Evaluation of a scoring system for vein suitability in platelet apheresis donors

INTRODUCTION

Donor vein assessment for the selection of good quality veins is crucial for a successful apheresis procedure. This study intends to find out the effectiveness of a vein assessment scoring tool (VST) used and found to be effective in selecting whole blood donors to reduce the difficulty in identifying good quality veins for the plateletpheresis procedure.

MATERIALS AND METHODS

This was a prospective observational study on platelet apheresis donors with the application of a VST consisting of three vein descriptor parameters (vein visibility, vein palpability, and vein size) with 5 Likert-type responses constituting a score of 0-12 for each arm. Two vein assessors independently evaluated the vein in both arms and marked their responses blinded from each other as well from the principal investigator. The scores were then calculated and analyzed at the end of the study for their association with phlebotomy and procedural outcomes.

RESULTS

A total of 190 donors were recruited. The mean scores for the arms with successful and failed phlebotomy were 9.1 and 9.4 (SD 2.3), respectively. The intra-class correlation Alpha Cronbach value was 0.834 and 0.837 for total scoring in the left arm and right arm, respectively, between the two assessors. Scores neither showed a correlation with other outcomes like low flow alarms, hematoma formation, number of phlebotomy attempts, and procedure completion.

CONCLUSION

The study showed that the vein score tool did not truly predict the phlebotomy outcome in apheresis donors, though there was a good degree of inter-assessor reliability.

Adopting a vein assessment tool improves procedural outcomes in double dose platelet collections - A prospective study

BACKGROUND

This study aims to determine the phlebotomy and procedural outcomes using a vein assessment tool (VAT) in Double Dose Platelet (DDP) collections by apheresis.

METHODS

VAT was based on assessing vein visibility, palpation and size with maximum score of 12 and the least being 0 and the scores were graded as adequate and inadequate. A vein-viewer was used for studying cubital vein patterns (type 1-5). Phlebotomy outcome was defined based on need for re-puncture. Procedural outcomes in terms of target yield attained and RBC reinfusion completed. Chi square test and Mann- Whitney U test were used to assess the vein score and pattern against phlebotomy and procedural outcome.

RESULTS

Out of 200 DDP collections, the phlebotomy was successful in 88 % with good procedural outcome in 94 % donations. The cut off in VAT scores for successful phlebotomy was ≥8 (AUC: 70 %). Median vein scores of the arm selected for phlebotomy was 9 and graded adequate in 154 (77 %) donations.Odds for successful phlebotomy was 3.7 times higher when donors had an adequate VAT grades(p = 0.003). Procedural outcomes was favourable when at least one arm had adequate VAT grade when compared to both arms being inadequate (98 % vs 82 %; p < 0.001). Phlebotomy failure was more with first time apheresis donors than repeat apheresis donors (p = 0.014).

CONCLUSION

This study indicated that a VAT score with a cut off of ≥8 had better phlebotomy and procedural outcomes in DDP collections and that donor with at least one arm having the VAT score of ≥8 are preferred for DDP collections.

Quality of the blood donation campaign in the military: A sample from Turkey

OBJECTIVES

In this study, the conformity of blood donation services performed by Turkish Red Crescent Mobile Medical Team in a Basic Military Training Centre to quality standards was researched and the results were discussed by taking the principles of biomedical ethics into consideration.

MATERIALS AND METHODS

This descriptive study was conducted at the Basic Military Training Centre, Canakkale, Turkey. In total, 269 voluntary non-remunerated blood donors who made blood donation between 10 and 12 August 2015 formed the population of the study. All of the donors were recruits who had joined the army to carry out their military service. A questionnaire for assessing the quality of the blood donation services was administered to the participants after the blood donation. SPSS 15.0 software package was used for data analysis.

RESULTS

In the study, 232 voluntary non-remunerated blood donors were reached with a response rate of 86.2%. It was seen that the phlebotomists in the mobile medical team followed the quality standards in the blood donation process with the rate of 91.8% to 100%. However, outstanding omissions were found in informing the donors about blood donation process.

CONCLUSION

In blood donation campaigns conducted in the institutions such as military units, the quality standards developed in line with the principles of biomedical ethics should not be neglected citing some reasons such as excessive numbers of donors, time limitations and organisational deficiencies. Increasing the quality in blood donation services will increase both donor satisfaction and their motivation to donate blood again in the future.

Preliminary evaluation of near-infrared vein visualization technology in the screening of palatal blood vessels

Background

Avoidance from palatal blood vessel rupture is a major concern during the palatal soft tissue graft surgery. There is no defined chair-side and case-specific palatal blood vessel detection approach to facilitate the harvesting process. The objective of this pilot study is to assess the feasibility of a near-infrared vein visualization system in the screening process of palatal blood vessels.

Material and Methods

An extraoral vein visualization device (AccuVein AV400) was applied to a total of 304 hemi-maxilla of 152 individuals by two blind examiners. The study groups were classified according to their maximum inter-incisal measurements. The distances between the coronal border of the vessel image and the mid-palatal gingival margins of the adjacent teeth were measured and in each group. The correlations among the measurements were evaluated within groups.

Results

The blood vessel to the adjacent teeth measurements exhibited no statistical difference between both examiners in all subjects (p<0.001). Correlations between the examiners gradually increased in all groups as the mouth opening rates of the subjects were increased (p<0.001).

Conclusions

In the current state, screening of the palatal blood vessels via near-infrared vein visualization technology seems to be not suitable for every individual due to the restrictive effect of mouth opening. However, the promising results of this preliminary study demonstrated increasing consistency between the measurements of the examiners as the inter-incisal distance increase which emphasized the need an intraoral version of the device. Considering the lack of local decision-making technology for the detection of palatal blood vessels, further studies are required for development and optimization of these systems.

Key words:Near-infrared vein visualization, palatal graft harvesting, surgical complications.