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Acharya D, Gaussen A, Poder TG, Lambert G, Renaud C, Nawej K, Lewin A. Associated criteria used in investigating suspected septic transfusion reactions: A scoping review. Vox Sang 2023; 118:1029-1037. [PMID: 37691585 DOI: 10.1111/vox.13521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 08/01/2023] [Accepted: 08/17/2023] [Indexed: 09/12/2023]
Abstract
BACKGROUND AND OBJECTIVES Septic transfusion reactions (STRs) occur as a result of bacterial contamination of blood or blood products, resulting in sepsis. This scoping review aimed to identify, explore and map the available literature on the STR criteria triggering the investigation of STR. MATERIALS AND METHODS Four electronic databases (MEDLINE, Web of Science, Science Direct, Embase) were searched to retrieve scientific literature reporting such criteria, published from 1 January 2000 to 5 May 2022. Grey literature was also searched from open web sources. RESULTS Of 1052 references identified, 43 (21 peer-reviewed and 22 grey literature) met the eligibility criteria for inclusion and data extraction after full article screening. Of them, most (27/43, 62.79%) were found to report a single set of criteria, and only two reported four or more sets of criteria. The analysis of 66 sets of criteria collected from the selected references revealed 57 different sets. A few sets of criteria used only one sign and symptom (s/s) (12.12%, n = 8), whereas 16 sets used 7-15 s/s (n = 16/66; 24.24%). Of the total 319 occurrences of s/s associated with the 66 sets of criteria, post-transfusion hyperthermia, body temperature increase and hypotension were the most common s/s categories. Of all the literature available, only one study tested the diagnostic accuracy of the STR criteria. CONCLUSION This scoping review revealed a substantial variation in criteria used to identify suspected STR. Consequently, conducting further studies to enhance the diagnostic accuracy of these criteria, which trigger STR investigations, is imperative for advancing clinical practice.
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Affiliation(s)
- Dilaram Acharya
- Department of Management, Evaluation and Health Policy, School of Public Health, Université de Montréal, Montréal, Québec, Canada
- Medical Affairs and Innovation, Héma-Québec, Montréal, Québec, Canada
| | - Amaury Gaussen
- Medical Affairs and Innovation, Héma-Québec, Montréal, Québec, Canada
| | - Thomas G Poder
- Department of Management, Evaluation and Health Policy, School of Public Health, Université de Montréal, Montréal, Québec, Canada
- Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal, CIUSSS de l'Est-de-L'île-de-Montréal, Montréal, Québec, Canada
| | - Gilles Lambert
- Direction régionale de santé publique, Centre intégré universitaire de santé et de services sociaux du Centre-Sud-de-l'Île-de-Montréal du Québec, Montréal, Québec, Canada
- Direction des risques biologiques et de la santé au travail, Institut national de santé publique du Québec, Montréal, Québec, Canada
| | - Christian Renaud
- Medical Affairs and Innovation, Héma-Québec, Montréal, Québec, Canada
| | - Karlitaj Nawej
- Direction des risques biologiques et de la santé au travail, Institut national de santé publique du Québec, Montréal, Québec, Canada
| | - Antoine Lewin
- Medical Affairs and Innovation, Héma-Québec, Montréal, Québec, Canada
- Faculty of Medicine and Health Science, Université de Sherbrooke, Sherbrooke, Québec, Canada
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2
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Wang Y, Rao Q, Li X. Adverse transfusion reactions and what we can do. Expert Rev Hematol 2022; 15:711-726. [PMID: 35950450 DOI: 10.1080/17474086.2022.2112564] [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: 11/04/2022]
Abstract
INTRODUCTION Transfusions of blood and blood components have inherent risks and the ensuing adverse reactions. It is very important to understand the adverse reactions of blood transfusion comprehensively for ensuring the safety of any future transfusions. AREAS COVERED According to the time of onset, adverse reactions of blood transfusion are divided into immediate and delayed transfusion reactions. In acute transfusion reactions, timely identification and immediate cessation of transfusion is critical. Vigilance is required to distinguish delayed responses or reactions that present non-specific signs and symptoms. In this review, we present the progress of mechanism, clinical characteristics and management of commonly encountered transfusion reactions. EXPERT OPINION The incidence of many transfusion-related adverse events is decreasing, but threats to transfusion safety are always emerging. It is particularly important for clinicians and blood transfusion staff to recognize the causes, symptoms and treatment methods of adverse blood transfusion reactions to improve the safety. In the future, at-risk patients will be better identified and can benefit from more closely matched blood components.
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Affiliation(s)
- Yajie Wang
- Department of Blood Transfusion, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - Quan Rao
- Department of General Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - Xiaofei Li
- Department of Blood Transfusion, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
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3
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Ness PM. The pursuit of platelet safety. Transfusion 2022; 62:1302-1304. [PMID: 35506509 PMCID: PMC9320799 DOI: 10.1111/trf.16898] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 04/25/2022] [Indexed: 01/01/2023]
Affiliation(s)
- Paul M Ness
- Transfusion Medicine Division, Department of Pathology, Johns Hopkins Medical Institutions, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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4
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Delaney M, Karam O, Lieberman L, Steffen K, Muszynski JA, Goel R, Bateman ST, Parker RI, Nellis ME, Remy KE. What Laboratory Tests and Physiologic Triggers Should Guide the Decision to Administer a Platelet or Plasma Transfusion in Critically Ill Children and What Product Attributes Are Optimal to Guide Specific Product Selection? From the Transfusion and Anemia EXpertise Initiative-Control/Avoidance of Bleeding. Pediatr Crit Care Med 2022; 23:e1-e13. [PMID: 34989701 PMCID: PMC8769352 DOI: 10.1097/pcc.0000000000002854] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
OBJECTIVES To present consensus statements and supporting literature for plasma and platelet product variables and related laboratory testing for transfusions in general critically ill children from the Transfusion and Anemia EXpertise Initiative-Control/Avoidance of Bleeding. DESIGN Systematic review and consensus conference of international, multidisciplinary experts in platelet and plasma transfusion management of critically ill children. SETTING Not applicable. PATIENTS Critically ill pediatric patients at risk of bleeding and receiving plasma and/or platelet transfusions. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS A panel of 10 experts developed evidence-based and, when evidence was insufficient, expert-based statements for laboratory testing and blood product attributes for platelet and plasma transfusions. These statements were reviewed and ratified by the 29 Transfusion and Anemia EXpertise Initiative - Control/Avoidance of Bleeding experts. A systematic review was conducted using MEDLINE, EMBASE, and Cochrane Library databases, from inception to December 2020. Consensus was obtained using the Research and Development/University of California, Los Angeles Appropriateness Method. Results were summarized using the Grading of Recommendations Assessment, Development, and Evaluation method. We developed five expert consensus statements and two recommendations in answer to two questions: what laboratory tests and physiologic triggers should guide the decision to administer a platelet or plasma transfusion in critically ill children; and what product attributes are optimal to guide specific product selection? CONCLUSIONS The Transfusion and Anemia EXpertise Initiative-Control/Avoidance of Bleeding program provides some guidance and expert consensus for the laboratory and blood product attributes used for decision-making for plasma and platelet transfusions in critically ill pediatric patients.
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Affiliation(s)
- Meghan Delaney
- Division of Pathology & Laboratory Medicine, Children’s National Hospital; Department of Pathology & Pediatrics, The George Washington University Health Sciences, Washington, DC
| | - Oliver Karam
- Division of Pediatric Critical Care Medicine, Children’s Hospital of Richmond at VCU, Richmond, VA
| | - Lani Lieberman
- Department of Clinical Pathology, University Health Network Hospitals. Department of Laboratory Medicine & Pathobiology; University of Toronto, Toronto, Canada
| | - Katherine Steffen
- Department of Pediatrics, Division of Pediatric Critical Care Medicine, Stanford University, Palo Alto, CA
| | - Jennifer A. Muszynski
- Department of Pediatrics, Division of Critical Care Medicine, Nationwide Children’s Hospital and the Ohio State University College of Medicine, Columbus, OH
| | - Ruchika Goel
- Division of Transfusion Medicine, Department of Pathology, Johns Hopkins University, Baltimore, MD
| | - Scot T. Bateman
- Division of Pediatric Critical Care, Department of Pediatrics, University of Massachusetts Medical School, Worcester, MA
| | - Robert I. Parker
- Emeritus, Renaissance School of Medicine, State University of New York at Stony Brook, Stony Brook, NY
| | - Marianne E. Nellis
- Pediatric Critical Care Medicine, NY Presbyterian Hospital-Weill Cornell Medicine, New York, NY
| | - Kenneth E. Remy
- Department of Pediatrics, Division of Critical Care Medicine, Washington University in St. Louis School of Medicine, St. Louis, MO
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Rajput S, Makroo RN, Chowdhry M, Thakur UK. Changes in hematological parameters post plateletpheresis: Single center study from North India. Transfus Apher Sci 2021; 60:103283. [PMID: 34625349 DOI: 10.1016/j.transci.2021.103283] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 09/01/2021] [Accepted: 09/13/2021] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Increasing demand for platelet transfusion implies the need to recruit greater numbers of donors. We planned this study to evaluate donor safety issues with regards to changes in hematological values after plateletpheresis to improve donor safety and satisfaction. MATERIALS & METHODS The study was conducted on 1000 healthy plateletpheresis donors over a period of 24 months. Pre- and post-apheresis hematological parameters of donors were analyzed. Recovery of platelet was also observed in plateletpheresis donor who returned to after 48 h. RESULT We observed that the Platelet counts decreased significantly in the plateletpheresis donors (p=<0.001) after each procedure and there was a non-significant decline in Hb (p = 0.34), Hct (p = 0.44) and RBCs (p = 0.08). The hematological changes were within the normal limits with no clinical evidence of anemia or thrombocytopenia. Recovery of platelets in plateletpheresis donors after 48 h was observed in 30 donors (0.03 %). CONCLUSION A significant immediate post procedure decrease in platelet count was observed in our study but the recovery of platelets was adequate suggesting next platelet collection from the donor can be safely done after a period of 48 h.
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Affiliation(s)
- Saroj Rajput
- Department of Transfusion Medicine, Molecular Biology and Transplant Immunology, Indraprastha Apollo Hospital, Delhi-Mathura Road, Sarita Vihar, New Delhi, 110076, India.
| | - Raj Nath Makroo
- Department of Transfusion Medicine, Molecular Biology and Transplant Immunology, Indraprastha Apollo Hospital, Delhi-Mathura Road, Sarita Vihar, New Delhi, 110076, India
| | - Mohit Chowdhry
- Department of Transfusion Medicine, Molecular Biology and Transplant Immunology, Indraprastha Apollo Hospital, Delhi-Mathura Road, Sarita Vihar, New Delhi, 110076, India
| | - Uday K Thakur
- Department of Transfusion Medicine, Molecular Biology and Transplant Immunology, Indraprastha Apollo Hospital, Delhi-Mathura Road, Sarita Vihar, New Delhi, 110076, India
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Lasky B, Nolasco J, Graff J, Ward DC, Ziman A, McGonigle AM. Pathogen-reduced platelets in pediatric and neonatal patients: Demographics, transfusion rates, and transfusion reactions. Transfusion 2021; 61:2869-2876. [PMID: 34448199 DOI: 10.1111/trf.16639] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 07/21/2021] [Accepted: 07/22/2021] [Indexed: 12/18/2022]
Abstract
BACKGROUND Pathogen-reduced platelets (PR PLT) are the emerging standard for proactive transfusion-transmitted infection (TTI) mitigation. There is, however, continued hesitation to transfuse PR PLT in children due to limited published data. We report demographics, rates of transfusion, and transfusion reactions (TR) associated with FDA-approved PR PLT in pediatric and neonatal patients at an academic medical center. METHODS Retrospective review was performed for patients <18 years receiving at least one platelet over a 300-day period at a large, tertiary care hospital. Patients were transfused PR or conventional (CONV) PLT, based on inventory availability. Statistical analysis was performed using Fisher Exact Test. RESULTS During the study period, 191 patients received 1010 platelet transfusions (892 units). Sixty-eight patients received PR PLT only (1.3 units/patient, 95% confidence interval [CI] 1.1-1.5; 1.8 transfusions/patient, 95% CI 1.4-2.2), and 56 patients received CONV PLT only (1.4 units/patient, 95% CI 1.1-1.7; 1.6 transfusions/patient, 95% CI 1.3-1.9). Patients with hematologic malignancies undergoing chemotherapy/radiation and allogeneic hematopoietic stem cell transplant received the most platelet transfusions and more commonly received both platelet types. Of 506 PR PLT units, 5 TRs occurred; 386 CONV PLT resulted in two TRs (p = .7052). Of 51 neonates, 37 received PR PLT without adverse events, including 13 receiving phototherapy. No TTIs were identified in any group. CONCLUSION There was no significant difference in rates of transfusion or TRs between PR and CONV PLT. Our study provides additional evidence that PR PLT can be transfused to pediatric and neonatal patients without increasing the risk of acute adverse events.
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Affiliation(s)
- Baia Lasky
- Division of Biomedical Services, American Red Cross, Biomedical Services, Washington, District of Columbia, USA
| | - Joseph Nolasco
- 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, Los Angeles, California, USA
| | - Jazmin Graff
- Department of Anesthesiology and Perioperative Medicine, Oregon Health and Science University, Portland, Oregon, USA
| | - Dawn C Ward
- 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, Los Angeles, California, USA
| | - 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, Los Angeles, California, USA
| | - Andrea M McGonigle
- 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, Los Angeles, California, USA
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7
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Koepsell S. Complications of Transfusion. Transfus Med 2021. [DOI: 10.1002/9781119599586.ch16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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8
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The Play of Citrate Infusion with Calcium in Plateletpheresis Donors. Indian J Hematol Blood Transfus 2020; 37:295-301. [PMID: 33867737 DOI: 10.1007/s12288-020-01339-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Accepted: 08/17/2020] [Indexed: 10/23/2022] Open
Abstract
Citrate is the anticoagulant of choice for plateletpheresis. Citrate toxicity is common during plateletpheresis as citrate chelates calcium and causes hypocalcemia in donors. We have conducted this study to analyze the effects of routine citrate infusion during plateletpheresis on laboratory and clinical parameters. We also compared the dose of citrate delivered to donors during plateletpheresis using two different cell separators as Haemonetics MCS + and Trima Accel. The study was conducted on 50 plateletpheresis donors who were eligible for donation. Donor demographics and baseline parameters were recorded. Pre, mid and post-procedure blood samples were collected for hematological and biochemical analysis. We found a significant decrease in baseline iCa (1.23 ± 0.07 mmol/L) from start to mid-procedure (1.19 ± 0.006 mmol/L) which recovered at 30 min post procedure (1.2 ± 0.01 mmol/L). The incidence of citrate toxicity was 10%. In donors with citrate toxicity, the post-procedure recovery of iCa was not seen and there was a further decrease in iCa levels. We also found a significant fall in Hb and platelet count post plateletpheresis. We observed that lower PLT counts (< 200 × 103/µL) necessitated higher blood volume processing and therefore a higher anticoagulant (citrate) dose. The Trima Accel cell separator reached platelet target yield faster but with a higher citrate dose as compared to Hemonetics MCS + . Ionized calcium decreases significantly during plateletpheresis but recovers soon after the completion of the procedure. Serious adverse events were not observed during plateletpheresis. The mild citrate toxicity which occurred was easily managed by slowing the procedure and administering oral calcium to donors. Trima Accel and Hemonetics MCS + both collected platelets efficiently, with minimal donor discomfort.
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9
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Satake M, Kozakai M, Matsumoto M, Matsubayashi K, Taira R, Goto N. Platelet safety strategies in Japan: impact of short shelf life on the incidence of septic reactions. Transfusion 2020; 60:731-738. [PMID: 32119134 DOI: 10.1111/trf.15733] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2019] [Revised: 01/17/2020] [Accepted: 01/29/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND Transfusion-transmitted bacterial infections (TTBIs) often have serious consequences for patients. The Japanese Red Cross (JRC) has not implemented culture screening for platelet concentrate (PC), but it has maintained a shelf life of 85 hours for PC. STUDY DESIGN AND METHODS The JRC collected reports of suspected TTBI and investigated causal relationships using PC samples and patient blood samples. PCs showing apparent abnormalities were retrieved and cultured and analyzed for bacterial growth. RESULTS The JRC analyzed 86 samples available from 135 transfused PCs with suspected TTBIs that were collected over the past 12 years; 17 (19.8%) were culture-positive. One, 6, and 10 TTBIs developed in patients on Days 1, 2, and 3 after PC collection, respectively. Assuming that PC is transfused on the day of issue, the TTBI risk was fourfold higher on Day 3 than on Day 2, after adjusting the TTBI incidence for the number of PCs issued per day. Compared with the model of issuing all PCs on Day 3, issuing PCs with the current distribution of storage time could have decreased the TTBI incidence by 56%. During the past 8 years, the JRC retrieved 960 PC units because of apparent abnormalities, 2.8% of which were culture-positive. CONCLUSION The short shelf life of PC is associated with a low incidence of reported TTBIs, more than half of which occurred on Day 3 relative to earlier time points. Visual inspection of PC before transfusion is crucial in detecting bacterially contaminated PC despite its low positive predictive value.
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Affiliation(s)
- Masahiro Satake
- Central Blood Institute, Japanese Red Cross, Tokyo, Japan.,Blood Service Headquarters, Japanese Red Cross, Tokyo, Japan
| | - Moe Kozakai
- Central Blood Institute, Japanese Red Cross, Tokyo, Japan
| | - Mami Matsumoto
- Central Blood Institute, Japanese Red Cross, Tokyo, Japan
| | | | - Rikizo Taira
- Blood Service Headquarters, Japanese Red Cross, Tokyo, Japan
| | - Naoko Goto
- Blood Service Headquarters, Japanese Red Cross, Tokyo, Japan
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10
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Zhu L, Li C, Wang D. A novel ultraviolet illumination used in riboflavin photochemical method to inactivate drug-resistant bacteria in blood components. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY B-BIOLOGY 2020; 204:111782. [PMID: 32062389 DOI: 10.1016/j.jphotobiol.2020.111782] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Revised: 01/06/2020] [Accepted: 01/07/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Ultraviolet (UV) fluorescent lamp (FL) was applied in mainstream riboflavin photochemical method (RPM) to inactivate pathogens in blood components. Low UV irradiance emitted by UV-FL resulted in more time to achieve effective inactivation. MATERIALS AND METHODS A novel light emitting diode (LED) UV illumination with adjustable irradiance was developed by us. Two strains of drug-resistant bacteria (DRB), pan-drug resistant Acinetobacter baumannii (PDRAB) and methicillin-resistant Staphylococcus aureus (MRSA) were cultured and used for evaluating the inactivation effectiveness of RPM using UV-LED or UV-FL against DRB in plasma or platelets. Three plasma factors and four platelet parameters were measured after treatments. RESULTS There was a linear relationship between UV-LED irradiance and electric current, the minimum UV irradiance was 24 mW/cm2, and the maximum was 258 mW/cm2. At the same UV dose of 15 J/cm2, inactivation effectiveness of UV-LED with 258 mW/cm2 against PDRAB in plasma or platelets were comparable to that of UV-FL with 16 mW/cm2, both above 98%. UV-FL treatment required 10-15 min, but UV-LED only required 1-2 min. However, MRSA showed a resistance to UV-LED (inactivation effectiveness was around 40%) compared with UV-FL (inactivation effectiveness was above 98%). The retention of fibrinogen, factor V, factor VII in plasma and platelet counts in platelets with UV-LED treatment were significantly higher than UV-FL at the same UV dose. CONCLUSION The treatment of RPM using UV-LED with high UV irradiance was able to dramatically shorten inactivation time against PDRAB in plasma or platelets and improve retention of blood components compared with UV-FL.
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Affiliation(s)
- Liguo Zhu
- Institute of Blood Transfusion, Peking Union Medical College and Chinese Academy of Medical Sciences, No.26 Huacai Road, Chenghua District, Chengdu, China.
| | - Changqing Li
- Institute of Blood Transfusion, Peking Union Medical College and Chinese Academy of Medical Sciences, No.26 Huacai Road, Chenghua District, Chengdu, China.
| | - Deqing Wang
- Department of Blood Transfusion, Chinese PLA General Hospital, No.28 Fuxing Road, Haidian District, Beijing, China.
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Scorer TG, Reddoch-Cardenas KM, Thomas KA, Cap AP, Spinella PC. Therapeutic Utility of Cold-Stored Platelets or Cold-Stored Whole Blood for the Bleeding Hematology-Oncology Patient. Hematol Oncol Clin North Am 2019; 33:873-885. [PMID: 31466610 DOI: 10.1016/j.hoc.2019.05.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Bleeding related to thrombocytopenia is common in hematology-oncology patients. Platelets stored at room temperature (RTPs) are the current standard of care. Platelets stored in the cold (CSPs) have enhanced hemostatic function relative to RTPs. CSPs were reported to reduce bleeding in hematology-oncology patients. Recent studies have confirmed the enhanced hemostatic properties of CSPs. CSPs may be the better therapeutic option for this population. CSPs may also offer a preferable immune profile, reduced thrombotic risk, and reduced transfusion-transmitted infection risk. The logistical advantages of CSPs would improve outcomes for many patients who currently cannot access platelet transfusions.
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Affiliation(s)
- Thomas G Scorer
- School of Cellular and Molecular Medicine, University of Bristol, Bristol Royal Infirmary, Research Floor 7, Queens Building, Bristol, BS2 8HW, UK; Centre of Defence Pathology, Royal Centre for Defence Medicine, Birmingham, UK.
| | - Kristin M Reddoch-Cardenas
- Coagulation and Blood Research, U.S. Army Institute of Surgical Research, 3698 Chambers Pass, BLDG 3610, JBSA-Fort Sam Houston, San Antonio, TX 78234, USA
| | - Kimberly A Thomas
- Department of Pediatrics, Division of Pediatric Critical Care Medicine, Washington University School of Medicine, 660 South Euclid Avenue, St. Louis, MO 63110, USA
| | - Andrew P Cap
- Coagulation and Blood Research, U.S. Army Institute of Surgical Research, 3698 Chambers Pass, BLDG 3610, JBSA-Fort Sam Houston, San Antonio, TX 78234, USA
| | - Philip C Spinella
- Department of Pediatrics, Division of Pediatric Critical Care Medicine, Washington University School of Medicine, 660 South Euclid Avenue, St. Louis, MO 63110, USA
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Desroches M, Clermont O, Lafeuillade B, Rodriguez C, Darty M, Royer G, Bouvet O, Ounnoughene N, Noizat-Pirenne F, Denamur E, Decousser JW. Genotypic and phenotypic characteristics of Escherichia coli involved in transfusion-transmitted bacterial infections: implications for preventive strategies. Transfusion 2019; 58:1940-1950. [PMID: 30198609 DOI: 10.1111/trf.14812] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Revised: 03/05/2018] [Accepted: 04/09/2018] [Indexed: 01/23/2023]
Abstract
BACKGROUND Transfusion-transmitted bacterial infections (TTBIs) are the main residual infectious complications of transfusions. Escherichia coli and platelet (PLT) concentrates may be epidemiologically associated, leading to severe, if not lethal, TTBIs. We investigated the genotypic and phenotypic reasons for this clinically deleterious combination. STUDY DESIGN AND METHODS We investigated a French national E. coli strain collection related to six independent episodes of TTBIs. Their phenotypic characterizations included antibiotic susceptibility testing, growth testing under different culture conditions, serum survival assays, and virulence in a sepsis mouse model. Their genotypic characterizations included polymerase chain reaction phylotyping, whole genome sequencing, and a subsequent in silico analysis. RESULTS We highlighted a selection process of highly extraintestinal virulent strains, mainly belonging to the B2 phylogroup, adapted to the hostile environment (high citrate concentration and a bactericidal serum effect) of apheresis-collected platelet concentrates (PCs). Compared to controls, the E. coli TTBI strains grew faster in the PCs due to a superior ability to capture iron. The in vitro growth performances were highly compatible with blood-derived product real-life conditions, including storage conditions and delays. The consistent serum resistance of TTBI strains promotes their survival in both the donor's and the receiver's blood and in the PCs. CONCLUSION This study pointed out that E. coli strains responsible for TTBI exhibit very specific traits. They belong to the extraintestinal pathogenic phylogroups and have a high intrinsic virulence. They can be resistant to complement, capture iron, and grow in the apheresis-collected PCs. These findings therefore support the reinforcement of the postdonation information.
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Affiliation(s)
- Marine Desroches
- INSERM UMR1137, IAME, Paris Diderot University, Faculty of Medicine Xavier Bichat, Paris, France.,Department of Bacteriology and Infection Control, University Hospital Henri Mondor, Assistance Publique-Hôpitaux de Paris, Créteil, France
| | - Olivier Clermont
- INSERM UMR1137, IAME, Paris Diderot University, Faculty of Medicine Xavier Bichat, Paris, France
| | - Bruno Lafeuillade
- Rhône-Alpes French Blood Establishment-Grenoble Site, La Tronche, France
| | - Christophe Rodriguez
- Next Generation Sequencing Platform, University Hospital Henri Mondor, Créteil, France
| | - Mélanie Darty
- Next Generation Sequencing Platform, University Hospital Henri Mondor, Créteil, France
| | - Guilhem Royer
- INSERM UMR1137, IAME, Paris Diderot University, Faculty of Medicine Xavier Bichat, Paris, France.,Department of Bacteriology and Infection Control, University Hospital Henri Mondor, Assistance Publique-Hôpitaux de Paris, Créteil, France
| | - Odile Bouvet
- INSERM UMR1137, IAME, Paris Diderot University, Faculty of Medicine Xavier Bichat, Paris, France
| | | | | | - Erick Denamur
- INSERM UMR1137, IAME, Paris Diderot University, Faculty of Medicine Xavier Bichat, Paris, France.,Department of Molecular Genetics, University Hospital Bichat, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Jean-Winoc Decousser
- INSERM UMR1137, IAME, Paris Diderot University, Faculty of Medicine Xavier Bichat, Paris, France.,Department of Bacteriology and Infection Control, University Hospital Henri Mondor, Assistance Publique-Hôpitaux de Paris, Créteil, France
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13
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Haass KA, Sapiano MRP, Savinkina A, Kuehnert MJ, Basavaraju SV. Transfusion-Transmitted Infections Reported to the National Healthcare Safety Network Hemovigilance Module. Transfus Med Rev 2019; 33:84-91. [PMID: 30930009 DOI: 10.1016/j.tmrv.2019.01.001] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Revised: 12/04/2018] [Accepted: 01/02/2019] [Indexed: 11/29/2022]
Abstract
Transfusion-transmitted infections (TTIs) can be severe and result in death. Transfusion-transmitted viral pathogen transmission has been substantially reduced, whereas sepsis due to bacterial contamination of platelets and transfusion-transmitted babesiosis may occur more frequently. Quantifying the burden of TTI is important to develop targeted interventions. From January 1, 2010, to December 31, 2016, health care facilities participating in the National Healthcare Safety Network Hemovigilance Module monitored transfusion recipients for evidence of TTI and recorded the total number of units transfused. Facilities use standard criteria to report TTIs. Incidence rates of TTIs, including for bacterial contamination of platelets and transfusion-transmitted babesiosis, are presented. One hundred ninety-five facilities reported 111 TTIs and 7.9 million transfused components to the National Healthcare Safety Network Hemovigilance Module. Of these 111 reports, 54 met inclusion criteria. The most frequently reported pathogens were Babesia spp in RBCs (16/23, 70%) and Staphylococcus aureus in platelets (12/30, 40%). There were 1.95 (26 apheresis, 4 whole blood derived) TTIs per 100 000 transfused platelet units and 0.53 TTI per 100 000 transfused RBC components, compared to 0.68 TTI per 100 000 all transfused components. Bacterial contamination of platelets and transfusion-transmitted babesiosis were the most frequently reported TTIs. Interventions that reduce the burden of bacterial contamination of platelets, particularly collected by apheresis, and Babesia transmission through RBC transfusion would reduce transfusion recipient morbidity and mortality. These analyses demonstrate the value and importance of facility participation in national recipient hemovigilance using standard reporting criteria.
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Affiliation(s)
- Kathryn A Haass
- Office of Blood, Organ, and Other Tissue Safety, Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention.
| | - Mathew R P Sapiano
- Surveillance Branch, Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, US Centers for Disease Control and Prevention
| | - Alexandra Savinkina
- Office of Blood, Organ, and Other Tissue Safety, Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention; Oak Ridge Institute for Science and Education
| | - Matthew J Kuehnert
- Office of Blood, Organ, and Other Tissue Safety, Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention
| | - Sridhar V Basavaraju
- Office of Blood, Organ, and Other Tissue Safety, Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention
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14
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Blood loss mitigation and replacement in facial surgery: a review. Curr Opin Otolaryngol Head Neck Surg 2018; 26:266-274. [PMID: 29846240 DOI: 10.1097/moo.0000000000000461] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
PURPOSE OF REVIEW To provide a comprehensive overview of the predisposing factors that contribute to a risk of excess bleeding for surgical therapy in the head and neck regions, provide a thorough overview of techniques and tools for managing blood loss complications, and provide intervention algorithms to help guide clinical decision making. RECENT FINDINGS With the current landscape of medications and reversal agents, protocols for intervention in a variety of situations, and new tools for blood loss management all rapidly changing and being developed it is critical to stay up to date to provide patients the best care in the most critical of situations. SUMMARY With the risk of blood loss complications in head and neck surgery ranging from minimal to extreme surgeons require a comprehensive understanding risk factors, patient evaluation tools, and proper management algorithms. The first opportunity to prevent unnecessary blood loss and blood loss complications is the health history and physical appointment where a clinician can identify any medications, conditions, or other predisposing factors that would elevate a patient's risk of excess bleeding and the necessity for treatment augmentation. Although not all complications can be prevented because of the natural physiological variation that occurs from patient to patient, despite proper and proper diagnostics, a full working knowledge of most likely complications, hemostatic tools, and concise communication with team members can prevent a lot of blood loss and the complications associated.
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15
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Viana JD, Ferreira SC, Matana SR, Rossi F, Patel P, Garson JA, Rocha V, Tedder R, Mendrone-Júnior A, Levi JE. Detection of bacterial contamination in platelet concentrates from Brazilian donors by molecular amplification of the ribosomal 16S gene. Transfus Med 2018; 28:420-426. [PMID: 30304760 DOI: 10.1111/tme.12561] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2018] [Revised: 08/09/2018] [Accepted: 09/12/2018] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The aim of our work was to establish a semi-automated high-throughput DNA amplification method for the universal screening of bacteria in platelet concentrates (PCs). BACKGROUND Among cases of transfusion transmission of infectious agents, bacterial contamination ranks first in the number of events, morbidity and mortality. Transmission occurs mainly by transfused PCs. Automated culture is adopted by some blood banks for screening of bacterial contamination, but this procedure is expensive and has a relatively long turnaround time. METHODS PCs were spiked with suspensions of five different bacterial species in a final concentration of 1 and 10 colony-forming units (CFU) per millilitre. After incubation, the presence of bacteria was investigated by real-time polymerase chain reaction (PCR) and by the Enhanced Bacterial Detection System (eBDS, Pall) assay as a reference method. Real-time PCR amplification was performed with a set of universal primers and probes targeting the 16S rRNA gene. Co-amplification of human mitochondrial DNA served as an internal control. RESULTS Using the real-time PCR method, it was possible to detect the presence of all bacterial species tested with an initial concentration of 10 CFU mL-1 24 h after contamination, except for Staphylococcus hominis. The PCR assay also detected, at 24 h, the presence of Serratia marcescens and Enterobacter cloacae with an initial concentration of 1 CFU mL-1 . CONCLUSIONS The real-time PCR assay may be a reliable alternative to conventional culture methods in the screening of bacterial contamination of PCs, enabling bacterial detection even with a low initial concentration of microorganisms.
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Affiliation(s)
- J D Viana
- Fundação Pró-Sangue Hemocentro de São Paulo, São Paulo, Brazil
| | - S C Ferreira
- Fundação Pró-Sangue Hemocentro de São Paulo, São Paulo, Brazil
| | - S R Matana
- Fundação Pró-Sangue Hemocentro de São Paulo, São Paulo, Brazil
| | - F Rossi
- Departamento de Microbiologia do Laboratório Central, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - P Patel
- Microbiology Services, NHS Blood and Transplant, London, UK
| | - J A Garson
- Microbiology Services, NHS Blood and Transplant, London, UK.,Division of Infection and Immunity, University College London, London, UK
| | - V Rocha
- Fundação Pró-Sangue Hemocentro de São Paulo, São Paulo, Brazil
| | - R Tedder
- Microbiology Services, NHS Blood and Transplant, London, UK.,Division of Infection and Immunity, University College London, London, UK
| | | | - J E Levi
- Fundação Pró-Sangue Hemocentro de São Paulo, São Paulo, Brazil
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16
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Erony SM, Marshall CE, Gehrie EA, Boyd JS, Ness PM, Tobian AA, Carroll KC, Blagg L, Shifflett L, Bloch EM. The epidemiology of bacterial culture-positive and septic transfusion reactions at a large tertiary academic center: 2009 to 2016. Transfusion 2018; 58:1933-1939. [DOI: 10.1111/trf.14789] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Revised: 04/08/2018] [Accepted: 04/08/2018] [Indexed: 01/21/2023]
Affiliation(s)
- Sean M. Erony
- Johns Hopkins Hospital and Medical Institutions; Baltimore Maryland
| | | | - Eric A. Gehrie
- Johns Hopkins Hospital and Medical Institutions; Baltimore Maryland
| | - Joan S. Boyd
- Johns Hopkins Hospital and Medical Institutions; Baltimore Maryland
| | - Paul M. Ness
- Johns Hopkins Hospital and Medical Institutions; Baltimore Maryland
| | | | - Karen C. Carroll
- Johns Hopkins Hospital and Medical Institutions; Baltimore Maryland
| | - Lorraine Blagg
- Johns Hopkins Hospital and Medical Institutions; Baltimore Maryland
| | - Lisa Shifflett
- Johns Hopkins Hospital and Medical Institutions; Baltimore Maryland
| | - Evan M. Bloch
- Johns Hopkins Hospital and Medical Institutions; Baltimore Maryland
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17
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The Role of Chitosan on Polyvinyl Chloride (PVC)-Glycerol Biocomposites for Blood Bag Application. JOURNAL OF BIOMIMETICS BIOMATERIALS AND BIOMEDICAL ENGINEERING 2018. [DOI: 10.4028/www.scientific.net/jbbbe.37.94] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The common blood bag in the market is made from a mixture of PVC and plasticizer. But the a number of occurrences where pockets of heavily polluted bacteria, blood requires blood bags which has the antibacterial characteristic. Antibacterial properties on the bags of blood can be raised with the addition of chitosan. This research aim is to know the influence of chitosan membrane biocomposite PVC-Glycerol against its biological and physical properties. Chitosan dissolved with a concentration of 0 wt/v%; wt/v 0.5%; 1 wt/v%; 1.5 v/wt% wt/v and 2 wt/v% mixed with glycerol with a 1:1 ratio. Then the mixture was mixed with PVC solution 15% and formed into a membrane by using the glass plates. Furthermore, the membranes are characterized using tensile test, hemolytic test, and antibacterial test. The physical characteristics of the tensile test indicate that the elongation percentage was 2.22 – 96.43% and tensile strength was 3.6-8 MPa. The test result of the hemolytic test and antibacterial test showed that biocomposite membrane of PVC-Glycerol-Chitosan are hemocompatible because it has a hemolysis percentage < 5%, while antibacterial test results showed that the membrane has a weak anti-bacterial due to bacterial inhibition zone diameter < 5 mm. Based on the characterization result, biocomposite membrane of PVC-Glycerol-Chitosan can be used for blood bag candidate.
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18
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Double Dose Plateletpheresis: A Savior to Shrinking Donor Pool and Platelet Inventory Management. Indian J Hematol Blood Transfus 2018; 34:691-696. [PMID: 30369742 DOI: 10.1007/s12288-018-0920-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Accepted: 01/10/2018] [Indexed: 10/18/2022] Open
Abstract
The double dose plateletpheresis (DDP) is considered to be a cost effective way of preparing platelets, owing to the low incidence of infectious complications and by also minimizing allogeneic donor exposure to the patients. We aimed at collecting DDP at our center and study its effect on donor hematological parameters, evaluate the product quality and the adverse donor reactions thereafter. Double Dose Platelet was collected from 160 eligible apheresis donors on Amicus cell separator (Fenwal, Inc. Three Corporate Drive Lake Zurich, IL, USA). The donor hematological parameters, product yield, adverse effects on the donors, collection efficiency (CE) and collection rate of the machine were noted. A total of 160 DDPs were collected. The total blood volume processed to achieve the yield of 6.0 × 1011 was 3673.5 ± 276.56 mL. The average yield achieved was 6.14 ± 0.26 × 1011. The average run time was 68.05 ± 6.25 min. Total ACD used was 408.33 ± 33.81 mL. We observed significant relation of pre-donation donor platelet count and platelet yield (p < 0.001). The CE was 78.09 ± 5.15%. There was a significant drop in the post DDP platelet count (p < 0.01) causing no adverse effect. Fourteen donors (8.75%) experienced mild citrate related adverse events. DDP does not lead to major adverse effects and post DDP hematological parameters are also within the acceptable range. It also helps to maintain apheresis platelet inventory, reduce donor exposure, reduce donor requirement and reduce the cost of the product.
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19
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Keklik M, Keklik E, Kalan U, Ozer O, Arik F, Sarikoc M. Comparison of Plateletpheresis on the Haemonetics and Trima Accel Cell Separators. Ther Apher Dial 2017; 22:87-90. [PMID: 29082642 DOI: 10.1111/1744-9987.12607] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2017] [Revised: 06/21/2017] [Accepted: 08/02/2017] [Indexed: 11/30/2022]
Abstract
The use of apheresis equipment to collect platelets has rapidly increased in recent years. We compared two apheresis instruments (Haemonetics MCS + and Trima Accel) with regard to platelet (PLT) yield and efficiency, and collection rate (CR) in a retrospective study. Overall 120 data obtained by Haemonetics and Trima systems (N = 60 for each) were randomly selected among 400 plateletpheresis procedures performed at the Apheresis Unit of Kayseri Education and Research Hospital between July 2016 and January 2017. The CR was significantly higher with the Haemonetics compared to the Trima (0.076 ± 0.016 vs. 0.065 ± 0.015 (PLT × 1011 /min) respectively; P < 0.001). The PLT yield/unit was higher with the Haemonetics (4.4 ± 0.8 vs. 3.9 ± 0.8 × 1011 , P = 0.001). Haemonetics and Trima Accel instruments collected platelets efficiently. We hope that these data will be a guide in selecting equipment for apheresis units.
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Affiliation(s)
- Muzaffer Keklik
- Department of Hematology, Kayseri Education and Research Hospital, Kayseri, Turkey
| | - Ertugrul Keklik
- Department of Physiology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Ugur Kalan
- Department of Internal Medicine, Kayseri Education and Research Hospital, Kayseri, Turkey
| | - Ozerhan Ozer
- Department of Internal Medicine, Kayseri Education and Research Hospital, Kayseri, Turkey
| | - Ferhat Arik
- Department of Internal Medicine, Kayseri Education and Research Hospital, Kayseri, Turkey
| | - Murat Sarikoc
- Apheresis Unit, Kayseri Education and Research Hospital, Kayseri, Turkey
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20
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Affiliation(s)
- Paul M Ness
- Transfusion Medicine, Johns Hopkins Medical Institutions, Baltimore, MD, USA.,Pathology, Medicine and Oncology, Johns Hopkins Medical Institutions, Baltimore, MD, USA
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21
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Jahn K, Suchodolski K, Schäfer A, Sahlmann B, Küster U, Echtermeyer F, Calmer S, Theilmeier G, Johanning K. Effect of Clopidogrel on Thrombus Formation in an Ex Vivo Parallel Plate Flow Chamber Model Cannot Be Reversed by Addition of Platelet Concentrates or vWF Concentrate. Anesth Analg 2017; 124:1091-1098. [DOI: 10.1213/ane.0000000000001903] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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22
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Zaidi NA. Transfusion-Related Infections. Infect Dis (Lond) 2017. [DOI: 10.1016/b978-0-7020-6285-8.00221-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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23
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Jaime-Pérez JC, Jiménez-Castillo RA, Vázquez-Hernández KE, Salazar-Riojas R, Méndez-Ramírez N, Gómez-Almaguer D. Plateletpheresis efficiency and mathematical correction of software-derived platelet yield prediction: A linear regression and ROC modeling approach. J Clin Apher 2016; 32:329-334. [DOI: 10.1002/jca.21518] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Revised: 10/24/2016] [Accepted: 10/25/2016] [Indexed: 11/08/2022]
Affiliation(s)
- José Carlos Jaime-Pérez
- Department of Hematology; Dr. José Eleuterio González University Hospital of the School of Medicine of the Universidad Autónoma de Nuevo León; Monterrey México
| | - Raúl Alberto Jiménez-Castillo
- Department of Hematology; Dr. José Eleuterio González University Hospital of the School of Medicine of the Universidad Autónoma de Nuevo León; Monterrey México
| | - Karina Elizabeth Vázquez-Hernández
- Department of Hematology; Dr. José Eleuterio González University Hospital of the School of Medicine of the Universidad Autónoma de Nuevo León; Monterrey México
| | - Rosario Salazar-Riojas
- Department of Hematology; Dr. José Eleuterio González University Hospital of the School of Medicine of the Universidad Autónoma de Nuevo León; Monterrey México
| | - Nereida Méndez-Ramírez
- Department of Hematology; Dr. José Eleuterio González University Hospital of the School of Medicine of the Universidad Autónoma de Nuevo León; Monterrey México
| | - David Gómez-Almaguer
- Department of Hematology; Dr. José Eleuterio González University Hospital of the School of Medicine of the Universidad Autónoma de Nuevo León; Monterrey México
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24
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25
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Complications of Transfusion. Transfus Med 2016. [DOI: 10.1002/9781119236504.ch14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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26
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Keklik M, Korkmaz S, Kalan U, Sarikoc M, Keklik E. Effectiveness of the Trima Accel cell separator in the double dose plateletpheresis. Transfus Apher Sci 2016; 55:240-242. [DOI: 10.1016/j.transci.2016.07.022] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2016] [Revised: 07/15/2016] [Accepted: 07/27/2016] [Indexed: 10/21/2022]
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27
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Chatterjee K, Zaman S, Chaurasia R, Singh S, Keil SD, Tewari S, Bisht A, Agarwal N, Rout D, Chand S, Saha K. Evaluation of Mirasol pathogen reduction system by artificially contaminating platelet concentrates with Staphylococcus epidermidis: A pilot study from India. Asian J Transfus Sci 2016; 10:127-31. [PMID: 27605849 PMCID: PMC4993081 DOI: 10.4103/0973-6247.187946] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND AND OBJECTIVES This study was conducted to assess the efficacy of Mirasol pathogen reduction system for platelets aimed at preventing bacterial regrowth by spiking buffy coat pooled platelets (BCPP) with clinically relevant load of Staphylococous epidermidis. MATERIALS AND METHODS BCPP units were prepared using Teruflex BP-kit with Imugard III-S-PL (Terumo BCT, Tokyo, Japan). Two BCPP units were pooled, of which 40 ml of negative control (NC) was removed. The remaining volume of the platelet unit was inoculated with clinically relevant load of bacteria (total of 30 CFU of S. epidermidis in 1 ml); following this the platelet unit was split into two parts. One part served as positive control (PC) and the other part was subjected to pathogen reduction technique (Mirasol PRT, CaridianBCT Biotechnologies, Lakewood, CO, USA). Bacterial detection was performed using BacT/ALERT system, controls after day 1 and day 7 following inoculation of bacteria and on day 7 for Mirasol-treated unit. RESULTS Of the 32 treatment cycles, 28 were valid and 4 were invalid. No regrowth was observed in 96.4% (27 of 28) after treatment with Mirasol pathogen reduction system. Of four invalid tests, on two instances the NC showed growth, whereas in other 2 no regrowth was detected in 7(th) day PC. Bacterial screening of PCs by BacT/ALERT after 24 h of incubation was 28.6%, whereas the effectiveness increased to 100% when incubated for 7 days. CONCLUSIONS Mirasol system was effective in inactivating S. epidermidis when it was deliberately inoculated into BCPP at clinically relevant concentrations. Such systems may significantly improve blood safety by inactivating traditional and emerging transfusion-transmitted pathogens.
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Affiliation(s)
- Kabita Chatterjee
- Department of Transfusion Medicine, All Institute of Medical Sciences, New Delhi, India
| | - Shamsuz Zaman
- Department of Transfusion Medicine, All Institute of Medical Sciences, New Delhi, India
| | - Rahul Chaurasia
- Department of Transfusion Medicine, All Institute of Medical Sciences, New Delhi, India
| | - Surinder Singh
- National Institute of Biologicals, Noida, Uttar Pradesh, India
| | | | - Shalini Tewari
- National Institute of Biologicals, Noida, Uttar Pradesh, India
| | - Akanksha Bisht
- Haemovigilance Programme, National Institute of Biologicals, Noida, Uttar Pradesh, India
| | - Nitin Agarwal
- Department of Transfusion Medicine, All Institute of Medical Sciences, New Delhi, India
| | - Diptiranjan Rout
- Department of Transfusion Medicine, All Institute of Medical Sciences, New Delhi, India
| | - Subhash Chand
- National Institute of Biologicals, Noida, Uttar Pradesh, India
| | - Kallol Saha
- National Institute of Biologicals, Noida, Uttar Pradesh, India
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28
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Seheult JN, Triulzi D, Yazer MH. I am the 9%: Making the case for whole-blood platelets. Transfus Med 2016; 26:177-85. [DOI: 10.1111/tme.12312] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Revised: 04/15/2016] [Accepted: 04/18/2016] [Indexed: 11/30/2022]
Affiliation(s)
- J. N. Seheult
- Department of Pathology; University of Pittsburgh School of Medicine; Pittsburgh PA USA
| | - D.J. Triulzi
- Department of Pathology; University of Pittsburgh School of Medicine; Pittsburgh PA USA
- The Institute for Transfusion Medicine; Pittsburgh PA USA
| | - M. H. Yazer
- Department of Pathology; University of Pittsburgh School of Medicine; Pittsburgh PA USA
- The Institute for Transfusion Medicine; Pittsburgh PA USA
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29
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Keklik M, Keklik E, Korkmaz S, Aygun B, Arik F, Kilic O, Sarikoc M. Effectiveness of the haemonetics MCS cell separator in the collection of apheresis platelets. Transfus Apher Sci 2015; 53:396-8. [DOI: 10.1016/j.transci.2015.08.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2015] [Accepted: 08/04/2015] [Indexed: 10/23/2022]
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31
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Keklik M, Eser B, Kaynar L, Sivgin S, Keklik E, Solmaz M, Ozturk A, Buyukoglan R, Yay M, Cetin M, Unal A. Comparison of plateletpheresis on the Fenwal Amicus, Fresenius COM.TEC, and Trima Accel Cell separators. J Clin Apher 2015; 30:171-5. [PMID: 25230340 DOI: 10.1002/jca.21358] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2014] [Revised: 07/02/2014] [Accepted: 08/28/2014] [Indexed: 02/05/2023]
Abstract
Blood component donations by apheresis have become more common in modern blood transfusion practices. We compared three apheresis instruments (Fenwal Amicus, Fresenius COM.TEC, and Trima Accel) with regard to platelet (PLT) yield, collection efficiency (CE), and collection rate (CR). The single-needle or double-needle plateletpheresis procedures of the three instruments were compared in a retrospective, randomized study in 270 donors. The blood volume processed was higher in the COM.TEC compared with the Amicus and Trima. Also there was a significantly higher median volume of ACD used in collections on the COM.TEC compared with the Amicus and Trima. The PLT yield was significantly lower with the COM.TEC compared with the Amicus and Trima. Additionally, the CE was significantly lower with the COM.TEC compared with the Amicus and Trima. There was no significant difference in median separation time and CR between the three groups. When procedures were compared regarding CE by using Amicus device, it was significantly higher in single-needle than double-needle plateletpheresis. When double-needle Amicus system was compared with double-needle COM.TEC system, CE and PLT yield were significantly higher with Amicus system. When single-needle Amicus system was compared with single-needle Trima system, CE and PLT yield were significantly higher with Trima system. All instruments collected PLTs efficiently. However, the CE was lower with the COM.TEC compared with the Amicus and Trima. Also, we found Amicus single-needle system collected PLTs more efficiently compared with the double-needle system. CE and PLT yields were significantly higher with the single-needle Trima instrument compared with the single-needle Amicus device.
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Affiliation(s)
- Muzaffer Keklik
- Department of Hematology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Bulent Eser
- Department of Hematology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Leylagul Kaynar
- Department of Hematology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Serdar Sivgin
- Department of Hematology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Ertugrul Keklik
- Department of Physiology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Musa Solmaz
- Apheresis Unit, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Ahmet Ozturk
- Department of Statistics, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Ruksan Buyukoglan
- Department of Genetics, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Mehmet Yay
- Blood Center, Erciyes University, Kayseri, Turkey
| | - Mustafa Cetin
- Department of Hematology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Ali Unal
- Department of Hematology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
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32
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Cannas G, Thomas X. Supportive care in patients with acute leukaemia: historical perspectives. BLOOD TRANSFUSION = TRASFUSIONE DEL SANGUE 2015; 13:205-20. [PMID: 25369611 PMCID: PMC4385068 DOI: 10.2450/2014.0080-14] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 03/23/2014] [Accepted: 06/24/2014] [Indexed: 01/09/2023]
Affiliation(s)
- Giovanna Cannas
- Haemovigilance Unit, Edouard Herriot Hospital and Croix-Rousse Hospital, Hospices Civils de Lyon, Lyon, France
| | - Xavier Thomas
- Leukaemia Unit, Haematology Department, Lyon-Sud Hospital, Hospices Civils de Lyon, Lyon, France
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33
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Refrigerated platelets for the treatment of acute bleeding: a review of the literature and reexamination of current standards. Shock 2014; 41 Suppl 1:51-3. [PMID: 24662779 DOI: 10.1097/shk.0000000000000078] [Citation(s) in RCA: 77] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
This review is a synopsis of the decisions that shaped global policy on platelet (PLT) storage temperature and a focused appraisal of the literature on which those discussions were based. We hypothesize that choices were centered on optimization of preventive PLT transfusion strategies, possibly to the detriment of the therapeutic needs of acutely bleeding patients. Refrigerated PLTs are a better hemostatic product, and they are safer in that they are less prone to bacterial contamination. They were abandoned during the 1970s because of the belief that clinically effective PLTs should both be hemostatically functional and survive in circulation for several days as indicated for prophylactic transfusion; however, clinical practice may be changing. Data from two randomized controlled trials bring into question the concept that stable autologous stem cell transplant patients with hypoproliferative thrombocytopenia should continue to receive prophylactic transfusions. At the same time, new findings regarding the efficacy of cold PLTs and their potential role in treating acute bleeding have revived the debate regarding optimal PLT storage temperature. In summary, a "one-size-fits-all" strategy for PLT storage may not be adequate, and a reexamination of whether cold-stored PLTs should be offered as a widely available therapeutic product may be indicated.
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Kulkarni N. A prospective study to determine the frequency of bacterial contamination of platelets. Indian J Hematol Blood Transfus 2014; 30:319-20. [PMID: 25435735 DOI: 10.1007/s12288-013-0236-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2011] [Accepted: 01/25/2013] [Indexed: 12/01/2022] Open
Abstract
Bacterial contamination of transfusion products is a long standing problem which includes donor bacteremia, contamination during the whole blood collection procedure, contamination of the collection pack and contamination during the blood processing procedure. The purpose of this study is to know the incidence of bacterial contamination of platelets and how to overcome it. During January 2009 to December 2010, 5,000 units of platelets concentrate were collected and 5 ml of platelet concentrate was sent for sterility test. A total of 8 units were reported as bacterially contaminated. Bacterial contamination can be reduced by better skin disinfection, collection of blood with a diversion pouch set, testing for bacteria and potentially the use of safe & effective pathogen reduction technologies and when available.
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Affiliation(s)
- Nagarekha Kulkarni
- Department of Pathology, Medical College (VIMS), Bellary, 583 104 Karnataka India
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Philip J, Biswas AK, Chatterjee T, Mallhi RS. Comparative Analysis of Various Aspects of Plateletpheresis on the Fenwal Amicus and Fresenius COM.TEC Cell Separator Instruments. Lab Med 2014; 45:315-23. [PMID: 25316663 DOI: 10.1309/lm491rnlmwlfhims] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
OBJECTIVE To compare the Fenwal Amicus and the Fresenius COM.TEC apheresis instruments regarding donor peripheral blood parameters, operational variables of the instruments, and quality control parameters of the product obtained. METHODS We performed 100 platelet collections from 100 voluntary donors using the 2 studied devices. We measured platelet count using an automated analyzer and analyzed the activation statuses using a flow cytometer. RESULTS The median time needed to perform the procedures was significantly longer with the COM.TEC. However, the product we obtained using the Amicus instrument showed higher degrees of platelet-activation. All products we obtained with both instruments had white blood cell counts of less than 5 × 10(6) per bag. We observed no statistical difference regarding collection efficiency and collection rates between the devices. CONCLUSION Both instruments collected platelets efficiently, with minimal donor discomfort. Compared with the COM.TEC instrument, the Amicus reached the platelet target yield more quickly; however, it displayed an increase in platelet activation.
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Affiliation(s)
- Joseph Philip
- Department of Immunohaematology and Blood Transfusion, Armed Forces Medical College, Pune, India
| | - Amit Kumar Biswas
- Department of Immunohaematology and Blood Transfusion, Armed Forces Medical College, Pune, India
| | - Tathagata Chatterjee
- Department of Immunohaematology and Blood Transfusion, Armed Forces Medical College, Pune, India
| | - Rajiv Singh Mallhi
- Department of Immunohaematology and Blood Transfusion, Armed Forces Medical College, Pune, India
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Keklik M, Eser B, Kaynar L, Solmaz M, Ozturk A, Yay M, Birekul A, Oztekin M, Sivgin S, Cetin M, Unal A. Comparison of double dose plateletpheresis on the Fenwal Amicus, Fresenius COM.TEC and Trima Accel cell separators. Transfus Apher Sci 2014; 51:193-6. [PMID: 25219639 DOI: 10.1016/j.transci.2014.08.022] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2014] [Revised: 08/01/2014] [Accepted: 08/25/2014] [Indexed: 02/08/2023]
Abstract
BACKGROUND A variety of apheresis instruments are now available on the market for double dose plateletpheresis. We compared three apheresis devices (Fenwal Amicus, Fresenius COM.TEC and Trima Accel) with regard to processing time, platelet (PLT) yield, collection efficiency (CE) and collection rate (CR). STUDY DESIGN AND METHODS The single-needle or double-needle double plateletpheresis procedures of the three instruments were compared in a retrospective, randomized study in 135 donors. RESULTS In the pre-apheresis setting, 45 double plateletpheresis procedures performed with each instrument revealed no significant differences in donor's age, sex, weight, hemoglobin, white blood cell and PLT count between three groups. The blood volume processed to reach a target PLT yield of ≥ 6 × 10(11) was higher in the COM.TEC compared with the Amicus and Trima (4394 vs. 3780 and 3340 ml, respectively; p < 0.001). Also there was a significantly higher median volume of ACD used in collections on the COM.TEC compared with the Amicus and Trima (426 vs. 387 and 329 ml, respectively; p < 0.001). There was a significantly higher median time needed for the procedures on the COM.TEC compared with the Amicus and Trima (66 vs. 62 and 63 min, respectively; p = 0.024). The CE was significantly higher with the Trima compared with the Amicus and COM.TEC (83.57 ± 17.19 vs. 66.71 ± 3.47 and 58.79 ± 5.14%, respectively; p < 0.001). Also, there was a significantly higher product volume on the Trima compared with the Amicus and COM.TEC (395.56 vs. 363.11 and 386.4 ml, respectively; p = 0.008). Additionally, the CR was significantly lower with the COM.TEC compared with the Amicus and Trima (0.092 ± 0.011 vs. 0.099 ± 0.013 and 0.097 ± 0.013 plt × 10(11)/min, respectively; p = 0.039). There was no significant differences in PLT yield between the three groups (p = 0.636). CONCLUSIONS Trima single-needle device collected double dose platelets more efficiently than Amicus and COM.TEC double-needle devices. Blood volume processed, ACD-A volume, and median separation time was significantly higher with the COM.TEC. Also, the CR was significantly lower with the COM.TEC.
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Affiliation(s)
- Muzaffer Keklik
- Department of Hematology, Faculty of Medicine, Erciyes University, Kayseri, Turkey.
| | - Bulent Eser
- Department of Hematology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Leylagul Kaynar
- Department of Hematology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Musa Solmaz
- Apheresis Unit, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Ahmet Ozturk
- Department of Statistics, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Mehmet Yay
- Blood Center, Erciyes University, Kayseri, Turkey
| | - Ayse Birekul
- Apheresis Unit, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Mehmet Oztekin
- Apheresis Unit, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Serdar Sivgin
- Department of Hematology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Mustafa Cetin
- Department of Hematology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Ali Unal
- Department of Hematology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
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Keklik M, Eser B, Kaynar L, Solmaz M, Ozturk A, Yay M, Birekul A, Oztekin M, Sivgin S, Cetin M, Unal A. Comparison of double dose plateletpheresis on the Fenwal Amicus, Fresenius COM.TEC and Trima Accel cell separators. Transfus Apher Sci 2014. [PMID: 25219639 DOI: : 10.1016/j.transci.2014.08.022] [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: 11/07/2022]
Abstract
BACKGROUND A variety of apheresis instruments are now available on the market for double dose plateletpheresis. We compared three apheresis devices (Fenwal Amicus, Fresenius COM.TEC and Trima Accel) with regard to processing time, platelet (PLT) yield, collection efficiency (CE) and collection rate (CR). STUDY DESIGN AND METHODS The single-needle or double-needle double plateletpheresis procedures of the three instruments were compared in a retrospective, randomized study in 135 donors. RESULTS In the pre-apheresis setting, 45 double plateletpheresis procedures performed with each instrument revealed no significant differences in donor's age, sex, weight, hemoglobin, white blood cell and PLT count between three groups. The blood volume processed to reach a target PLT yield of ≥ 6 × 10(11) was higher in the COM.TEC compared with the Amicus and Trima (4394 vs. 3780 and 3340 ml, respectively; p < 0.001). Also there was a significantly higher median volume of ACD used in collections on the COM.TEC compared with the Amicus and Trima (426 vs. 387 and 329 ml, respectively; p < 0.001). There was a significantly higher median time needed for the procedures on the COM.TEC compared with the Amicus and Trima (66 vs. 62 and 63 min, respectively; p = 0.024). The CE was significantly higher with the Trima compared with the Amicus and COM.TEC (83.57 ± 17.19 vs. 66.71 ± 3.47 and 58.79 ± 5.14%, respectively; p < 0.001). Also, there was a significantly higher product volume on the Trima compared with the Amicus and COM.TEC (395.56 vs. 363.11 and 386.4 ml, respectively; p = 0.008). Additionally, the CR was significantly lower with the COM.TEC compared with the Amicus and Trima (0.092 ± 0.011 vs. 0.099 ± 0.013 and 0.097 ± 0.013 plt × 10(11)/min, respectively; p = 0.039). There was no significant differences in PLT yield between the three groups (p = 0.636). CONCLUSIONS Trima single-needle device collected double dose platelets more efficiently than Amicus and COM.TEC double-needle devices. Blood volume processed, ACD-A volume, and median separation time was significantly higher with the COM.TEC. Also, the CR was significantly lower with the COM.TEC.
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Affiliation(s)
- Muzaffer Keklik
- Department of Hematology, Faculty of Medicine, Erciyes University, Kayseri, Turkey.
| | - Bulent Eser
- Department of Hematology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Leylagul Kaynar
- Department of Hematology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Musa Solmaz
- Apheresis Unit, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Ahmet Ozturk
- Department of Statistics, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Mehmet Yay
- Blood Center, Erciyes University, Kayseri, Turkey
| | - Ayse Birekul
- Apheresis Unit, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Mehmet Oztekin
- Apheresis Unit, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Serdar Sivgin
- Department of Hematology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Mustafa Cetin
- Department of Hematology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Ali Unal
- Department of Hematology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
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Xiao W, Tormey CA, Capetillo A, Maitta RW. Allergic transfusion reactions to platelets are more commonly associated with prepooled than apheresis components. Vox Sang 2013; 105:334-40. [DOI: 10.1111/vox.12063] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2013] [Revised: 05/29/2013] [Accepted: 05/31/2013] [Indexed: 11/29/2022]
Affiliation(s)
| | | | - A. Capetillo
- Department of Pathology; University Hospitals Case Medical Center; Cleveland; OH; USA
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Vuk T, Strauss Patko M, Gulan-Harcet J, Očić T, Šarlija D, Jukić I. Quality control of leucocyte-depleted platelet concentrates obtained by buffy-coat method. Transfus Med 2013; 23:338-43. [PMID: 23772840 DOI: 10.1111/tme.12051] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2013] [Revised: 03/13/2013] [Accepted: 05/20/2013] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Quality control results on leukoreduced buffy-coat platelet pools during the 7-year period (2005-2011) are presented with the aim to assess their overall quality and trends recorded during the study period. METHODS Data of the Quality Assurance Department, Croatian Institute of Transfusion Medicine were used in the study. Measurement results of all study parameters are presented for the entire study period, while the rate of controlled platelet pools consistent with the specified quality requirements is additionally presented for each study year. RESULTS The mean component volume was 50 ± 9 mL per 6 × 10(10) platelets (91.5% of conformable results), mean platelet count 7.81 ± 1.26 × 10(10) per single unit equivalent (97.5% of conformable results), mean leucocyte count 0.01 ± 0.08 × 10(6) per single unit equivalent (99.6% of conformable results), and mean pH 7.45 ± 0.16 (99.4% of conformable results). Bacteriologic testing showed negative result in 99.8% of tested components. CONCLUSION Study results indicated the results of platelet pool quality control to be highly conformable with the specified quality requirements. It is illustrated how simple interventions in the preparation process can have significant impact on product quality improvement and thus on redefining quality requirements.
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Affiliation(s)
- T Vuk
- Croatian Institute of Transfusion Medicine, Zagreb, Croatia
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40
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Current methods for the reduction of blood-borne pathogens: a comprehensive literature review. BLOOD TRANSFUSION = TRASFUSIONE DEL SANGUE 2013; 11:343-8. [PMID: 23522896 DOI: 10.2450/2013.0218-12] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Received: 10/01/2012] [Accepted: 12/06/2012] [Indexed: 11/21/2022]
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Refaai MA, Blumberg N. The transfusion dilemma – Weighing the known and newly proposed risks of blood transfusions against the uncertain benefits. Best Pract Res Clin Anaesthesiol 2013; 27:17-35. [DOI: 10.1016/j.bpa.2012.12.006] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2012] [Revised: 12/03/2012] [Accepted: 12/17/2012] [Indexed: 10/27/2022]
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Burch M, Schneider R, Barakat A, Abushahin L, Cao Y, Ewing J, Stone MJ. Results of an educational program to promote the use of pooled instead of single-donor platelet transfusions. Proc (Bayl Univ Med Cent) 2013; 26:3-5. [PMID: 23382598 DOI: 10.1080/08998280.2013.11928897] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
Transfusion of platelets is commonly indicated in the inpatient oncology setting. These platelets are obtained either through apheresis from a single donor or pooled from the whole blood of several donors. The amount of transfused platelets, infection risk, incidence of alloimmunization, and increases in posttransfusion platelet count are similar for these two platelet products. Although single-donor platelets are preferred over pooled platelets in some instances, single-donor platelets are often given regularly, despite a higher cost and more limited donor supply. Oncology fellows at Baylor University Medical Center at Dallas initiated an education campaign regarding the indications for pooled and single-donor platelet transfusions. The quality improvement campaign included seminars led by oncology fellows for nursing personnel and resident housestaff on the two oncology floors, as well as electronic correspondence to attending physicians. The number of pooled and single-donor platelet transfusions on the two floors was recorded for the 3 months after the education campaign (July-September 2011) and compared with the corresponding data from the previous year. Over the 3-month study period after the education campaign, the average percentage of pooled platelets transfused increased to 34.1% from 13.1% for the prior year. Given this increase, the estimated cost benefit over the 3-month study period was $45,000.
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Affiliation(s)
- Micah Burch
- Department of Oncology, the Baylor Charles A. Sammons Cancer Center at Dallas and Baylor University Medical Center at Dallas
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Dunbar NM, Kreuter JD, Marx-Wood CR, Dumont LJ, Szczepiorkowski ZM. Routine bacterial screening of apheresis platelets on Day 4 using a rapid test: a 4-year single-center experience. Transfusion 2013; 53:2307-13. [DOI: 10.1111/trf.12083] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2012] [Revised: 11/21/2012] [Accepted: 11/21/2012] [Indexed: 11/29/2022]
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Arewa OP. Evaluation of transfusion pyrexia: a review of differential diagnosis and management. ISRN HEMATOLOGY 2012; 2012:524040. [PMID: 23119174 PMCID: PMC3478717 DOI: 10.5402/2012/524040] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/21/2012] [Accepted: 09/07/2012] [Indexed: 11/23/2022]
Abstract
Background/purpose. Transfusion pyrexia (fever) is an important clinical sign/symptom occurring either as an isolated event or as part of a constellation of signs and symptoms in relation to blood transfusion. It is an important cause of morbidity and may be an important sign of life-threatening complications of blood transfusion. Pyrexia is often a reason for the discontinuation of a blood transfusion episode, and adequate evaluation remains a challenge for clinicians. The decision to stop a blood transfusion episode on account of fever is often a difficult one. This paper reviews the differential diagnosis of transfusion pyrexia (TP), the pathogenesis as well as current management measures. Study selection and data source. Literature sources include medical texts, journals, dissertations, and internet-based electronic materials Results and conclusion. Adequate evaluation of pyrexia accompanying blood transfusion remains a challenge for clinicians. An algorithm to assist the clinician in the evaluation of fever occurring in a blood transfusion recipient is developed and presented. Continuous medical education is necessary for clinicians towards improved patient care in transfusion medicine.
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Affiliation(s)
- Oladimeji P. Arewa
- Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, AB, Canada T6G 2R3
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Vuk T, Barišić M, Hećimović A, Rukavina L, Batarilo I, Šarlija D, Jukić I. Bacterial contamination of blood products at the Croatian Institute of Transfusion Medicine: results of eleven-year monitoring. Transfus Med 2012; 22:432-9. [PMID: 23020303 DOI: 10.1111/j.1365-3148.2012.01190.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2012] [Revised: 05/14/2012] [Accepted: 09/05/2012] [Indexed: 11/28/2022]
Abstract
OBJECTIVES The aim of this study is to present the results and experiences of the Croatian Institute of Transfusion Medicine (CITM) in blood product testing for the presence of bacterial contamination. This is the first study analysing the results of bacterial testing of blood products in Croatia. METHODS Results of monitoring blood products for the presence of bacterial contamination during an 11-year period (2000-2010) were retrospectively analysed. As universal screening of platelet concentrates for bacterial contamination is not mandatory in Croatia, the results presented refer to the products tested within the frame of statistical process control. RESULTS A total of 23,130 blood products were tested during the study period. There were 122 (0·53%) initially positive and 41 (0·18%) confirmed positive blood products, whereas suspicion of bacterial contamination could be neither confirmed nor ruled out in 8 (0·03%) blood products. While the frequency of bacterial contamination of plasma products was very low (0·03%), there was no statistically significant difference between bacterial contamination of platelet concentrates (0·26%) and RBC concentrates (0·20%). There were 73 (0·32%) false-positive blood products, with nearly equal proportion of causes related to laboratory contamination (n = 34; 0·15%) and those related to the testing system (n = 39; 0·17%). CONCLUSION The results obtained in the study did not differ significantly from literature data. A number of measures to reduce the risk of bacterial contamination of blood products have been implemented at CITM. The introduction of universal screening of platelet concentrates for the presence of bacterial contamination should be taken into consideration.
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Affiliation(s)
- T Vuk
- Croatian Institute of Transfusion Medicine, Zagreb, Croatia.
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Brecher ME, Blajchman MA, Yomtovian R, Ness P, AuBuchon JP. Addressing the risk of bacterial contamination of platelets within the United States: a history to help illuminate the future. Transfusion 2012; 53:221-31. [PMID: 22612780 DOI: 10.1111/j.1537-2995.2012.03708.x] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Mark E Brecher
- Laboratory Corporation of America, Burlington, NC 27215, USA.
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47
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Preparation of blood products for transfusion: Is there a best method? Biologicals 2012; 40:187-90. [DOI: 10.1016/j.biologicals.2011.11.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2011] [Accepted: 11/03/2011] [Indexed: 11/22/2022] Open
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Chavan PD, Bhat VG, Ojha S, Kelkar RS, Rajadhyaksha SB, Marathe AN. Detection of bacterial growth in blood components using oxygen consumption as a surrogate marker in a tertiary oncology setup. Indian J Med Microbiol 2012; 30:212-4. [DOI: 10.4103/0255-0857.96695] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Pandey P, Tiwari AK, Sharma J, Singh MB, Dixit S, Raina V. A prospective quality evaluation of single donor platelets (SDP) - an experience of a tertiary healthcare center in India. Transfus Apher Sci 2012; 46:163-7. [PMID: 22365925 DOI: 10.1016/j.transci.2012.01.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2011] [Accepted: 01/26/2012] [Indexed: 10/28/2022]
Abstract
Quality assurance of single donor platelets (SDP) is incomplete unless clinical response to platelet transfusion is measured. The primary objective of the study was to evaluate the quality of SDP derived from plateletpheresis procedures and to evaluate the response to platelet transfusion. Procedures were performed on 2287 accepted donors while 271 donors were deferred. Platelet count <1.5 lac/μl and hemoglobin <12.5 g/dl were the leading cause of deferral. The median platelet yield in a SDP bag was found to be 3.1×10(11). The median corrected count increment (CCI) and post-transfusion platelet recovery (PPR) were found to be 10110×m(2)/μl and 24.5%, respectively. In India, the criteria for the selection of plateletpheresis donors should be revisited. Based on quality parameters, the Fresenius COM.TEC cell separator is comparable to other cell separators.
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Affiliation(s)
- Prashant Pandey
- Department of Transfusion Medicine, Medanta-The Medicity, Sector-38, Gurgaon-122001, India.
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Complications of Transfusion. Transfus Med 2011. [DOI: 10.1002/9781444398748.ch14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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