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Israelyan N, Vege S, Friedman DF, Zhang Z, Uter S, Fasano RM, Yee M, Piccone C, Kelly S, Hankins JS, Zheng Y, Westhoff CM, Chou ST. RH genotypes and red cell alloimmunization rates in chronically transfused patients with sickle cell disease: A multisite study in the USA. Transfusion 2024; 64:526-535. [PMID: 38289184 PMCID: PMC10947898 DOI: 10.1111/trf.17740] [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: 10/27/2023] [Revised: 01/08/2024] [Accepted: 01/12/2024] [Indexed: 03/16/2024]
Abstract
BACKGROUND Red cell alloimmunization remains a challenge for individuals with sickle cell disease (SCD) and contributes to increased risk of hemolytic transfusion reactions and associated comorbidities. Despite prophylactic serological matching for ABO, Rh, and K, red cell alloimmunization persists, in part, due to a high frequency of variant RH alleles in patients with SCD and Black blood donors. STUDY DESIGN AND METHODS We compared RH genotypes and rates of alloimmunization in 342 pediatric and young adult patients with SCD on chronic transfusion therapy exposed to >90,000 red cell units at five sites across the USA. Genotyping was performed with RHD and RHCE BeadChip arrays and targeted assays. RESULTS Prevalence of overall and Rh-specific alloimmunization varied among institutions, ranging from 5% to 41% (p = .0035) and 5%-33% (p = .0002), respectively. RH genotyping demonstrated that 33% RHD and 57% RHCE alleles were variant in this cohort. Patients with RHCE alleles encoding partial e antigens had higher rates of anti-e identified than those encoding at least one conventional e antigen (p = .0007). There was no difference in anti-D, anti-C, or anti-E formation among patients with predicted partial or altered antigen expression compared to those with conventional antigens, suggesting that variant Rh on donor cells may also stimulate alloimmunization to these antigens. DISCUSSION These results highlight variability in alloimmunization rates and suggest that a molecular approach to Rh antigen matching may be necessary for optimal prevention of alloimmunization given the high prevalence of variant RH alleles among both patients and Black donors.
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Affiliation(s)
- Narek Israelyan
- Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA
| | - Sunitha Vege
- Immunohematology and Genomics Laboratory, New York Blood Center Enterprise, Long Island City, NY
| | - David F. Friedman
- Division of Hematology, Department of Pediatrics, The Children’s Hospital of Philadelphia, Philadelphia, PA
- Division of Transfusion Medicine, Department of Pathology and Laboratory Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
| | - Zhe Zhang
- Department of Biomedical Informatics, Children’s Hospital of Philadelphia, Philadelphia, PA
| | - Stacey Uter
- Division of Hematology, Department of Pediatrics, The Children’s Hospital of Philadelphia, Philadelphia, PA
| | - Ross M. Fasano
- Center for Transfusion Medicine and Cellular Therapies, Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, GA
- Aflac Cancer and Blood Disorders Center, Children’s Healthcare of Atlanta, Atlanta, GA
| | - Marianne Yee
- Aflac Cancer and Blood Disorders Center, Children’s Healthcare of Atlanta, Atlanta, GA
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA
| | - Connie Piccone
- Pediatric Hematology, Carle Foundation Hospital; Carle Illinois College of Medicine, Urbana, IL
| | - Shannon Kelly
- UCSF Benioff Children’s Hospital Oakland, Oakland, CA
| | - Jane S. Hankins
- Departments of Global Pediatric Medicine and Hematology, St. Jude Children’s Research Hospital, Memphis, TN
| | - Yan Zheng
- Department of Pathology, St. Jude Children’s Research Hospital, Memphis, TN
| | - Connie M. Westhoff
- Immunohematology and Genomics Laboratory, New York Blood Center Enterprise, Long Island City, NY
| | - Stella T. Chou
- Division of Hematology, Department of Pediatrics, The Children’s Hospital of Philadelphia, Philadelphia, PA
- Division of Transfusion Medicine, Department of Pathology and Laboratory Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
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Fung YL, Alcantara RM, Cavalli LB, Chen JW, Chen YY, Donkin R, Kupatawintu P, Kwon SY, Lee CK, Nadarajan VS, Namjil E, Bat S, Odajima T, Sachdev S, Siswishanto R, Tadsomboon S, Sharma RR, Triyono T, Tsuno NH. Insights into the diversity of blood donation practice across Asia: How blood collection agencies adapt donor criteria and processes to their population. Vox Sang 2023; 118:1046-1060. [PMID: 37753662 DOI: 10.1111/vox.13530] [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: 07/25/2023] [Revised: 08/22/2023] [Accepted: 08/29/2023] [Indexed: 09/28/2023]
Abstract
BACKGROUND AND OBJECTIVES Securing an adequate blood supply relies on accurate knowledge of blood donors and donation practices. As published evidence on Asian populations is sparse, this study aims to gather up-to-date information on blood donors and donation practices in Asia to assist planning and strategy development. MATERIALS AND METHODS Ten blood collection agencies (BCAs) provided 12 months' data on donors who met eligibility criteria or were deferred, as well as details of their donation practices. Body mass index and blood volumes were calculated and analysed. RESULTS Data on 9,599,613 donations and 154,834 deferrals from six national and four regional BCAs revealed varied donation eligibility and collection practices. Seven used haemoglobin (Hb) criteria below the World Health Organization anaemia threshold. Seven accepted donors weighing <50 kg. Data collection on the weight and height of donors and on deferrals was inconsistent, often not routine. Deferred donors appear to weigh less, with corresponding lower estimated blood volume. CONCLUSION The diversity in eligibility criteria and donation practices reflects each BCA's strategy for balancing donor health with securing an adequate blood supply. Use of lower Hb criteria substantiate their appropriateness in Asia and indicate the need to define Hb reference intervals relevant to each population. We encourage routine gathering of donor weight and height data to enable blood volume estimation and local optimization of donation volumes. Blood volume estimation formulae specific for the Asian phenotype is needed. Information from this study would be useful for tailoring donation criteria of Asian donors around the world.
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Affiliation(s)
- Yoke-Lin Fung
- School of Health, University of the Sunshine Coast, Sippy Downs, Queensland, Australia
| | | | | | - Jen-Wei Chen
- Taiwan Blood Services Foundation, Taipei City, Taiwan
| | - Yun-Yuan Chen
- Taiwan Blood Services Foundation, Taipei City, Taiwan
| | - Rebecca Donkin
- School of Health, University of the Sunshine Coast, Sippy Downs, Queensland, Australia
- School of Medicine and Dentistry, Griffith University, Birtinya, Queensland, Australia
| | - Pawinee Kupatawintu
- National Blood Centre, Thai Red Cross Society, Thai National Stem Cell Donor Registry (TSCDR), Bangkok, Thailand
| | - So-Yong Kwon
- Blood Safety Bureau, Blood Services Headquarters, Korean Red Cross, Wonju-si, Gangwon-do, Republic of Korea
| | - Cheuk-Kwong Lee
- Hong Kong Red Cross Blood Transfusion Services, Kowloon, Hong Kong SAR, China
| | | | - Erdenebayar Namjil
- National Center for Transfusion Medicine, Ministry of Health, Mongolian Red Cross Society, Ulaanbaatar, Mongolia
| | - Solongo Bat
- National Center for Transfusion Medicine, Ministry of Health, Mongolian Red Cross Society, Ulaanbaatar, Mongolia
| | - Takeshi Odajima
- Japanese Red Cross, Kanto-Koshinetsu Block Blood Center, Tokyo, Japan
| | - Suchet Sachdev
- Department of Transfusion Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | | | - Sahit Tadsomboon
- National Blood Centre, Thai Red Cross Society, Thai National Stem Cell Donor Registry (TSCDR), Bangkok, Thailand
| | - Ratti Ram Sharma
- Department of Transfusion Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Teguh Triyono
- Sardjito Hospital, Gadjah Mada University, Yogyakarta, Indonesia
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Sotolongo G, Poisson JL. Increased red blood cell alloimmunization rates in transfused aplastic anemia and myelofibrosis patients. Transfusion 2023; 63:1803-1808. [PMID: 37644882 DOI: 10.1111/trf.17529] [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: 09/01/2022] [Revised: 07/26/2023] [Accepted: 07/28/2023] [Indexed: 08/31/2023]
Abstract
BACKGROUND Red blood cell (RBC) alloimmunization (AI) is a well-known complication of RBC transfusions, which results in the formation of alloantibodies to non-self antigens on donor RBCs, putting patients at risk of transfusion-related complications. The rate of AI with RBC transfusions in the general hospitalized population is estimated to be 2%-3%. However, some patients who are deemed "transfusion-dependent" require regular transfusions of blood products due to persistently low cell counts, putting them at even greater risk of RBC AI and increased morbidity. However, few studies currently exist investigating RBC AI in some transfusion-dependent patient populations, e.g., aplastic anemia (AA) and myelofibrosis (MF). STUDY DESIGN AND METHODS We conducted a 5-year retrospective review to investigate the prevalence of RBC AI, alloantibody incidence, and the number of RBC transfusions in AA and MF patients, who received RBC transfusions within our hospital system. RESULTS During the study period, 64 AA and 93 MF patients received 1301 and 2766 RBC transfusions, respectively. Compared to the RBC AI rate in the generalized hospitalized patient population (1%-2%), patients with AA and MF had an increased rate of RBC AI incidence rate at 14.1% and 12.9%, respectively. Furthermore, patients with primary MF demonstrated an isolated increased RBC AI incidence rate of 13.3%. The most common alloantibodies produced were anti-E and anti-K. DISCUSSION Within our institution, patients with AA and MF had increased incidence rates of RBC AI compared to the general hospitalized patient population and may benefit from an antigen-matched protocol to minimize AI-related complications.
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Affiliation(s)
- G Sotolongo
- Department of Pathology, Duke University Hospital, Durham, North Carolina, USA
| | - J L Poisson
- Department of Pathology, Duke University Hospital, Durham, North Carolina, USA
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Kracalik I, Sapiano MRP, Wild RC, Ortiz JC, Stewart P, Berger JJ, Basavaraju SV, Free RJ. Supplemental findings of the 2021 National Blood Collection and Utilization Survey. Transfusion 2023; 63 Suppl 4:S19-S42. [PMID: 37702255 PMCID: PMC10783319 DOI: 10.1111/trf.17509] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 08/03/2023] [Accepted: 08/03/2023] [Indexed: 09/14/2023]
Abstract
BACKGROUND The Department of Health and Human Services' National Blood Collection and Utilization Survey (NBCUS) has been conducted biennially since 1997. Data are used to estimate national blood collection and use. Supplemental data from the 2021 NBCUS not presented elsewhere are presented here. METHODS Data on survey participation, donor characteristics, blood component cost, transfusion-associated adverse reactions, and implementation of blood safety measures, including pathogen-reduction of platelets, during 2021, were analyzed. Comparisons are made to 2019 survey data where available (2013-2019 for survey participation). RESULTS During 2021, there were 11,507,000 successful blood donations in the United States, a 4.8% increase from 2019. Persons aged 45-64 years accounted for 42% of all successful blood donations. Donations by persons aged 65 years and older increased by 40.7%, while donations among minorities and donors aged <25 years decreased. From 2019 to 2021, the median price hospitals paid per unit of leukoreduced red blood cells, leukoreduced and pathogen-reduced apheresis platelets, and fresh frozen plasma increased. The largest increase in price per unit of blood component in 2021 was for leukoreduced apheresis platelets, which increased by ~$51. Between 2019 and 2021, the proportion of transfusing facilities reporting use of pathogen-reduced platelets increased, from 13% to 60%. Transfusion-related adverse reactions declined slightly between 2019 and 2021, although the rate of transfusion-transmitted bacterial infections remained unchanged. CONCLUSION During 2021, blood donations increased nationally, although donations from those aged <25 years and minorities declined. The prices hospitals paid for most blood products increased, as did the use of pathogen-reduced platelets.
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Affiliation(s)
- Ian Kracalik
- Division of Healthcare Quality Promotion, National Center
for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and
Prevention, Atlanta, Georgia, USA
| | - Mathew R. P. Sapiano
- Division of Healthcare Quality Promotion, National Center
for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and
Prevention, Atlanta, Georgia, USA
- Lantana Consulting Group, East Thetford, Vermont, USA
| | - Robert C. Wild
- Division of Healthcare Quality Promotion, National Center
for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and
Prevention, Atlanta, Georgia, USA
- CACI International, Reston, Virginia, USA
| | - Joel Chavez Ortiz
- Division of Healthcare Quality Promotion, National Center
for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and
Prevention, Atlanta, Georgia, USA
- Oakridge Institute for Science and Education, Atlanta,
Georgia, USA
| | - Phylicia Stewart
- Division of Healthcare Quality Promotion, National Center
for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and
Prevention, Atlanta, Georgia, USA
- Chenega Corporation, Atlanta, Georgia, USA
| | - James J. Berger
- Office of Infectious Disease and HIV/AIDS Policy, Office of
the Assistant Secretary for Health, Department of Health and Human Services,
Washington, District of Columbia, USA
| | - Sridhar V. Basavaraju
- Division of Healthcare Quality Promotion, National Center
for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and
Prevention, Atlanta, Georgia, USA
| | - Rebecca J. Free
- Division of Healthcare Quality Promotion, National Center
for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and
Prevention, Atlanta, Georgia, USA
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Lomas-Francis C, Thornton N, Nance ST. The need for rare blood programs is real. Transfusion 2023; 63:659-664. [PMID: 36938955 DOI: 10.1111/trf.17307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Accepted: 02/25/2023] [Indexed: 03/21/2023]
Abstract
See article on page 670–678, in this issue
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Affiliation(s)
| | - Nicole Thornton
- International Blood Group Reference Laboratory, NHS Blood and Transplant, Bristol, United Kingdom
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Oviedo P, Jaffré Y, Danic B, Mazières S, Chiaroni J. Impact of societal and legal context on the blood supply of African-ancestry populations in Western countries: A review of practices and the French example. Vox Sang 2022; 117:1137-1144. [PMID: 35697918 PMCID: PMC9796234 DOI: 10.1111/vox.13326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 02/28/2022] [Accepted: 05/09/2022] [Indexed: 01/01/2023]
Abstract
In Western countries, blood supply agencies encounter impediments in providing blood groups defined as rare or of interest, notably for sub-Saharan African ancestry (SSAA) recipients. To establish warning levels and anticipate future blood needs, an estimate of the current carriers of rare blood groups, both potential patients or donors, is crucial but complex. Indeed, if the strict needs can be estimated in medical terms, the modalities of blood product collection must be considered from an interdisciplinary perspective, at the interface of biological data and social norms. Here, we aim to understand how legal choices and a set of representations of otherness may influence the supply of rare blood for SSAA populations. After examining these issues, considering different norms and limits that govern French society, we compare this data with those of four Western countries facing the same difficulties (United States, United Kingdom, Italy and the Netherlands). This work began as part as the reflections of Social Lab, an institutional programme created by the French Blood Establishment (EFS). How can we effectively improve the qualitative blood coverage for SSAA populations? There is no unique solution, but there are many more or less effective answers. Comparison across countries reveals a strong influence of the socio-political histories and ethical choices before technical and medical considerations. We consider that an institutional policy is required to resolve recruitment issues of SSAA donors sustainably. Lastly, we introduce a working group called the EFS Social Lab, which aims to set up a monitoring mechanism for donors and societal trends to make blood donation effective.
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Affiliation(s)
- Pauline Oviedo
- Aix Marseille Univ, CNRS, EFS, ADES, UMR 7268MarseilleFrance
- Etablissement Français du Sang PACA Corse, “Biologie des groupes sanguins”MarseilleFrance
| | | | - Bruno Danic
- Etablissement Français du Sang BretagneRennesFrance
- Etablissement Français du Sang SocialabSaint‐DenisFrance
| | | | - Jacques Chiaroni
- Aix Marseille Univ, CNRS, EFS, ADES, UMR 7268MarseilleFrance
- Etablissement Français du Sang PACA Corse, “Biologie des groupes sanguins”MarseilleFrance
- Etablissement Français du Sang SocialabSaint‐DenisFrance
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Hopkins CK, Townsend M, Vassallo RR. Leukoreduction filters: Still stuck on sickle trait red cells. Transfusion 2022; 62:1683-1687. [PMID: 36039825 DOI: 10.1111/trf.17077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 08/08/2022] [Indexed: 11/29/2022]
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Gehrie EA, Petran L, Young PP. Sickle cell trait results in a high leukoreduction quality control failure rate for whole blood donations. Transfusion 2022; 62:1727-1730. [PMID: 35841199 PMCID: PMC9546366 DOI: 10.1111/trf.17021] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 06/11/2022] [Accepted: 06/20/2022] [Indexed: 11/29/2022]
Abstract
Background Prior studies have shown that sickle cell trait (SCT) is the most common reason attributed to leukoreduction (LR) filter failure due to physical blockage. However, current Food and Drug Administration (FDA) guidelines do not require blood collectors to take a specific action to mitigate inadequate LR that may occur among donors with SCT. We sought to determine the scope of inadequate LR among whole blood (WB) donations collected from individuals with SCT and processed under standard manufacturing conditions. Study Design and Methods Between 8/2021 and 2/2022, a total of 40 red blood cells units (RBCs) manufactured from WB donations collected from donors historically positive for SCT had residual leukocyte testing performed. All 40 of the units had appeared to successfully complete leukofiltration. Results Out of the 40 units tested, 22 failed routine residual leukocyte quality control testing (55% failure rate, 95% confidence interval 40%–70%). Nine out of the 22 failures resulted in more than 100 residual leukocytes per microliter of product. Conclusion Even when leukofiltration appears to have been completed successfully, WB units collected from donors with SCT have a high (55% in aggregate) rate of inadequate leukoreduction. Correlating this result with previous studies showing that of up to 50% of WB units collected from donors with SCT fail to pass through the leukoreduction filter, we estimate that only 25% of WB donations collected from individuals with SCT will result in a leukoreduced RBC unit that meets all FDA requirements. Blood centers should encourage individuals with SCT to donate platelets or plasma, rather than WB. See editorial on page 1683–1687, in this issue
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Affiliation(s)
- Eric A Gehrie
- American Red Cross, Biomedical Services Division, Washington, District of Columbia, USA
| | - Lori Petran
- American Red Cross, Biomedical Services Division, Peoria, Illinois, USA
| | - Pampee P Young
- American Red Cross, Biomedical Services Division, Washington, District of Columbia, USA
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Ferguson E, Dawe‐Lane E, Khan Z, Reynolds C, Davison K, Edge D, Brailsford SR. Trust and distrust: Identifying recruitment targets for ethnic minority blood donors. Transfus Med 2022; 32:276-287. [PMID: 35499471 PMCID: PMC9542243 DOI: 10.1111/tme.12867] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 02/17/2022] [Accepted: 04/03/2022] [Indexed: 01/13/2023]
Abstract
Background We explore the role of trust, distrust, and the prevailing socio‐political context to better understand why people from ethnic minority communities are less likely to be blood donors compared to people from White communities. Recruiting more ethnic minority donors will enhance representativeness, reduce inequality, and help meet the clinical need to increase the proportion of blood with Ro Kell antigen to treat Sickle Cell Disease (SCD). Study design and methods A 2 (donor‐status: current donor; non‐donors) by 4 (ethnicity: People from Asian, Black, Mixed and White ethnic backgrounds) quasi‐experiment (N = 981) was conducted to examine perceptions of trust/distrust and their influence on willingness to donate blood, within the socio‐political context of the Windrush scandal and Brexit. Results We identified five domains of trust (‘National Health Service [NHS] and staff,’ ‘NHS Blood and Transplant,’ ‘outgroups,’ ‘individuals’ and ‘politics’), and a single domain of conditional distrust domain. Trust across all the domains was lower, and ‘conditional distrust’ higher for ethnic minorities. Trust in ‘individuals’ and ‘NHSBT’ predicted willingness to donate in non‐donors from ethnic minorities and White non‐donors, respectively. Concerns about the Windrush scandal were related to lower political trust. Viewing Brexit as ‘positive for the UK’ was related to lower trust across domains and reduced willingness to donate in White non‐donors through its influence on reduced trust in NHSBT. Conclusion Distinct domains of trust and distrust are identified, and targeting ‘trust in others’ through conditional cooperation is recommended as a strategy to increase donor numbers from ethnic minority communities.
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Affiliation(s)
| | - Erin Dawe‐Lane
- School of Psychology University of Nottingham Nottingham UK
| | - Zaynah Khan
- School of Psychology University of Nottingham Nottingham UK
- Leciestershire PartnershipTrust Mill Lodge, The Rise, Narborough Leicester UK
| | - Claire Reynolds
- NHS Blood and Transplant/UK Health Security Agency Epidemiology Unit London UK
| | - Katy Davison
- NHS Blood and Transplant/UK Health Security Agency Epidemiology Unit London UK
| | - Dawn Edge
- Division of Psychology and Mental Health University of Manchester Manchester UK
| | - Susan R. Brailsford
- NHS Blood and Transplant/UK Health Security Agency Epidemiology Unit London UK
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Kim H, Shin KH, Kim HH, Lee HJ. Perceptions and Experiences of Migrants in Korea Regarding Blood Donation in Association with Sociodemographic Status. Ann Lab Med 2022; 42:258-267. [PMID: 34635617 PMCID: PMC8548250 DOI: 10.3343/alm.2022.42.2.258] [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: 01/27/2021] [Revised: 05/11/2021] [Accepted: 09/15/2021] [Indexed: 11/19/2022] Open
Abstract
Background With increasing number of migrants in Korea, there is an increasing need for blood products with rare blood antigens. Accordingly, the role of blood donors among migrants has been acknowledged. We investigated migrants’ experiences and perceptions of blood donation along with their sociodemographic status and identified the effects on self-reported blood donation status. Methods A cross-sectional survey using a self-developed, structured questionnaire was conducted on 479 migrants. The questionnaire included items about experiences, knowledge, and perceptions on blood donation and sociodemographic factors of respondents. Results Most migrants in this study were from Southeast Asia (54.7%) or China (39.9%). Among them, 28.6% (N=137) had donated blood previously, and 2.7% (N=13) had previously donated blood in Korea. All previous blood donors were volunteers, and the two major deterrents of blood donation for non-donors were the fear of pain and lack of knowledge about blood donation. In multivariable logistic regression analysis, the country of birth (odds ratio [OR]=2.65, P<0.001 [China]; OR=4.85, P=0.001 [countries other than China and Southeast Asian countries]) and employment status (OR=2.80, P=0.034) were independently associated with blood donation. Conclusions This is the first Korean study to analyze migrants’ experiences and perceptions of blood donation in relation to their sociodemographic status. Our findings can help establish blood donation policies for migrants, devise campaigns to enhance blood donation awareness, and ultimately create a pool of rare blood resources in a multicultural society.
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Affiliation(s)
- Hyerin Kim
- Department of Laboratory Medicine, Pusan National University Hospital, Busan, Korea
| | - Kyung-Hwa Shin
- Department of Laboratory Medicine, Pusan National University Hospital, Busan, Korea
| | - Hyung-Hoi Kim
- Department of Laboratory Medicine, Pusan National University Hospital, Busan, Korea.,Biomedical Informatics Unit, Pusan National University Hospital, Busan, Korea
| | - Hyun-Ji Lee
- Department of Laboratory Medicine and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea
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11
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Sheykhsoltan M, Wu W, Mei Z, Ward DC, Ziman A. Who donates? Patterns of blood donation and donor characteristics at a university-affiliated hospital-based donor center. Transfusion 2021; 62:346-354. [PMID: 34859437 DOI: 10.1111/trf.16754] [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: 09/22/2021] [Revised: 11/13/2021] [Accepted: 11/14/2021] [Indexed: 01/28/2023]
Abstract
BACKGROUND Blood donors are a crucial element of the blood supply chain. Optimal recruitment strategies built upon the robust understanding of local donor behavior and demographics-specifically, the donor characteristics of our university-affiliated hospital-based donor center-improve outreach and retention of donors. STUDY DESIGN AND METHODS This retrospective study analyzed blood donors' genders, ethnicities, and donation frequencies at a university-affiliated hospital-based donor center from 2014-2019, stratified into seven age cohorts. Donor ethnicity demographics were compared to the reported student, employee, and LA County population. RESULTS Female donors outnumbered male donors in all age cohorts. The majority of donors self-identified (SI) as White (36.7%), Hispanic/Latino (21.6%), or Asian (19.1%). Older donors (age > 25) donated more frequently (4.1 vs. 2.3 donations per donor) than younger donors (age ≤ 25). Repeat donors who donated in multiple years during the study period were more likely to donate multiple times each year than those donors who only donated during 1 year. DISCUSSION Our donor demographics more closely reflect the university student and employee demographics than LA County demographics, demonstrating the broad local efforts of recruitment by student groups and donor center recruitment staff. However, non-White populations continue to be underrepresented. The majority of donors only donated once during the study period. Recruitment strategies to increase donor engagement among underrepresented populations and increase the proportion of repeat donors are likely to prove most beneficial.
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Affiliation(s)
| | - Wesley Wu
- University of California Los Angeles, Los Angeles, California, USA
| | - Zhen Mei
- Department of Pathology and Laboratory Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Dawn C Ward
- Department of Pathology and Laboratory Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Alyssa Ziman
- Department of Pathology and Laboratory Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
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Comparative Performance of Latest-Generation and FDA-Cleared Serology Tests for the Diagnosis of Chagas Disease. J Clin Microbiol 2021; 59:JCM.00158-21. [PMID: 33762363 DOI: 10.1128/jcm.00158-21] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 03/20/2021] [Indexed: 11/20/2022] Open
Abstract
Confirmed diagnosis of chronic Chagas disease (CD) requires positive results by two different IgG serology tests. Variable sensitivity has been reported among tests and in different geographic regions. Inadequate specificity presents a particular challenge in low-prevalence settings such as the United States. This study provides a direct comparison of the latest-generation IgG serology assays with four previously assessed FDA-cleared tests. Seven hundred ten blood donor plasma specimens were evaluated by Wiener Lisado and Wiener v.4.0 enzyme-linked immunosorbent assays (ELISAs) and Abbott PRISM Chagas chemiluminescent assay (ChLIA). Sensitivity and specificity were assessed relative to infection status as determined by the original blood donation testing algorithm. All three latest-generation assays demonstrated 100% specificity (95% confidence interval [CI], 98.6 to 100.0). Wiener Lisado, Wiener v.4.0, and Abbott PRISM had sensitivities of 97.1% (95% CI, 95.1 to 98.4), 98.9% (95% CI, 97.4 to 99.6), and 95.5% (95% CI, 93.2 to 97.3), respectively. As with previously evaluated FDA-cleared tests, all three assays had the highest reactivity and sensitivity in samples from donors born in South America and lowest reactivity and sensitivity in specimens from those born in Mexico, with intermediate results in specimens from Central American donors. Wiener v.4.0 had the highest diagnostic sensitivity in all comparisons. Our findings suggest that the latest-generation CD serology tests could improve diagnostic sensitivity without affecting specificity.
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Schwab ME, Schmidt CN, Gonzalez-Velez JM, Bakhtary S. Racial/ethnic disparities among women receiving intrauterine transfusions for alloimmunization at a single fetal treatment center. Transfusion 2021; 61:2019-2024. [PMID: 33745158 DOI: 10.1111/trf.16379] [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: 12/21/2020] [Revised: 03/08/2021] [Accepted: 03/09/2021] [Indexed: 01/18/2023]
Abstract
Disparities are prevalent in numerous areas of healthcare. We sought to investigate whether there were racial/ethnic disparities among pregnant women with the most severe form of alloimmunization who require intrauterine transfusions (IUT). We reviewed patients who underwent IUT for alloimmunization at a single fetal treatment center between 2015 and 2020. This "IUT cohort" was compared to an "Alloimmunization cohort": patients seen at our institution with a diagnosis of alloimmunization during pregnancy, who did not receive IUT. We collected maternal demographics including self-identified race/ethnicity and primary language, transfusion, and antibody characteristics. The cohorts were compared using unpaired t-tests, Mann-Whitney tests, and Fischer's exact tests, as appropriate. The IUT cohort included 43 patients and the alloimmunization cohort included 1049 patients. Compared to the alloimmunization cohort, there were significantly more patients of Latina descent in the IUT cohort (23.3% vs. 3.4%, p < .0001), and more non-English speakers (18.6% vs. 4.6%, p = .001). Twenty-one percent (9/43) of patients had immigrated to the United States, all of whom had pregnancies or miscarriages in their country of origin. A third of patients had new antibodies identified on serial screens during the current pregnancy. Significantly more women of Latina ethnicity and non-English speakers required IUTs compared to the cohort of women with alloimmunization. Insufficient access to care prior to arriving in the United States and among racial and ethnic minorities in the United States may contribute to these findings. Providers should be cognizant of potential, racial, and ethnic inequalities among women receiving intrauterine transfusions.
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Affiliation(s)
- Marisa E Schwab
- Fetal Treatment Center, University of California San Francisco, San Francisco, California, USA
| | - Christina N Schmidt
- School of Medicine, University of California San Francisco, San Francisco, California, USA
| | - Juan M Gonzalez-Velez
- Fetal Treatment Center, University of California San Francisco, San Francisco, California, USA
| | - Sara Bakhtary
- Department of Laboratory Medicine, University of California San Francisco, San Francisco, California, USA
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14
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Blood donation for all: inclusivity is important to the blood supply. BLOOD TRANSFUSION = TRASFUSIONE DEL SANGUE 2020; 19:1-2. [PMID: 33085597 DOI: 10.2450/2020.0303-20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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15
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Hamilton JR. Low prevalence red blood cell antigens: transfusions, babies, and changing demographics. Transfusion 2020; 60:659-662. [PMID: 32246481 DOI: 10.1111/trf.15764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 03/02/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Janis R Hamilton
- American Red Cross, Southeastern Michigan Region, Detroit, MI, USA
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16
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Chagas Disease Serological Test Performance in U.S. Blood Donor Specimens. J Clin Microbiol 2019; 57:JCM.01217-19. [PMID: 31511333 PMCID: PMC6879282 DOI: 10.1128/jcm.01217-19] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Accepted: 09/04/2019] [Indexed: 12/19/2022] Open
Abstract
Chagas disease affects an estimated 300,000 individuals in the United States. Diagnosis in the chronic phase requires positive results from two different IgG serological tests. Three enzyme-linked immunosorbent assays (ELISAs) (Hemagen, Ortho, and Wiener) and one rapid test (InBios) are FDA cleared, but comparative data in U.S. populations are sparse. We evaluated 500 seropositive and 300 seronegative blood donor plasma samples. Country of birth was known for 255 seropositive specimens, which were grouped into regions as follows: Mexico (n = 94), Central America (n = 88), and South America (n = 73). Specimens were tested by the four FDA-cleared IgG serological assays. Test performance was evaluated by two comparators and latent class analysis. InBios had the highest sensitivity (97.4% to 99.3%) but the lowest specificity (87.5% to 92.3%). Hemagen had the lowest sensitivity (88.0% to 92.0%) but high specificity (99.0% to 100.0%). The level of sensitivity was intermediate for Ortho (92.4% to 96.5%) and Wiener (94.0% to 97.1%); both had high specificity (98.8% to 100.0% and 96.7% to 99.3%, respectively). The levels of antibody reactivity and clinical sensitivity were lowest in donors from Mexico, intermediate in those from Central America, and highest in those from South America. Our findings provide an initial evidence base to improve laboratory diagnosis of Chagas disease in the United States. The best current testing algorithm would employ a high-sensitivity screening test followed by a high-specificity confirmatory test.
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17
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Gronowski AM, Budelier MM, Campbell SM. Ethics for Laboratory Medicine. Clin Chem 2019; 65:1497-1507. [PMID: 31434657 DOI: 10.1373/clinchem.2019.306670] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Accepted: 07/08/2019] [Indexed: 01/26/2023]
Abstract
BACKGROUND Laboratory medicine, like other areas of medicine, is obliged to adhere to high ethical standards. There are particular ethical issues that are unique to laboratory medicine and other areas in which ethical issues uniquely impact laboratory practice. Despite this, there is variability in ethics education within the profession. This review provides a foundation for the study of ethics within laboratory medicine. CONTENT The Belmont Report identifies 3 core principles in biomedical ethics: respect for persons (including autonomy), beneficence (and its corollary nonmalfeasance), and justice. These core principles must be adhered to in laboratory medicine. Informed consent is vital to maintain patient autonomy. However, balancing patient autonomy with the desire for beneficence can sometimes be difficult when patients refuse testing or treatment. The use of leftover or banked samples is fundamental to the ability to do research, create reference intervals, and develop new tests, but it creates problems with consent. Advances in genetic testing have created unique ethical issues regarding privacy, incidental findings, and informed consent. As in other professions, the emergence of highly contagious and deadly infectious diseases poses a difficult ethical dilemma of helping patients while protecting healthcare workers. CONCLUSIONS Although many clinical laboratorians do not see or treat patients, they must be held accountable to the highest ethical and professional behavior. Recognition and understanding of ethical issues are essential to ethical practice of laboratory medicine.
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Affiliation(s)
- Ann M Gronowski
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO;
| | - Melissa M Budelier
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO
| | - Sheldon M Campbell
- Department of Laboratory Medicine, Yale University School of Medicine, New Haven, CT
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18
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Patel EU, Bloch EM, Grabowski MK, Goel R, Lokhandwala PM, Brunker PAR, White JL, Shaz B, Ness PM, Tobian AAR. Sociodemographic and behavioral characteristics associated with blood donation in the United States: a population-based study. Transfusion 2019; 59:2899-2907. [PMID: 31222779 DOI: 10.1111/trf.15415] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 05/22/2019] [Accepted: 05/22/2019] [Indexed: 01/28/2023]
Abstract
BACKGROUND Contemporary population-based data on characteristics associated with blood donation in the United States (U.S.) are limited. STUDY DESIGN AND METHODS A cross-sectional analysis was performed among 28,739 persons aged 18 years and older who participated in the 2016 National Health Interview Survey, a household survey of the noninstitutionalized U.S. civilian population. Analyses were weighted and accounted for the complex survey design. Adjusted prevalence ratios (aPR) were estimated by multivariable log-binomial regression. RESULTS The percentage of individuals reporting a past-year history of blood donation was 5.7% (95% confidence interval [CI], 5.3%-6.1%) and was highest in the youngest age group (18-24 years, 8.4%). A past-year history of blood donation was more common in males compared to females (6.3% vs. 5.1%; aPR, 1.12 [95% CI, 0.99-1.27]) and those born in the U.S. compared to individuals born outside the U.S. (6.4% vs. 2.4%; aPR, 1.92 [95% CI, 1.49-2.47]). The percentage of individuals with a past-year history of blood donation was significantly lower in blacks (3.9%; aPR, 0.60 [95% CI, 0.47-0.75]) and Hispanics (3.0%; aPR, 0.63 [95% CI, 0.48-0.83]) in comparison to whites (6.9%). Being a college graduate, being employed, being physically active, and never being a cigarette smoker were factors positively associated with blood donation. The percentage of individuals with a past-year history of blood donation varied by geographic census region, with prevalence being higher in the Midwest (7.3%) and South (6.0%) compared to the Northeast (4.7%) and West (4.4%). CONCLUSION Continued differences in the blood donor population with reference to the U.S. population underscore the need to understand barriers or deterrents to blood donation. Evidence-based donor recruitment and related policies remain imperative to ensure that there is a sustainable blood supply.
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Affiliation(s)
- Eshan U Patel
- Division of Transfusion Medicine, Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Evan M Bloch
- Division of Transfusion Medicine, Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Mary K Grabowski
- Division of Transfusion Medicine, Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Ruchika Goel
- Division of Transfusion Medicine, Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland.,Division of Hematology/Oncology, Simmons Cancer Institute at SIU School of Medicine, Springfield, Illinois
| | - Parvez M Lokhandwala
- Division of Transfusion Medicine, Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Patricia A R Brunker
- Division of Transfusion Medicine, Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland.,Biomedical Services, Greater Chesapeake and Potomac Region, The American Red Cross, Baltimore, Maryland
| | - Jodie L White
- Division of Transfusion Medicine, Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Beth Shaz
- New York Blood Center, New York, New York
| | - Paul M Ness
- Division of Transfusion Medicine, Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Aaron A R Tobian
- Division of Transfusion Medicine, Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland
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19
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20
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Makin JK, Francis KL, Polonsky MJ, Renzaho AMN. Interventions to Increase Blood Donation among Ethnic/Racial Minorities: A Systematic Review. JOURNAL OF ENVIRONMENTAL AND PUBLIC HEALTH 2019; 2019:6810959. [PMID: 31143209 PMCID: PMC6501160 DOI: 10.1155/2019/6810959] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Accepted: 03/20/2019] [Indexed: 12/12/2022]
Abstract
Ethnic/racial minorities are under-represented in blood donor populations in most developed countries. This is of particular concern where minorities differ from a country's majority population in terms of blood or tissue typing, especially where type matching is required for effective management of rare disorders such as sickle-cell disease that require multiple transfusions. This systematic review assessed the effectiveness of interventions to increase blood donation among ethnic/racial minority populations in developed countries. We searched MEDLINE, EMBASE, CINAHL, and ProQuest on 20 March 2017 with no date restrictions and supplemented this with searches on Google Scholar, blood collection agency websites, reference lists of included studies, and a forward search of citations of included studies. We included intervention studies designed to increase recruitment and/or retention of adult, ethnic/racial minority blood donors in developed countries. The review identified eight studies reported in nine publications. Six were conducted in the USA with African Americans. Four studies reported on multifaceted, community-based interventions; three reported on one-off information and educational video interventions, presented face-to-face, or delivered via post or e-mail. The level of evidence for efficacy was low, and the majority of studies were assessed as having some risk of bias related to one or more methodological issues. All eight studies reported positive outcomes in blood donation and/or intention to donate. Seven trials found that the intervention increased presentation for donation, and three found an increase in the percentage of new donors from the ethnic minority targeted. The review findings demonstrate that it is possible to design and implement effective interventions to motivate individuals from ethnic/racial minority groups to donate blood. One-off interventions may be as effective as multifaceted, community-based interventions. There was insufficient evidence to recommend particular interventions, and future research should empirically assess alternative interventions using robust study designs.
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Affiliation(s)
- Jennifer K. Makin
- Menzies Institute for Medical Research, University of Tasmania, Hobart 7000, Australia
| | - Kate L. Francis
- Murdoch Children's Research Institute, Melbourne 3052, Australia
| | | | - Andre M. N. Renzaho
- School of Social Sciences and Psychology, Western Sydney University, Sydney 2751, Australia
- Translational Health Research Institute, Western Sydney University, Sydney 2751, Australia
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21
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Kanias T, Stone M, Page GP, Guo Y, Endres-Dighe SM, Lanteri MC, Spencer BR, Cable RG, Triulzi DJ, Kiss JE, Murphy EL, Kleinman S, Gladwin MT, Busch MP, Mast AE. Frequent blood donations alter susceptibility of red blood cells to storage- and stress-induced hemolysis. Transfusion 2018; 59:67-78. [PMID: 30474858 DOI: 10.1111/trf.14998] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2018] [Revised: 05/14/2018] [Accepted: 05/27/2018] [Indexed: 12/20/2022]
Abstract
BACKGROUND Frequent whole blood donations increase the prevalence of iron depletion in blood donors, which may subsequently interfere with normal erythropoiesis. The purpose of this study was to evaluate the associations between donation frequency and red blood cell (RBC) storage stability in a racially/ethnically diverse population of blood donors. STUDY DESIGN Leukoreduced RBC concentrate-derived samples from 13,403 donors were stored for 39 to 42 days (1-6°C) and then evaluated for storage, osmotic, and oxidative hemolysis. Iron status was evaluated by plasma ferritin measurement and self-reported intake of iron supplements. Donation history in the prior 2 years was obtained for each subject. RESULTS Frequent blood donors enrolled in this study were likely to be white, male, and of older age (56.1 ± 5.0 years). Prior donation intensity was negatively associated with oxidative hemolysis (p < 0.0001) in multivariate analyses correcting for age, sex, and race/ethnicity. Increased plasma ferritin concentration was associated with increased RBC susceptibility to each of the three measures of hemolysis (p < 0.0001 for all), whereas self-reported iron intake was associated with reduced susceptibility to osmotic and oxidative hemolysis (p < 0.0001 for both). CONCLUSIONS Frequent blood donations may alter the quality of blood components by modulating RBC predisposition to hemolysis. RBCs collected from frequent donors with low ferritin have altered susceptibility to hemolysis. Thus, frequent donation and associated iron loss may alter the quality of stored RBC components collected from iron-deficient donors. Further investigation is necessary to assess posttransfusion safety and efficacy in patients receiving these RBC products.
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Affiliation(s)
- Tamir Kanias
- Pittsburgh Heart, Lung, Blood and Vascular Medicine Institute, University of Pittsburgh, Pittsburgh, Pennsylvania.,Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Mars Stone
- Blood Systems Research Institute, San Francisco, and Department of Laboratory Medicine, University of California, San Francisco, California
| | | | - Yuelong Guo
- RTI International, Research Triangle Park, North Carolina
| | | | - Marion C Lanteri
- Blood Systems Research Institute, San Francisco, and Department of Laboratory Medicine, University of California, San Francisco, California
| | | | | | - Darrell J Triulzi
- Department of Pathology, University of Pittsburgh, Pittsburgh, Pennsylvania.,The Institute for Transfusion Medicine, Pittsburgh, Pennsylvania
| | - Joseph E Kiss
- The Institute for Transfusion Medicine, Pittsburgh, Pennsylvania
| | - Edward L Murphy
- Blood Systems Research Institute, San Francisco, and Department of Laboratory Medicine, University of California, San Francisco, California
| | - Steve Kleinman
- University of British Columbia, Victoria, British Columbia, Canada
| | - Mark T Gladwin
- Pittsburgh Heart, Lung, Blood and Vascular Medicine Institute, University of Pittsburgh, Pittsburgh, Pennsylvania.,Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Michael P Busch
- Blood Systems Research Institute, San Francisco, and Department of Laboratory Medicine, University of California, San Francisco, California
| | - Alan E Mast
- Blood Research Institute, Blood Center of Wisconsin, and Department of Cell Biology, Neurobiology and Anatomy, Medical College of Wisconsin, Milwaukee
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22
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RH genotype matching for transfusion support in sickle cell disease. Blood 2018; 132:1198-1207. [DOI: 10.1182/blood-2018-05-851360] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Accepted: 07/05/2018] [Indexed: 11/20/2022] Open
Abstract
Key PointsRH genotyping of red cells may improve matching of patients and donors and reduce Rh alloimmunization. RH genotype matching may improve use of an African American blood donor inventory.
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23
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Khan J, Delaney M. Transfusion Support of Minority Patients: Extended Antigen Donor Typing and Recruitment of Minority Blood Donors. Transfus Med Hemother 2018; 45:271-276. [PMID: 30283277 DOI: 10.1159/000491883] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Accepted: 07/06/2018] [Indexed: 01/16/2023] Open
Abstract
One of the most important and persistent complications of blood transfusion is red blood cell (RBC) alloimmunization. When a patient is exposed to RBC antigens that differ from their own they can form alloantibodies to these foreign antigens. Blood group antigens are highly conserved and follow ancestral patterns of inheritance that may demonstrate population restriction. Minority populations who require chronic transfusion are at particularly high risk of alloimmunization when the blood donor population does not share the same ancestral background, resulting in exposure to non-self RBC antigens. It is incumbent on blood collectors to support patients with risk factors for alloimmunization as well as patients who have already formed alloantibodies. Increasing utilization of RBC genotyping may represent an opportunity to improve access to RBC units from donors that match the extended RBC phenotype of all possible patients.
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Affiliation(s)
- Jenna Khan
- Department of Laboratory Medicine, University of Washington, Seattle, WA, USA
| | - Meghan Delaney
- Pathology & Laboratory Medicine Division, Children's National Health System, Washington, DC, USA.,Department of Pathology & Pediatrics, The George Washington University, Washington, DC, USA
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24
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Francis KL, Polonsky MJ, Jones SC, Renzaho AMN. The effects of a culturally-tailored campaign to increase blood donation knowledge, attitudes and intentions among African migrants in two Australian States: Victoria and South Australia. PLoS One 2017; 12:e0188765. [PMID: 29190655 PMCID: PMC5708787 DOI: 10.1371/journal.pone.0188765] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Accepted: 11/13/2017] [Indexed: 11/26/2022] Open
Abstract
Research suggests that African migrants are often positively predisposed towards blood donation, but are under-represented in participation. A culturally-tailored intervention targeting the African migrant community in Australia was developed and implemented, to enhance knowledge about blood donation, improve attitudes towards donating, increase intentions to donate blood, and increase the number of new African donors in Australia. Four weeks after a targeted campaign, a survey evaluation process commenced, administered face-to-face by bilingual interviewers from the African community in Melbourne and Adelaide, Australia (community survey). The questionnaires covered demographics, campaign awareness, blood donation knowledge and intentions, medical mistrust and perceived discrimination, and were analysed to evaluate changes in knowledge and intention. Sixty-two percent of survey participants (n = 454) reported being aware of the campaign. With increasing campaign awareness, there was a 0.28 increase in knowledge score (p = .005); previous blood donation was also associated with an increased blood donation knowledge score. Blood donation intention scores were not associated with campaign awareness (p = 0.272), but were associated with previous blood donation behaviour and a positive blood donation attitude score. More positive scores on the blood donation attitude measure were associated with increasing blood donation intentions, self-efficacy and campaign awareness (score increases of 0.27, 0.30 and 0.04, respectively, all p<0.05). Data were collected on the ethnicity of new blood donors in six blood collection centres before and after the intervention, and independent of the intervention evaluation survey. These data were also used to assess behavioural changes and the proportions of donors from different countries before and after the survey. There was no difference in the number of new African migrant donors, before and after the intervention. The culturally-relevant marketing campaign was associated with improved blood donation knowledge and attitudes, but there was no short-term change in blood donation intentions or the number of African donors.
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Affiliation(s)
- Kate L. Francis
- Centre for Health and Social Research, Australian Catholic University, Melbourne, Australia
- Department of Marketing, Deakin Business School, Deakin University, Burwood, Australia
- * E-mail:
| | - Michael J. Polonsky
- Department of Marketing, Deakin Business School, Deakin University, Burwood, Australia
| | - Sandra C. Jones
- Centre for Health and Social Research, Australian Catholic University, Melbourne, Australia
| | - Andre M. N. Renzaho
- School of Social Sciences and Psychology, Western Sydney University, Penrith, Australia
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25
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Rossmann SN. Donors and data-increasing deficits. Transfusion 2017; 57:1635-1638. [PMID: 28675528 DOI: 10.1111/trf.14180] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Accepted: 04/27/2017] [Indexed: 11/27/2022]
Affiliation(s)
- Susan N Rossmann
- Medical Services, Gulf Coast Regional Blood Center, Houston, Texas
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26
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Bachegowda LS, Timm B, Dasgupta P, Hillyer CD, Kessler D, Rebosa M, France CR, Shaz BH. Impact of predictive scoring model and e-mail messages on African American blood donors. Transfusion 2017; 57:1515-1521. [DOI: 10.1111/trf.14113] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Revised: 02/04/2017] [Accepted: 02/04/2017] [Indexed: 11/28/2022]
Affiliation(s)
| | - Brad Timm
- Hindsait, Inc.; Hackensack New Jersey
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27
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Yazer MH, Vassallo R, Delaney M, Germain M, Karafin MS, Sayers M, van de Watering L, Shaz BH. Trends in age and red blood cell donation habits among several racial/ethnic minority groups in the United States. Transfusion 2017; 57:1644-1655. [DOI: 10.1111/trf.14108] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Revised: 02/06/2017] [Accepted: 02/06/2017] [Indexed: 11/26/2022]
Affiliation(s)
- Mark H. Yazer
- The Institute for Transfusion Medicine; Pittsburgh Pennsylvania
| | | | | | | | | | - Merlyn Sayers
- Carter BloodCare and the University of Texas Southwestern; Dallas Texas
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