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Infanti L, Leitner G, Moe M, Pehlic V, Cattaneo M, Benkert P, Holbro A, Passweg J, Worel N, Buser A. Blood donation for iron removal in individuals with HFE mutations: study of efficacy and safety and short review on hemochromatosis and blood donation. Front Med (Lausanne) 2024; 11:1362941. [PMID: 38566922 PMCID: PMC10986032 DOI: 10.3389/fmed.2024.1362941] [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: 12/29/2023] [Accepted: 03/07/2024] [Indexed: 04/04/2024] Open
Abstract
Background Elevated serum ferritin with/without HFE variants in asymptomatic persons leads frequently to referral for blood donation. Hemochromatosis (p.C282Y/p.C282Y) only requires treatment. We evaluated safety and feasibility of iron removal in healthy persons with elevated ferritin and HFE variants using blood donation procedures. Materials and methods Thirty subjects with ferritin >200 ng/mL (women) or >300 ng/mL (men) with p.C282Y/p.C282Y, p.C282Y/p.H63D or p.H63D/p.H63D were randomized to weekly phlebotomy (removal of 450 mL whole blood) or erythrapheresis (removal of 360 mL red blood cells) every 14 days. The ferritin target was <100 ng/mL. A full blood count and ferritin were measured at each visit. Hemoglobin (Hb) ≥140 g/L was required at inclusion. If Hb dropped to <120 g/L (women) or <130 g/L (men), procedures were postponed (7 or 14 days). Primary endpoint was the number of procedures needed to the ferritin target; secondary objectives were duration of treatment and compliance. The treatment effect was tested with Poisson regression; number of procedures and treatment duration were compared between study arms with the Kruskal-Wallis test. Results Twenty-five of 30 participants were men (83%); mean age was 47 years (SD 10.5), mean BMI 26.6 kg/m2 (SD 3.6); 17 had p.C282Y/p.C282Y, nine p.C282Y/p.H63D, four p.H63D/p.H63D. Median baseline Hb was 150 g/L (IQR 144, 1,559), median ferritin 504 ng/mL (IQR 406,620). Twenty-seven subjects completed the study. Treatment arm (p < 0.001) and HFE variant (p = 0.007) influenced the primary endpoint significantly. To ferritin levels <100 ng/mL, a median number of 7.5 (IQR 6.2, 9.8) phlebotomies and 4.0 (IQR 3.0, 5.8) erythraphereses (p = 0.001) was needed during a median of 66.5 days (IQR 49,103) and 78.5 days (IQR 46139), respectively (p = 0.448). Low Hb was the principal reason for protocol violation; anemia occurred in 13 participants (48%). Immediate complications were infrequent; fatigue was reported after 25% of phlebotomies and 45% of erythraphereses. Thirty-five procedures were postponed because of low Hb and 15 for non-medical reasons. The median interval was 7.0 (IQR 7.7) and 14.0 (IQR 14, 20) days between phlebotomies and erythraphereses, respectively. Conclusion Blood donation procedures remove iron effectively in HC, but frequent treatments cause Hb decrease and fatigue that can impair feasibility.
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Affiliation(s)
- Laura Infanti
- Regional Blood Transfusion Centre Swiss Red Cross Basel, Basel, Switzerland
- Division of Hematology, University Hospital, University of Basel, Basel, Switzerland
| | | | - Morten Moe
- Unit of Medical Biochemistry, Division of Diagnostics and Technology, Akershus University Hospital, Akershus, Norway
| | - Vildana Pehlic
- Regional Blood Transfusion Centre Swiss Red Cross Basel, Basel, Switzerland
| | - Marco Cattaneo
- Clinical Trial Unit, Department of Clinical Research, University and University Hospital Basel, Basel, Switzerland
| | - Pascal Benkert
- Clinical Trial Unit, Department of Clinical Research, University and University Hospital Basel, Basel, Switzerland
| | - Andreas Holbro
- Regional Blood Transfusion Centre Swiss Red Cross Basel, Basel, Switzerland
- Division of Hematology, University Hospital, University of Basel, Basel, Switzerland
| | - Jakob Passweg
- Division of Hematology, University Hospital, University of Basel, Basel, Switzerland
| | - Nina Worel
- Department for Transfusion Medicine and Cell Therapy, Medical University Vienna, Vienna, Austria
| | - Andreas Buser
- Regional Blood Transfusion Centre Swiss Red Cross Basel, Basel, Switzerland
- Division of Hematology, University Hospital, University of Basel, Basel, Switzerland
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2
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Zoller H, Schaefer B, Vanclooster A, Griffiths B, Bardou-Jacquet E, Corradini E, Porto G, Ryan J, Cornberg M. EASL Clinical Practice Guidelines on haemochromatosis. J Hepatol 2022; 77:479-502. [PMID: 35662478 DOI: 10.1016/j.jhep.2022.03.033] [Citation(s) in RCA: 35] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 03/29/2022] [Indexed: 12/15/2022]
Abstract
Haemochromatosis is characterised by elevated transferrin saturation (TSAT) and progressive iron loading that mainly affects the liver. Early diagnosis and treatment by phlebotomy can prevent cirrhosis, hepatocellular carcinoma, diabetes, arthropathy and other complications. In patients homozygous for p.Cys282Tyr in HFE, provisional iron overload based on serum iron parameters (TSAT >45% and ferritin >200 μg/L in females and TSAT >50% and ferritin >300 μg/L in males and postmenopausal women) is sufficient to diagnose haemochromatosis. In patients with high TSAT and elevated ferritin but other HFE genotypes, diagnosis requires the presence of hepatic iron overload on MRI or liver biopsy. The stage of liver fibrosis and other end-organ damage should be carefully assessed at diagnosis because they determine disease management. Patients with advanced fibrosis should be included in a screening programme for hepatocellular carcinoma. Treatment targets for phlebotomy are ferritin <50 μg/L during the induction phase and <100 μg/L during the maintenance phase.
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3
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Mikaelsdottir M, Vidarsson B, Runarsson G, Bjarnadottir U, Onundarson PT, Sigurjonsson OE, Halldorsdottir AM. A comparison of platelet quality between platelets from healthy donors and hereditary hemochromatosis donors over seven-day storage. Transfusion 2020; 61:202-211. [PMID: 33166431 DOI: 10.1111/trf.16176] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 09/02/2020] [Accepted: 10/09/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND Therapeutic phlebotomy is the standard treatment of hereditary hemochromatosis (HH), the most common genetic disease in people of Northern European descent. Red cell concentrates from HH donors have been reported safe for transfusion, but little data is available on the storage properties of platelet concentrates from HH donors. STUDY DESIGN AND METHODS Whole blood was collected from 10 healthy individuals and 10 newly diagnosed HH patients with elevated serum ferritin. Platelet-rich plasma (PRP) was prepared and split into four 20-mL units. Platelet quality tests were performed on days 0, 1, 3, 5, and 7 of storage, including platelet aggregation (ADP, arachidonic acid, collagen, and epinephrine agonists), blood gas analysis, flow cytometry (CD41, CD42b, and CD62P expression), and ELISA (sCD40L and sCD62p in supernatant). RESULTS Mean serum ferritin levels were higher in HH patients than in controls (847.5 vs 45.8 ng/mL, P < .001). Overall, no difference in quality test results was observed between the two study groups over 7-day storage (P > .05), including blood gas analysis, platelet aggregation, and expression of surface (CD62p and CD42b) and secreted (sCD62P and sCD40L) activation markers. Expected alterations in metabolic (CO2 and glucose decrease, O2 and lactate increase, P < .001) and platelet activation markers (CD42b decrease, CD62P increase, P < .05) over time were observed in both groups. CONCLUSION Although these findings indicate that platelets of individuals with HH are comparable to platelets from healthy donors, more extensive studies are needed before definite conclusions can be drawn.
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Affiliation(s)
| | - Brynjar Vidarsson
- Department of Hematology, Landspitali - The National University Hospital of Iceland, Reykjavik, Iceland
| | - Gudmundur Runarsson
- Department of Hematology, Landspitali - The National University Hospital of Iceland, Reykjavik, Iceland
| | - Una Bjarnadottir
- Department of Immunology, Landspitali - The National University Hospital of Iceland, Reykjavik, Iceland
| | - Pall T Onundarson
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland.,Department of Hematology, Landspitali - The National University Hospital of Iceland, Reykjavik, Iceland
| | - Olafur E Sigurjonsson
- The Blood Bank, Landspitali - The National University Hospital of Iceland, Reykjavik, Iceland.,School of Science and Engineering, Reykjavik University, Reykjavik, Iceland
| | - Anna M Halldorsdottir
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland.,The Blood Bank, Landspitali - The National University Hospital of Iceland, Reykjavik, Iceland
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4
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Herb-Derived Products: Natural Tools to Delay and Counteract Stem Cell Senescence. Stem Cells Int 2020; 2020:8827038. [PMID: 33101419 PMCID: PMC7568162 DOI: 10.1155/2020/8827038] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 09/14/2020] [Accepted: 09/15/2020] [Indexed: 12/13/2022] Open
Abstract
Cellular senescence plays a very important role in organismal aging increasing with age and in age-related diseases (ARDs). This process involves physiological, structural, biochemical, and molecular changes of cells, leading to a characteristic trait referred to "senescence-associated secretory phenotype (SASP)." In particular, with aging, stem cells (SCs) in situ exhibit a diminished capacity of self-renewal and show a decline in their functionality. The identification of interventions able to prevent the accumulation of senescent SCs in the organism or to pretreat cultured multipotent mesenchymal stromal cells (MSCs) prior to employing them for cell therapy is a main purpose of medical research. Many approaches have been investigated and resulted effective to prevent or counteract SC senescence in humans, as well as other animal models. In this work, we have reviewed the chance of using a number of herb-derived products as novel tools in the treatment of cell senescence, highlighting the efficacy of these agents, often still far from being clearly understood.
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5
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Richardson KJ, McNamee AP, Simmonds MJ. Mechanical sensitivity of red blood cells improves in individuals with hemochromatosis following venesection therapy. Transfusion 2020; 60:3001-3009. [PMID: 32939772 DOI: 10.1111/trf.16080] [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: 05/09/2020] [Revised: 06/22/2020] [Accepted: 08/11/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Individuals with hereditary hemochromatosis (HH) receive frequent blood withdrawals (ie, venesections) as part of their primary treatment to assist in normalizing blood iron levels. It remains unclear whether this source of blood is suitable for use in blood product development, as current data indicate that red blood cell (RBC) deformability, both before and after shear stress exposure, is impaired in individuals with HH, relative to healthy controls. Given that venesection therapy is known to significantly reduce circulating iron levels in individuals with HH, the current study examined whether venesection therapy is effective at improving RBC mechanical properties, both before and after shear stress exposure, in individuals with HH. STUDY DESIGN AND METHODS Blood samples were initially collected from untreated HH patients (age, 61 ± 9 years; 14% female) undergoing their first venesection, and then again during their second (approx. 9 weeks later) and third (approx. 16 weeks later) venesections. RBC deformability was measured at each time point with a commercial ektacytometer. Moreover, to determine cell responses to mechanical stimuli, the mechanical sensitivity of blood samples was determined at each time point. RESULTS The salient findings indicate that venesection therapy used for managing plasma ferritin concentration significantly improves the cellular deformability of RBC in individuals with HH. Further, the sensitivity of RBC to supraphysiological mechanical stress is decreased (ie, improved) in a dose-response fashion with routine venesection. CONCLUSION While cellular mechanics of RBC from individuals with HH are impaired when untreated, venesection therapy significantly improves cellular properties of RBC, supporting the use of venesections in blood product development from individuals with well-managed HH.
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Affiliation(s)
- Kieran J Richardson
- Biorheology Research Laboratory, Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
| | - Antony P McNamee
- Biorheology Research Laboratory, Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
| | - Michael J Simmonds
- Biorheology Research Laboratory, Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
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6
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West KA, Eder AF. Accepting hereditary hemochromatosis blood donors: ask not why, ask why not. Transfusion 2018; 56:2907-2909. [PMID: 27933629 DOI: 10.1111/trf.13919] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Accepted: 10/05/2016] [Indexed: 12/26/2022]
Affiliation(s)
- Kamille A West
- Department of Transfusion Medicine, Blood Services Section, National Institutes of Health Clinical Center, Bethesda, MD
| | - Anne F Eder
- Department of Transfusion Medicine, Blood Services Section, National Institutes of Health Clinical Center, Bethesda, MD
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7
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Adams P, Altes A, Brissot P, Butzeck B, Cabantchik I, Cançado R, Distante S, Evans P, Evans R, Ganz T, Girelli D, Hultcrantz R, McLaren G, Marris B, Milman N, Nemeth E, Nielsen P, Pineau B, Piperno A, Porto G, Prince D, Ryan J, Sanchez M, Santos P, Swinkels D, Teixeira E, Toska K, Vanclooster A, White D. Therapeutic recommendations in HFE hemochromatosis for p.Cys282Tyr (C282Y/C282Y) homozygous genotype. Hepatol Int 2018; 12:83-86. [PMID: 29589198 PMCID: PMC5904234 DOI: 10.1007/s12072-018-9855-0] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Accepted: 03/08/2018] [Indexed: 12/15/2022]
Abstract
Although guidelines are available for hereditary hemochromatosis, a high percentage of the recommendations within them are not shared between the different guidelines. Our main aim is to provide an objective, simple, brief, and practical set of recommendations about therapeutic aspects of HFE hemochromatosis for p.Cys282Tyr (C282Y/C282Y) homozygous genotype, based on the published scientific studies and guidelines, in a form that is reasonably comprehensible to patients and people without medical training. This final version was approved at the Hemochromatosis International meeting on 12th May 2017 in Los Angeles.
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Affiliation(s)
- Paul Adams
- University Hospital, Western University, London, ON, Canada
| | - Albert Altes
- Asociación Española de Hemocromatosis, Santa Coloma, Spain
| | - Pierre Brissot
- Inserm Unit 1241, University Hospital Pontchaillou, Rennes, France.
- HI - Haemochromatosis International, London, UK.
| | - Barbara Butzeck
- HI - Haemochromatosis International, London, UK
- European Federation of Associations of Patients with Haemochromatosis, Seine, France
- Haemochromatose-Vereinigung Deutschland, Hürth, Germany
| | - Ioav Cabantchik
- International Bioiron Society, Schaumburg, USA
- Hebrew University of Jerusalem, Jerusalem, Israel
| | - Rodolfo Cançado
- Division of Hematology, Santa Casa Medical School of Sao Paulo, Sao Paulo, SP, Brazil
| | - Sonia Distante
- Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway
| | - Patricia Evans
- HI - Haemochromatosis International, London, UK
- European Federation of Associations of Patients with Haemochromatosis, Seine, France
| | - Robert Evans
- HI - Haemochromatosis International, London, UK
- Department of Electronic and Computer Engineering, School of Engineering and Design, Brunel University, Uxbridge, UK
- The Haemochromatosis Society, Hertfordshire, UK
| | - Tomas Ganz
- David Geffen School of Medicine, UCLA, Los Angeles, CA, USA
| | - Domenico Girelli
- Department of Medicine, University of Verona Veneto Region Referral Center for Iron Metabolism Disorders, Verona, Italy
| | - Rolf Hultcrantz
- Department of Medicine, Unit of Gastroenterology and Rheumatology, Karolinska Institutet, Stockholm, Sweden
| | - Gordon McLaren
- Division of Hematology/Oncology, University of California, Irvine, CA, USA
| | - Ben Marris
- HI - Haemochromatosis International, London, UK
- Haemochromatosis Australia, Meridan Plains, Australia
| | - Nils Milman
- Danish Haemochromatosis Association, Copenhagen, Denmark
| | - Elizabeta Nemeth
- Center for Iron Disorders, David Geffen School of Medicine, UCLA, Los Angeles, CA, USA
| | - Peter Nielsen
- Institut für Biochemie und Molekulare Zellbiologie, University Medical Center Hamburg, Hamburg, Germany
| | - Brigitte Pineau
- Fédération Française des Associations de Malades de l'hémochromatose, Paris, France
| | - Alberto Piperno
- Department of Medicine and Surgery, Centre for Rare Diseases, University of Milano-Bicocca, Monza, Italy
- Association for the Study of Hemochromatosis and Iron Overload Diseases, Monza, Italy
| | - Graça Porto
- IBMC - Instituto de Biologia Molecular e Celular, Universidade do Porto, Porto, Portugal
- i3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal
- CHP-HSA - Centro Hospitalar do Porto - Hospital Santo António, Porto, Portugal
| | - Dianne Prince
- HI - Haemochromatosis International, London, UK
- Haemochromatosis Australia, Meridan Plains, Australia
| | - John Ryan
- Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Oxford, UK
| | - Mayka Sanchez
- Asociación Española de Hemocromatosis, Santa Coloma, Spain
| | - Paulo Santos
- HI - Haemochromatosis International, London, UK.
- Department of Pharmacology, Universidade Federal de Sao Paulo, São Paulo, Brazil.
- Laboratory of Genetics and Molecular Cardiology, Heart Institute (InCor), University of São Paulo Medical School, 03 de Maio St. INFAR, 4° andar - Vila Clementino, São Paulo, SP, Brazil.
| | - Dorine Swinkels
- Department of Laboratory Medicine, Radboudumc, Nijmegen, The Netherlands
| | - Emerência Teixeira
- HI - Haemochromatosis International, London, UK
- IBMC - Instituto de Biologia Molecular e Celular, Universidade do Porto, Porto, Portugal
- i3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal
- FCUP - Faculdade de Ciências da Universidade do Porto, Porto, Portugal
- APH - Associação Portuguesa de Hemocromatose, Porto, Portugal
| | - Ketil Toska
- HI - Haemochromatosis International, London, UK
- Norwegian Haemochromatosis Association, Bergen, Norway
| | - Annick Vanclooster
- University Hospitals Leuven, Gasthuisberg, Louvain, Belgium
- Haemochromatose Vereniging Vlaanderen, Leuven, Belgium
| | - Desley White
- HI - Haemochromatosis International, London, UK
- University of Plymouth, Plymouth, UK
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8
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Is it safe for people with epilepsy to donate blood? A systematic review. Epilepsy Res 2018; 139:143-149. [DOI: 10.1016/j.eplepsyres.2017.11.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Revised: 08/24/2017] [Accepted: 11/10/2017] [Indexed: 11/24/2022]
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9
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Braseth TA, Hervig T, Rosvik AS. Hemochromatosis and blood donation. Transfus Apher Sci 2017; 56:485-489. [PMID: 28610845 DOI: 10.1016/j.transci.2017.05.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The voluntary, unpaid, altruistic blood donor is a cornerstone of current transfusion medicine. The complexity of medical and ethical issues related to blood donation and hemochromatosis has led to a large number of studies related to the safety of the hemochromatosis donor and the quality of the blood components produced from these donations. The issue of accepting persons with HC as blood donors is diverting, both in Europe and worldwide and without joint guidelines. A questionnaire-based study was performed and mailed to all 25 blood bank leaders in Norway. Descriptive analysis was used to evaluate the data. Eight of 22 blood banks strictly followed national guidelines concerning persons with hemochromatosis. Other blood banks make local adjustments. 16 of 22 responding blood banks accept hemochromatosis donors and five do not, and one answered partly yes. The reasons the blood bank leaders supported the acceptance of hemochromatosis donors differ. Based on published papers and the present questionnaire, we believe that a clear definition of the "hemochromatosis donor" and guidelines with more detailed information on an acceptable donation regime would be important to overcome the weak points in blood donor eligibility criteria.
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Affiliation(s)
- Turid Aarhus Braseth
- Faculty of Engineering and Business Administration, Department of Biomedical Laboratory Sciences and Chemical Engineering, Bergen University College, pb 7030, 5020 Bergen, Norway; Western Norway University of Applied Sciences, Postbox 7030, 5020 Bergen, Norway
| | - Tor Hervig
- Institute of Clinical Sciences, University of Bergen, 5021 Bergen, Norway; Department of Immunology and transfusion medicine, Haukeland University Hospital, 5021 Bergen, Norway.
| | - Anne Synnove Rosvik
- Department of Biological Sciences Aalesund, Faculty of Natural Sciences and Technology, The Norwegian University of Science and Technology (NTNU) in Aalesund, PB1517, N-6025 Aalesund, Norway
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10
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Sut C, Hamzeh-Cognasse H, Laradi S, Bost V, Aubrège C, Acquart S, Vignal M, Boutahar N, Arthaud CA, Ange Eyraud M, Pozzetto B, Tiberghien P, Garraud O, Cognasse F. Properties of donated red blood cell components from patients with hereditary hemochromatosis. Transfusion 2016; 57:166-177. [PMID: 27807848 DOI: 10.1111/trf.13890] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Revised: 08/25/2016] [Accepted: 08/25/2016] [Indexed: 01/28/2023]
Abstract
BACKGROUND Red blood cells (RBCs) contain large amounts of iron, and periodic therapeutic phlebotomy is thus the main treatment for hereditary hemochromatosis (HH). However, the donation of therapeutic phlebotomy products from asymptomatic patients for transfusion purposes remains controversial. In this study, we compared the quality of RBCs obtained from HH patients with those of non-HH RBCs, within the allowed 42-day storage period. STUDY DESIGN AND METHODS RBCs were obtained from HH patient donors and random regular blood donors by whole blood collection. RBCs were stored for up to 42 days, according to national regulations and standard blood bank conditions in France. The following variables were assessed: hematologic and biochemical results, RBC membrane and soluble inflammatory markers, and the proinflammatory potential of HH RBC supernatant toward endothelial cells in an in vitro model. RESULTS There were no major differences between the two groups in terms of biophysical, biochemical, or soluble immunomodulatory factors. However, we observed small but significant differences in changes in RBC membrane proteins during storage, including increased phosphatidylserine expression and decreased hemolysis in HH compared with normal RBCs. However, there were no differences in terms of bioactivity of soluble immunomodulatory factors in the RBC supernatant during storage between HH and control donors, as determined by their effects on endothelial cells in vitro. CONCLUSIONS These in vitro studies suggest that RBCs from HH patients appear, while exhibiting subtle differences, to be suitable for transfusion purposes according to currently accepted criteria.
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Affiliation(s)
- Caroline Sut
- Etablissement Français du Sang Rhône-Alpes-Auvergne.,Université de Lyon, GIMAP-EA3064
| | | | - Sandrine Laradi
- Etablissement Français du Sang Rhône-Alpes-Auvergne.,Université de Lyon, GIMAP-EA3064
| | - Vincent Bost
- Etablissement Français du Sang Rhône-Alpes-Auvergne
| | | | | | | | - Nadia Boutahar
- Département de Biochimie Hôpital Nord, CHU de Saint-Etienne, Saint Etienne
| | | | | | - Bruno Pozzetto
- Université de Lyon, GIMAP-EA3064.,Département de Microbiologie Hôpital Nord, CHU de Saint-Etienne, Saint Etienne, France
| | - Pierre Tiberghien
- UMR1098, INSERM, Etablissement Français du Sang, Université de Franche-Comté, Besançon, France.,Etablissement Français du Sang, Saint-Denis, France
| | - Olivier Garraud
- Université de Lyon, GIMAP-EA3064.,Institut National de Transfusion Sanguine (INTS), Paris, France
| | - Fabrice Cognasse
- Etablissement Français du Sang Rhône-Alpes-Auvergne.,Université de Lyon, GIMAP-EA3064
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11
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Hoad V, Bentley P, Bell B, Pathak P, Chan HT, Keller A. The infectious disease blood safety risk of Australian hemochromatosis donations. Transfusion 2016; 56:2934-2940. [PMID: 27662424 DOI: 10.1111/trf.13802] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Revised: 07/14/2016] [Accepted: 07/17/2016] [Indexed: 12/12/2022]
Abstract
BACKGROUND It has been suggested that blood donors with hereditary hemochromatosis may pose an increased infectious disease risk and adversely affect recipient outcomes. This study compares the infectious disease risk of whole blood (WB) donors enrolled as therapeutic (T) donors to voluntary WB donors to evaluate the safety of blood products provided by the T donors. STUDY DESIGN AND METHODS This was a retrospective cohort study of all WB donations at the Australian Red Cross Blood Service who donated between January 1, 2011, and December 31, 2013, comparing a yearly mean of 11,789 T donors with 107,773 total donations and a yearly mean of 468,889 voluntary WB donors with 2,584,705 total donations. We compared postdonation notification of infectious illnesses, bacterial contamination screening results, and positive tests for blood borne viruses in T and WB donors. RESULTS Rates of transfusion-transmissible infections in donations destined for component manufacture were significantly lower in therapeutic donations compared to voluntary donations (8.4 vs. 21.6 per 100,000 donations). Bacterial contamination (43.0 vs. 45.9 per 100,000 donations) and postdonation illness reporting (136.2 vs. 110.8 per 100,000 donations) were similar in both cohorts. CONCLUSIONS The Australian therapeutic venisection program enables T donors to provide a safe and acceptable source of donated WB that has a low infectious disease risk profile.
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Affiliation(s)
- Veronica Hoad
- Australian Red Cross Blood Service, Perth, Western Australia, Australia
| | - Peter Bentley
- Australian Red Cross Blood Service, Perth, Western Australia, Australia
| | - Barbara Bell
- Australian Red Cross Blood Service, Perth, Western Australia, Australia
| | - Praveen Pathak
- Australian Red Cross Blood Service, Perth, Western Australia, Australia
| | - Hiu Tat Chan
- Australian Red Cross Blood Service, Perth, Western Australia, Australia
| | - Anthony Keller
- Australian Red Cross Blood Service, Perth, Western Australia, Australia
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12
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Abstract
Quality, safety, risks and risk management are currently the leading words in transfusion medicine, and several approaches are necessary to correctly evaluate the fundamental basis of blood transfusion. Ethics is probably the most focused approach with which to examine the inconsistencies and conflicts of interest of the various stakeholders involved in the transfusion medicine field. In this short review, the authors will present some aspects of ethics related to blood transfusion, particularly those involving blood donation.
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13
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Garraud O, Tissot JD. Bloodletting for non-medical reasons: what about safety and quality? Transfus Med 2015; 25:424-5. [PMID: 26299397 DOI: 10.1111/tme.12234] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2015] [Accepted: 07/30/2015] [Indexed: 12/26/2022]
Affiliation(s)
- O Garraud
- Institut National de la Transfusion Sanguine, Paris, France.,Faculty of Medicine, University of Lyon, Saint-Etienne, France
| | - J D Tissot
- Transfusion Interrégionale CRS, Site d'Epalinges, Epalinges, Switzerland
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Marrow B, Clarkson J, Chapman CE, Masson S. Facilitation of blood donation amongst haemochromatosis patients. Transfus Med 2015; 25:239-42. [DOI: 10.1111/tme.12182] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2014] [Revised: 02/02/2015] [Accepted: 02/23/2015] [Indexed: 01/15/2023]
Affiliation(s)
- B. Marrow
- Liver Transplant Unit, Freeman Hospital
| | | | | | - S. Masson
- Liver Transplant Unit, Freeman Hospital
- Institute of Cellular Medicine, Newcastle University Medical School; Newcastle UK
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15
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Second Evidence Aid Conference: prioritizing evidence in disaster aid. Disaster Med Public Health Prep 2014; 7:593-6. [PMID: 24444132 DOI: 10.1017/dmp.2013.109] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The Second Evidence Aid Conference took place in Brussels, Belgium, in October 2012, jointly organized by Evidence Aid and the Belgian Red Cross-Flanders. It provided an opportunity to build on the discussions from the 2011 First Evidence Aid Conference in Oxford, England, and prioritize the future work of Evidence Aid. Within the plenary presentations, discussions, and small work groups, the more than 80 international participants addressed issues regarding the need, use, and prioritization of evidence. Three parallel workshops focused on the prioritization of research, systematic reviews, and data to be collected during disasters, leading to a suggested prioritization framework and a commitment to identify key areas for evidence in disasters. Working with a wide variety of people and organizations from the disaster and humanitarian sectors, Evidence Aid will take this framework and develop a list of top priority questions in need of research and systematic reviews. Although Evidence Aid will not be able to address all of the research questions that will be identified in this process, it will collect them for sharing with relevant agencies. (Disaster Med Public Health Preparedness. 2013;7:593-596).
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Graves KD, Hay JL, O'Neill SC. The promise of using personalized genomic information to promote behavior change: is the debate over, or just beginning? Per Med 2014; 11:173-185. [PMID: 29751381 DOI: 10.2217/pme.13.110] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Over recent years, significant debate has centered on whether and how communication of personalized genomic risk information can positively influence health behavior change. Several thoughtful commentaries have cautioned that efforts to incorporate genomic risk feedback to motivate health behavior change have had little success. As a field, we should consider the reasons for this limited success and be strategic in the next steps for this line of research. In this article, we consider several reasons that prior research that integrates personalized genomic information has had relative degrees of success in changing or maintaining health behaviors. We suggest ways forward and outline the possibilities presented by emerging technologies and novel approaches in translational genomic research.
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Affiliation(s)
- Kristi D Graves
- Department of Oncology, Jess & Mildred Fisher Center for Familial Cancer Research, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, USA
| | - Jennifer L Hay
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | - Suzanne C O'Neill
- Department of Oncology, Jess & Mildred Fisher Center for Familial Cancer Research, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, USA
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18
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Stefashyna O, Stern M, Infanti L, Holbro A, Tichelli A, Buser A, O'Meara A. Pattern of care of blood donors with early-uncomplicated hereditary haemochromatosis in a Swiss blood donation centre. Vox Sang 2013; 106:111-7. [DOI: 10.1111/vox.12078] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2013] [Revised: 07/27/2013] [Accepted: 08/05/2013] [Indexed: 12/27/2022]
Affiliation(s)
- O. Stefashyna
- Blood Transfusion Centre; Swiss Red Cross; Basel Switzerland
| | - M. Stern
- Hematology; University Hospital; Basel Switzerland
| | - L. Infanti
- Blood Transfusion Centre; Swiss Red Cross; Basel Switzerland
| | - A. Holbro
- Blood Transfusion Centre; Swiss Red Cross; Basel Switzerland
| | - A. Tichelli
- Hematology; University Hospital; Basel Switzerland
| | - A. Buser
- Blood Transfusion Centre; Swiss Red Cross; Basel Switzerland
| | - A. O'Meara
- Hematology; University Hospital; Basel Switzerland
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Pauwels NS, De Buck E, Compernolle V, Vandekerckhove P. Worldwide policies on haemochromatosis and blood donation: a survey among blood services. Vox Sang 2013; 105:121-8. [PMID: 23663183 DOI: 10.1111/vox.12038] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2012] [Revised: 03/04/2013] [Accepted: 03/13/2013] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND OBJECTIVES Haemochromatosis (HC) is a disorder of iron metabolism, requiring frequent phlebotomy to normalize high serum iron levels. There is currently no consensus relating to the eligibility of these patients to donate blood for transfusion. To gain a better understanding of the policies worldwide, a survey amongst blood services was performed. MATERIALS AND METHODS A web-based questionnaire was developed and distributed among 44 blood services in 41 countries to identify the different policies relating to patients with HC and blood donation. RESULTS Respondents from 35 blood services (80%) of 33 countries completed the questionnaire. In 24 blood services among them (69%), individuals with genetic susceptibility for HC and/or patients with HC are accepted as blood donors. In approximately one-third of these blood centres (33%), genetic carriers/patients are allowed to donate blood more frequently than regular donors. Prescription from/approval by the patient's treating physician and/or a donor physician is required in the majority of the blood services (87%). Similar policies were identified in a few countries; however, in general, the policies regarding blood donation from patients with HC remain widely variable. CONCLUSION The results of our survey demonstrate large differences in the blood donation policies regarding carriers/patients with HC illustrating the need for uniform evidence-based and cost-effective policies which could benefit both HC patients and the blood supply around the world.
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Affiliation(s)
- N S Pauwels
- Centre for Evidence-Based Practice, Belgian Red Cross-Flanders, Mechelen, Belgium.
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