre, France
| | - Anaïs Lotens
- Service du Sang, Belgian Red Cross, Brussel, Belgium
| | - Ólafur E Sigurjónsson
- Blood bank, Landspitalinn, Reykjavik, Iceland.,School of Technology, University of Iceland, Reykjavik, Iceland
| | | | - Chloë George
- Department of Component Development, Welsh Blood Service, Wrexham, UK
| | | | - Ryan Evans
- Department of New Developments, Scottish National Blood Transfusion Service, Edinburgh, UK
| | - Linda Larsson
- Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockhold, Sweden.,Department of Clinical Immunology and Transfusion Medicine, Karolinska University Hospital, Stockhol, Sweden
| | | | | | - Wiebke Handke
- Department of Research and Development, Bavarian Red Cross Blood Service, Nuremberg, Germany
| | - Juha Eronen
- Finnish Red Cross Blood Service, Helsinki, Finland
| | - Birte Mallas
- Finnish Red Cross Blood Service, Helsinki, Finland
| | - Dirk de Korte
- Department of Product and Process Development, Sanquin Blood Supply, Amsterdam, The Netherlands
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53
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Loudon AM, Rushing AP, Hue JJ, Ziemak A, Sarode AL, Moorman ML. When is enough enough? Odds of survival by unit transfused. J Trauma Acute Care Surg 2023; 94:205-211. [PMID: 36694331 DOI: 10.1097/ta.0000000000003835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
BACKGROUND Balanced transfusion is lifesaving for hemorrhagic shock. The American Red Cross critical blood shortage in 2022 threatened the immediate availability of blood. To eliminate waste, we reviewed the utility of transfusions per unit to define expected mortality at various levels of balanced transfusion. METHODS A retrospective study of 296 patients receiving massive transfusion on presentation at a level 1 trauma center was performed from January 2018 to December 2021. Units of packed red blood cells (PRBCs), fresh frozen plasma (FFP), and platelets received in the first 4 hours were recorded. Patients were excluded if they died in the emergency department, died on arrival, received <2 U PRBCs or FFP, or received PRBC/FFP >2:1. Primary outcomes were mortality and odds of survival to discharge. Subgroups were defined as transfused if receiving 2 to 9 U PRBCs, massive transfusion for 10 to 19 U PRBCs, and ultramassive transfusion for ≥20 U PRBCs. RESULTS A total of 207 patients were included (median age, 32 years; median Injury Severity Score, 25; 67% with penetrating mechanism). Mortality was 29% (61 of 207 patients). Odds of survival is equal to odds of mortality at 11 U PRBCs (odds ratio [OR], 0.95; 95% confidence interval [CI], 0.50-1.79). Beyond 16 U PRBCs, odds of mortality exceed survival (OR, 0.36; 95% CI, 0.16-0.82). Survival approaches zero >36 U PRBCs (OR, 0.09; 95% CI, 0.00-0.56). Subgroup mortality rates increased with unit transfused (16% transfused vs. 36% massive transfusion, p = 0.003; 36% massive transfusion vs. 67% ultramassive transfusion, p = 0.006). CONCLUSION Mortality increases with each unit balanced transfusion. Surgeons should view efforts heroic beyond 16 U PRBCs/4 hours and near futile beyond 36 U PRBCs/4 hours. While extreme outliers can survive, consider cessation of resuscitation beyond 36 U PRBCs. This is especially true if hemostasis has not been achieved or blood supplies are limited. LEVEL OF EVIDENCE Prognostic and Epidemiologic; Level IV.
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Affiliation(s)
- Andrew M Loudon
- From the Department of Surgery, University Hospitals Cleveland Medical Center, Case Western Reserve University School of Medicine, Cleveland, Ohio
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54
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Pervaiz O, Dhanapal J, Pillai L, Pavord S, Leary H, Eyre T, Peniket A, Staves J, Polzella P, Desborough MJR. Real world reduction in red cell transfusion with restrictive transfusion threshold in haematology inpatients. Transfus Med 2023. [PMID: 36680494 DOI: 10.1111/tme.12952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 12/20/2022] [Accepted: 01/14/2023] [Indexed: 01/22/2023]
Abstract
OBJECTIVES The aim of this study was to assess the reduction in red cell transfusions following a change in the red cell transfusion threshold for haematology inpatients from 80 to 70 g/L. BACKGROUND Haematology patients are among the high users of red blood cells. We reduced the threshold for transfusion of haematology inpatients to 70 g/L. This was based on evidence provided by randomised controlled trial published in 2020 that showed restrictive transfusion is non-inferior to liberal transfusion. METHOD We assessed red cell transfusions for haematology inpatients at Oxford University Hospitals NHS Foundation Trust for 9 months before and 9 months after a change in red cell transfusion threshold from 80 to 70 g/L. RESULTS After the change in threshold to 70 g/L or less from 80 g/L, the median number of red cell transfusions per month reduced to 88 from 111. This was a 23% reduction in the total number of red cells administered per month. CONCLUSION These results show the real-world reductions in transfusion that can be made by putting local transfusion guidelines in line with the international recommendations. This is of particular importance at a time of national blood shortage.
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Affiliation(s)
- Omer Pervaiz
- Department of Clinical Haematology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Jay Dhanapal
- Department of Clinical Haematology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Lakshmi Pillai
- Department of Clinical Haematology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Sue Pavord
- Department of Clinical Haematology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.,Radcliffe Department of Medicine, University of Oxford, Oxford, UK
| | - Heather Leary
- Department of Clinical Haematology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Toby Eyre
- Department of Clinical Haematology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Andrew Peniket
- Department of Clinical Haematology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Julie Staves
- Transfusion laboratory, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Paolo Polzella
- Department of Clinical Haematology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Michael J R Desborough
- Department of Clinical Haematology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.,Radcliffe Department of Medicine, University of Oxford, Oxford, UK
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55
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Bodley T, Levi O, Chan M, Friedrich JO, Hicks LK. Reducing unnecessary diagnostic phlebotomy in intensive care: a prospective quality improvement intervention. BMJ Qual Saf 2023:bmjqs-2022-015358. [PMID: 36657786 DOI: 10.1136/bmjqs-2022-015358] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 12/23/2022] [Indexed: 01/20/2023]
Abstract
BACKGROUND Critically ill patients receive frequent routine and recurring blood tests, some of which are unnecessary. AIM To reduce unnecessary routine phlebotomy in a 30-bed tertiary medical-surgical intensive care unit (ICU) in Toronto, Ontario. METHODS This prospective quality improvement study included a 7-month preintervention baseline, 5-month intervention and 11-month postintervention period. Change strategies included education, ICU rounds checklists, electronic order set modifications, an electronic test add-on tool and audit and feedback. The primary outcome was mean volume of blood collected per patient-day. Secondary outcomes included the number blood tubes used and red cell transfusions. Balancing measures included the timing and types of blood tests, ICU length of stay and mortality. Outcomes were evaluated using process control charts and segmented regression. RESULTS Patient demographics did not differ between time periods; total number of patients: 2096, median age: 61 years, 60% male. Mean phlebotomy volume±SD decreased from 41.1±4.0 to 34.1±4.7 mL/patient-day. Special cause variation was met at 13 weeks. Segmental regression demonstrated an immediate postintervention decrease of 6.6 mL/patient-day (95% CI 1.8 to 11.4 p=0.009), which was sustained. Blood tube consumption decreased by 1.4 tubes/patient-day (95% CI 0.4 to 2.4, p=0.005) amounting to 13 276 tubes (95% CI 4602 to 22 127 tubes) saved over 11 months. Red blood cell transfusions decreased from 10.5±5.2 to 8.3±4.4 transfusions/100 patient-days (incident rate ratio 0.56, 95% CI 0.35 to 0.88, p=0.01). There was no impact on length of stay (2 days, IQR 1-5) and mortality (18.1%±2.0%). CONCLUSION Iterative improvement interventions targeting clinician test ordering behaviour can reduce ICU phlebotomy and may impact red cell transfusions. Frequent stakeholder consultation, incorporating stewardship into daily workflow, and audit and feedback are effective strategies.
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Affiliation(s)
- Thomas Bodley
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada .,Department of Critical Care Medicine, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Olga Levi
- Li Ka Shing Knowledge Institute, Unity Health Toronto-St Michael's Hospital, Toronto, Ontario, Canada.,Medical Surgical Intensive Care, Unity Health Toronto-St Michael's Hospital, Toronto, Ontario, Canada
| | - Maverick Chan
- Li Ka Shing Knowledge Institute, Unity Health Toronto-St Michael's Hospital, Toronto, Ontario, Canada.,Division of Hematology/Oncology, Unity Health Toronto-St Michael's Hospital, Toronto, Ontario, Canada
| | - Jan O Friedrich
- Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Ontario, Canada.,Critical Care and Medicine Departments, Unity Health Toronto-St Michael's Hospital, Toronto, Ontario, Canada
| | - Lisa K Hicks
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada.,Li Ka Shing Knowledge Institute, Unity Health Toronto-St Michael's Hospital, Toronto, Ontario, Canada.,Division of Hematology/Oncology, Unity Health Toronto-St Michael's Hospital, Toronto, Ontario, Canada
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56
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Multivariate time-series blood donation/demand forecasting for resilient supply chain management during COVID-19 pandemic. CLEANER LOGISTICS AND SUPPLY CHAIN 2022. [PMCID: PMC9359598 DOI: 10.1016/j.clscn.2022.100078] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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Lee BH, Lee KS, Kim HI, Jung JS, Shin HJ, Park JH, Hong SC, Ahn KH. Blood Transfusion, All-Cause Mortality and Hospitalization Period in COVID-19 Patients: Machine Learning Analysis of National Health Insurance Claims Data. Diagnostics (Basel) 2022; 12:diagnostics12122970. [PMID: 36552977 PMCID: PMC9777003 DOI: 10.3390/diagnostics12122970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 11/18/2022] [Accepted: 11/25/2022] [Indexed: 11/29/2022] Open
Abstract
This study presents the most comprehensive machine-learning analysis for the predictors of blood transfusion, all-cause mortality, and hospitalization period in COVID-19 patients. Data came from Korea National Health Insurance claims data with 7943 COVID-19 patients diagnosed during November 2019−May 2020. The dependent variables were all-cause mortality and the hospitalization period, and their 28 independent variables were considered. Random forest variable importance (GINI) was introduced for identifying the main factors of the dependent variables and evaluating their associations with these predictors, including blood transfusion. Based on the results of this study, blood transfusion had a positive association with all-cause mortality. The proportions of red blood cell, platelet, fresh frozen plasma, and cryoprecipitate transfusions were significantly higher in those with death than in those without death (p-values < 0.01). Likewise, the top ten factors of all-cause mortality based on random forest variable importance were the Charlson Comorbidity Index (53.54), age (45.68), socioeconomic status (45.65), red blood cell transfusion (27.08), dementia (19.27), antiplatelet (16.81), gender (14.60), diabetes mellitus (13.00), liver disease (11.19) and platelet transfusion (10.11). The top ten predictors of the hospitalization period were the Charlson Comorbidity Index, socioeconomic status, dementia, age, gender, hemiplegia, antiplatelet, diabetes mellitus, liver disease, and cardiovascular disease. In conclusion, comorbidity, red blood cell transfusion, and platelet transfusion were the major factors of all-cause mortality based on machine learning analysis. The effective management of these predictors is needed in COVID-19 patients.
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Affiliation(s)
- Byung-Hyun Lee
- Department of Internal Medicine, Korea University Anam Hospital, Seoul 02841, Republic of Korea
- Korea University Anam Hospital Bloodless Medicine Center, Seoul 02841, Republic of Korea
| | - Kwang-Sig Lee
- Korea University Anam Hospital Bloodless Medicine Center, Seoul 02841, Republic of Korea
- AI Center, Korea University Anam Hospital, Seoul 02841, Republic of Korea
| | - Hae-In Kim
- Korea University Anam Hospital Bloodless Medicine Center, Seoul 02841, Republic of Korea
- School of Industrial Management Engineering, Korea University, Seoul 02841, Republic of Korea
- Department of Obstetrics and Gynecology, Korea University Anam Hospital, Seoul 02841, Republic of Korea
| | - Jae-Seung Jung
- Korea University Anam Hospital Bloodless Medicine Center, Seoul 02841, Republic of Korea
- Department of Thoracic and Cardiovascular Surgery, Korea University Anam Hospital, Seoul 02841, Republic of Korea
| | - Hyeon-Ju Shin
- Korea University Anam Hospital Bloodless Medicine Center, Seoul 02841, Republic of Korea
- Department of Anesthesiology and Pain Medicine, Korea University Anam Hospital, Seoul 02841, Republic of Korea
| | - Jong-Hoon Park
- Korea University Anam Hospital Bloodless Medicine Center, Seoul 02841, Republic of Korea
- Department of Orthopedic Surgery, Korea University Anam Hospital, Seoul 02841, Republic of Korea
| | - Soon-Cheol Hong
- Korea University Anam Hospital Bloodless Medicine Center, Seoul 02841, Republic of Korea
- Department of Obstetrics and Gynecology, Korea University Anam Hospital, Seoul 02841, Republic of Korea
| | - Ki Hoon Ahn
- Korea University Anam Hospital Bloodless Medicine Center, Seoul 02841, Republic of Korea
- Department of Obstetrics and Gynecology, Korea University Anam Hospital, Seoul 02841, Republic of Korea
- Correspondence:
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58
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Zeidan AM, Platzbecker U, Garcia-Manero G, Sekeres MA, Fenaux P, DeZern AE, Greenberg PL, Savona MR, Jurcic JG, Verma AK, Mufti GJ, Buckstein R, Santini V, Shetty JK, Ito R, Zhang J, Zhang G, Ha X, Backstrom JT, Komrokji RS. Longer-term benefit of luspatercept in transfusion-dependent lower-risk myelodysplastic syndromes with ring sideroblasts. Blood 2022; 140:2170-2174. [PMID: 35797468 PMCID: PMC10653038 DOI: 10.1182/blood.2022016171] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 06/22/2022] [Indexed: 11/20/2022] Open
Abstract
Luspatercept is an approved therapy for selected patients with lower risk myelodysplasia requiring transfusion despite erythropoiesis-stimulating agents, based on the early results of a randomized trial against placebo. Zeidan and colleagues report that after a median of 26 months follow-up, 27% of patients commencing luspatercept were continuing therapy. Their updated analyses confirm that a significant minority (45%) of eligible patients can achieve transfusion independence, with a median durability of 30 weeks. These longer follow-up data better quantify the incremental benefit of luspatercept over placebo.
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Affiliation(s)
- Amer M. Zeidan
- Department of Internal Medicine, Yale School of Medicine and Yale Cancer Center, Yale University, New Haven, CT
| | - Uwe Platzbecker
- Department of Hematology, Cellular Therapy and Hemostaseology, Leipzig University Hospital, Leipzig, Germany
| | | | - Mikkael A. Sekeres
- Division of Hematology, Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL
| | - Pierre Fenaux
- Service d’Hématologie Séniors, Hôpital Saint-Louis, Université de Paris 7, Paris, France
| | - Amy E. DeZern
- The Sidney Kimmel Comprehensive Cancer Center, The Johns Hopkins Hospital, Baltimore, MD
| | | | - Michael R. Savona
- Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN
| | - Joseph G. Jurcic
- Division of Hematology/Oncology, Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, New York, NY
| | - Amit K. Verma
- Department of Oncology, Albert Einstein College of Medicine, Montefiore Medical Center, New York, NY
| | - Ghulam J. Mufti
- Department of Haemato-Oncology, King’s College Hospital, London, United Kingdom
| | - Rena Buckstein
- Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Valeria Santini
- MDS Unit, Azienda Ospedaliero Universitaria Careggi, University of Florence, Florence, Italy
| | - Jeevan K. Shetty
- Celgene International Sàrl, a Bristol-Myers Squibb Company, Boudry, Switzerland
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Iqbal A. Outcomes of Induction Therapy in Patients With Acute Myeloid Leukemia During the COVID-19 Pandemic: A Retrospective Study From a Tertiary Cancer Center. Cureus 2022; 14:e29940. [DOI: 10.7759/cureus.29940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/05/2022] [Indexed: 11/06/2022] Open
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Sakai H, Yasuda S, Okuda C, Yamada T, Owaki K, Miwa Y. Examination of central nervous system by functional observation battery after massive intravenous infusion of carbon monoxide-bound and oxygen-bound hemoglobin vesicles in rats. CURRENT RESEARCH IN PHARMACOLOGY AND DRUG DISCOVERY 2022; 3:100135. [PMID: 36568263 PMCID: PMC9780079 DOI: 10.1016/j.crphar.2022.100135] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 09/14/2022] [Accepted: 10/03/2022] [Indexed: 11/05/2022] Open
Abstract
Carbon monoxide (CO) is known as a toxic gas inducing "CO poisoning", which acutely affects the central nervous system (CNS) and which persistently affects brain functions depending on the exposure time and CO concentration. By contrast, in pathological rodent models, intravenous infusion of CO-bound hemoglobin vesicles (CO-HbV) has shown various beneficial effects such as anti-oxidative and anti-inflammatory reactions. This study assessed effects of CO-HbV infusion on CNS using a functional observation battery, sensory reflexes, grip strength, and landing foot splay measurements. The test fluids were CO-HbV and O2-bound HbV (O2-HbV) suspended in saline ([Hb] = 10 g/dL), and saline alone for comparison. The rats received either 16 or 32 mL/kg of fluid intravenously at 1.5 mL/min/kg. Observations were made before infusion, and at 5 min, 4, 8, 24, 48 and 72 h after infusion. Massive doses of 16 and 32 mL/kg respectively corresponded to about 29 and 57% of the whole circulating blood volume (56 mL/kg). No toxicological effect was observed in any measurement item for any group in comparison to the control saline infusion group. Histopathological examination of hippocampal tissue at 14 days after infusion showed the number of necrotic cells to be minimal. Results obtained from rats in this experiment suggest that the massive intravenous infusion of CO-HbV yields beneficial anti-oxidative and anti-inflammatory effects without showing CO-poisoning-related symptoms of CNS damage.
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Affiliation(s)
- Hiromi Sakai
- Department of Chemistry, Nara Medical University, Kashihara, Nara, Japan,Corresponding author. Department of Chemistry, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8521, Japan.
| | - Shunichi Yasuda
- Hashima Laboratory, Nihon Bioresearch Inc, Hashima, Gifu, Japan
| | - Chie Okuda
- Department of Chemistry, Nara Medical University, Kashihara, Nara, Japan,Department of Anesthesiology, Nara Medical University, Kashihara, Nara, Japan
| | - Tetsuya Yamada
- Hashima Laboratory, Nihon Bioresearch Inc, Hashima, Gifu, Japan
| | - Keita Owaki
- Hashima Laboratory, Nihon Bioresearch Inc, Hashima, Gifu, Japan
| | - Yoji Miwa
- Hashima Laboratory, Nihon Bioresearch Inc, Hashima, Gifu, Japan
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61
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Kaur P, Bedi RK, Mittal K, Sood T. Exploring the unseen effect of COVID 19 pandemic on blood transfusion services in a tertiary care centre. Transfus Apher Sci 2022; 62:103569. [PMID: 36088214 PMCID: PMC9444304 DOI: 10.1016/j.transci.2022.103569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 08/21/2022] [Accepted: 09/02/2022] [Indexed: 01/28/2023]
Abstract
Background The coronavirus pandemic confronted blood transfusion services with major challenges. The present study was conducted to explore the effect of the COVID-19 pandemic on blood transfusion services including seroprevalence of transfusion-transmitted infections. Material and Methods A retrospective cross-sectional study was conducted and data on blood donation, utilization, camps, plateletpheresis and seroprevalence of transfusion-transmitted infections (TTI) was retrieved from software from March to September 2020 and 2021 and compared with corresponding time periods of three preceding non-pandemic years. Results There was a decline of 53.79% and 34.4% in blood donations in 2020 and 2021 respectively with a significant reduction in voluntary donations from 91.8% in the pre-pandemic period to 72.2% in 2020 and 77.7% in 2021. Replacement donors increased by 60.81% and 72.89% in 2020 and 2021 respectively. There was a decline of 48.4% in the number of plateletpheresis procedures in 2020 which increased in 2021 during the dengue outbreak. The decline in total blood donations and issue of packed red blood cells was statistically significant but supply and demand were balanced with no deficit. TTI seroprevalence increased from 1.01% to 1.49%(p<0.001) and 1.51%(p<0.001) in 2020 and 2021 respectively. Replacement donors showed a significantly higher TTI prevalence as compared to voluntary donors(p<0.001). A significant increase in prevalence was observed for Syphilis (0.4%) in 2020 and HBsAg (0.54%), HCV(0.63%) and syphilis (0.25%) in 2021. Conclusion The potential consequences of the COVID-19 pandemic on blood safety cannot be undermined. Developing a strong database of regular voluntary donors can be instrumental in dealing with future waves and surges in infections.
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Affiliation(s)
- Paramjit Kaur
- Department of Transfusion Medicine, Government Medical College and Hospital, Chandigarh, India.
| | - Ravneet Kaur Bedi
- Department of Transfusion Medicine, Government Medical College and Hospital, Chandigarh, India.
| | - Kshitija Mittal
- Department of Transfusion Medicine, Government Medical College and Hospital, Chandigarh, India.
| | - Tanvi Sood
- Department of Transfusion Medicine, Government Medical College and Hospital, Chandigarh, India.
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62
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Amenge J, Scherphof S, Osemwengie D, Nierich A, Lagerberg JW. Comparison of Washing Efficiency and Recovery of Blood Cells Between Centrifugation, Coarse Filtration and Microfiltration Techniques to Prepare Autologous Blood for Transfusion. J Blood Med 2022; 13:549-558. [PMID: 36204560 PMCID: PMC9531611 DOI: 10.2147/jbm.s367918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 09/16/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose Cell salvage is the process by which blood lost in surgery is collected and washed or filtered to produce autologous blood for re-transfusion to the patient. Cell salvage aims to reduce the need for donor blood. Centrifugal cell salvage washing technique is a preferred medical treatment in order to retain lost red blood cells (RBCs) without contaminants. Although this technology very efficiently collects and washes shed blood, it is costly and often impractical or unavailable, especially in middle- or low-income countries. This study assessed two innovative filter devices as an alternative to centrifugal cell salvage technology: a coarse collection filter device (Hemafuse) and a microfiltration device (HemoClear). In contrast to centrifugal technology, both filter devices do not require electricity, nor costly equipment and extensive training. We compared the effectiveness of these filtration technologies to remove plasma constituents and recover and concentrate the cellular components with centrifugal technology (autoLog® device). Methods Whole blood was processed with each technology according to the device manufacturer’s instructions. Before and after processing, the blood products were analyzed for supernatant solutes and cellular composition. Results The centrifugal technology confirmed its efficacy to remove potentially harmful solutes and capture red blood cells. The microfiltration technology (HemoClear) reached comparable levels of removal of solutes, with a potential advantage over centrifugal technology in the ability to also recover platelets. The coarse filtration technology (Hemafuse) had no washing capacity but, like the microfiltration technology, has the advantage of recovering platelets. Conclusion Innovative filtration devices represent an alternative to centrifugal technology in the preparation of autologous blood for reinfusion. The HemoClear technology for the first time enables the recovery of washed platelets and red blood cells. Clinical trials will have to be performed to investigate the clinical value of this new autologous blood product.
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Affiliation(s)
- James Amenge
- Department of Obstetrics and Gynaecology, Kenyatta National Hospital, Nairobi, Kenya
| | | | | | - Arno Nierich
- Clinical Department, HemoClear BV, Zwolle, the Netherlands
- Department of Anaesthesiology & Intensive Care, Isala Clinics, Zwolle, the Netherlands
- Correspondence: Arno Nierich, Clinical Department, HemoClear BV, Dokter Stolteweg 70, Zwolle, 8025 AZ, the Netherlands, Tel +31 0 38 303 26 30, Email
| | - Johan W Lagerberg
- Department of Product and Process Development, Sanquin Blood Bank, Amsterdam, the Netherlands
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Fabbro M, Patel PA, Henderson RA, Bolliger D, Tanaka KA, Mazzeffi MA. Coagulation and Transfusion Updates From 2021. J Cardiothorac Vasc Anesth 2022; 36:3447-3458. [PMID: 35750604 PMCID: PMC8986228 DOI: 10.1053/j.jvca.2022.03.042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 03/31/2022] [Indexed: 12/02/2022]
Abstract
2021 and the COVID 19 pandemic have brought unprecedented blood shortages worldwide. These deficits have propelled national efforts to reduce blood usage, including limiting elective services and accelerating Patient Blood Management (PBM) initiatives. A host of research dedicated to blood usage and management within cardiac surgery has continued to emerge. The intent of this review is to highlight this past year's research pertaining to PBM and COVID-19-related coagulation changes.
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Clinical characteristics and indications for blood transfusion in patients with SARS-CoV-2 infection. MEDICINA CLÍNICA (ENGLISH EDITION) 2022; 159:230-233. [PMID: 36065233 PMCID: PMC9435025 DOI: 10.1016/j.medcle.2021.07.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Accepted: 07/21/2021] [Indexed: 01/28/2023]
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Lu Z, Xu G, Li Y, Lu C, Shen Y, Zhao B. Discovery of N-arylcinnamamides as novel erythroblast enucleation inducers. Bioorg Chem 2022; 128:106105. [PMID: 36031698 DOI: 10.1016/j.bioorg.2022.106105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 08/12/2022] [Accepted: 08/17/2022] [Indexed: 01/28/2023]
Abstract
Derivation of mature red blood cells (RBCs) from stem cells in vitro is a promising solution to the current shortage of blood supply, in which terminal enucleation is the rate-limiting step. Here we discovered two cinnamamides B8 and B16 showed potential activities of enhancing the enucleation of erythroblasts through the screening of "in-house" compound library. Subsequently, twenty-four N-arylcinnamamides were rationally designed and synthesized on the basis of the structure of B8 and B16, in which N-(9H-carbazol-2-yl)cinnamamide (KS-2) significantly elevated the percentage of reticulocytes in the cultured mouse fetal liver cells in vitro (relative enucleation = 2.43). The underlying mechanism of KS-2 in promoting mouse erythroid enucleation is accelerating the process of cell cycle exit via p53 activation in late stage erythrocytes. These results strongly suggest that compound KS-2 is worthy of further study as a potential erythrocyte enucleation inducer.
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Affiliation(s)
- Zhiyuan Lu
- Key Laboratory of Chemical Biology (Ministry of Education), School of Pharmaceutical Sciences, Cheeloo College of Medicine, Shandong University, Jinan 250012, China; Institute of Materia Medica, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan 250062, China
| | - Guangsen Xu
- Key Laboratory of Chemical Biology (Ministry of Education), School of Pharmaceutical Sciences, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
| | - Yanxia Li
- Department of Pharmacology, School of Pharmaceutical Sciences, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
| | - Chunhua Lu
- Key Laboratory of Chemical Biology (Ministry of Education), School of Pharmaceutical Sciences, Cheeloo College of Medicine, Shandong University, Jinan 250012, China; NMPA Key Laboratory for Technology Research and Evaluation of Drug Products, School of Pharmaceutical Sciences, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, China
| | - Yuemao Shen
- Key Laboratory of Chemical Biology (Ministry of Education), School of Pharmaceutical Sciences, Cheeloo College of Medicine, Shandong University, Jinan 250012, China; NMPA Key Laboratory for Technology Research and Evaluation of Drug Products, School of Pharmaceutical Sciences, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, China
| | - Baobing Zhao
- Key Laboratory of Chemical Biology (Ministry of Education), School of Pharmaceutical Sciences, Cheeloo College of Medicine, Shandong University, Jinan 250012, China; Department of Pharmacology, School of Pharmaceutical Sciences, Cheeloo College of Medicine, Shandong University, Jinan 250012, China; NMPA Key Laboratory for Technology Research and Evaluation of Drug Products, School of Pharmaceutical Sciences, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, China.
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66
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Gilani Larimi N, Azhdari A, Ghousi R, Du B. Integrating GIS in reorganizing blood supply network in a robust-stochastic approach by combating disruption damages. SOCIO-ECONOMIC PLANNING SCIENCES 2022; 82:101250. [PMID: 36475013 PMCID: PMC9716013 DOI: 10.1016/j.seps.2022.101250] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 12/25/2021] [Accepted: 01/22/2022] [Indexed: 05/16/2023]
Abstract
As supplying adequate blood in multiple countries has failed due to the Covid-19 pandemic, the importance of redesigning a sensible protective-resilience blood supply chain is underscored. The outbreak-as an extensive disruption-has caused a delay in ordering and delivering blood and its by-products, which leads to severe social and financial loss to healthcare organizations. This paper presents a robust multi-phase optimization approach to model a blood supply network ensuring blood is collected efficiently. We evaluate the effectiveness of the model using real-world data from two mechanisms. Firstly, a Geographic Information System (GIS)-based method is presented to find potential alternative locations for blood donation centers to maximize availability, accessibility, and proximity to blood donors. Then, a protective mathematical model is developed with the incorporation of (a) blood perishability, (b) efficient collation centers, (c) multiple-source of suppliers, (d) back-up centers, (e) capacity limitation, and (f) uncertain demand. Emergency back-up for laboratory centers to supplement and offset the processing plants against the possible disorders is applied in a two-stage stochastic robust optimization model to maximize the level of hospitals' coverage. The results highlight the fraction cost of considering back-up facilities in the total costs and provide more resilient decisions with lower risks by examining resource limitations.
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Affiliation(s)
- Niloofar Gilani Larimi
- Gustavson School of Business, University of Victoria, Victoria, British Columbia, Canada
| | - Abolghasem Azhdari
- School of Earth and Environmental Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Rouzbeh Ghousi
- School of Industrial Engineering, Iran University of Science and Technology, Tehran, Iran
| | - Bo Du
- SMART Infrastructure Facility, University of Wollongong, Wollongong, NSW, Australia
- School of Civil, Mining and Environmental Engineering, University of Wollongong, Wollongong, NSW, Australia
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67
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Wang Z, Wang H. Exploring Blood Donation Challenges and Mobilization Mechanisms in North China During the COVID-19 Pandemic: A Qualitative Study. Healthc Policy 2022; 15:1593-1605. [PMID: 36061880 PMCID: PMC9433754 DOI: 10.2147/rmhp.s372945] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Accepted: 08/07/2022] [Indexed: 01/28/2023] Open
Abstract
Purpose The coronavirus disease 2019 (COVID-19) pandemic disrupted the supply of blood globally, resulting in numerous studies focusing on the challenges in maintaining blood supply, and the responses to it, in countries with a mixed blood donation model. This study explored blood donation challenges and mobilization mechanisms in North China, which employs a non-remunerative donation model, during the COVID-19 pandemic’s first wave. Materials and Methods A qualitative approach was adopted to investigate blood donation practices in Chengde from April to June 2020. Data were collected from eight blood donors, six potential donors, three blood donation station leaders, and two government officials, through semi-structured interviews. Results The major challenge for blood supply was decreased blood donations, owing to lockdown restrictions, and individual and familial apprehensions. Mobilization mechanisms included bureaucratic and ideological mobilization. However, although group blood donation alleviates the pressure on supply chains during emergencies, it is detrimental to the cultivation of civic engagement in the long run. Conclusion This study contributes to the understanding of how countries with uncompensated blood donation models respond to public health emergencies. It suggests that striking a balance between the society’s and the state’s perception of blood donation would allow the state to incorporate the different “voices” of society, and devise an inclusive blood donation policy.
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Affiliation(s)
- Zhuo Wang
- School of Social and Behavioral Sciences, Nanjing University, Nanjing, People’s Republic of China
- The National Police University for Criminal Justice, Hebei, People's Republic of China
- Correspondence: Zhuo Wang, School of Social and Behavioral Sciences, Nanjing University, Nanjing, People’s Republic of China, Tel +86 15062263226, Email
| | - Hejian Wang
- School of Social and Behavioral Sciences, Nanjing University, Nanjing, People’s Republic of China
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68
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Jones JM, Swett AD, Crowe EP, Lawrence C, Bloch EM, Lanzkron SM. Implementation of national blood conservation recommendations at an adult sickle cell center. Transfusion 2022; 62:1763-1771. [PMID: 35837727 DOI: 10.1111/trf.17007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 05/24/2022] [Accepted: 05/27/2022] [Indexed: 02/05/2023]
Abstract
BACKGROUND Due to the national blood supply crisis caused by the COVID-19 pandemic, the American Society of Hematology proposed guidance to decrease blood utilization for sickle cell patients on chronic transfusion therapy (CTT). Little evidence exists to support the efficacy and safety of these blood conservation strategies. STUDY DESIGN AND METHODS Through retrospective analysis, we sought to describe outcomes following implementation of these recommendations in 58 adult sickle cell patients on chronic exchange transfusions. The strategies employed included: relaxing the goal fraction of cells remaining (FCR) to 30%-50%, utilizing depletion exchanges in select patients, and transitioning select patients to monthly simple transfusions. We compared hemoglobin S%, hemoglobin values, and other laboratory parameters, acute care visits, and red blood cell usage during the first year of the COVID-19 pandemic to the year prior using Wilcoxon signed rank test. RESULTS Of 53 patients who remained on chronic exchanges during the pandemic, use of depletion exchange increased (15%-23%) and FCR increased (34.9 [SD 4.7] vs. 37.6 [SD 4.5], p < .05). These changes resulted in 854 units conserved without clinically significant changes to pre-exchange laboratory parameters, including hemoglobin S%, or number of acute care presentations. In contrast, five patients who transitioned to predominantly simple transfusions, experienced difficulty maintaining hemoglobin S% less than 30 and worsening anemia. DISCUSSION Our data suggest that in a blood shortage crisis, optimizing the exchange procedure itself may be the safest means of conserving blood in a population of adult patients with sickle cell disease.
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Affiliation(s)
- Jennifer M Jones
- Department of Hematology, Johns Hopkins Hospital, Baltimore, Maryland, USA
| | - Ariel D Swett
- Department of Hematology, Johns Hopkins Hospital, Baltimore, Maryland, USA
| | - Elizabeth P Crowe
- Division of Transfusion Medicine, Department of Pathology, Johns Hopkins Hospital, Baltimore, Maryland, USA
| | - Courtney Lawrence
- Division of Transfusion Medicine, Department of Pathology, Johns Hopkins Hospital, Baltimore, Maryland, USA.,Division of Pediatric Hematology, Department of Pediatrics, Johns Hopkins Hospital, Baltimore, Maryland, USA
| | - Evan M Bloch
- Division of Transfusion Medicine, Department of Pathology, Johns Hopkins Hospital, Baltimore, Maryland, USA
| | - Sophie M Lanzkron
- Department of Hematology, Johns Hopkins Hospital, Baltimore, Maryland, USA
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69
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Lu W, Yazer M, Li N, Ziman A, Wendel S, Tang H, Tsang H, Titlestad K, Thibodeaux SR, Shih AW, Poisson JL, Pham T, Pandey S, Pagano MB, Shan H, Murphy M, Murphy C, Savioli ML, Kutner JM, Hess AS, Fontaine MJ, Fachini R, Dunbar NM, Kaufman RM. Hospital red blood cell and platelet supply and utilization from March to December of the first year of the COVID-19 pandemic: The BEST Collaborative Study. Transfusion 2022; 62:1559-1570. [PMID: 35808950 PMCID: PMC9349645 DOI: 10.1111/trf.17023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 06/21/2022] [Accepted: 06/21/2022] [Indexed: 11/29/2022]
Abstract
Background At the start of the coronavirus disease 2019 (COVID‐19) pandemic, widespread blood shortages were anticipated. We sought to determine how hospital blood supply and blood utilization were affected by the first wave of COVID‐19. Study Design and Methods Weekly red blood cell (RBC) and platelet (PLT) inventory, transfusion, and outdate data were collected from 13 institutions in the United States, Brazil, Canada, and Denmark from March 1st to December 31st of 2020 and 2019. Data from the sites were aligned based on each site's local first peak of COVID‐19 cases, and data from 2020 (pandemic year) were compared with data from the corresponding period in 2019 (pre‐pandemic baseline). Results RBC inventories were 3% lower in 2020 than in 2019 (680 vs. 704, p < .001) and 5% fewer RBCs were transfused per week compared to 2019 (477 vs. 501, p < .001). However, during the first COVID‐19 peak, RBC and PLT inventories were higher than normal, as reflected by deviation from par, days on hand, and percent outdated. At this time, 16% fewer inpatient beds were occupied, and 43% fewer surgeries were performed compared to 2019 (p < .001). In contrast to 2019 when there was no correlation, there was, in 2020, significant negative correlations between RBC and PLT days on hand and both percentage occupancy of inpatient beds and percentage of surgeries performed. Conclusion During the COVID‐19 pandemic in 2020, RBC and PLT inventories remained adequate. During the first wave of cases, significant decreases in patient care activities were associated with excess RBC and PLT supplies and increased product outdating.
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Affiliation(s)
- Wen Lu
- Department of Pathology, Brigham and Women's Hospital, Boston, MA, USA
| | - Mark Yazer
- Department of Pathology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Na Li
- Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Alyssa Ziman
- Wing-Kwai and Alice Lee-Tsing Chung Transfusion Service, Department of Pathology and Laboratory Medicine, David Geffen School of Medicine, University of California Los Angeles, California, Los Angeles, USA
| | | | - Hongying Tang
- Department of Pathology, Brigham and Women's Hospital, Boston, MA, USA
| | - Hamilton Tsang
- Department of Laboratory Medicine and Pathology, Transfusion Medicine Division, University of Washington, Seattle, WA, USA
| | - Kjell Titlestad
- Department of Clinical Immunology, Odense University, South Danish Transfusion Services, Odense, Denmark
| | - Suzanne R Thibodeaux
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO, USA
| | - Andrew W Shih
- Department of Pathology and Laboratory Medicine, Vancouver General Hospital, Vancouver, British Columbia, Canada
| | | | - Tho Pham
- Stanford Blood Center, Palo Alto, CA, USA
| | | | - Monica B Pagano
- Department of Laboratory Medicine and Pathology, Transfusion Medicine Division, University of Washington, Seattle, WA, USA
| | - Hua Shan
- Transfusion Medicine Service, Department of Pathology, Stanford University School of Medicine, Stanford, CA, USA
| | - Mike Murphy
- Radcliffe Department of Medicine, University of Oxford, Oxford, UK
| | - Colin Murphy
- Department of Pathology, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Mariana Lorenzi Savioli
- Hemotherapy and Cell therapy Department, Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - José Mauro Kutner
- Hemotherapy and Cell therapy Department, Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - Aaron S Hess
- Departments of Anesthesiology and Pathology & Laboratory Medicine, University of Wisconsin, Madison, Wisconsin, USA
| | - Magali J Fontaine
- Department of Pathology, University of Maryland School of Medicine, Baltimore, MD, USA
| | | | - Nancy M Dunbar
- Department of Pathology and Laboratory Medicine and Department of Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA
| | - Richard M Kaufman
- Department of Pathology, Brigham and Women's Hospital, Boston, MA, USA
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Tunthanathip T, Sae-heng S, Oearsakul T, Kaewborisutsakul A, Taweesomboonyat C. Economic impact of a machine learning-based strategy for preparation of blood products in brain tumor surgery. PLoS One 2022; 17:e0270916. [PMID: 35776752 PMCID: PMC9249218 DOI: 10.1371/journal.pone.0270916] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 06/17/2022] [Indexed: 11/18/2022] Open
Abstract
Background
Globally, blood donation has been disturbed due to the pandemic. Consequently, the optimization of preoperative blood preparation should be a point of concern. Machine learning (ML) is one of the modern approaches that have been applied by physicians to help decision-making. The main objective of this study was to identify the cost differences of the ML-based strategy compared with other strategies in preoperative blood products preparation. A secondary objective was to compare the effectiveness indexes of blood products preparation among strategies.
Methods
The study utilized a retrospective cohort design conducted on brain tumor patients who had undergone surgery between January 2014 and December 2021. Overall data were divided into two cohorts. The first cohort was used for the development and deployment of the ML-based web application, while validation, comparison of the effectiveness indexes, and economic evaluation were performed using the second cohort. Therefore, the effectiveness indexes of blood preparation and cost difference were compared among the ML-based strategy, clinical trial-based strategy, and routine-based strategy.
Results
Over a 2-year period, the crossmatch to transfusion (C/T) ratio, transfusion probability (Tp), and transfusion index (Ti) of the ML-based strategy were 1.10, 57.0%, and 1.62, respectively, while the routine-based strategy had a C/T ratio of 4.67%, Tp of 27.9%%, and Ti of 0.79. The overall costs of blood products preparation among the ML-based strategy, clinical trial-based strategy, and routine-based strategy were 30, 061.56$, 57,313.92$, and 136,292.94$, respectively. From the cost difference between the ML-based strategy and routine-based strategy, we observed cost savings of 92,519.97$ (67.88%) for the 2-year period.
Conclusion
The ML-based strategy is one of the most effective strategies to balance the unnecessary workloads at blood banks and reduce the cost of unnecessary blood products preparation from low C/T ratio as well as high Tp and Ti. Further studies should be performed to confirm the generalizability and applicability of the ML-based strategy.
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Affiliation(s)
- Thara Tunthanathip
- Division of Neurosurgery, Department of Surgery, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
- * E-mail:
| | - Sakchai Sae-heng
- Division of Neurosurgery, Department of Surgery, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Thakul Oearsakul
- Division of Neurosurgery, Department of Surgery, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Anukoon Kaewborisutsakul
- Division of Neurosurgery, Department of Surgery, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Chin Taweesomboonyat
- Division of Neurosurgery, Department of Surgery, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
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71
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Apelseth TO, Arsenovic M, Strandenes G. The Norwegian blood preparedness project: A whole blood program including civilian walking blood banks for early treatment of patients with life-threatening bleeding in municipal health care services, ambulance services, and rural hospitals. Transfusion 2022; 62 Suppl 1:S22-S29. [PMID: 35751878 PMCID: PMC9543315 DOI: 10.1111/trf.16968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 05/02/2022] [Accepted: 05/02/2022] [Indexed: 11/30/2022]
Abstract
Background Civilian and military guidelines recommend early balanced transfusion to patients with life‐threatening bleeding to improve survival. To provide the best care to patients with hemorrhagic shock in regions with reduced access to evacuation, blood preparedness must be ensured also on a municipal health care level. The primary aim of the Norwegian Blood Preparedness project is to enable rural hospitals, prehospital ambulance services, and municipal health care services to start early balanced blood transfusions for patients with life‐threatening bleeding regardless of etiology. Study Design and Methods The project is designed based on three principles: (1) Early balanced transfusion should be provided for patients with life‐threatening bleeding, (2) Management of an emergency requires a planned and rehearsed day‐to‐day system for blood preparedness, and (3) A decentralized system is needed to ensure local self‐sufficiency in an emergency. We developed a system for education and training in blood‐based resuscitation with a focus on the municipal health care service. Results In this publication, we describe the implementation of emergency whole blood collections from a preplanned civilian walking blood bank in the municipal health care service. This includes donor selection, whole blood collection, emergency transfusion and quality assessment of practice. Conclusion We conclude that implementation of a Whole Blood based emergency transfusion program is feasible on all health care levels and that a preplanned civilian walking blood bank should be considered in locations were prolonged transport‐times may reduce access to blood transfusion for patients with life threatening bleeding.
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Affiliation(s)
- Torunn Oveland Apelseth
- Department of Immunology and Transfusion Medicine, Haukeland University Hospital, Bergen, Norway.,Norwegian Armed Forces Joint Medical Services, Sessvollmoen, Norway.,Institute of Clinical Science, University of Bergen, Bergen, Norway
| | - Mirjana Arsenovic
- Department of Laboratory Medicine, University Hospital of North Norway, Tromso, Norway
| | - Geir Strandenes
- Department of Immunology and Transfusion Medicine, Haukeland University Hospital, Bergen, Norway
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72
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Braathen H, Hagen KG, Kristoffersen EK, Strandenes G, Apelseth TO. Implementation of a dual platelet inventory in a tertiary hospital during the COVID-19 pandemic enabling cold-stored apheresis platelets for treatment of actively bleeding patients. Transfusion 2022; 62 Suppl 1:S193-S202. [PMID: 35732490 PMCID: PMC9349781 DOI: 10.1111/trf.16988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 05/01/2022] [Accepted: 06/02/2022] [Indexed: 11/26/2022]
Abstract
Background To increase preparedness and mitigate the risk of platelet shortage without increasing the number of collections, we introduced a dual platelet inventory with cold‐stored platelets (CSP) with 14‐days shelf life for actively bleeding patients during the COVID‐19 pandemic. Study design and methods We collected apheresis platelet concentrates with blood type O or A. All patients receiving CSP units were included in a quality registry. Efficacy was evaluated by total blood usage and laboratory analysis of platelet count, hemoglobin, and TEG 6s global hemostasis assay. Feasibility was evaluated by monitoring inventory and a survey among laboratory staff. Results From 17 March, 2020, to 31 December, 2021, we produced 276 CSP units and transfused 186 units to 92 patients. Main indication for transfusion was surgical bleeding (88%). No transfusion reactions were reported. 24‐h post‐transfusion patient survival was 96%. Total outdate in the study period was 33%. The majority (75%) of survey respondents answered that they had received sufficient information and training before CSP was implemented. Lack of information about bleeding status while issuing platelets, high workload, and separate storage location was described as main reasons for outdates. Discussion CSP with 14‐days shelf life is a feasible alternative for the treatment of patients with bleeding. Implementation of a dual platelet inventory requires thorough planning, including information and training of clinical and laboratory staff, continuous follow‐up of practice and patients, and an easy‐to‐follow algorithm for use of CSP units. A dual platelet inventory may mitigate the risk of platelet shortage during a pandemic situation.
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Affiliation(s)
- Hanne Braathen
- Department of Immunology and Transfusion Medicine, Haukeland University Hospital, Bergen, Norway
| | - Kristin G Hagen
- Department of Immunology and Transfusion Medicine, Haukeland University Hospital, Bergen, Norway
| | - Einar K Kristoffersen
- Department of Immunology and Transfusion Medicine, Haukeland University Hospital, Bergen, Norway.,Department of Clinical Science, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Geir Strandenes
- Department of Immunology and Transfusion Medicine, Haukeland University Hospital, Bergen, Norway
| | - Torunn O Apelseth
- Department of Immunology and Transfusion Medicine, Haukeland University Hospital, Bergen, Norway.,Department of Clinical Science, Faculty of Medicine, University of Bergen, Bergen, Norway.,Norwegian Armed Forces Joint Medical Services, Oslo, Norway
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Abstract
Thalassaemia is a diverse group of genetic disorders with a worldwide distribution affecting globin chain synthesis. The pathogenesis of thalassaemia lies in the unbalanced globin chain production, leading to ineffective erythropoiesis, increased haemolysis, and deranged iron homoeostasis. The clinical phenotype shows heterogeneity, ranging from close to normal without complications to severe requiring lifelong transfusion support. Conservative treatment with transfusion and iron chelation has transformed the natural history of thalassaemia major into a chronic disease with a prolonged life expectancy, albeit with co-morbidities and substantial disease burden. Curative therapy with allogeneic haematopoietic stem cell transplantation is advocated for suitable patients. The understanding of the pathogenesis of the disease is guiding therapeutic advances. Novel agents have shown efficacy in improving anaemia and transfusion burden, and initial results from gene therapy approaches are promising. Despite scientific developments, worldwide inequality in the access of health resources is a major concern, because most patients live in underserved areas.
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Affiliation(s)
- Antonis Kattamis
- Division of Paediatric Haematology-Oncology, First Department of Paediatrics, National and Kapodistrian University of Athens, Athens, Greece.
| | - Janet L Kwiatkowski
- Division of Haematology, Children's Hospital of Philadelphia, Philadelphia, PA, USA; Department of Paediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Yesim Aydinok
- Department of Paediatric Heamatology and Oncology, Ege University School of Medicine, Izmir, Turkey
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Stanworth SJ, Dowling K, Curry N, Doughty H, Hunt BJ, Fraser L, Narayan S, Smith J, Sullivan I, Green L. A guideline for the haematological management of major haemorrhage: a British Society for Haematology Guideline. Br J Haematol 2022; 198:654-667. [PMID: 35687716 DOI: 10.1111/bjh.18275] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 05/07/2022] [Accepted: 05/09/2022] [Indexed: 12/17/2022]
Affiliation(s)
- Simon J Stanworth
- Transfusion Medicine, NHS Blood and Transplant, Oxford, UK.,Department of Haematology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.,Radcliffe Department of Medicine, University of Oxford, and NIHR Oxford Biomedical Research Centre, Oxford, UK
| | - Kerry Dowling
- Transfusion Laboratory Manager, Southampton University Hospitals NHS Foundation Trust, Southampton, UK
| | - Nikki Curry
- Department of Haematology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.,Radcliffe Department of Medicine, University of Oxford, and NIHR Oxford Biomedical Research Centre, Oxford, UK
| | - Heidi Doughty
- Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK.,NIHR Surgical Reconstruction and Microbiology Research Centre, Birmingham, UK
| | - Beverley J Hunt
- Department of Haematology, Guy's and St Thomas's Hospital, London, UK
| | - Laura Fraser
- Transfusion Practitioner, NHS Lanarkshire, University Hospital Wishaw, Wishaw, UK.,National Services Scotland/Scottish National Blood Transfusion, Edinburgh, UK
| | - Shruthi Narayan
- Medical director, Serious Hazards of Transfusion, Manchester, UK
| | - Juliet Smith
- Lead Transfusion Practitioner, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Ian Sullivan
- Transfusion Laboratory Manager, Royal Cornwall Hospitals NHS Trust, Truro, UK
| | - Laura Green
- Transfusion Medicine, NHS Blood and Transplant, London, UK.,Barts Health NHS Trust, London, UK.,Blizzard Institute, Queen Mary University of London, London, UK
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75
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Moving from “Surgeries” to Patients: Progress and Pitfalls While Using Machine Learning to Personalize Transfusion Prediction. Anesthesiology 2022; 137:9-12. [DOI: 10.1097/aln.0000000000004250] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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The Effect of COVID-19 on Hemoglobinopathy Patients’ Daily Lives While Quarantined: Four Greek Hospitals’ Experiences. THALASSEMIA REPORTS 2022. [DOI: 10.3390/thalassrep12020008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
During a pandemic, people are fearful of becoming infected with the virus, which causes anxiety, loss of purpose, and depression. This study aimed to evaluate the social and psychological impact, as well as the impact on homecare, of patients with hemoglobinopathies during the pandemic. Material and Methods: In total, 130 patients from four Thalassemia and Sickle Cell Disease Units of the National Health System of Greece Hospitals were examined via an anonymous questionnaire developed and distributed through stratified sampling. Results: Transfusion-dependent thalassemia, transfused sickle cell disease, and other hemoglobinopathies were represented by 130 patients. During the pandemic, the main concern of patients was the affordability of blood for transfusion. During the lockdown, patients’ moods varied, and their daily lives were disrupted by a lack of access to basic goods and communication with friends and family. Their eating habits, access to exercise, and, to a lesser extent, their financial situation have all been affected in their daily lives. It is crucial to highlight that while access to health services did not suffer in terms of medication and regular visits for their actual disease, it did suffer in terms of the systematic monitoring of complications.
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77
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Hunain R, Uday U, Rackimuthu S, Nawaz FA, Narain K, Essar MY, Rehman MU, Ahmad S, Butt A. Effects of SARS-CoV-2 vaccination on blood donation and blood banks in India. Ann Med Surg (Lond) 2022; 78:103772. [PMID: 35573470 PMCID: PMC9090855 DOI: 10.1016/j.amsu.2022.103772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Revised: 05/04/2022] [Accepted: 05/08/2022] [Indexed: 01/28/2023] Open
Abstract
India, the second most populous country in the world, started its mass vaccination campaign on January 16th, 2021. With the aim to vaccinate 1.3 billion people, this vaccination programme was dubbed as the world's largest vaccination drive. However, with depleted blood stores due to the COVID-19 pandemic and lockdown leading to reduced blood camps, the superposed regulations on blood donation deferral poses an impending risk of depletion of blood and its products. This will lead to the inability in meeting unpredictable patterns of demand in blood requirement post-pandemic. Hence to prevent avoidable risks of blood shortage in surgeries and lifesaving procedures, a secure storage system should be ensured.
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Affiliation(s)
| | - Utkarsha Uday
- West Bengal University of Health Sciences, Kolkata, India
- Corresponding author.
| | | | - Faisal A. Nawaz
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Kapil Narain
- Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
| | | | | | - Shoaib Ahmad
- Punjab Medical College, Faisalabad, Punjab, Pakistan
| | - Ayesha Butt
- Section of Hematology, Yale University School of Medicine, Connecticut, USA
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78
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Outcomes of Anesthesiologist-Led Care of Patients Following Liver Transplantation During the COVID-19 Pandemic. Jt Comm J Qual Patient Saf 2022; 48:458-467. [PMID: 35792038 PMCID: PMC9186534 DOI: 10.1016/j.jcjq.2022.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 06/01/2022] [Accepted: 06/07/2022] [Indexed: 12/03/2022]
Abstract
Background During the COVID-19 pandemic, anesthesiologists were redeployed as transplant ICU intensivists and a postanesthesia care unit was converted to a novel transplant ICU. This study compared the outcomes of patients undergoing liver transplantation under the new model with the prepandemic model. Methods Adult patients who underwent liver transplantation at an urban tertiary care center in the United States from December 28, 2015, through May 1, 2020, were identified and grouped according to date of procedure. Peri-COVID cases included transplants that were performed after March 3, 2020. Transplants performed before March 3, 2020, served as pre-COVID controls. Results A total of 523 liver transplant patients (30 study cases, 493 controls) were included. Kaplan-Meier survival analysis showed no significant difference in novel transplant ICU length of stay (N-TLOS) (median LOS 3.8 vs. 4.5 days, log-rank p = 0.60) and hospital length of stay (HLOS) (median LOS 14.2 vs. 14.5 days, log-rank p = 0.66). Cox proportional hazards regression with inverse probability of treatment weighting showed no difference in N-TLOS (hazard ratio [HR] 0.91, 95% confidence interval [CI] 0.67–1.23, p = 0.55) or HLOS (HR 0.90, 95% CI 0.65–1.25, p = 0.52). In addition, there were no significant differences (pre-COVID vs. COVID) in time to extubation (median [interquartile range] 28.7 [20.6–50.7] vs. 26.8 [17.4–40.8] hours, p = 0.35), one-year patient survival (12.0% vs. 6.7%, p = 0.055), one-year graft survival (13.4% vs. 6.7%, p = 0.43), and readmission to the ICU (15.0% vs. 20.0%, p = 0.68). Conclusion Care provided by non-intensivist anesthesiologists to patients undergoing orthotopic liver transplantation during a pandemic emergency resulted in outcomes similar to those of care provided by intensivists.
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Peng HT, Rhind SG, Moes K, Devine D, Jenkins C, Beckett A. Freeze‐dried plasma: From damage control resuscitation to coronavirus disease 2019 therapy. Transfusion 2022; 62:1408-1416. [DOI: 10.1111/trf.16947] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 05/15/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Henry T. Peng
- Defence Research and Development Canada, Toronto Research Centre Toronto Ontario Canada
| | - Shawn G. Rhind
- Defence Research and Development Canada, Toronto Research Centre Toronto Ontario Canada
| | - Katy Moes
- Defence Research and Development Canada, Toronto Research Centre Toronto Ontario Canada
| | - Dana Devine
- Centre for Innovation, Canadian Blood Services, Edmonton, Hamilton, Ottawa, and Vancouver Canada
| | - Craig Jenkins
- Centre for Innovation, Canadian Blood Services, Edmonton, Hamilton, Ottawa, and Vancouver Canada
| | - Andrew Beckett
- St. Michael's Hospital, Toronto, Ontario and Royal Canadian Medical Services Ottawa Canada
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80
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Quee FA, Spekman MLC, Prinsze FJ, Ramondt S, Huis in ’t Veld EMJ, Hurk K, Merz E. Blood donor motivators during the
COVID
‐19 pandemic. JOURNAL OF PHILANTHROPY AND MARKETING 2022. [PMCID: PMC9348007 DOI: 10.1002/nvsm.1757] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
While donating blood during the COVID‐19 pandemic offers individuals a possibility to contribute to their community, donation also exposes donors to additional risks, as physical distancing is impossible during a donation. This study explored what motivated blood and plasma donors in the Netherlands to donate during the COVID‐19 pandemic, in order to identify potential focus points for donor recruitment in future crises. In total, 3175 of the invited 7286 donors who donated between 1 and 14 April 2020 participated in an online questionnaire including questions about motivations for blood donation. Motivations for blood donation were compared among donation types, sexes, age groups, and regions. Respondents consisted of 10.6% new, 18.9% whole blood, and 70.5% plasma donors. About 80% of all donors indicated wanting to help COVID‐19 patients. Particularly whole blood donors were motivated by a call for donations (90.8%). Plasma donors more often hoped to get tested for SARS‐CoV‐2 antibodies than new and whole blood donors. Older donors (aged ≥40) more often reported hoping to get tested for SARS‐CoV‐2 antibodies, wanting to help COVID‐19 patients, and thinking that getting infected during the donation process was impossible. Younger donors (aged ≤39) more often indicated that getting out of the house and not having to go to work motivated them to donate. Donors mainly had pro‐social motivations to donate during the COVID‐19 pandemic, as helping COVID‐19 patients was the most important motivator. This shows the promise of explicitly expressing need in times of crisis, for blood banks in particular and philanthropic organizations in general.
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Affiliation(s)
- Franke A. Quee
- Donor Studies, Department of Donor Medicine Research Sanquin Research Amsterdam The Netherlands
| | - Marloes L. C. Spekman
- Donor Studies, Department of Donor Medicine Research Sanquin Research Amsterdam The Netherlands
| | - Femmeke J. Prinsze
- Donor Studies, Department of Donor Medicine Research Sanquin Research Amsterdam The Netherlands
| | - Steven Ramondt
- Donor Studies, Department of Donor Medicine Research Sanquin Research Amsterdam The Netherlands
- Department of Communication Science Vrije Universiteit Amsterdam Amsterdam The Netherlands
| | - Elisabeth M. J. Huis in ’t Veld
- Donor Studies, Department of Donor Medicine Research Sanquin Research Amsterdam The Netherlands
- Department of Cognitive Science and Artificial Intelligence Tilburg University Tilburg The Netherlands
| | - Katja Hurk
- Donor Studies, Department of Donor Medicine Research Sanquin Research Amsterdam The Netherlands
| | - Eva‐Maria Merz
- Donor Studies, Department of Donor Medicine Research Sanquin Research Amsterdam The Netherlands
- Department of Sociology Vrije Universiteit Amsterdam Amsterdam The Netherlands
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81
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Tsilingiris D, Nasiri-Ansari N, Spyrou N, Magkos F, Dalamaga M. Management of Hematologic Malignancies in the Era of COVID-19 Pandemic: Pathogenetic Mechanisms, Impact of Obesity, Perspectives, and Challenges. Cancers (Basel) 2022; 14:2494. [PMID: 35626099 PMCID: PMC9139192 DOI: 10.3390/cancers14102494] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 05/14/2022] [Accepted: 05/16/2022] [Indexed: 02/04/2023] Open
Abstract
The COVID-19 pandemic brought about an unprecedented societal and healthcare system crisis, considerably affecting healthcare workers and patients, particularly those with chronic diseases. Patients with hematologic malignancies faced a variety of challenges, pertinent to the nature of an underlying hematologic disorder itself as well as its therapy as a risk factor for severe SARS-CoV-2 infection, suboptimal vaccine efficacy and the need for uninterrupted medical observation and continued therapy. Obesity constitutes another factor which was acknowledged since the early days of the pandemic that predisposed people to severe COVID-19, and shares a likely causal link with the pathogenesis of a broad spectrum of hematologic cancers. We review here the epidemiologic and pathogenetic features that obesity and hematologic malignancies share, as well as potential mutual pathophysiological links predisposing people to a more severe SARS-CoV-2 course. Additionally, we attempt to present the existing evidence on the multi-faceted crucial challenges that had to be overcome in this diverse patient group and discuss further unresolved questions and future challenges for the management of hematologic malignancies in the era of COVID-19.
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Affiliation(s)
- Dimitrios Tsilingiris
- First Department of Propaedeutic Internal Medicine, School of Medicine, National and Kapodistrian University of Athens, Laiko General Hospital, 17 St Thomas Street, 11527 Athens, Greece
| | - Narjes Nasiri-Ansari
- Department of Biological Chemistry, School of Medicine, National and Kapodistrian University of Athens, 75 Mikras Asias, 11527 Athens, Greece
| | - Nikolaos Spyrou
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Faidon Magkos
- Department of Nutrition, Exercise, and Sports, University of Copenhagen, DK-2200 Frederiksberg, Denmark
| | - Maria Dalamaga
- Department of Biological Chemistry, School of Medicine, National and Kapodistrian University of Athens, 75 Mikras Asias, 11527 Athens, Greece
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82
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Solís-Díez G, Turu-Pedrola M, Roig-Izquierdo M, Zara C, Vallano A, Pontes C. Dealing With Immunoglobulin Shortages: A Rationalization Plan From Evidence-Based and Data Collection. Front Public Health 2022; 10:893770. [PMID: 35664094 PMCID: PMC9160570 DOI: 10.3389/fpubh.2022.893770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 04/13/2022] [Indexed: 11/13/2022] Open
Abstract
Background The demand and consumption of immunoglobulins (IgGs) are growing, and there are many difficulties in obtaining supplies. The aim of the study was to analyze the evolution of IgG consumption and cost over a decade, describe the measures implemented for clinical management in the context of regional public health system, and evaluate the initial impact of these measures. Methods We performed a retrospective longitudinal study including patients of all public health systems in Catalonia. First, we analyzed data on consumption and cost of IgGs during a period between 1 January, 2010 and 31 December 2021. Second, we analyzed the impact of a set of regional measures in terms of annual consumption and cost of IgGs. Regional measures were based on rational evidence-based measures and computer registries. We compared the data of year before applying intervention measures (1 January and 31 December 2020) with data of year after applying clinical management interventions (1 January and 31 December 2021). In addition, detailed information on clinical indications of IgG use between 1 January and 31 December 2021 was collected. Results Overall, in terms of population, the consumption of IgGs (g/1,000 inhabitants) increased from 40.4 in 2010 to 94.6 in 2021. The mean cost per patient increased from €10,930 in 2010 to €15,595 in 2021. After implementing the measures, the mean annual estimated consumption per patient in 2021 was statistically lower than the mean annual estimated consumption per patient in 2020 (mean difference −47 g, 95% CI −62.28 g, −31.72 g, p = 0.03). The mean annual estimated cost per patient in 2021 was also lower than the mean annual estimated cost per patient in 2020 (the mean difference was –€1,492, 95% CI –€2,132.12, –€851.88; p = 0.027). In 2021, according to evidence-based classification, 75.66% treatments were prescribed for a demonstrated therapeutic evidence-based indication, 12.17% for a developed therapeutic evidence-based indication, 4.66% for non-evidence-based therapeutic role indication, and 8.1% could not be classified because of lack of information. Conclusion The annual consumption and cost of IgGs have grown steadily over the last decade in our regional public health system. After implementing a set of regional measures, the annual consumption of IgGs per patient and annual cost per patient decreased. However, the decrease has occurred in the context of the coronavirus disease 2019 (COVID-19) pandemic, which may have influenced their clinical use. Managing the use of IgGs through a rational plan with strategies including evidence-based and data collection may be useful in a shortage situation with growing demand. Registries play a key role in collection of systematic data to analyze, synthesize, and obtain valuable information for decision support. The action developed needs close monitoring in order to verify its effectiveness.
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Affiliation(s)
- Gerard Solís-Díez
- Gerència del Medicament, Servei Català de la Salut, Generalitat de Catalunya, Barcelona, Spain
| | - Marta Turu-Pedrola
- Gerència del Medicament, Servei Català de la Salut, Generalitat de Catalunya, Barcelona, Spain
| | - Marta Roig-Izquierdo
- Gerència del Medicament, Servei Català de la Salut, Generalitat de Catalunya, Barcelona, Spain
| | - Corinne Zara
- Gerència del Medicament, Servei Català de la Salut, Generalitat de Catalunya, Barcelona, Spain
| | - Antoni Vallano
- Gerència del Medicament, Servei Català de la Salut, Generalitat de Catalunya, Barcelona, Spain
- *Correspondence: Antoni Vallano
| | - Caridad Pontes
- Gerència del Medicament, Servei Català de la Salut, Generalitat de Catalunya, Barcelona, Spain
- Departament de Farmacologia, de Terapèutica i de Toxicologia, Unitat Docent Parc Taulí, Facultat de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain
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83
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Brunson DC, Belanger GA, Sussmann H, Fine AM, Pandey S, Pham TD. Factors associated with first-time and repeat blood donation: Adverse reactions and effects on donor behavior. Transfusion 2022; 62:1269-1279. [PMID: 35510783 DOI: 10.1111/trf.16893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 04/04/2022] [Accepted: 04/04/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Blood centers have a dual mission to protect donors and patients; donor safety is paramount to maintaining an adequate blood supply. Elucidating donor factors associated with adverse reactions (AR) is critical to this mission. STUDY DESIGN/METHODS A retrospective cohort analysis of whole blood donors from 2003 to 2020 was conducted at a single blood center in northern California. Adjusted odds ratios (AORs) with 95% CIs for ARs were estimated via multivariable logistic regression on demographics, donation history, and physical examination data. Where appropriate, Wilcoxon-Rank Sum and chi-squared tests were used to determine significance. RESULTS First-time blood donors (FTD) exhibited a higher AR rate than repeat donors (4.4% vs. 1.9% p < .0001). When compared with FTDs without AR, FTDs with ARs (FT-AR) were less likely to return (30.0% vs. 47.3%, p < .0001), and, of those who returned, had a higher rate of reaction 20.2% versus 2.8% (p < .001). Factors found to be associated with FT-AR (younger age, increased heart rate, and higher diastolic blood pressure) still correlated positively with AR on return donation, but to a lower degree. FTD who potentially witnessed an AR had a lower return rate (44.6% vs. 47.3%, p = <.001) and donated fewer units (2.38 vs. 3.37, p < .001) when compared to FTD who did not witness an AR. CONCLUSION The AR on FTD increases the AR likelihood of return donation. Longitudinal analysis shows that a time-based deferral policy targeted at FT-AR young donors can reduce the number of ARs while not dramatically impacting the blood supply.
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Affiliation(s)
- Dalton C Brunson
- Stanford School of Medicine, Stanford University School of Medicine, Stanford, California, USA
| | | | | | - Andrew M Fine
- Division of Emergency Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Suchitra Pandey
- Stanford Blood Center, Palo Alto, California, USA.,Department of Pathology, Stanford University School of Medicine, Stanford, California, USA
| | - Tho D Pham
- Stanford Blood Center, Palo Alto, California, USA.,Department of Pathology, Stanford University School of Medicine, Stanford, California, USA
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84
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Park M, Hur M, Kim H, Oh K, Kim H, Song YH, Ko DH, Chung Y. Questionnaire Survey on Current Red Blood Cell Transport and Storage in Korea for Reducing Wastage. Ann Lab Med 2022; 42:342-351. [PMID: 34907104 PMCID: PMC8677485 DOI: 10.3343/alm.2022.42.3.342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 10/13/2021] [Accepted: 11/08/2021] [Indexed: 11/19/2022] Open
Abstract
Background To ensure safe red blood cell (RBC) transfusion practice, it is important to comply with storage and transport requirements of RBC units. We conducted a comprehensive survey on the practice of RBC transport and storage to explore the awareness of and compliance with the 30-minute rule, the current status of RBC unit transport, and possible utility of temperature indicators (TIs) to reduce RBC wastage. Methods From June to August of 2019, 64 blood bank physicians (14 questions) in 64 secondary- and tertiary-care hospitals and 673 nurses (13 questions) in 42 tertiary-care hospitals replied to a questionnaire survey. The results of the survey were analyzed with descriptive statistics. Results Among the physicians surveyed, 97.0% (N=62) of hospitals had transfusion guidelines in place. The RBC wastage in 2018 ranged from less than five units to more than 200 units. Among the nurses surveyed, 99.4% (N=669) were aware of and complied with the 30-minute rule; 13.5% (N=91) of the nurses had experience of RBC wastage due to violation of the 30-minute rule. Both physicians (67%, N=43) and nurses (83.1%, N=559) responded that TIs would help reduce RBC wastage. Conclusions This is the first survey on the practices related to RBC transport and storage in Korea. This study provides fundamental data on current practice for the blood cold chain, insights into RBC wastage, and highlights the utility of TIs.
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Affiliation(s)
- Mikyoung Park
- Department of Laboratory Medicine, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Mina Hur
- Department of Laboratory Medicine, Konkuk University School of Medicine, Seoul, Korea
| | - Hahah Kim
- Department of Laboratory Medicine, Konkuk University School of Medicine, Seoul, Korea
| | - Kyungmi Oh
- Department of Nursing, Kyungbok University, Namyangju, Korea
| | - Hyunmi Kim
- Department of Nursing, Konkuk University Medical Center, Seoul, Korea
| | - Young Hye Song
- Department of Nursing, Konkuk University Medical Center, Seoul, Korea
| | - Dae-Hyun Ko
- Department of Laboratory Medicine, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea
| | - Yousun Chung
- Department of Laboratory Medicine, Hallym University College of Medicine, Seoul, Korea
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85
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Gkirtsou C, Konstantinidis T, Cassimos D, Konstantinidou EI, Kontekaki EG, Rekari V, Bezirtzoglou E, Martinis G, Stergiannis P. Views and Attitudes of Blood Donors toward Blood Donation during the COVID-19 Pandemic in Thrace Region, Greece. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19094963. [PMID: 35564360 PMCID: PMC9101185 DOI: 10.3390/ijerph19094963] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 03/29/2022] [Accepted: 04/16/2022] [Indexed: 12/03/2022]
Abstract
The COVID-19 pandemic has been going on for the last two years and it has affected our society and, amongst other things, has had a negative impact on blood donation, which has led to a significant reduction in blood supplies worldwide. The imposed restrictions in terms of physical presence and transportation, and the fear of the unknown, have aggravated the situation. In Greece, after the first cases of COVID-19 were reported, the blood supplies at the blood transfusion units (BTUs) were dramatically reduced. Although the blood transfusions were lessened during the COVID-19 pandemic period, the blood stocks at all the BTUs of the country were also reduced.
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Affiliation(s)
- Christina Gkirtsou
- Blood Transfusion Center, University General Hospital of Alexandroupolis Dragana Campus, 68100 Alexandroupolis, Greece; (C.G.); (E.G.K.); (G.M.)
- School of Social Sciences, The Hellenic Open University, 26335 Patra, Greece;
| | - Theocharis Konstantinidis
- Blood Transfusion Center, University General Hospital of Alexandroupolis Dragana Campus, 68100 Alexandroupolis, Greece; (C.G.); (E.G.K.); (G.M.)
- Correspondence: ; Tel.: +30-2551352005
| | - Dimitrios Cassimos
- Pediatric Department, Democritus University of Thrace, 68100 Alexandroupolis, Greece;
| | | | - Eftychia G. Kontekaki
- Blood Transfusion Center, University General Hospital of Alexandroupolis Dragana Campus, 68100 Alexandroupolis, Greece; (C.G.); (E.G.K.); (G.M.)
| | - Viki Rekari
- Blood Transfusion Department, General Hospital of Xanthi, 67100 Xanthi, Greece;
| | - Eugenia Bezirtzoglou
- Laboratory of Hygiene and Environmental Protection, Department of Medicine, Democritus University of Thrace, 68100 Alexandroupolis, Greece;
| | - Georges Martinis
- Blood Transfusion Center, University General Hospital of Alexandroupolis Dragana Campus, 68100 Alexandroupolis, Greece; (C.G.); (E.G.K.); (G.M.)
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86
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Youssry I, Abd Elaziz D, Ayad N, Eyada I. The Cause–Effect Dilemma of Hematologic Changes in COVID-19: One Year after the Start of the Pandemic. Hematol Rep 2022; 14:95-102. [PMID: 35466178 PMCID: PMC9036247 DOI: 10.3390/hematolrep14020014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 02/19/2022] [Accepted: 03/24/2022] [Indexed: 01/08/2023] Open
Abstract
COVID-19 is a systemic infection that leads to multisystem affection, including hematological changes. On the other hand, the patients who have certain hematological diseases are more susceptible to COVID-19 infection. The aim of this review is to examine the wide spectrum of hematological changes that are reported to occur due to COVID-19 infection. Most of the studies over the past year mainly show that most of these changes are mainly non-specific, but are of prognostic value. On the other hand, the susceptibility of hematological patients to COVID-19 infection and complications remains questionable. Patients with certain hematological diseases (including malignancy) and those who are treated by aggressive immunosuppressive therapy have shown higher rates of COVID-19 infection and complications. On the other hand, for most of the patients suffering from other chronic hematological conditions, no evidence has shown a greater risk of infection, compared to the general population.
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Affiliation(s)
- Ilham Youssry
- Pediatric Hematology and BMT Unit, Cairo University, Giza 12613, Egypt;
| | - Dalia Abd Elaziz
- Pediatric Department, Faculty of Medicine, Cairo University, Giza 12211, Egypt; (D.A.E.); (I.E.)
| | - Nardeen Ayad
- Pediatric Hematology and BMT Unit, Cairo University, Giza 12613, Egypt;
- Correspondence:
| | - Iman Eyada
- Pediatric Department, Faculty of Medicine, Cairo University, Giza 12211, Egypt; (D.A.E.); (I.E.)
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87
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YILMAZ A, ZERDE H, ALAY B, SOYLU VG. Distribution of pre- and mid-pandemic transfusions by blood types. JOURNAL OF HEALTH SCIENCES AND MEDICINE 2022. [DOI: 10.32322/jhsm.1027697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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88
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Shortage of plasma-derived products: a looming crisis? Blood 2022; 139:3222-3225. [PMID: 35259239 DOI: 10.1182/blood.2021015370] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 02/19/2022] [Indexed: 11/20/2022] Open
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89
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Al-Riyami AZ, Burnouf T, Wood EM, Devine DV, Oreh A, Apelseth TO, Goel R, Bloch EM, van Den Berg K, Getshen M, Louw V, Ang AL, Lee CK, Rahimi-Levene N, Stramer SL, Vassallo R, Schulze TJ, Patidar GK, Pandey HC, Dubey R, Badawi M, Hindawi S, Meshi A, Matsushita T, Sorrentino E, Grubovic Rastvorceva RM, Bazin R, Vermeulen M, Nahirniak S, Tsang HC, Vrielink H, Triyono T, Addas-Carvalho M, Hećimović A, Torres OW, Mutindu SM, Bengtsson J, Dominguez D, Sayedahmed A, Hanisa Musa R, Gautam B, Herczenik E, So-Osman C. International Society of Blood Transfusion survey of experiences of blood banks and transfusion services during the COVID-19 pandemic. Vox Sang 2022; 117:822-830. [PMID: 35262978 PMCID: PMC9115426 DOI: 10.1111/vox.13256] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 01/23/2022] [Accepted: 01/24/2022] [Indexed: 10/31/2022]
Abstract
BACKGROUND AND OBJECTIVES The coronavirus disease 2019 (COVID-19) pandemic has impacted blood systems worldwide. Challenges included maintaining blood supplies and initiating the collection and use of COVID-19 convalescent plasma (CCP). Sharing information on the challenges can help improve blood collection and utilization. MATERIALS AND METHODS A survey questionnaire was distributed to International Society of Blood Transfusion members in 95 countries. We recorded respondents' demographic information, impacts on the blood supply, CCP collection and use, transfusion demands and operational challenges. RESULTS Eighty-two responses from 42 countries, including 24 low- and middle-income countries, were analysed. Participants worked in national (26.8%) and regional (26.8%) blood establishments and hospital-based (42.7%) institutions. CCP collection and transfusion were reported by 63% and 36.6% of respondents, respectively. Decreases in blood donations occurred in 70.6% of collecting facilities. Despite safety measures and recruitment strategies, donor fear and refusal of institutions to host blood drives were major contributing factors. Almost half of respondents working at transfusion medicine services were from large hospitals with over 10,000 red cell transfusions per year, and 76.8% of those hospitals experienced blood shortages. Practices varied in accepting donors for blood or CCP donations after a history of COVID-19 infection, CCP transfusion, or vaccination. Operational challenges included loss of staff, increased workloads and delays in reagent supplies. Almost half of the institutions modified their disaster plans during the pandemic. CONCLUSION The challenges faced by blood systems during the COVID-19 pandemic highlight the need for guidance, harmonization, and strengthening of the preparedness and the capacity of blood systems against future infectious threats.
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Affiliation(s)
- Arwa Z Al-Riyami
- Department of Haematology, Sultan Qaboos University Hospital, Muscat, Sultanate of Oman
| | - Thierry Burnouf
- Graduate Institute of Biomedical Materials and Tissue Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei, Taiwan.,International PhD Programme in Biomedical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei, Taiwan
| | - Erica M Wood
- Transfusion Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Dana V Devine
- Centre for Innovation, Canadian Blood Services, Vancouver, British Columbia, Canada.,Centre for Blood Research, University of British Columbia, Vancouver, British Columbia, Canada
| | - Adaeze Oreh
- National Blood Service Commission, Federal Ministry of Health, Abuja, Nigeria
| | - Torunn Oveland Apelseth
- Department of Immunology and Transfusion Medicine, Haukeland University Hospital, Bergen, Norway
| | - Ruchikha Goel
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.,Division of Hematology/Oncology, Simmons Cancer Institute at SIU School of Medicine and Mississippi Valley Regional Blood Center, Springfield, Illinois, USA
| | - Evan M Bloch
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Karin van Den Berg
- Transfusion Medicine and Technical Services Division, South African National Blood Service, Roodepoort, South Africa.,Division of Clinical Haematology, Department of Medicine, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa
| | - Mahrukh Getshen
- National Blood Bank, Department of Pathology and Laboratory Medicine, Jigme Dorji Wangchuck National Referral Hospital, Thimphu, Bhutan
| | - Vernon Louw
- Division of Clinical Haematology, Department of Medicine, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa
| | - Ai Leen Ang
- Blood Services Group, Health Sciences Authority, Singapore, Singapore
| | - Cheuk Kwong Lee
- Hong Kong Red Cross Blood Transfusion Service, Hong Kong SAR
| | | | - Susan L Stramer
- Scientific Affairs, American Red Cross, Gaithersburg, Maryland, USA
| | | | | | - Gopal Kumar Patidar
- Department of Transfusion Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Hem Chandra Pandey
- Department of Transfusion Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Rounak Dubey
- Department of Transfusion Medicine, NRI Academy of Medical Sciences, Andhra Pradesh, India
| | - Maha Badawi
- Haematology Department, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Salwa Hindawi
- Haematology Department, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Abdullah Meshi
- Department of Blood Bank, King Fahd Central Hospital, Jazan, Saudi Arabia
| | | | | | - Rada M Grubovic Rastvorceva
- Institute for Transfusion Medicine of RNM, Skopje, North Macedonia.,Faculty of Medical Sciences, University Goce Delcev, Štip, North Macedonia
| | - Renée Bazin
- Medical Affairs and Innovation, Héma-Québec, Québec, Canada
| | - Marion Vermeulen
- Transfusion Medicine and Technical Services Division, South African National Blood Service, Roodepoort, South Africa
| | - Susan Nahirniak
- Transfusion and Transplantation Medicine, Alberta Precision Laboratories, Calgary, Alberta, Canada
| | | | - Hans Vrielink
- Unit Transfusion Medicine, Sanquin Blood Supply Foundation, Amsterdam, the Netherlands
| | - Teguh Triyono
- Faculty of Medicine, Universitas Gadjah Mada/Dr Sardjito Hospital, Yogyakarta, Indonesia
| | | | - Ana Hećimović
- Croatian Institute of Transfusion Medicine, Zagreb, Croatia
| | - Oscar W Torres
- Transfusion Medicine Service, Hospital Churruca, Buenos Aires, Argentina
| | - Samclide M Mutindu
- Unit of Transfusion Medicine, Centre Hospitalier Monkole, Kinshasa, Democratic Republic of Congo
| | - Jesper Bengtsson
- Department of Clinical Immunology and Transfusion Medicine, University and Regional Laboratories, Lund, Sweden
| | - Diego Dominguez
- Centro Regional de Hemoterapia, Hospital Zonal Caleta Olivia, Caleta Olivia, Argentina
| | - Ahmed Sayedahmed
- Omdurman Islamic University/National Central Laboratory, Khartoum, Sudan
| | - Rozi Hanisa Musa
- Clinical Transfusion, National Immunohematology Reference Laboratory, National Blood Centre, Kuala Lumpur, Malaysia
| | | | | | - Cynthia So-Osman
- Unit Transfusion Medicine, Sanquin Blood Supply Foundation, Amsterdam, the Netherlands.,Department of Haematology, Erasmus Medical Centre, Rotterdam, the Netherlands
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90
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Ahmadi E, Bagherpour Z, Zarei E, Omidkhoda A. Pathological effects of SARS-CoV-2 on hematological and immunological cells: Alterations in count, morphology, and function. Pathol Res Pract 2022; 231:153782. [PMID: 35121363 PMCID: PMC8800420 DOI: 10.1016/j.prp.2022.153782] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Revised: 01/22/2022] [Accepted: 01/25/2022] [Indexed: 01/08/2023]
Abstract
The novel Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2), the causative agent of COVID-19 outbreak, spread rapidly and infected more than 140 million people with more than three million victims worldwide. The SARS-CoV-2 causes destructive changes in the immunological and hematological system of the host. These alterations appear to play a critical role in disease pathology and the emerging of clinical manifestations. In this review, we aimed to discuss the effect of COVID-19 on the count, function and morphology of immune and blood cells and the role of these changes in the pathophysiology of the disease. Knowledge of these changes may help with better management and treatment of COVID-19 patients.
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Affiliation(s)
- Ehsan Ahmadi
- Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
| | - Zahra Bagherpour
- Department of Hematology and Blood Banking, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran.
| | - Elmira Zarei
- Department of Hematology and Blood Banking, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran.
| | - Azadeh Omidkhoda
- Department of Hematology and Blood Banking, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran.
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91
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Okamoto W, Hasegawa M, Usui T, Kashima T, Sakata S, Hamano T, Onozawa H, Hashimoto R, Iwazaki M, Kohno M, Komatsu T. Hemoglobin-albumin clusters as an artificial O 2 carrier: Physicochemical properties and resuscitation from hemorrhagic shock in rats. J Biomed Mater Res B Appl Biomater 2022; 110:1827-1838. [PMID: 35191606 DOI: 10.1002/jbm.b.35040] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Revised: 12/30/2021] [Accepted: 02/09/2022] [Indexed: 01/10/2023]
Abstract
A bovine hemoglobin (HbBv) or human adult hemoglobin (HbA) wrapped covalently by human serum albumins (HSAs), hemoglobin-albumin clusters (HbBv-HSA3 and HbA-HSA3 ), are artificial O2 carriers used as a red blood cell substitute. This article describes the physicochemical properties of the HbBv-HSA3 and HbA-HSA3 solutions, and their abilities to restore the systemic condition after resuscitation from hemorrhagic shock in anesthetized rats. The HbBv-HSA3 and HbA-HSA3 , which have high colloid osmotic activity, showed equivalent solution characteristics and O2 binding parameters. Shock was induced by 50% blood withdrawal. Rats exhibited hypotension and significant metabolic acidosis. After 15 min, the rats were administered shed autologous blood (SAB), HbBv-HSA3 , HbA-HSA3 , or Ringer's lactate (RL) solution. Survival rates, circulation parameters, hematological parameters, and blood gas parameters were monitored during the hemorrhagic shock and for 6 h after administration. All rats in the SAB, HbBv-HSA3 , and HbA-HSA3 groups survived for 6 h. The HbBv-HSA3 and HbA-HSA3 groups restored mean arterial pressure after the resuscitation. No remarkable difference was observed in the time courses of blood gas parameters in any resuscitated group except for the RL group. Serum biochemical tests showed increases in aspartate aminotransferase (AST) and alanine aminotransferase (ALT) in the HbBv-HSA3 and HbA-HSA3 groups compared to the SAB group. Therefore, we observed other rats awakened after resuscitation with HbA-HSA3 for 7 days. The blood cell count, AST, and ALT recovered to the baseline values by 7 days. All the results implied that HbBv-HSA3 and HbA-HSA3 clusters provide restoration from hemorrhagic shock as an alternative material for SAB transfusion.
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Affiliation(s)
- Wataru Okamoto
- Department of Applied Chemistry, Faculty of Science and Engineering, Chuo University, Tokyo, Japan
| | - Mai Hasegawa
- Department of Applied Chemistry, Faculty of Science and Engineering, Chuo University, Tokyo, Japan
| | - Tomone Usui
- Department of Applied Chemistry, Faculty of Science and Engineering, Chuo University, Tokyo, Japan
| | - Tomonori Kashima
- Department of Applied Chemistry, Faculty of Science and Engineering, Chuo University, Tokyo, Japan
| | - Sho Sakata
- Department of Applied Chemistry, Faculty of Science and Engineering, Chuo University, Tokyo, Japan
| | - Tatsuhiko Hamano
- Department of Applied Chemistry, Faculty of Science and Engineering, Chuo University, Tokyo, Japan
| | - Hiroto Onozawa
- Department of General Thoracic Surgery, School of Medicine, Tokai University, Kanagawa, Japan
| | - Ryo Hashimoto
- Department of General Thoracic Surgery, School of Medicine, Tokai University, Kanagawa, Japan
| | - Masayuki Iwazaki
- Department of General Thoracic Surgery, School of Medicine, Tokai University, Kanagawa, Japan
| | - Mitsutomo Kohno
- Department of General Thoracic Surgery, School of Medicine, Tokai University, Kanagawa, Japan.,Department of General Thoracic Surgery, Saitama Medical Center, Saitama Medical University, Saitama, Japan
| | - Teruyuki Komatsu
- Department of Applied Chemistry, Faculty of Science and Engineering, Chuo University, Tokyo, Japan
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92
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Routray SS, Ray GK, Prakash S, Sahu A, Naik A, Mukherjee S. Impact of COVID-19 on blood donor deferral patterns during the COVID-19 pandemic: A retrospective analysis. Vox Sang 2022; 117:656-663. [PMID: 35114023 DOI: 10.1111/vox.13240] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 12/14/2021] [Accepted: 12/15/2021] [Indexed: 01/28/2023]
Abstract
BACKGROUND AND OBJECTIVES Blood donor deferral is an essential tool for blood safety. The ongoing COVID-19 pandemic has adversely affected blood transfusion services all over the world. But its impact on donor deferral rate and the pattern is unclear in light of the new donor deferral policy due to the COVID-19 pandemic. MATERIALS AND METHODS This retrospective study was divided into pre-COVID and COVID (15 March 2019-14 March 2021). All the deferred donors were divided into six different categories: (1) medical causes, (2) surgical causes, (3) drugs and vaccination, (4) risk of transfusion-transmitted diseases, (5) miscellaneous causes and (6) flu-like symptoms. In addition, COVID-related deferrals were also incorporated. All these above categories along with the donor demography were analysed by SPSS software version 25. RESULTS The donor deferral rate was 17.03% and 12.74% during the pre-COVID and COVID periods, respectively. During the pre-COVID period, Category 3 deferrals and during COVID period, Category 6 deferrals were significantly higher. A reversal in pattern with increased blood pressure (40.2% vs. 24.04%) over-riding low haemoglobin (34.77% vs. 55.5%) was noted in the Category 1 deferral during the COVID period. Category 1 deferral was more in middle-aged adults as compared to young and old adults (p < 0.05). Among middle-aged adults, deferral due to flu-like symptoms was also significantly more during the COVID period (p < 0.05). CONCLUSION COVID-19 significantly affected the donor pool and changed the pattern of donor deferral. Understanding donor deferral patterns may help in identifying targeted donor populations and planning donor recruitment strategies in future pandemic crises.
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Affiliation(s)
- Suman Sudha Routray
- Department of Transfusion Medicine, All India Institute of Medical Sciences, Bhubaneswar, India
| | - Gopal Krushna Ray
- Department of Transfusion Medicine, All India Institute of Medical Sciences, Bhubaneswar, India
| | - Satya Prakash
- Department of Transfusion Medicine, All India Institute of Medical Sciences, Bhubaneswar, India
| | - Ansuman Sahu
- Department of Transfusion Medicine, All India Institute of Medical Sciences, Bhubaneswar, India
| | - Archana Naik
- Department of Transfusion Medicine, All India Institute of Medical Sciences, Bhubaneswar, India
| | - Somnath Mukherjee
- Department of Transfusion Medicine, All India Institute of Medical Sciences, Bhubaneswar, India
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93
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Oreh AC, Irechukwu C, Biyama F, Nnabuihe A, Ihimekpen A, Oshiame D, Bozegha T, Leo-Nnadi I, Izedonmwen O, Oga E, Suberu EJ, Odiabara K, Amedu OJ. COVID-19 impact on Nigeria's national blood service commission - Lessons for Low- and Middle-Income Countries (LMICs). Niger Postgrad Med J 2022; 29:6-12. [PMID: 35102944 DOI: 10.4103/npmj.npmj_720_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Background In February 2020, Nigeria officially announced its first case of COVID-19. As numbers rose, government-led non-pharmaceutical interventions such as lockdowns, curfews, restrictions on mass gatherings and other physical distancing measures ensued, negatively affecting blood donor mobilisation activities. Objectives We aimed to assess the blood service activities across 17 National Blood Service Commission (NBSC) centres in Nigeria, including number of blood donations, mobile blood drives, blood units screened, screening outcomes, number of hospitals NBSC provided services to and number of blood units discarded over the study period. Materials and Methods A retrospective descriptive study was conducted to determine the impact of the COVID-19 pandemic on blood services in 17 NBSC centres in Nigeria, comparing from January-December 2019 (pre-COVID-19) to January-December 2020 (peri-COVID-19). Results Mobile blood donation drives declined by 100% in the first 2 months following government-imposed lockdowns, the number of all blood donations and voluntary blood donations declined by 9.8%. The number of blood units screened declined by 11.9%, while the number of blood units that screened positive for transfusion-transmissible infections reduced by 28.6%. Discarded blood units reduced by 3.1%, while a 32.6% increase was observed in the number of hospitals that NBSC issued blood for transfusion. Conclusions The COVID-19 pandemic affected NBSC operations in Nigeria. However, by strengthening hospital linkages and employing innovative strategies, NBSC ensured continuity of operations, thereby significantly managing the challenges of COVID-19 to voluntary blood donor recruitment and the availability of safe blood for transfusion.
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Affiliation(s)
- Adaeze Chidinma Oreh
- Department of Planning, Research and Statistics, National Blood Service Commission Headquarters, Abuja, Nigeria
| | - Christopher Irechukwu
- Department of Planning, Research and Statistics, National Blood Service Commission Headquarters, Abuja, Nigeria
| | - Felix Biyama
- Department of Planning, Research and Statistics, National Blood Service Commission Headquarters, Abuja, Nigeria
| | - Agatha Nnabuihe
- Department of Planning, Research and Statistics, National Blood Service Commission Headquarters, Abuja, Nigeria
| | - Andrew Ihimekpen
- Department of Planning, Research and Statistics, National Blood Service Commission Headquarters, Abuja, Nigeria
| | - Daniel Oshiame
- Department of Planning, Research and Statistics, National Blood Service Commission Headquarters, Abuja, Nigeria
| | - Tariere Bozegha
- Department of Planning, Research and Statistics, National Blood Service Commission Headquarters, Abuja, Nigeria
| | - Ijeoma Leo-Nnadi
- Department of Planning, Research and Statistics, National Blood Service Commission Headquarters, Abuja, Nigeria
| | - Omosigho Izedonmwen
- Department of Planning, Research and Statistics, National Blood Service Commission Headquarters, Abuja, Nigeria
| | - Elton Oga
- Department of Planning, Research and Statistics, National Blood Service Commission Headquarters, Abuja, Nigeria
| | - Eneye Jimoh Suberu
- Department of Planning, Research and Statistics, National Blood Service Commission Headquarters, Abuja, Nigeria
| | - Kingsley Odiabara
- Department of Planning, Research and Statistics, National Blood Service Commission Headquarters, Abuja, Nigeria
| | - Omale Joseph Amedu
- Department of Planning, Research and Statistics, National Blood Service Commission Headquarters, Abuja, Nigeria
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94
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Barnes LS, Al-Riyami AZ, Ipe TS, Bloch EM, Sibinga CS, Eichbaum QG. COVID-19 and the impact on blood availability and transfusion practices in low- and middle-income countries. Transfusion 2022; 62:336-345. [PMID: 35023585 DOI: 10.1111/trf.16798] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 11/04/2021] [Accepted: 12/12/2021] [Indexed: 01/28/2023]
Abstract
BACKGROUND/CASE STUDIES The coronavirus disease 2019 (COVID-19) pandemic disrupted the global blood supply. Low- and middle-income countries (LMICs) already experienced blood supply deficits that preceded the pandemic. We sought to characterize the challenges experienced during the pandemic, and adaptations, such as COVID-19 convalescent plasma (CCP). STUDY DESIGN/METHODS A cross-sectional survey explored blood availability, challenges, and adaptations. The survey contained 31 questions, e-mailed in English, French, or Spanish, to selected LMIC blood transfusion practitioners. Data acquisition occurred between October 28 and December 28, 2020. A mixed methods analysis followed. RESULTS/FINDINGS A total of 31 responses from 111 invitations represented 26 LMIC countries. Languages included English (22, 71%), Spanish (7, 22.6%), and French (2, 6.4%). Most respondents (29/31, 93.5%) collected blood; 58% also transfused blood (18/31). The supply of blood came from hospital-based blood donations (61%, 11/18); blood suppliers (17%, 3/18); and both sources (22%, 4/18). Collectively, 77.4% (24/31) of respondents experienced a decline in blood availability, ranging from 10% to 50%. Contributing factors included public fear of COVID-19 (21/24); stay-at-home measures (18/24); logistics (14/24); and canceled blood drives (16/24). Adaptations included increased collaboration within and between institutions (17/27), donor eligibility changes (21/31); social media or phone promotion (22/39); and replacement donation (3/27). Fifteen of 31 responses reported CCP donation (48.4%); CCP transfusion occurred in 6 (19.4%). The primary barrier was engaging recovered patients for donation (7/15). CONCLUSION Our survey describes challenges experienced by LMIC blood systems during the COVID-19 pandemic. While the decline in blood supplies was severe, adaptive measures included collaboration, outreach, and CCP programs.
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Affiliation(s)
- Linda S Barnes
- Biotherapies, AABB, Bethesda, Maryland, USA
- Doctor of Public Health Leadership Department, University of Illinois at Chicago, Chicago, Illinois, USA
- X-CellSystem, Inc., Seattle, Washington, USA
| | - Arwa Z Al-Riyami
- Department of Hematology, Sultan Qaboos University Hospital, Muscat, Oman
| | - Tina S Ipe
- Department of Pathology, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Evan M Bloch
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Cees Smit Sibinga
- International Development of Transfusion Medicine, University of Groningen, Zuidhorn, The Netherlands
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95
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Green L, Stanworth S, McQuilten Z, Lin V, Tucker H, Jackson B, Badawi M, Hindawi S, Chaurasia R, Patidar G, Pandey HC, Fasola F, Miyata S, Matsumoto M, Matsushita T, Rahimi-Levene N, Peer V, Pavenski K, Callum J, Thompson T, Murphy M, Staves J, Maegele M, Abeyakoon C, Rushford K, Wood E, Nuñez MA, Mellado S, Saa E, Triyono T, Pratomo B, Apelseth TO, Dunbar N. International Forum on the Management of Major Haemorrhage: Summary. Vox Sang 2022; 117:746-753. [PMID: 35050497 DOI: 10.1111/vox.13244] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 12/16/2021] [Indexed: 12/24/2022]
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96
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Halawani AJ. The impact of blood campaigns using mobile blood collection drives on blood supply management during the COVID-19 pandemic. Transfus Apher Sci 2022; 61:103354. [PMID: 35042671 PMCID: PMC8757647 DOI: 10.1016/j.transci.2022.103354] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 01/03/2022] [Accepted: 01/10/2022] [Indexed: 01/28/2023]
Abstract
Background and objectives Blood transfusion is a lifesaving procedure for transfusion-dependent patients. Therefore, maintaining blood supply is extremely crucial. The coronavirus disease 2019 (COVID-19) pandemic has negatively affected blood supply by affecting donor attendance. This study aimed to investigate blood supply and demand during the pandemic and demonstrate the positive impact of blood donation campaigns through mobile blood drives. Materials and methods A cross-sectional study was conducted based on data of the blood bank at Prince Muhammad bin Nasser Hospital (PMBNH) in southwestern Saudi Arabia. Data on the attendance of blood donors at PMBNH were retrieved and retrospectively reviewed to assess the impact of mobile blood drives during the COVID-19 pandemic. Results Blood supply and donor attendance during the COVID-19 pandemic dropped by 17.32 %. However, blood supply increased between March and May 2020 due to national blood donation campaigns conducted through mobile blood drives. The drop in blood supply after 3 months of mobile blood drives significantly decreased to 0.17 % (P < 0.01). This means the blood supply was increased as follows; (March 2020 = 32.67 %, April 2020 = 45.54 %, and May 2020 = 19.47 %). On the other hand, blood demand decreased by 12.83 %. Conclusion This study demonstrated the significant impact of establishing blood donation campaigns through mobile blood drives. Our results showed that the strategy can contribute to sufficient blood units to patients during pandemics and emergencies.
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Affiliation(s)
- Amr J Halawani
- Department of Laboratory Medicine, Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah, Saudi Arabia.
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97
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Sungkaro K, Taweesomboonyat C, Kaewborisutsakul A. Prediction of massive transfusions in neurosurgical operations using machine learning. Asian J Transfus Sci 2022. [DOI: 10.4103/ajts.ajts_42_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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98
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Kandasamy D, Shastry S, Chenna D, Mohan G. COVID-19 pandemic and blood transfusion services: The impact, response and preparedness experience of a tertiary care Blood Center in southern Karnataka, India. Hematol Transfus Cell Ther 2021; 44:17-25. [PMID: 34931179 PMCID: PMC8674497 DOI: 10.1016/j.htct.2021.09.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Accepted: 09/26/2021] [Indexed: 01/28/2023] Open
Abstract
Introduction With the outbreak of COVID-19 and its containment measures, blood centers faced a huge challenge in balancing blood demand and supply and devising a preparedness plan to withstand the uncertain situation. This study assesses the effect of the COVID-19 pandemic on blood transfusion services and discusses the appropriate mitigation strategies adopted. Methods We analyzed our center's blood transfusion services during the first half-period of the pandemic (Y3) and non-pandemic years 2018(Y1) and 2019(Y2) in two-quarters Q1 (pre-lockdown), from January to March and Q2 (post-lockdown), from April to June. The blood donation variables, the packed red blood cells (PRBCs) demand and the utilization pattern were compared between pandemic (Y3) and non-pandemic years (Y1 and Y2) in each quarter. The mitigation strategy adopted at every step of the transfusion service is highlighted. Results During post-lockdown (Q2) of the pandemic year (Y3), the blood donation was majorly by repeat donors (83%) from the in-house site (82.5%). Furthermore, the proportion of outdoor donation, deferral, blood collection, demand and issue demonstrated a significant drop of 50%, 32.6%, 33%, 31.8% and 32.3%, respectively, in comparison to Q2 of the non-pandemic years (Y1 and Y2), with a statistically significant difference for surgical and hemorrhagic indications (p < 0.05). Coping strategies, such as blood donor education and motivation using e-platforms emphasizing eligibility during the pandemic, staggering of donor in-flow, postponement of elective surgeries and donor and staff’ COVID-19 safety assurance, were followed. Conclusion The timely adoption of coping strategies played a crucial role in the better handling of shortcomings at our center's blood transfusion services caused by the COVID-19 pandemic.
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Affiliation(s)
- Dhivya Kandasamy
- Department of Immunohematology and Blood Transfusion, Kasturba Medical College, Manipal, Manipal Academy of Higher Education,Manipal, Karnataka, India.
| | - Shamee Shastry
- Department of Immunohematology and Blood Transfusion, Kasturba Medical College, Manipal, Manipal Academy of Higher Education,Manipal, Karnataka, India
| | - Deepika Chenna
- Department of Immunohematology and Blood Transfusion, Kasturba Medical College, Manipal, Manipal Academy of Higher Education,Manipal, Karnataka, India
| | - Ganesh Mohan
- Department of Immunohematology and Blood Transfusion, Kasturba Medical College, Manipal, Manipal Academy of Higher Education,Manipal, Karnataka, India
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99
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David KB, Simfukwe K, Musa MB, Munharo S, Lucero-Prisno DE. Impact of COVID-19 on blood donation and supply in Africa. Afr J Lab Med 2021; 10:1408. [PMID: 34853778 PMCID: PMC8602960 DOI: 10.4102/ajlm.v10i1.1408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Accepted: 06/23/2021] [Indexed: 01/28/2023] Open
Affiliation(s)
- Kenneth B David
- Faculty of Pharmaceutical Sciences, Kaduna State University, Kaduna, Nigeria.,Hull York Medical School, University of Hull, Hull, United Kingdom
| | | | - Mohamed B Musa
- Faculty of Pharmacy, Omdurman Islamic University, Khartoum, Sudan
| | - Steven Munharo
- Training and Research Unit of Excellence, College of Medicine, University of Malawi, Blantyre, Malawi
| | - Don E Lucero-Prisno
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, United Kingdom
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Manupati VK, Schoenherr T, Wagner SM, Soni B, Panigrahi S, Ramkumar M. Convalescent plasma bank facility location-allocation problem for COVID-19. TRANSPORTATION RESEARCH. PART E, LOGISTICS AND TRANSPORTATION REVIEW 2021; 156:102517. [PMID: 34725541 PMCID: PMC8552553 DOI: 10.1016/j.tre.2021.102517] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 09/25/2021] [Accepted: 10/14/2021] [Indexed: 05/27/2023]
Abstract
With convalescent plasma being recognized as an eminent treatment option for COVID-19, this paper addresses the location-allocation problem for convalescent plasma bank facilities. This is a critical topic, since limited supply and overtly increasing cases demand a well-established supply chain. We present a novel plasma supply chain model considering stochastic parameters affecting plasma demand and the unique features of the plasma supply chain. The primary objective is to first determine the optimal location of the plasma banks and to then allocate the plasma collection facilities so as to maintain proper plasma flow within the network. In addition, recognizing the perishable nature of plasma, we integrate a deteriorating rate with the objective that as little plasma as possible is lost. We formulate a robust mixed-integer linear programming (MILP) model by considering two conflicting objective functions, namely the minimization of overall plasma transportation time and total plasma supply chain network cost, with the latter also capturing inventory costs to reduce wastage. We then propose a CPLEX-based optimization approach for solving the MILP functions. The feasibility of our results is validated by a comparison study using the Non-Dominated Sorting Genetic Algorithm-II (NSGA-II) and a proposed modified NSGA-III. The application of the proposed model is evaluated by implementing it in a real-world case study within the context of India. The optimized numerical results, together with their sensitivity analysis, provide valuable decision support for policymakers.
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Affiliation(s)
- Vijaya Kumar Manupati
- Department of Mechanical Engineering, National Institute of Technology Warangal, Warangal, Telangana 506004, India
| | - Tobias Schoenherr
- Department of Supply Chain Management, Broad College of Business, Michigan State University, 632 Bogue St., East Lansing, MI, USA
| | - Stephan M Wagner
- Chair of Logistics Management, Department of Management, Technology, and Economics, Swiss Federal Institute of Technology Zurich, Weinbergstrasse 56/58, 8092 Zurich, Switzerland
| | - Bhanushree Soni
- Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Gorimedu, Puducherry 605006, India
| | - Suraj Panigrahi
- Department of Mechanical Engineering, National Institute of Technology Warangal, Warangal, Telangana 506004, India
| | - M Ramkumar
- Operations and Quantitative Methods Group, Indian Institute of Management Raipur, Atal Nagar, Kurru (Abhanpur), Raipur 493 661, India
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