1
|
LeVine DN, Goggs R, Kohn B, Mackin AJ, Kidd L, Garden OA, Brooks MB, Eldermire ERB, Abrams-Ogg A, Appleman EH, Archer TM, Bianco D, Blois SL, Brainard BM, Callan MB, Fellman CL, Haines JM, Hale AS, Huang AA, Lucy JM, O'Marra SK, Rozanski EA, Thomason JM, Walton JE, Wilson HE. ACVIM consensus statement on the treatment of immune thrombocytopenia in dogs and cats. J Vet Intern Med 2024. [PMID: 38779941 DOI: 10.1111/jvim.17079] [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: 03/29/2024] [Accepted: 04/04/2024] [Indexed: 05/25/2024] Open
Abstract
Management of immune thrombocytopenia (ITP) in dogs and cats is evolving, but there are no evidence-based guidelines to assist clinicians with treatment decisions. Likewise, the overall goals for treatment of ITP have not been established. Immunosuppressive doses of glucocorticoids are the first line treatment, but optimal treatment regimens beyond glucocorticoids remain uncertain. Additional options include secondary immunosuppressive drugs such as azathioprine, modified cyclosporine, and mycophenolate mofetil, usually selected based on clinician preference. Vincristine, human IV immunoglobulin (hIVIg), and transfusion of platelet or red blood cell-containing products are often used in more severe cases. Splenectomy and thrombopoietin receptor agonists are usually reserved for refractory cases, but when and in which patient these modalities should be employed is under debate. To develop evidence-based guidelines for individualized treatment of ITP patients, we asked 20 Population Intervention Comparison Outcome (PICO) format questions. These were addressed by 17 evidence evaluators using a literature pool of 288 articles identified by a structured search strategy. Evidence evaluators, using panel-designed templates and data extraction tools, summarized evidence and created guideline recommendations. These were integrated by treatment domain chairs and then refined by iterative Delphi survey review to reach consensus on the final guidelines. In addition, 19 non-PICO questions covering scenarios in which evidence was lacking or of low quality were answered by expert opinion using iterative Delphi surveys with panelist integration and refinement. Commentary was solicited from multiple relevant professional organizations before finalizing the consensus. The rigorous consensus process identified few comparative treatment studies, highlighting many areas of ITP treatment requiring additional studies. This statement is a companion manuscript to the ACVIM Consensus Statement on the Diagnosis of Immune Thrombocytopenia in Dogs and Cats.
Collapse
Affiliation(s)
- Dana N LeVine
- Department of Clinical Sciences, College of Veterinary Medicine, Auburn University, Auburn, Alabama, USA
| | - Robert Goggs
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York, USA
| | - Barbara Kohn
- Small Animal Clinic, School of Veterinary Medicine, Freie Universität Berlin, Berlin, Germany
| | - Andrew J Mackin
- Department of Clinical Sciences, College of Veterinary Medicine, Mississippi State University, Mississippi State, Mississippi, USA
| | - Linda Kidd
- Linda Kidd Veterinary Internal Medicine Consulting, Carlsbad, California, USA
| | - Oliver A Garden
- School of Veterinary Medicine, Louisiana State University, Baton Rouge, Louisiana, USA
| | - Marjory B Brooks
- Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York, USA
| | - Erin R B Eldermire
- Flower-Sprecher Veterinary Library, College of Veterinary Medicine, Cornell University, Ithaca, New York, USA
| | - Anthony Abrams-Ogg
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada
| | - Elizabeth H Appleman
- Department of Internal Medicine, The Animal Medical Center, New York, New York, USA
| | - Todd M Archer
- Bluff City Veterinary Specialists, Memphis, Tennessee, USA
| | - Domenico Bianco
- College of Veterinary Medicine, Western University of Health Sciences, Pomona, California, USA
| | - Shauna L Blois
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada
| | - Benjamin M Brainard
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, Georgia, USA
| | - Mary Beth Callan
- Department of Clinical Sciences and Advanced Medicine, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Claire L Fellman
- Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, Massachusetts, USA
| | - Jillian M Haines
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Washington State University, Pullman, Washington, USA
| | - Anne S Hale
- Zia Pet Hospital, Rio Rancho, New Mexico, USA
| | | | - John M Lucy
- Oradell Animal Hospital, Paramus, New Jersey, USA
| | - Shana K O'Marra
- Northwest Veterinary Critical Care Services, Vancouver, Washington, USA
| | - Elizabeth A Rozanski
- Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, Massachusetts, USA
| | - John M Thomason
- Department of Clinical Sciences, College of Veterinary Medicine, Mississippi State University, Mississippi State, Mississippi, USA
| | - Jenny E Walton
- Veterinary Apheresis Service UK, Washington, Tyne and Wear, United Kingdom
| | - Helen E Wilson
- Langford Vets, University of Bristol, Langford, Somerset, United Kingdom
| |
Collapse
|
2
|
Kretsch CM, Alonso FH, Buktenica M, Heller MC. Agglutination and hemolytic crossmatching to determine transfusion reaction differences between large and small breed goats. J Vet Intern Med 2023; 37:1594-1602. [PMID: 37226646 PMCID: PMC10365034 DOI: 10.1111/jvim.16738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 05/07/2023] [Indexed: 05/26/2023] Open
Abstract
BACKGROUND Blood transfusions are performed frequently in goats, but crossmatches are rarely performed. HYPOTHESIS/OBJECTIVES Determine differences in the frequency of agglutination and hemolytic crossmatch reactions between large and small breed goats. ANIMALS Healthy adult goats, 10 large and 10 small breed. METHODS Two hundred eighty major and minor agglutination and hemolytic crossmatches: 90 large breed donor to large breed recipient (L-L), 90 small breed donor to small breed recipient (S-S), 100 large breed donor to small breed recipient (L-S). A linear mixed model with treatment group (L-L, S-S, L-S) as a fixed effect and individual crossmatch as a random effect was used to identify variations in reaction frequency among groups and individuals. RESULTS Frequency of major agglutination reactions for L-L, S-S, and L-S were 3/90 (3.3%), 7/90 (7.8%), and 10/100 (10.0%), respectively. Frequency of major hemolytic reactions for L-L, S-S, and L-S were 27/84 (32.1%), 7/72 (9.7%), and 31/71 (43.7%). Individual pairings and groupings had no effect on agglutination reactions. Individual pairings had no effect on the frequency of hemolytic reactions. For major hemolytic crossmatches, pairwise comparisons identified higher frequencies of reactions when comparing L-L to S-S (P = .007) and L-S to S-S (P < .001). CONCLUSION AND CLINICAL IMPORTANCE Goats experience increased frequencies of hemolytic reactions compared to agglutination. Significant increases in hemolysis were seen between large breed donors and small breed recipients, compared to small breed pairings. Additional studies are required to determine correlations between crossmatches and transfusion reactions.
Collapse
Affiliation(s)
- Cileah M. Kretsch
- Department of Medicine and Epidemiology, School of Veterinary MedicineUniversity of California, Davis, 1 Garrod DriveDavisCalifornia95616USA
| | - Flavio H. Alonso
- Veterinary Medical Teaching Hospital, School of Veterinary MedicineUniversity of California, Davis, 1 Garrod DriveDavisCalifornia95616USA
| | - Maggie Buktenica
- Department of Medicine and Epidemiology, School of Veterinary MedicineUniversity of California, Davis, 1 Garrod DriveDavisCalifornia95616USA
| | - Meera C. Heller
- Department of Medicine and Epidemiology, School of Veterinary MedicineUniversity of California, Davis, 1 Garrod DriveDavisCalifornia95616USA
| |
Collapse
|
3
|
Elkin M, Amichay-Menashe N, Segev G, Kelmer E, Adlersberg D, Aroch I, Klainbart S. Retrospective study of canine blood xenotransfusion compared with type-matched feline blood allotransfusion to cats: indications, effectiveness, limitations and adverse effects. J Feline Med Surg 2023; 25:1098612X231183930. [PMID: 37466270 PMCID: PMC10812059 DOI: 10.1177/1098612x231183930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/20/2023]
Abstract
OBJECTIVES Xenotransfusion is the transfusion of blood from one species to another. With varying availability of allogenic feline blood (AFB) and in emergency conditions, circumstances occur when canine blood is transfused to cats. This study aimed to characterise the indications, effectiveness, limitations, and acute and late transfusion-related adverse effects of canine blood xenotransfusion compared with matched AFB to anaemic cats, and their survival and longer-term outcome. METHODS This retrospective study (2013-2020) examined cats receiving canine blood xenotransfusions or AFB. RESULTS The study included 311 cats (xenotransfusion [X-group], n = 105; allotransfusion [A-group], n = 206). Xenotransfusion was more frequent among cats sustaining haemorrhage than in those with haemolysis (P <0.01) or hypoproliferative anaemia (P <0.001). Financial constraints were the most common reason to elect xenotransfusion (49%). The post-transfusion mean packed cell volume was higher (P <0.001) in the X-group (22%) compared with the A-group (18%), and also higher (P <0.001) at 48-96 h post-transfusion (23% vs 18%, respectively). Transfusion-related adverse effects (TRAEs) were more frequent (P = 0.001) in the X-group (37.1%) compared with the A-group (19.4%), as were delayed haemolytic transfusion reactions (85% vs 42.5%, respectively; P <0.001). Acute transfusion reactions (ATRs) were more frequent (P <0.001) in the A-group (60%) compared with the X-group (20%). TRAEs were unassociated with survival to discharge. The survival to discharge rate of the X-group (55%) was lower (P = 0.007) than in the A-group (73%), while post-discharge survival rates to 30 days of cats surviving to discharge were 90% and 88%, respectively (P = 0.85). CONCLUSIONS AND RELEVANCE Canine blood xenotransfusions to cats might save lives in emergency conditions when AFB is unavailable or blood typing is infeasible. The survival to discharge rate of the X-group was lower than that of the A-group. The longer-term survival rate of cats administered xenotransfusions and surviving to discharge from the hospital was good.
Collapse
Affiliation(s)
- Maria Elkin
- Department of Small Animals Emergency and Critical Care, The Hebrew University Veterinary Teaching Hospital and Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, Israel
| | - Noa Amichay-Menashe
- Department of Small Animals Emergency and Critical Care, The Hebrew University Veterinary Teaching Hospital and Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, Israel
| | - Gilad Segev
- Department of Small Animal Internal Medicine, The Hebrew University Veterinary Teaching Hospital and Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, Israel
| | - Efrat Kelmer
- Department of Small Animals Emergency and Critical Care, The Hebrew University Veterinary Teaching Hospital and Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, Israel
| | - Dana Adlersberg
- Department of Small Animals Emergency and Critical Care, The Hebrew University Veterinary Teaching Hospital and Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, Israel
| | - Itamar Aroch
- Department of Small Animal Internal Medicine, The Hebrew University Veterinary Teaching Hospital and Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, Israel
| | - Sigal Klainbart
- Department of Small Animals Emergency and Critical Care, The Hebrew University Veterinary Teaching Hospital and Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, Israel
| |
Collapse
|
4
|
Coll AC, Ross MK, Williams ML, Wills RW, Mackin AJ, Thomason JM. Effect of washing units of canine red blood cells on storage lesions. J Vet Intern Med 2021; 36:66-77. [PMID: 34939231 PMCID: PMC8783348 DOI: 10.1111/jvim.16340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 12/02/2021] [Accepted: 12/08/2021] [Indexed: 11/30/2022] Open
Abstract
Background In humans, washing stored blood products before transfusion reduces storage lesions and incidence of transfusion reactions, but the effectiveness of washing canine blood is unknown. Objectives The objective was to determine if manually washing units of stored blood would reduce storage lesions without adversely affecting erythrocytes. We hypothesized that washing stored units would reduce concentrations of storage lesions and cause minimal erythrocyte damage. Animals Eight healthy research dogs. Methods Repeated measure cohort study. Units of whole blood were stored for 28 days and washed 3 times with 0.9% NaCl. Blood samples were collected before and after storage, after each wash, and after being held at a simulated transfusion temperature. Variables measured included CBC variables, blood gas analysis, erythrocyte morphology, mean corpuscular fragility (MCF), and eicosanoid concentrations. A Friedman's test was used to evaluate changes in variables (P < .05 was considered significant). Results After the first wash, compared to values after storage, there was a significant decrease in potassium (4.3 mmol/L [4.0‐4.7] to 1.2 mmol/L [1‐1.6]; P < .0001, median [range]), lactate (1.45 mmol/L [1.07‐1.79] to 0.69 mmol/L [0.39‐0.93]; P = .002), and partial pressure carbon dioxide (102 mm Hg [80.2‐119.2] to 33.7 mm Hg [24.5‐44.5]; P < .0001), and increase in MCV (69.3 fL [65.7‐72.3] to 74 fL [69.6‐79.5]; P = .0003), and MCF (0.444 fL [0.279‐0.527] to 0.491 fL [0.43‐0.616]; P = .0006). Conclusions and Clinical Importance A single wash of stored whole blood significantly reduces most extracellular storage lesions, and additional washing might cause hemolysis.
Collapse
Affiliation(s)
- Ashley C Coll
- Department of Clinical Sciences, College of Veterinary Medicine, Mississippi State University, Mississippi State, Mississippi, USA
| | - Matthew K Ross
- Department of Comparative Biomedical Sciences, College of Veterinary Medicine, Mississippi State University, Mississippi State, Mississippi, USA
| | - Matthew L Williams
- Department of Pathobiology and Population Medicine, College of Veterinary Medicine, Mississippi State University, Mississippi State, Mississippi, USA
| | - Robert W Wills
- Department of Comparative Biomedical Sciences, College of Veterinary Medicine, Mississippi State University, Mississippi State, Mississippi, USA
| | - Andrew J Mackin
- Department of Clinical Sciences, College of Veterinary Medicine, Mississippi State University, Mississippi State, Mississippi, USA
| | - John M Thomason
- Department of Clinical Sciences, College of Veterinary Medicine, Mississippi State University, Mississippi State, Mississippi, USA
| |
Collapse
|
5
|
Silvestre-Ferreira A, Pastor J. Wild Felids Blood Group System. Animals (Basel) 2021; 11:3533. [PMID: 34944308 PMCID: PMC8698159 DOI: 10.3390/ani11123533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 12/03/2021] [Accepted: 12/07/2021] [Indexed: 11/16/2022] Open
Abstract
Wild felids and domestic cats share the AB blood group. However, there have been few studies regarding the characterization and prevalence of the different blood types in wild animals. The erythrocyte membrane glycolipids of the wild cats correspond to the major disialoganglioside patterns observed in domestic cats. Like in domestic cats, type A blood seems to be the most common, although wild felid species seem to exhibit one single blood type. Of the species studied, the wild domestic cats, and the Panthera and ocelot lineages, all had type A blood; the Puma lineage showed almost exclusively type B blood. The prevalence of wild felids blood types show that there seems to be variation between species, but not within species, and no evidence of geographical variation has yet been found, showing apparently no genetic variability. The presence of alloantibodies has also been demonstrated, so the risk of life-threatening transfusion reactions due to mismatched transfusions and neonatal isoerythrolysis is a possibility. Like in other species, the recognition of wild felids blood groups is clinically relevant, as it can also be important in establishing phylogenetic relationships within the Felidae family. We will review the current knowledge on this topic and give insights into the wild felids blood groups potential for zoo transfusion medicine and phylogenetic studies in order to help support reintroduction projects and to preserve genetic diversity.
Collapse
Affiliation(s)
- Ana Silvestre-Ferreira
- Department of Veterinary Sciences, University of Trás-os-Montes and Alto Douro (UTAD), Quinta de Prados, 5000-801 Vila Real, Portugal
- Animal and Veterinary Research Centre (CECAV), University of Trás-os-Montes and Alto Douro (UTAD), Quinta de Prados, 5000-801 Vila Real, Portugal
| | - Josep Pastor
- Department de Medicinia i Cirurgia Animals, Facultat de Veterinària, Universititat Autònoma de Barcelona, Bellaterra, 08193 Barcelona, Spain;
| |
Collapse
|
6
|
Taylor S, Spada E, Callan MB, Korman R, Leister E, Steagall P, Lobetti R, Seth M, Tasker S. 2021 ISFM Consensus Guidelines on the Collection and Administration of Blood and Blood Products in Cats. J Feline Med Surg 2021; 23:410-432. [PMID: 33896248 PMCID: PMC10741281 DOI: 10.1177/1098612x211007071] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
PRACTICAL RELEVANCE Blood and blood products are increasingly available for practitioners to use in the management of haematological conditions, and can be lifesaving and therapeutically useful for patients with anaemia and/or coagulopathies. It is important for feline healthcare that donors are selected appropriately, and transfusions of blood or blood products are given to recipients that will benefit from them. Complications can occur, but can be largely avoided with careful donor management and recipient selection, understanding of blood type compatibility, and transfusion monitoring. CLINICAL CHALLENGES Feline blood transfusion, while potentially a lifesaving procedure, can also be detrimental to donor and recipient without precautions. Cats have naturally occurring alloantibodies to red cell antigens and severe reactions can occur with type-mismatched transfusions. Blood transfusions can also transmit infectious agents to the recipient, so donor testing is essential. Finally, donors must be in good health, and sedated as appropriate, with blood collected in a safe and sterile fashion to optimise the benefit to recipients. Transfusion reactions are possible and can be mild to severe in nature. Autologous blood transfusions and xenotransfusions may be considered in certain situations. EVIDENCE BASE These Guidelines have been created by a panel of authors convened by the International Society of Feline Medicine (ISFM), based on available literature. They are aimed at general practitioners to provide a practical guide to blood typing, cross-matching, and blood collection and administration.
Collapse
Affiliation(s)
| | - Eva Spada
- Veterinary Transfusion Research Laboratory
(REVLab), Department of Veterinary Medicine (DIMEVET), University of Milan,
Italy
| | - Mary Beth Callan
- Department of Clinical Sciences and Advanced
Medicine, School of Veterinary Medicine, University of Pennsylvania,
USA
| | - Rachel Korman
- Cat Specialist Services, Underwood, Queensland,
Australia
| | - Ellie Leister
- Pet Intensive Care Unit, Underwood, Queensland,
Australia
| | - Paulo Steagall
- Department of Clinical Sciences, Faculty of
Veterinary Medicine, Universite de Montréal, QC, Canada
| | - Remo Lobetti
- Bryanston Veterinary Hospital, Johannesburg,
South Africa
| | | | - Séverine Tasker
- Bristol Veterinary School, University of
Bristol, Langford, UK; and Linnaeus Group, Shirley, UK
| |
Collapse
|
7
|
Davidow EB, Blois SL, Goy-Thollot I, Harris L, Humm K, Musulin S, Nash KJ, Odunayo A, Sharp CR, Spada E, Thomason J, Walton J, Wardrop KJ. Association of Veterinary Hematology and Transfusion Medicine (AVHTM) Transfusion Reaction Small Animal Consensus Statement (TRACS). Part 1: Definitions and clinical signs. J Vet Emerg Crit Care (San Antonio) 2021; 31:141-166. [PMID: 33792171 DOI: 10.1111/vec.13044] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Accepted: 02/06/2021] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To use a systematic, evidence-based consensus process to develop definitions for transfusion reactions in dogs and cats. DESIGN Evidence evaluation of the literature was carried out for identified transfusion reaction types in dogs and cats. Reaction definitions were generated based on synthesis of human and veterinary literature. Consensus on the definitions was achieved through Delphi-style surveys. Draft recommendations were made available through industry specialty listservs and comments were incorporated. RESULTS Definitions with imputability criteria were developed for 14 types of transfusion reactions. CONCLUSIONS The evidence review and consensus process resulted in definitions that can be used to facilitate future veterinary transfusion reaction research.
Collapse
Affiliation(s)
| | - Shauna L Blois
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Canada
| | | | | | - Karen Humm
- Department of Clinical Science and Services, The Royal Veterinary College, London, UK
| | - Sarah Musulin
- College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
| | - Katherine J Nash
- VetMED Emergency and Specialty Veterinary Hospital, Phoenix, AZ, USA
| | - Adesola Odunayo
- Department of Small Animal Clinical Sciences, University of Tennessee, Knoxville, TN, USA
| | - Claire R Sharp
- School of Veterinary Medicine, Murdoch University, Perth, Australia
| | - Eva Spada
- Department of Veterinary Medicine, University of Milan, Lodi, Italy
| | - John Thomason
- Department of Clinical Sciences, Mississippi State University, Mississippi State, MS, USA
| | | | - K Jane Wardrop
- Veterinary Clinical Sciences, Washington State University, Pullman, WA, USA
| |
Collapse
|
8
|
Blois SL, Marshall H, Abrams-Ogg ACG, Bersenas AM, Ruotsalo K, Monteith G. Accuracy of a point-of-care major crossmatch test and risk factors for major crossmatch incompatibility in cats. Vet J 2021; 272:105663. [PMID: 33941337 DOI: 10.1016/j.tvjl.2021.105663] [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: 10/15/2020] [Revised: 03/18/2021] [Accepted: 03/23/2021] [Indexed: 10/21/2022]
Abstract
Major crossmatch testing can help identify immunologic incompatibilities between blood donors and recipients; however, there are limited studies describing the accuracy of point-of-care crossmatch tests. The first aim of this study was to determine if a gel-based, point-of-care major crossmatch method (GEL-CM), without antiglobulin-enhancement, could accurately detect compatible and incompatible donor-recipient pairings, using an antiglobulin-enhanced laboratory-based major crossmatch method (LAB-CM) as the reference standard. The second aim was to describe the incidence of, and risk factors for, major crossmatch incompatibility in cats. Nineteen previously-transfused cats and 32 transfusion-naïve cats, representing 132 unique donor-recipient pairings, were included in this study. Both LAB-CM and GEL-CM tests were performed for most parings. There was poor agreement between the LAB-CM and GEL-CM results (kappa = 0.111; 95% confidence interval [CI], -0.093 to 0.314). Transfusion-naïve cats had incompatibility rates of 3% and 6% using LAB-CM and GEL-CM, respectively; previously-transfused cats had incompatibility rates of 32% and 26% using LAB-CM and GEL-CM, respectively. History of previous transfusion was the only identified cat risk factor for an incompatible LAB-CM (odds ratio [OR], 31.0; 95% CI, 3.77-254.98; P = 0.0019) and GEL-CM (OR, 5.7; 95% CI, 1.72-19.20; P = 0.0054). Further studies are needed to determine if GEL-CM can detect clinically-relevant immunologic incompatibilities that would result in transfusion reactions. Major crossmatch testing is of greater importance in cats that have previously received a transfusion.
Collapse
Affiliation(s)
- S L Blois
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario N1G 2W1, Canada.
| | - H Marshall
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario N1G 2W1, Canada
| | - A C G Abrams-Ogg
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario N1G 2W1, Canada
| | - A M Bersenas
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario N1G 2W1, Canada
| | - K Ruotsalo
- Animal Health Laboratory, University of Guelph, Guelph, Ontario N1G 2W1, Canada
| | - G Monteith
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario N1G 2W1, Canada
| |
Collapse
|
9
|
Davidow EB, Blois SL, Goy-Thollot I, Harris L, Humm K, Musulin S, Nash KJ, Odunayo A, Sharp CR, Spada E, Thomason J, Walton J, Wardrop KJ. Association of Veterinary Hematology and Transfusion Medicine (AVHTM) Transfusion Reaction Small Animal Consensus Statement (TRACS) Part 2: Prevention and monitoring. J Vet Emerg Crit Care (San Antonio) 2021; 31:167-188. [PMID: 33751789 DOI: 10.1111/vec.13045] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 02/06/2021] [Indexed: 12/15/2022]
Abstract
OBJECTIVE To systematically review available evidence to develop guidelines for the prevention of transfusion reactions and monitoring of transfusion administration in dogs and cats. DESIGN Evidence evaluation of the literature (identified through Medline searches through Pubmed and Google Scholar searches) was carried out for identified transfusion reaction types in dogs and cats. Evidence was evaluated using PICO (Population, Intervention, Comparison, Outcome) questions generated for each reaction type. Evidence was categorized by level of evidence (LOE) and quality (Good, Fair, or Poor). Guidelines for prevention and monitoring were generated based on the synthesis of the evidence. Consensus on the final recommendations and a proposed transfusion administration monitoring form was achieved through Delphi-style surveys. Draft recommendations and the monitoring form were made available through veterinary specialty listservs and comments were incorporated. RESULTS Twenty-nine guidelines and a transfusion administration monitoring form were formulated from the evidence review with a high degree of consensus CONCLUSIONS: This systematic evidence evaluation process yielded recommended prevention and monitoring guidelines and a proposed transfusion administration form. However, significant knowledge gaps were identified, demonstrating the need for additional research in veterinary transfusion medicine.
Collapse
Affiliation(s)
- Elizabeth B Davidow
- Veterinary Clinical Sciences, Washington State University, Pullman, Washington, USA
| | - Shauna L Blois
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Canada
| | | | | | - Karen Humm
- Department of Clinical Science and Services, The Royal Veterinary College, London, UK
| | - Sarah Musulin
- College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, USA
| | - Katherine J Nash
- VetMED Emergency and Specialty Veterinary Hospital, Phoenix, Arizona, USA
| | - Adesola Odunayo
- Department of Small Animal Clinical Sciences, University of Tennessee, Knoxville, Tennessee, USA
| | - Claire R Sharp
- School of Veterinary Medicine, Murdoch University, Perth, Australia
| | - Eva Spada
- Department of Veterinary Medicine, University of Milan, Lodi, Italy
| | - John Thomason
- Department of Clinical Sciences, Mississippi State University, Mississippi State, Mississippi, USA
| | | | - K Jane Wardrop
- Veterinary Clinical Sciences, Washington State University, Pullman, Washington, USA
| |
Collapse
|
10
|
Odunayo A, Nash KJ, Davidow EB, Blois SL, Goy-Thollot I, Harris L, Humm K, Musulin S, Sharp CR, Spada E, Thomason J, Walton J, Jane Wardrop K. Association of Veterinary Hematology and Transfusion Medicine (AVHTM) transfusion reaction small animal consensus statement (TRACS). Part 3: Diagnosis and treatment. J Vet Emerg Crit Care (San Antonio) 2021; 31:189-203. [PMID: 33751797 DOI: 10.1111/vec.13043] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Accepted: 02/06/2021] [Indexed: 01/15/2023]
Abstract
OBJECTIVE To systematically review available evidence to develop guidelines for diagnosis and treatment of transfusion-associated reactions in dogs and cats. DESIGN Standardized and systemic evaluation of the literature (identified through Medline via PubMed and Google Scholar searches) was carried out for identified transfusion reaction types in dogs and cats. The available evidence was evaluated using PICO (Population, Intervention, Comparison, Outcome) questions generated for each reaction type. The evidence was categorized by level of evidence (LOE) and quality (Good, Fair, or Poor). Guidelines, diagnostic, and treatment algorithms were generated based on the evaluation of the evidence. Consensus on the final guidelines was achieved through Delphi-style surveys. Draft recommendations were disseminated through veterinary specialty listservs for review and comments, which were evaluated and integrated prior to final publication. RESULTS Medline via PubMed and Google Scholar databases were searched. There were 14 Population Intervention Comparison Outcome questions identified and corresponding worksheets were developed focusing on the diagnosis and treatment of transfusion-associated reactions in dogs and cats. Fourteen guidelines and four algorithms were developed with a high degree of consensus. CONCLUSIONS This systematic evidence evaluation process yielded recommended diagnostic and treatment algorithms for use in practice. However, significant knowledge gaps were identified, demonstrating the need for additional research in veterinary transfusion medicine.
Collapse
Affiliation(s)
- Adesola Odunayo
- Department of Small Animal Clinical Sciences, University of Tennessee, Knoxville, Tennessee, USA
| | - Katherine J Nash
- VetMED Emergency and Specialty Veterinary Hospital, Phoenix, Arizona, USA
| | - Elizabeth B Davidow
- Veterinary Clinical Sciences, Washington State University, Pullman, Washington, USA
| | - Shauna L Blois
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Canada
| | | | | | - Karen Humm
- Department of Clinical Science and Services, The Royal Veterinary College, London, UK
| | - Sarah Musulin
- College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, USA
| | - Claire R Sharp
- School of Veterinary Medicine, Murdoch University, Perth, Australia
| | - Eva Spada
- Department of Veterinary Medicine, University of Milan, Lodi, Italy
| | - John Thomason
- Department of Clinical Sciences, Mississippi State University, Mississippi State, Mississippi, USA
| | | | - K Jane Wardrop
- Veterinary Clinical Sciences, Washington State University, Pullman, Washington, USA
| |
Collapse
|
11
|
Holovina KM, Bobrova OM, Kovalenko SY, Hovorova YS, Nardid OA. Effect of ozonation on resistance of ovine and human erythrocytes to hypothermic storage. REGULATORY MECHANISMS IN BIOSYSTEMS 2021. [DOI: 10.15421/022118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Long-term hypothermic storage of animal blood can lead to the loss of its quality and can cause complications in recipient animals after transfusion, so the search for new methods of increasing the preservation of erythrocytes after hypothermic storage continues. The article presents the data of the ozonation effect on the preservation rate of ovine and human erythrocytes during hypothermic storage with Alsever’s solution and mannitol medium. Hemolysis, osmotic fragility and distribution density of ovine and human erythrocytes by the sphericity index were determined at different stages of hypothermic storage. The ovine erythrocytes in the control had a lower osmotic resistance compared to human erythrocytes; however, their osmotic fragility did not change significantly after hypothermic storage for 8 weeks, and for human erythrocytes, it significantly increased. Storage of ovine and human erythrocytes longer than 8 weeks led to a sharp hemolysis, while the level of hemolysis of ovine erythrocytes was lower than that of human erythrocytes. Preservation of ozonated erythrocytes is higher than non-ozonated ones during prolonged hypothermic storage. The effect of ozonation on the preservation rate of red blood cells depended on the composition of the preservation media. Hypothermal storage of human erythrocytes in Alsever’s solution for up to 8 weeks led to a shift in the density of distribution according to the sphericity index towards spheroidization of cells; in a medium with mannitol, the number of flattened cell forms increased. After 8 weeks of hypothermic storage of ovine erythrocytes, most of the cells had high sphericity indices. Pretreatment of human and sheep erythrocytes with ozone allows the distribution of cells to be kept closer to the control during long-term storage, which is especially pronounced in mannitol medium. Ovine erythrocytes retained the ability to form rosettes with human T-lymphocytes after hypothermic storage for up to 12 weeks. Thus, ozone pretreatment and the use of mannitol as part of hypothermic storage medium could be an approach to improve the quality of preserved ovine erythrocytes.
Collapse
|
12
|
Binvel M, Arsenault J, Depré B, Blais MC. Identification of 5 novel feline erythrocyte antigens based on the presence of naturally occurring alloantibodies. J Vet Intern Med 2020; 35:234-244. [PMID: 33336860 PMCID: PMC7848337 DOI: 10.1111/jvim.16010] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 12/06/2020] [Accepted: 12/07/2020] [Indexed: 11/29/2022] Open
Abstract
Background Since the discovery of the Mik antigen, several studies have described blood incompatibilities unrelated to the AB system in cats. Objective To estimate the prevalence of cats with non‐AB incompatibilities associated with naturally occurring alloantibodies (NOAb), and to begin mapping the corresponding feline erythrocyte antigens (FEA). Animals Two hundred and fifty‐eight type A cats. Methods Prospectively, cats were evaluated for the presence of NOAb by crossmatching in groups of 4‐6 cats. When NOAb were detected in a cat, its plasma was used as reagent to assess for the presence of the corresponding FEA in all cats included thereafter, and agreement observed between results of this extensive blood typing was evaluated. Results The chance of detecting incompatibilities by randomly crossmatching 2 cats was 3.9%, which resulted in at least 7% of type A cats having NOAb. Blood typing and agreement analyses performed with 7 newly detected NOAb allowed the identification of 5 presumably distinct FEA. Feline erythrocyte antigens 1 and 5 were most frequent with prevalence of 84% and 96%, respectively. Only FEA 1‐negative status was associated with a higher risk of presenting NOAb; with 16.7% of 42 FEA 1‐negative cats having NOAb compared to 5.1% of 216 FEA 1‐positive cats. Conclusions and Clinical Importance This study represents a first step of FEA identification outside the AB system. Because of its prevalence and association with NOAb, FEA 1 might correspond to the Mik antigen.
Collapse
Affiliation(s)
- Marie Binvel
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, Canada
| | - Julie Arsenault
- Department of Pathology and Microbiology, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, Canada
| | - Boris Depré
- Emergency and Critical Care, Adomvet, Lyon, France
| | - Marie-Claude Blais
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, Canada
| |
Collapse
|