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Zhu H, Ding W, Han W, Zheng X, Hu Y, Dong J, Wu Y, Wu D, Liu J, Zhu F. Prevalence and Residual Risk of HIV in Volunteer Blood Donors of Zhejiang Province, China, from 2018 to 2022. THE CANADIAN JOURNAL OF INFECTIOUS DISEASES & MEDICAL MICROBIOLOGY = JOURNAL CANADIEN DES MALADIES INFECTIEUSES ET DE LA MICROBIOLOGIE MEDICALE 2024; 2024:4749097. [PMID: 38826677 PMCID: PMC11142854 DOI: 10.1155/2024/4749097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 04/26/2024] [Accepted: 05/06/2024] [Indexed: 06/04/2024]
Abstract
Background Blood safety levels have been significantly improved since the implementation of nucleic acid amplification technology (NAT) testing for blood donors. However, there remains a residual risk of transfusion transmission infections. This study aimed to evaluate the prevalence of HIV and its residual risk transmission among volunteer blood donors of Zhejiang Province, China, for five years after NAT implementation. Materials and Methods All specimens and information were collected from voluntary unpaid donors at all blood services in Zhejiang Province, China, from January 2018 to December 2022. The HIV antibody or antigen and HIV RNA were detected using enzyme-linked immunosorbent assay and NAT, respectively. The HIV residual risk transmission was calculated using the incidence or window period model. Results A total of 3,375,678 voluntary blood donors were detected, revealing an HIV prevalence of 9.92/100000. The HIV prevalence of blood donors in 12 blood services in Zhejiang Province was 6.11, 6.98, 7.45, 8.21, 8.36, 8.94, 9.04, 9.66, 9.73, 10.22, 11.80, and 12.47 per 100000 donors, without statistically significant difference observed among the services (p > 0.05). The HIV prevalence of males (15.49/100000) was significantly higher compared to females (1.95/100000; p < 0.05). There was an insignificant difference in HIV prevalence among blood donors of all different age groups (p > 0.05), but the HIV prevalence in the 26-35 age group and 18-25 age group was significantly higher compared to the 36-45 age group (p < 0.05). The difference in HIV prevalence between first-time blood donors (13.65/100,000) and repeat blood donors (6.78/100,000) was statistically significant (p < 0.05). From 2018 to 2022, the HIV residual risk in blood transfusion transmission was 0.266/100000. Conclusion The prevalence of HIV among blood donors in Zhejiang Province, China, is associated with age, gender, and times of blood donation. The HIV residual risk in blood transfusion transmission remains low in the province, and increasing the rate of repeat blood donors is beneficial to improve blood safety.
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Affiliation(s)
- Hong Zhu
- Blood Center of Zhejiang Province, Jianye Road 789, Hangzhou, Zhejiang 310052, China
- Key Laboratory of Blood Safety Research of Zhejiang Province, Jianye Road 789, Hangzhou, Zhejiang 310052, China
| | - Wei Ding
- Blood Center of Zhejiang Province, Jianye Road 789, Hangzhou, Zhejiang 310052, China
- Key Laboratory of Blood Safety Research of Zhejiang Province, Jianye Road 789, Hangzhou, Zhejiang 310052, China
| | - Wenjuan Han
- Blood Center of Zhejiang Province, Jianye Road 789, Hangzhou, Zhejiang 310052, China
| | - Xiaofan Zheng
- Blood Center of Zhejiang Province, Jianye Road 789, Hangzhou, Zhejiang 310052, China
| | - Yiqing Hu
- Blood Center of Zhejiang Province, Jianye Road 789, Hangzhou, Zhejiang 310052, China
| | - Jie Dong
- Blood Center of Zhejiang Province, Jianye Road 789, Hangzhou, Zhejiang 310052, China
- Key Laboratory of Blood Safety Research of Zhejiang Province, Jianye Road 789, Hangzhou, Zhejiang 310052, China
| | - Yaling Wu
- Blood Center of Zhejiang Province, Jianye Road 789, Hangzhou, Zhejiang 310052, China
- Key Laboratory of Blood Safety Research of Zhejiang Province, Jianye Road 789, Hangzhou, Zhejiang 310052, China
| | - Danxiao Wu
- Blood Center of Zhejiang Province, Jianye Road 789, Hangzhou, Zhejiang 310052, China
- Key Laboratory of Blood Safety Research of Zhejiang Province, Jianye Road 789, Hangzhou, Zhejiang 310052, China
| | - Jinhui Liu
- Blood Center of Zhejiang Province, Jianye Road 789, Hangzhou, Zhejiang 310052, China
- Key Laboratory of Blood Safety Research of Zhejiang Province, Jianye Road 789, Hangzhou, Zhejiang 310052, China
| | - Faming Zhu
- Blood Center of Zhejiang Province, Jianye Road 789, Hangzhou, Zhejiang 310052, China
- Key Laboratory of Blood Safety Research of Zhejiang Province, Jianye Road 789, Hangzhou, Zhejiang 310052, China
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Mengjiao L, Yushan X, Yan L, Dawei C, Xiaojun Z, Yongjun W, Cuifen S, Jue X. Prevalence of transfusion-transmitted infections in hospitalized patients before transfusion and volunteer blood donors in Zhejiang Province, China. Infect Dis Now 2024; 54:104861. [PMID: 38316362 DOI: 10.1016/j.idnow.2024.104861] [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: 07/26/2023] [Revised: 01/29/2024] [Accepted: 01/31/2024] [Indexed: 02/07/2024]
Abstract
OBJECTIVES To assess the need for screening of transfusion-transmitted infections (TTIs) in blood products, we assessed TTI seroprevalence in blood donors and hospitalized patients. METHODS We collected 2760 serum samples from three regions of Hangzhou, Ningbo and Huzhou from April 2021 to March 2022, and they tested by enzyme-linked immunosorbent assay (ELISA) for Hepatitis B surface antigen (HBsAg), Hepatitis C (HCV), Treponema pallidum (TP), Cytomegalovirus (CMV), Epstein-Barr virus (EBV), Hepatitis E virus (HEV) and Human T-cell lymphotropic virus type 1/2 (HTLV-1/2) antibody levels. RESULTS Screening test results showed that the positive rates for HBsAg, anti-HCV and anti-TP were 3.01 %, 0.39 % and 0.18 %, respectively. The positive rates for CMV IgM and CMV IgG were 0.76 % and 96.96 %, while the positive rates for EB VCA-IgM and EB EA-IgG were 1.88 % and 10.47 %; those for HEV IgM and HEV IgG were 1.16 % and 26.05 %, while the HTLV-1/2 antibody positive rate was 0.04 %. The positive rates for CMV IgG, EB EA-IgG and HEV IgG in hospitalized patients before transfusion were higher than in volunteer blood donors, and the difference was statistically significant (P < 0.05). The overall co-infection rate was 0.29 %. The positive rates for EB VCA-IgM in the males were significantly higher than in females, and EB VCA-IgM and HEV IgG prevalence varied significantly by age. CONCLUSION Our data demonstrate the risk of TTI exposure and TTI transmission in the Zhejiang population, which poses a threat to blood safety. It is hoped that expansion of pathogen categories (CMV, EBV, HEV and HTLV-1/2) and blood screening programs will contribute to the future adoption of scientific blood transfusion methods.
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Affiliation(s)
- Lin Mengjiao
- Department of Blood Transfusion, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
| | - Xu Yushan
- Department of Blood Transfusion, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
| | - Lv Yan
- Department of Blood Transfusion, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
| | - Cui Dawei
- Department of Blood Transfusion, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
| | | | - Wang Yongjun
- Key Laboratory of Blood Safety Research of Zhejiang Province, Blood Center of Zhejiang Province, Hangzhou 310052, China
| | - Shen Cuifen
- Department of Clinical Laboratory, Huzhou Central Hospital, Huzhou 313000, China
| | - Xie Jue
- Department of Blood Transfusion, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.
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Dahlén T, Zhao J, Busch MP, Edgren G. Using routine health-care data to search for unknown transfusion-transmitted disease: a nationwide, agnostic retrospective cohort study. Lancet Digit Health 2024; 6:e105-e113. [PMID: 38278613 DOI: 10.1016/s2589-7500(23)00228-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 10/20/2023] [Accepted: 11/08/2023] [Indexed: 01/28/2024]
Abstract
BACKGROUND Identification and prevention of transfusion-transmitted disease is essential for blood transfusion safety. However, current surveillance systems are largely driven by reports of sentinel events, which is an approach that might be inadequate for identifying transmission of pathogens not known to be transmissible or pathogens with long incubation periods. Using a combination of health-data registers and blood-bank databases, we aimed to perform an agnostic search for potential transfusion-transmitted diseases and to identify unknown threats to the blood supply. METHODS In this nationwide, agnostic retrospective cohort study, we developed a systematic algorithm for performing a phenome-wide search for transfusion-transmitted disease without consideration of any a-priori suspicion of blood-borne transmissibility. We applied this algorithm to a nationwide Swedish transfusion database (SCANDAT-3S) to test for possible transmission of 1155 disease entities based on all relevant diagnostic coding systems in use during the period. We ascertained health outcomes of blood donors and transfusion recipients from the Swedish National Inpatient Register, Swedish Cause of Death Register, and Swedish Cancer Register. Analyses were two-pronged, studying both disease diagnosis concordance between donors and recipients and a possible shared increased disease risk among all recipients of a given donor. For both approaches, we used Cox proportional hazards regression models with time-dependent covariates. Adjustment for multiple comparisons was done using a false discovery rate method. FINDINGS The analyses included data on 1·72 million patients who had received 18·97 million transfusions (red blood cell, plasma, platelet, or whole blood units) between Jan 1, 1968, and Dec 31, 2017, from 1·04 million blood donors. The median follow-up was 4·5 (IQR 0·9-11·4) years for recipients and 18·5 (8·3-26·2) years for donors. We found evidence of transfusion-transmission for 15 diseases, of which 13 were validated using a second conceptually different approach. We identified transmission of viral hepatitis and its complications (eg, oesophageal varices) but also transmission of other conditions (eg, pneumonia of unknown origin). The diseases that could not be validated in this second approach, HIV and abnormal findings in specimens from male genital organs, were not statistically significant after adjustment for multiple testing. The effect sizes were small (close to 1) for other conditions. INTERPRETATION We find no strong evidence of unexpected, widespread transfusion-transmitted disease. This novel approach serves as a proof-of-concept for agnostic, data-driven surveillance for transfusion-transmitted disease using routinely collected blood-bank and health-care data. FUNDING Department of Health and Human Services, US National Heart, Lung, and Blood Institute, US National Institutes of Health, Swedish Research Council and Region Stockholm.
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Affiliation(s)
- Torsten Dahlén
- Department of Medicine, Clinical Epidemiology Division, Karolinska Institutet, Stockholm, Sweden; Department of Haematology, Karolinska University Hospital, Stockholm, Sweden
| | - Jingcheng Zhao
- Department of Medicine, Clinical Epidemiology Division, Karolinska Institutet, Stockholm, Sweden
| | - Michael P Busch
- Vitalant Research Institute, San Francisco, CA, USA; Department of Laboratory Medicine, UCSF, San Francisco, CA, USA
| | - Gustaf Edgren
- Department of Medicine, Clinical Epidemiology Division, Karolinska Institutet, Stockholm, Sweden; Department of Cardiology, Södersjukhuset, Stockholm, Sweden.
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Jacobs JW, Booth GS, Stephens LD, Woo JS, Adkins BD. Considering the impact of climate change and viral hemorrhagic fevers on the safety of the blood supply. Transfus Clin Biol 2023; 30:454-455. [PMID: 37392817 DOI: 10.1016/j.tracli.2023.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 06/26/2023] [Indexed: 07/03/2023]
Affiliation(s)
- Jeremy W Jacobs
- Department of Laboratory Medicine, Yale School of Medicine, New Haven, CT, USA.
| | - Garrett S Booth
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Laura D Stephens
- Department of Pathology, University of California San Diego, La Jolla, CA, USA
| | - Jennifer S Woo
- Department of Pathology, City of Hope National Medical Center, Irvine, CA, USA
| | - Brian D Adkins
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX, USA
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Song J, Kim S, Chung HS, Park I, Kwon SS, Myung J. Predictive indicators for determining red blood cell transfusion strategies in the emergency department. Eur J Emerg Med 2023; 30:260-266. [PMID: 37115971 DOI: 10.1097/mej.0000000000001032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Abstract
BACKGROUND AND IMPORTANCE Appropriate decision-making is critical for transfusions to prevent unnecessary adverse outcomes; however, transfusion in the emergency department (ED) can only be decided based on sparse evidence in a limited time window. OBJECTIVES This study aimed to identify factors associated with appropriate red blood cell (RBC) transfusion in the ED by analyzing retrospective data of patients who received transfusions at a single center. OUTCOME MEASURES AND ANALYSIS This study analyzed associations between transfusion appropriateness and sex, age, initial vital signs, an ED triage score [the Korean Triage and Acuity Scale (KTAS)], the length of stay, and the hemoglobin (Hb) concentration. MAIN RESULTS Of 10 490 transfusions, 10 109 were deemed appropriate, and 381 were considered inappropriate. A younger age ( P < 0.001) and a KTAS level of 3-5 ( P = 0.028) were associated with inappropriate transfusions, after adjusting for O 2 saturation and the Hb level. CONCLUSIONS In this single-center retrospective study, younger age and higher ED triage scores were associated with the appropriateness of RBC transfusions.
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Affiliation(s)
| | | | - Hyun Soo Chung
- Department of Emergency Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Incheol Park
- Department of Emergency Medicine, Yonsei University College of Medicine, Seoul, Korea
| | | | - Jinwoo Myung
- Department of Emergency Medicine, Yonsei University College of Medicine, Seoul, Korea
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6
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Ivkin AA, Grigoriev E, Sinitskaya AV. Refraining from Packed Red Blood Cells in Cardiopulmonary Bypass Priming as a Method of Neuroprotection in Pediatric Cardiac Surgery. J Clin Med 2023; 12:jcm12041465. [PMID: 36836000 PMCID: PMC9961526 DOI: 10.3390/jcm12041465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 01/27/2023] [Accepted: 02/08/2023] [Indexed: 02/15/2023] Open
Abstract
Congenital heart defect (CHD) surgeries are performed with cardiopulmonary bypass (CPB) and are complicated by several factors that affect the child's brain. However, to date, the number of studies on brain protection in cardiac surgery remains small. The aim of this study was to assess the impact of refraining from using packed red blood cells (PRBCs) in priming solutions in children with congenital defects (CHDs) who require surgical interventions using CPB to prevent brain injury in the postoperative period. MATERIAL AND METHODS This study included 40 children, and the mean age was 14 (12-22.5) months and the mean weight was 8.8 (7.25-11) kg. All patients underwent CHD closure using CPB. The patients were divided into two groups depending on the use of PRBCs in the priming solution. Brain injury was assessed using three specific blood serum markers, namely S100 calcium-binding protein β (S100β), neuron-specific enolase (NSE) and glial fibrillary acidic protein (GFAP) before surgery, after the completion of CPB and 16 h after surgery (first, second and third control points). Markers of systemic inflammatory response were also analyzed, including interleukin-1, -6, -10 and tumor necrosis factor alpha (TNF-α). A clinical assessment of brain injury was carried out using a valid, rapid, observational tool for screening delirium in children of this age group, i.e., "Cornell Assessment of Pediatric Delirium". RESULTS Factors of the intra- and postoperative period were analyzed, such as hemoglobin levels, oxygen delivery (cerebral tissue oxygenation, blood lactate level and venous oxygen saturation) and indicators of organ dysfunction (creatinine, urea, bilirubin levels, duration of CPB and length of stay in the ICU). Following the procedure, there were no significant differences between the groups and all indicators were within the reference values, thus demonstrating the safety of CHD closure without transfusion. Moreover, the highest level of specific markers of brain injury were noted immediately after the completion of CPB in both groups. The concentration of all three markers was significantly higher in the group with transfusion after the completion of CPB. Moreover, GFAP levels were higher in the transfusion group and 16 h after surgery. CONCLUSIONS The results of the study show the safety and effectiveness of brain injury prevention strategies that consist of not conducting PRBC transfusion.
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7
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Slavov SN. Viral Metagenomics for Identification of Emerging Viruses in Transfusion Medicine. Viruses 2022; 14:v14112448. [PMID: 36366546 PMCID: PMC9699440 DOI: 10.3390/v14112448] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 10/24/2022] [Accepted: 10/26/2022] [Indexed: 11/06/2022] Open
Abstract
Viral metagenomics has revolutionized our understanding for identification of unknown or poorly characterized viruses. For that reason, metagenomic studies gave been largely applied for virus discovery in a wide variety of clinical samples, including blood specimens. The emerging blood-transmitted virus infections represent important problem for public health, and the emergence of HIV in the 1980s is an example for the vulnerability of Blood Donation systems to such infections. When viral metagenomics is applied to blood samples, it can give a complete overview of the viral nucleic acid abundance, also named "blood virome". Detailed characterization of the blood virome of healthy donors could identify unknown (emerging) viral genomes that might be assumed as hypothetic transfusion threats. However, it is impossible only by application of viral metagenomics to assign that one viral agent could impact blood transfusion. That said, this is a complex issue and will depend on the ability of the infectious agent to cause clinically important infection in blood recipients, the viral stability in blood derivatives and the presence of infectious viruses in blood, making possible its transmission by transfusion. This brief review summarizes information regarding the blood donor virome and some important challenges for use of viral metagenomics in hemotherapy for identification of transfusion-transmitted viruses.
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Affiliation(s)
- Svetoslav Nanev Slavov
- Department of Cellular and Molecular Therapy (NuCeL), Butantan Institute, São Paulo 05503-900, SP, Brazil; ; Tel.: +55-(16)-2101-9300 (ext. 9365)
- Laboratory of Bioinformatics, Blood Center of Ribeirão Preto, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Rua Tenente Catão Roxo 2501, Ribeirão Preto CEP 14051-140, SP, Brazil
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Anti-Viral Photodynamic Inactivation of T4-like Bacteriophage as a Mammalian Virus Model in Blood. Int J Mol Sci 2022; 23:ijms231911548. [PMID: 36232850 PMCID: PMC9570132 DOI: 10.3390/ijms231911548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 09/24/2022] [Accepted: 09/26/2022] [Indexed: 11/20/2022] Open
Abstract
The laboratorial available methods applied in plasma disinfection can induce damage in other blood components. Antimicrobial photodynamic therapy (aPDT) represents a promising approach and is approved for plasma and platelet disinfection using non-porphyrinic photosensitizers (PSs), such as methylene blue (MB). In this study, the photodynamic action of three cationic porphyrins (Tri-Py(+)-Me, Tetra-Py(+)-Me and Tetra-S-Py(+)-Me) towards viruses was evaluated under white light irradiation at an irradiance of 25 and 150 mW·cm−2, and the results were compared with the efficacy of the approved MB. None of the PSs caused hemolysis at the isotonic conditions, using a T4-like phage as a model of mammalian viruses. All porphyrins were more effective than MB in the photoinactivation of the T4-like phage in plasma. Moreover, the most efficient PS promoted a moderate inactivation rate of the T4-like phage in whole blood. Nevertheless, these porphyrins, such as MB, can be considered promising and safe PSs to photoinactivate viruses in blood plasma.
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Wang Y, Rao Q, Li X. Adverse transfusion reactions and what we can do. Expert Rev Hematol 2022; 15:711-726. [PMID: 35950450 DOI: 10.1080/17474086.2022.2112564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Transfusions of blood and blood components have inherent risks and the ensuing adverse reactions. It is very important to understand the adverse reactions of blood transfusion comprehensively for ensuring the safety of any future transfusions. AREAS COVERED According to the time of onset, adverse reactions of blood transfusion are divided into immediate and delayed transfusion reactions. In acute transfusion reactions, timely identification and immediate cessation of transfusion is critical. Vigilance is required to distinguish delayed responses or reactions that present non-specific signs and symptoms. In this review, we present the progress of mechanism, clinical characteristics and management of commonly encountered transfusion reactions. EXPERT OPINION The incidence of many transfusion-related adverse events is decreasing, but threats to transfusion safety are always emerging. It is particularly important for clinicians and blood transfusion staff to recognize the causes, symptoms and treatment methods of adverse blood transfusion reactions to improve the safety. In the future, at-risk patients will be better identified and can benefit from more closely matched blood components.
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Affiliation(s)
- Yajie Wang
- Department of Blood Transfusion, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - Quan Rao
- Department of General Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - Xiaofei Li
- Department of Blood Transfusion, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
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10
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Madan FH, Khamis E, Alhassan MA, Alrashid M, Saleh A, Rahma M. Hemoglobin Drop and the Need for Transfusion in Primary Knee Arthroplasty. Cureus 2022; 14:e27659. [PMID: 36072165 PMCID: PMC9440275 DOI: 10.7759/cureus.27659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/03/2022] [Indexed: 11/05/2022] Open
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Chozie NA, Satiti MA, Sjarif DR, Oswari H, Ritchie NK. The impact of nucleic acid testing as a blood donor screening method in transfusion-associated hepatitis C among children with bleeding disorders in Indonesia: a single-center experience. Blood Res 2022; 57:129-134. [PMID: 35620907 PMCID: PMC9242827 DOI: 10.5045/br.2022.2021219] [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: 12/22/2021] [Revised: 02/08/2022] [Accepted: 04/07/2022] [Indexed: 11/29/2022] Open
Abstract
Background Children with bleeding disorders, such as hemophilia and von Willebrand disease (VWD), have an increased risk of acquiring transfusion-transmitted infections (TTI). Screening methods to exclude blood donations that are at risk of transmitting infection from donors to recipients are critical to preventing disease transmission. Nucleic acid testing (NAT) is the latest blood donor-screening method. This study aimed to determine the incidence of hepatitis C virus (HCV) infection in children with hemophilia and VWD at Dr. Cipto Mangunkusumo Hospital with a history of blood transfusion before and after implementation of a NAT screening method. Methods A cohort retrospective study was conducted on children aged 0‒18 years with bleeding disorders and a history of blood transfusion. In our center, all blood transfusions before 2015 were screened using non-NAT methods, while all blood transfusions were screened using NAT starting in 2015. Eligible patient characteristics were collected from medical records. From July to December 2019, blood samples were obtained from eligible patients for anti-HCV examination. HCV RNA examinations were performed on subjects with reactive anti-HCV results, and the relative risk was calculated. Results In total, 108 eligible participants were included in this study. We observed that 91 (94.3%) patients had history of receiving non-NAT blood transfusions, while 17 (15.7%) patients received NAT-screened blood transfusions. The proportion of anti-HCV reactivity in the non-NAT group and that in the NAT group were 3.3% (3/91) and 0% (0/17), respectively. Conclusion None of the patients exhibited reactivity to anti-HCV after implementing the NAT screening method.
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Affiliation(s)
- Novie Amelia Chozie
- Department of Child Health, Faculty of Medicine University of Indonesia/Dr. Cipto Mangunkusumo Hospital, Jakarta Pusat, Indonesia
| | - Melati Arum Satiti
- Department of Child Health, Faculty of Medicine University of Indonesia/Dr. Cipto Mangunkusumo Hospital, Jakarta Pusat, Indonesia
| | - Damayanti Rusli Sjarif
- Department of Child Health, Faculty of Medicine University of Indonesia/Dr. Cipto Mangunkusumo Hospital, Jakarta Pusat, Indonesia
| | - Hanifah Oswari
- Department of Child Health, Faculty of Medicine University of Indonesia/Dr. Cipto Mangunkusumo Hospital, Jakarta Pusat, Indonesia
| | - Ni Ken Ritchie
- Jakarta Blood Center, Indonesian Red Cross Society, Jakarta Pusat, Indonesia
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12
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Chen L, Chang K, Chen Y, Xu Z, Shen W. Does Autologous Transfusion Decrease Allogeneic Transfusion in Liposuction Surgery of Lymphedema Patients? Front Med (Lausanne) 2022; 9:778230. [PMID: 35479938 PMCID: PMC9037081 DOI: 10.3389/fmed.2022.778230] [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: 09/16/2021] [Accepted: 02/14/2022] [Indexed: 11/13/2022] Open
Abstract
Background and Objective Liposuction is an effective treatment for fat disposition in lymphedema. Blood transfusion has been seldom investigated in lymphedema liposuction surgery. The purpose of the study was to analyze clinical factors associated with blood transfusion in liposuction surgery of lymphedema patients and compare the autologous and allogeneic transfusion patterns. Methods A total of 1,187 cases of liposuction due to lymphedema were recruited. Demographic, laboratory tests and operation information were collected. Patients were divided into a transfusion and a non-transfusion group. Different transfusion patterns were compared and analyzed. Results Between the two groups, there is a significant difference in postoperative hemoglobin levels, and as well as gender, age, surgery duration, body weight change, intraoperative transfusion volume and blood loss, hospital length of stay, and surgical site distribution. There is a significant difference in the comparison of hospital stay length, autologous transfusion volume, combined allogeneic volume, operative blood loss, intraoperative transfusion volume, and change in hemoglobin levels between predonation and acute normovolemic hemodilution (ANH) transfusion. In comparison with the allogeneic transfusion-only patients, the mean allogeneic transfusion volume in either ANH group, predonated transfusion group, or mixed group is statistically lower. Allogeneic transfusion volume in the predonated-only group is significantly lower than that of either the ANH-only group or the mixing ANH with predonation group. Ordinary least squares regression analysis suggests that autologous transfusion in the ANH-only mode is statistically associated with allogeneic transfusion. Conclusions This study described the blood transfusion in lymphedema liposuction surgery and compared autologous and allogeneic transfusion patterns in these patients. Autologous transfusion can reduce the transfusion volume of allogeneic blood and might be a beneficial mode of transfusion in these patients.
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Affiliation(s)
- Linfeng Chen
- Department of Blood Transfusion, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| | - Kun Chang
- Department of Lymph Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| | - Yan Chen
- Department of Blood Transfusion, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| | - Zhenhua Xu
- HealSci Technology Co. Ltd., Beijing, China
| | - Wenbin Shen
- Department of Lymph Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
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Mawuli G, Dzudzor B, Tachi K, Kuma AABA, Odame-Aboagye J, Obeng BM, Boateng AT, Edu-Quansah EP, Attiku KO, Agbosu E, Arjarquah A, Bonney JHK. Hepatitis C virus (HCV) infection among patients with sickle cell disease at the Korle-Bu teaching hospital. Virol J 2022; 19:73. [PMID: 35459145 PMCID: PMC9026067 DOI: 10.1186/s12985-022-01797-z] [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: 11/12/2021] [Accepted: 04/11/2022] [Indexed: 11/12/2022] Open
Abstract
Background Hepatitis C virus (HCV) infection is a blood borne infection that remains potentially transmissible through blood transfusions. Sickle cell disease (SCD) is a common inheritable haemoglobinopathy in Ghana that requires multiple blood transfusions as part of its management. The SCD patient is therefore at a high risk of HCV infection; however, data on the occurrence of HCV in SCD patients has not been documented in Ghana. This study sought to determine the prevalence and genotypes of HCV infection in SCD patients. Materials and methods This was a cross-sectional study which enrolled 141 sickle-cell disease patients from the Ghana Institute for Clinical Genetics, Korle-Bu Teaching Hospital (KBTH). Patient information was obtained through a structured questionnaire. Aliquots of the plasma obtained was used for both serology with Advanced Quality Rapid Anti-HCV Test Strip and molecular testing by RT-PCR with primers targeting the HCV core gene. The amplified DNA were purified and subjected to phylogenetic analysis to characterize HCV genotypes. Results Twelve (9%) out of the 141 patients were sero-positive for HCV total antibodies. HCV RNA was amplified from 8 (6%) out of the total number of patients’ samples. One of the 12 sero-positives was HCV RNA positive. Five (63%) out of the 8 HCV RNA positive samples were successfully sequenced. The phylogenetic tree constructed with the study and GenBank reference sequences, clustered all five study sequences into HCV genotype 1. Conclusion The HCV seroprevalence of 9% among sickle cell disease patients is higher than reported for the general Ghanaian population which is 3%. Genotype 1 is the common HCV genotype infecting SCD patients. Sickle cell disease is likely to be a high-risk group for HCV inapparent infections in Ghana as seroprevalence does not correlate with viremia. However, even with higher seroprevalence, the group must be given priority in resource allocation for preventive, diagnostic and therapeutic strategies.
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Affiliation(s)
- Gifty Mawuli
- Department of Virology, College of Health Sciences, Noguchi Memorial Institute for Medical Research, University of Ghana, P. O. Box, LG 581, Legon Accra, Ghana.,Department of Medical Biochemistry, University of Ghana Medical School, University of Ghana, Accra, Ghana
| | - Bartholomew Dzudzor
- Department of Medical Biochemistry, University of Ghana Medical School, University of Ghana, Accra, Ghana
| | - Kenneth Tachi
- Department of Medicine and Therapeutics, University of Ghana Medical School, University of Ghana, Accra, Ghana
| | | | - James Odame-Aboagye
- Department of Virology, College of Health Sciences, Noguchi Memorial Institute for Medical Research, University of Ghana, P. O. Box, LG 581, Legon Accra, Ghana
| | | | - Anthony Twumasi Boateng
- Department of Virology, College of Health Sciences, Noguchi Memorial Institute for Medical Research, University of Ghana, P. O. Box, LG 581, Legon Accra, Ghana
| | | | - Keren Okyerebea Attiku
- Department of Virology, College of Health Sciences, Noguchi Memorial Institute for Medical Research, University of Ghana, P. O. Box, LG 581, Legon Accra, Ghana
| | - Esinam Agbosu
- Department of Virology, College of Health Sciences, Noguchi Memorial Institute for Medical Research, University of Ghana, P. O. Box, LG 581, Legon Accra, Ghana
| | - Augustina Arjarquah
- Department of Virology, College of Health Sciences, Noguchi Memorial Institute for Medical Research, University of Ghana, P. O. Box, LG 581, Legon Accra, Ghana
| | - Joseph Humphrey Kofi Bonney
- Department of Virology, College of Health Sciences, Noguchi Memorial Institute for Medical Research, University of Ghana, P. O. Box, LG 581, Legon Accra, Ghana.
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14
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Kasirye R, Hume HA, Bloch EM, Lubega I, Kyeyune D, Shrestha R, Ddungu H, Musana HW, Dhabangi A, Ouma J, Eroju P, de Lange T, Tartakovsky M, White JL, Kakura C, Fowler MG, Musoke P, Nolan M, Grabowski MK, Moulton LH, Stramer SL, Whitby D, Zimmerman PA, Wabwire D, Kajja I, McCullough J, Goodrich R, Quinn TC, Cortes R, Ness PM, Tobian AAR. The Mirasol Evaluation of Reduction in Infections Trial (MERIT): study protocol for a randomized controlled clinical trial. Trials 2022; 23:257. [PMID: 35379302 PMCID: PMC8978156 DOI: 10.1186/s13063-022-06137-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 03/02/2022] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Transfusion-transmitted infections (TTIs) are a global health challenge. One new approach to reduce TTIs is the use of pathogen reduction technology (PRT). In vitro, Mirasol PRT reduces the infectious load in whole blood (WB) by at least 99%. However, there are limited in vivo data on the safety and efficacy of Mirasol PRT. The objective of the Mirasol Evaluation of Reduction in Infections Trial (MERIT) is to investigate whether Mirasol PRT of WB can prevent seven targeted TTIs (malaria, bacteria, human immunodeficiency virus, hepatitis B virus, hepatitis C virus, hepatitis E virus, and human herpesvirus 8). METHODS MERIT is a randomized, double-blinded, controlled clinical trial. Recruitment started in November 2019 and is expected to end in 2024. Consenting participants who require transfusion as medically indicated at three hospitals in Kampala, Uganda, will be randomized to receive either Mirasol-treated WB (n = 1000) or standard WB (n = 1000). TTI testing will be performed on donor units and recipients (pre-transfusion and day 2, day 7, week 4, and week 10 after transfusion). The primary endpoint is the cumulative incidence of one or more targeted TTIs from the Mirasol-treated WB vs. standard WB in a previously negative recipient for the specific TTI that is also detected in the donor unit. Log-binomial regression models will be used to estimate the relative risk reduction of a TTI by 10 weeks associated with Mirasol PRT. The clinical effectiveness of Mirasol WB compared to standard WB products in recipients will also be evaluated. DISCUSSION Screening infrastructure for TTIs in low-resource settings has gaps, even for major TTIs. PRT presents a fast, potentially cost-effective, and easy-to-use technology to improve blood safety. MERIT is the largest clinical trial designed to evaluate the use of Mirasol PRT for WB. In addition, this trial will provide data on TTIs in Uganda. TRIAL REGISTRATION Mirasol Evaluation of Reduction in Infections Trial (MERIT) NCT03737669 . Registered on 9 November 2018.
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Affiliation(s)
- Ronnie Kasirye
- grid.421981.7MUJHU Research Collaboration, Kampala, Uganda
| | - Heather A. Hume
- grid.14848.310000 0001 2292 3357Department of Pediatrics, University of Montreal, Montréal, QC Canada
| | - Evan M. Bloch
- grid.21107.350000 0001 2171 9311Department of Pathology, School of Medicine, Johns Hopkins University, Baltimore, MD USA
| | - Irene Lubega
- grid.421981.7MUJHU Research Collaboration, Kampala, Uganda
| | | | - Ruchee Shrestha
- grid.21107.350000 0001 2171 9311Department of Pathology, School of Medicine, Johns Hopkins University, Baltimore, MD USA
| | - Henry Ddungu
- grid.512320.70000 0004 6015 3252Uganda Cancer Institute, Kampala, Uganda
| | | | - Aggrey Dhabangi
- grid.11194.3c0000 0004 0620 0548Child Health and Development Centre, Makerere University College of Health Sciences, Kampala, Uganda
| | - Joseph Ouma
- grid.421981.7MUJHU Research Collaboration, Kampala, Uganda
| | | | - Telsa de Lange
- grid.419681.30000 0001 2164 9667National Institute of Allergy and Infectious Diseases Office of Cyber Infrastructure and Computational Biology, Bethesda, MD USA
| | - Michael Tartakovsky
- grid.419681.30000 0001 2164 9667National Institute of Allergy and Infectious Diseases Office of Cyber Infrastructure and Computational Biology, Bethesda, MD USA
| | - Jodie L. White
- grid.21107.350000 0001 2171 9311Department of Pathology, School of Medicine, Johns Hopkins University, Baltimore, MD USA
| | - Ceasar Kakura
- grid.421981.7MUJHU Research Collaboration, Kampala, Uganda
| | - Mary Glenn Fowler
- grid.21107.350000 0001 2171 9311Department of Pathology, School of Medicine, Johns Hopkins University, Baltimore, MD USA
| | - Philippa Musoke
- grid.11194.3c0000 0004 0620 0548Makerere University, Kampala, Uganda
| | - Monica Nolan
- grid.421981.7MUJHU Research Collaboration, Kampala, Uganda
| | - M. Kate Grabowski
- grid.21107.350000 0001 2171 9311Department of Pathology, School of Medicine, Johns Hopkins University, Baltimore, MD USA
| | - Lawrence H. Moulton
- grid.21107.350000 0001 2171 9311Department of International Health, School of Public Health, Johns Hopkins University, Baltimore, MD USA
| | - Susan L. Stramer
- grid.281926.60000 0001 2214 8581Department of Scientific Affairs, American Red Cross, Gaithersburg, MD USA
| | - Denise Whitby
- grid.418021.e0000 0004 0535 8394Leidos Biomedical Research, AIDS and Cancer Virus Program, Frederick National Laboratory for Cancer Research, Frederick, MD USA
| | - Peter A. Zimmerman
- grid.67105.350000 0001 2164 3847The Center for Global Health & Diseases, Pathology Department, Case Western Reserve University, Cleveland, OH USA
| | - Deo Wabwire
- grid.421981.7MUJHU Research Collaboration, Kampala, Uganda
| | - Isaac Kajja
- grid.11194.3c0000 0004 0620 0548Department of Orthopaedics, Makerere University College of Health Sciences, Kampala, Uganda
| | - Jeffrey McCullough
- grid.215654.10000 0001 2151 2636College of Health Solutions, Arizona State University, Phoenix, AZ USA
| | - Raymond Goodrich
- grid.47894.360000 0004 1936 8083Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, CO USA
| | - Thomas C. Quinn
- grid.21107.350000 0001 2171 9311Department of Pathology, School of Medicine, Johns Hopkins University, Baltimore, MD USA ,grid.21107.350000 0001 2171 9311Department of International Health, School of Public Health, Johns Hopkins University, Baltimore, MD USA ,grid.94365.3d0000 0001 2297 5165Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD USA
| | | | - Paul M. Ness
- grid.21107.350000 0001 2171 9311Department of Pathology, School of Medicine, Johns Hopkins University, Baltimore, MD USA
| | - Aaron A. R. Tobian
- grid.21107.350000 0001 2171 9311Department of Pathology, School of Medicine, Johns Hopkins University, Baltimore, MD USA ,grid.11194.3c0000 0004 0620 0548Department of Paediatrics and Child Health, College of Health Sciences, Makerere University, Kampala, Uganda
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15
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Trends of Infectious Disease Markers Among Healthy Blood Donors In Northern India: A Ten Year Study. Transfus Apher Sci 2022; 61:103442. [PMID: 35450806 DOI: 10.1016/j.transci.2022.103442] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 03/23/2022] [Accepted: 03/31/2022] [Indexed: 10/18/2022]
Abstract
OBJECTIVE Transfusion transmitted infection (TTI) is a major hazard for blood transfusion. The present retrospective chart review was undertaken to study the demographic profile and TTI trends among blood donors to see impact of interventions on blood safety. METHODS Data of donors and TTI screening results from 2010 to 2019 were analyzed. Degree of significance was determined by Chi square test. RESULTS Out of 1,68,570 donors, 33,227 (19.7%) were voluntary and 1,35,343 (80.3%) were replacement with 2.8% females and 54% belonging to the age group 18-29 years. Voluntary donation increased by only 3% in ten years and total reactivity rate was 1.6%. The reactive rate for all infections was 0.8% in volunteer donors and 1.95% in replacement donors (p-value < 0.001). The prevalence of HBsAg, HCV, HIV and syphilis showed a significant decline from 2010 to 2014. Of the donors who were reactive for HBV, 8.7% were missed by ELISA but detected by NAT. Donor reactivity for malaria remained the same in this period. CONCLUSION Newer strategies and effort to increase voluntary donation helping the general public adopt a healthy lifestyle is urgently needed in India. Higher prevalence of TTI among replacement donors is substantiated by this study. Role of counseling of donors cannot be overemphasized. Utility of malaria screening for blood donors needs to be reexamined by evaluating evidences from other blood banks. A rational policy approach, based on a careful assessment of epidemiological data, cost effectiveness analysis, and opinion of stakeholders is necessary for universal adoption of NAT.
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16
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Sarker T, Katz LM, Bloch EM, Goel R. Blood Product (Donor) Noninfectious and Infectious Testing and Modification. Clin Lab Med 2021; 41:579-598. [PMID: 34689966 DOI: 10.1016/j.cll.2021.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Blood transfusion begins with safe donor selection and testing. In the United States, the blood supply and transfusion are highly regulated. Blood transfusion safety is multifaceted, whereby each of the elements of the blood safety value chain, spanning donor recruitment and qualification, to collection, blood processing, testing, transfusion practice, and posttransfusion surveillance, must be optimized to minimize risk. Pathogen inactivation is a promising approach to decrease bacterial contamination of platelets, inactivate parasites and viruses, and decrease risks associated with emerging and unidentified pathogens. This article offers an overview of blood donor infectious and noninfectious testing in the United States.
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Affiliation(s)
- Tania Sarker
- Department of Pathology and Laboratory Medicine, Center for Transfusion and Cellular Therapies, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Louis M Katz
- Mississippi Valley Regional Blood Center, Davenport, IA, USA; Carver College of Medicine, UIHC, Iowa City, IA, USA
| | - Evan M Bloch
- Department of Pathology, Transfusion Medicine, Johns Hopkins University School of Medicine, 600 North Wolfe Street/Carnegie 446 D1, Baltimore, MD 21287, USA
| | - Ruchika Goel
- Mississippi Valley Regional Blood Center, Davenport, IA, USA; Division of Hematology/Oncology, Simmons Cancer Institute at SIU SOM; Division of Transfusion Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD, USA.
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17
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Abstract
Blood transfusions are generally safe but can carry considerable risks. This review summarizes the different types of transfusion reactions and ways to diagnose and manage them. Symptoms are often overlapping and nonspecific. When a reaction is suspected, it is critical to stop the transfusion immediately and report the reaction to the blood bank, as this can affect the patient's outcome. New evidence-based algorithms of transfusion, newer blood screening methods and donor policies and deferrals, new laboratory testing, electronic verification systems, and improved hemovigilance lead to the avoidance of unnecessary transfusions and decrease the incidence of serious transfusion reactions.
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Affiliation(s)
- Rim Abdallah
- Department of Transfusion Medicine, Warren G. Magnuson Clinical Center, National Institutes of Health, Bethesda, MD, USA
| | - Herleen Rai
- Department of Transfusion Medicine, Warren G. Magnuson Clinical Center, National Institutes of Health, Bethesda, MD, USA
| | - Sandhya R Panch
- Department of Transfusion Medicine, Warren G. Magnuson Clinical Center, National Institutes of Health, Bethesda, MD, USA.
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18
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Prevalence of positivity to antibodies to hepatitis C virus among volunteer blood donors in China: a meta-analysis. Public Health 2021; 199:87-95. [PMID: 34571442 DOI: 10.1016/j.puhe.2021.07.011] [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: 12/12/2020] [Revised: 06/17/2021] [Accepted: 07/09/2021] [Indexed: 11/21/2022]
Abstract
OBJECTIVES Safe blood transfusion plays an important role in the prevention of transfusion-transmissible infections, and hepatitis C virus (HCV) infection is one of the major problems associated with this procedure. This meta-analysis aimed to determine the prevalence of HCV infection in Chinese blood donors. STUDY DESIGN The study design of this study is a meta-analysis. METHODS Eligible studies were retrieved from PubMed, Embase, China National Knowledge Infrastructure, China Science and Technology Journal Database and Wanfang literature databases from 2010 to 2020. The effect measure was presented as HCV prevalence with a 95% confidence interval (CI). Q test was used to assess the heterogeneity, and the I2 statistics was determined to decide whether a random effects model or a fixed effects model should be used as the pooling method. Subgroup analyses were also conducted. RESULTS A total of 62 eligible studies, including 9,007,220 HCV blood donors, were analysed. Of the total blood donors, 35,017 were infected with HCV. The pooled HCV prevalence was 0.415% (95% CI: 0.371-0.458). The subgroup analysis revealed that the prevalence of positivity to anti-HCV antibodies was significantly different in each year (P < 0.05). However, no significant difference was observed in HCV prevalence in terms of sex. Moreover, the prevalence of positivity to anti-HCV was remarkably higher in first-time blood donors than in repeat blood donors (P < 0.05), and the rate of HCV infection among university students was significantly lower than that among soldiers (P < 0.05). CONCLUSIONS The rate of HCV infection showed a downward trend from 2010 to 2014, increased in 2015-2016, and finally decreased in 2017-2018. Thus, the prevalence of HCV infection has decreased in Chinese blood donors after comprehensive prevention and treatment.
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19
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Obrová K, Grumaz S, Remely M, Czurda S, Krickl I, Herndlhofer S, Gleixner KV, Sperr WR, Größlinger L, Frank T, Andrade N, Egger‐Matiqi T, Peters C, Engstler G, Dworzak M, Attarbaschi A, Grotel M, Heuvel‐Eibrink MM, Moiseev IS, Rogacheva Y, Zubarovskaya L, Zubarovskaya N, Pichler H, Lawitschka A, Koller E, Keil F, Valent P, Sohn K, Lion T. Presence of viremia during febrile neutropenic episodes in patients undergoing chemotherapy for malignant neoplasms. Am J Hematol 2021; 96:719-726. [PMID: 33784434 DOI: 10.1002/ajh.26177] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 03/25/2021] [Accepted: 03/25/2021] [Indexed: 12/17/2022]
Abstract
The importance of viral infections as a leading cause of morbidity and mortality is well documented in severely immunosuppressed patients undergoing allogeneic stem cell transplantation. By contrast, viral infections generally receive less attention in patients with malignant disorders undergoing chemotherapy, where the onset of neutropenic fever is mostly associated with bacterial or fungal infections, and screening for viral infections is not routinely performed. To address the occurrence of invasive viral infections in a clinical setting commonly associated with less pronounced immunosuppression, we have prospectively screened 237 febrile neutropenic episodes in pediatric (n = 77) and adult (n = 69) patients undergoing intensive chemotherapy, primarily for treatment of acute leukemia. Serial peripheral blood specimens were tested by RQ-PCR assays for the presence and quantity of the clinically relevant viruses CMV, EBV, HHV6 and HAdV, commonly reactivated in highly immunocompromised patients. Viremia was documented in 36 (15%) episodes investigated, including the detection of HHV6 (n = 14), EBV (n = 15), CMV (n = 6), or HAdV (n = 1). While low or intermediate levels of viremia (<104 virus copies/mL) were commonly associated with bacterial or fungal co-infection, viremia at higher levels (>104 copies/mL) was documented in patients without evidence for other infections, raising the possibility that at least in some instances the onset of fever may have been attributable to the virus detected. The observations suggest that viral infections, potentially resulting from reactivation, might also play a clinically relevant role in patients receiving chemotherapy for treatment of malignant neoplasms, and routine screening for viremia in this clinical setting might be warranted.
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Affiliation(s)
- Klára Obrová
- St.Anna Children's Cancer Research Institute (CCRI) Vienna Austria
| | | | - Marlene Remely
- St.Anna Children's Cancer Research Institute (CCRI) Vienna Austria
| | - Stefan Czurda
- St.Anna Children's Cancer Research Institute (CCRI) Vienna Austria
| | - Isabella Krickl
- St.Anna Children's Cancer Research Institute (CCRI) Vienna Austria
| | - Susanne Herndlhofer
- Department of Internal Medicine I, Division of Hematology & Hemostaseology Medical University of Vienna Vienna Austria
| | - Karoline V. Gleixner
- Department of Internal Medicine I, Division of Hematology & Hemostaseology Medical University of Vienna Vienna Austria
- Ludwig Boltzmann Institute for Hematology & Oncology Medical University of Vienna Vienna Austria
| | - Wolfgang R. Sperr
- Department of Internal Medicine I, Division of Hematology & Hemostaseology Medical University of Vienna Vienna Austria
- Ludwig Boltzmann Institute for Hematology & Oncology Medical University of Vienna Vienna Austria
| | | | - Tijana Frank
- St.Anna Children's Cancer Research Institute (CCRI) Vienna Austria
| | - Nuno Andrade
- St.Anna Children's Cancer Research Institute (CCRI) Vienna Austria
| | - Teresa Egger‐Matiqi
- St. Anna Children's Hospital, Department of Pediatrics Medical University of Vienna Vienna Austria
| | - Christina Peters
- St. Anna Children's Hospital, Department of Pediatrics Medical University of Vienna Vienna Austria
| | - Gernot Engstler
- St. Anna Children's Hospital, Department of Pediatrics Medical University of Vienna Vienna Austria
| | - Michael Dworzak
- St. Anna Children's Hospital, Department of Pediatrics Medical University of Vienna Vienna Austria
| | - Andishe Attarbaschi
- St. Anna Children's Hospital, Department of Pediatrics Medical University of Vienna Vienna Austria
| | - Martine Grotel
- Princess Máxima Center for Pediatric Oncology Utrecht The Netherlands
| | | | - Ivan S. Moiseev
- I. P. Pavlov First Saint Petersburg State Medical University Saint Petersburg Russia
| | - Yuliya Rogacheva
- I. P. Pavlov First Saint Petersburg State Medical University Saint Petersburg Russia
| | - Ludmilla Zubarovskaya
- I. P. Pavlov First Saint Petersburg State Medical University Saint Petersburg Russia
| | - Natalia Zubarovskaya
- St. Anna Children's Hospital, Department of Pediatrics Medical University of Vienna Vienna Austria
| | - Herbert Pichler
- St. Anna Children's Hospital, Department of Pediatrics Medical University of Vienna Vienna Austria
| | - Anita Lawitschka
- St. Anna Children's Hospital, Department of Pediatrics Medical University of Vienna Vienna Austria
| | | | - Felix Keil
- Ludwig Boltzmann Institute for Hematology & Oncology Medical University of Vienna Vienna Austria
- 3rd Medical Department Hanuschhospital Vienna Austria
| | - Peter Valent
- Department of Internal Medicine I, Division of Hematology & Hemostaseology Medical University of Vienna Vienna Austria
- Ludwig Boltzmann Institute for Hematology & Oncology Medical University of Vienna Vienna Austria
| | - Kai Sohn
- Fraunhofer IGB Stuttgart Germany
| | - Thomas Lion
- St.Anna Children's Cancer Research Institute (CCRI) Vienna Austria
- Ludwig Boltzmann Institute for Hematology & Oncology Medical University of Vienna Vienna Austria
- Labdia Labordiagnostik GmbH Vienna Austria
- Department of Pediatrics Medical University of Vienna Vienna Austria
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Qureshi MZ, Handoo S, Sultan B, Reshi R, Bashir M. TRANSFUSION TRANSMITTED INFECTIONS (TTIs) AMONG BLOOD DONORS IN THE BLOOD BANK OF A TERTIARY CARE HOSPITAL IN INDIA: A RECORD BASED STUDY. SANAMED 2020. [DOI: 10.24125/sanamed.v15i3.445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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21
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Park C, Gellman C, O'Brien M, Eidelberg A, Subudhi I, Gorodetsky EF, Asriel B, Furlow A, Mullen M, Nadkarni G, Somani S, Sigel K, Reich DL. Blood Donation and COVID-19: Reconsidering the 3-Month Deferral Policy for Gay, Bisexual, Transgender, and Other Men Who Have Sex With Men. Am J Public Health 2020; 111:247-252. [PMID: 33211588 DOI: 10.2105/ajph.2020.305974] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
In April 2020, in light of COVID-19-related blood shortages, the US Food and Drug Administration (FDA) reduced the deferral period for men who have sex with men (MSM) from its previous duration of 1 year to 3 months.Although originally born out of necessity, the decades-old restrictions on MSM donors have been mitigated by significant advancements in HIV screening, treatment, and public education. The severity of the ongoing COVID-19 pandemic-and the urgent need for safe blood products to respond to such crises-demands an immediate reconsideration of the 3-month deferral policy for MSM.We review historical HIV testing and transmission evidence, discuss the ethical ramifications of the current deferral period, and examine the issue of noncompliance with donor deferral rules. We also propose an eligibility screening format that involves an individual risk-based screening protocol and, unlike current FDA guidelines, does not effectively exclude donors on the basis of gender identity or sexual orientation. Our policy proposal would allow historically marginalized community members to participate with dignity in the blood donation process without compromising blood donation and transfusion safety outcomes.
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Affiliation(s)
- Christopher Park
- Christopher Park, Caroline Gellman, Madeline O'Brien, Benjamin Asriel, Andrew Furlow, Michael Mullen, Girish Nadkarni, Sulaiman Somani, Keith Sigel, and David L. Reich are with the Icahn School of Medicine at Mount Sinai, New York, NY. Andrew Eidelberg is with the Weill Cornell School of Medicine, New York, NY. Ipsita Subudhi and Elizabeth F. Gorodetsky are with the New York University Grossman School of Medicine, New York, NY
| | - Caroline Gellman
- Christopher Park, Caroline Gellman, Madeline O'Brien, Benjamin Asriel, Andrew Furlow, Michael Mullen, Girish Nadkarni, Sulaiman Somani, Keith Sigel, and David L. Reich are with the Icahn School of Medicine at Mount Sinai, New York, NY. Andrew Eidelberg is with the Weill Cornell School of Medicine, New York, NY. Ipsita Subudhi and Elizabeth F. Gorodetsky are with the New York University Grossman School of Medicine, New York, NY
| | - Madeline O'Brien
- Christopher Park, Caroline Gellman, Madeline O'Brien, Benjamin Asriel, Andrew Furlow, Michael Mullen, Girish Nadkarni, Sulaiman Somani, Keith Sigel, and David L. Reich are with the Icahn School of Medicine at Mount Sinai, New York, NY. Andrew Eidelberg is with the Weill Cornell School of Medicine, New York, NY. Ipsita Subudhi and Elizabeth F. Gorodetsky are with the New York University Grossman School of Medicine, New York, NY
| | - Andrew Eidelberg
- Christopher Park, Caroline Gellman, Madeline O'Brien, Benjamin Asriel, Andrew Furlow, Michael Mullen, Girish Nadkarni, Sulaiman Somani, Keith Sigel, and David L. Reich are with the Icahn School of Medicine at Mount Sinai, New York, NY. Andrew Eidelberg is with the Weill Cornell School of Medicine, New York, NY. Ipsita Subudhi and Elizabeth F. Gorodetsky are with the New York University Grossman School of Medicine, New York, NY
| | - Ipsita Subudhi
- Christopher Park, Caroline Gellman, Madeline O'Brien, Benjamin Asriel, Andrew Furlow, Michael Mullen, Girish Nadkarni, Sulaiman Somani, Keith Sigel, and David L. Reich are with the Icahn School of Medicine at Mount Sinai, New York, NY. Andrew Eidelberg is with the Weill Cornell School of Medicine, New York, NY. Ipsita Subudhi and Elizabeth F. Gorodetsky are with the New York University Grossman School of Medicine, New York, NY
| | - Elizabeth F Gorodetsky
- Christopher Park, Caroline Gellman, Madeline O'Brien, Benjamin Asriel, Andrew Furlow, Michael Mullen, Girish Nadkarni, Sulaiman Somani, Keith Sigel, and David L. Reich are with the Icahn School of Medicine at Mount Sinai, New York, NY. Andrew Eidelberg is with the Weill Cornell School of Medicine, New York, NY. Ipsita Subudhi and Elizabeth F. Gorodetsky are with the New York University Grossman School of Medicine, New York, NY
| | - Benjamin Asriel
- Christopher Park, Caroline Gellman, Madeline O'Brien, Benjamin Asriel, Andrew Furlow, Michael Mullen, Girish Nadkarni, Sulaiman Somani, Keith Sigel, and David L. Reich are with the Icahn School of Medicine at Mount Sinai, New York, NY. Andrew Eidelberg is with the Weill Cornell School of Medicine, New York, NY. Ipsita Subudhi and Elizabeth F. Gorodetsky are with the New York University Grossman School of Medicine, New York, NY
| | - Andrew Furlow
- Christopher Park, Caroline Gellman, Madeline O'Brien, Benjamin Asriel, Andrew Furlow, Michael Mullen, Girish Nadkarni, Sulaiman Somani, Keith Sigel, and David L. Reich are with the Icahn School of Medicine at Mount Sinai, New York, NY. Andrew Eidelberg is with the Weill Cornell School of Medicine, New York, NY. Ipsita Subudhi and Elizabeth F. Gorodetsky are with the New York University Grossman School of Medicine, New York, NY
| | - Michael Mullen
- Christopher Park, Caroline Gellman, Madeline O'Brien, Benjamin Asriel, Andrew Furlow, Michael Mullen, Girish Nadkarni, Sulaiman Somani, Keith Sigel, and David L. Reich are with the Icahn School of Medicine at Mount Sinai, New York, NY. Andrew Eidelberg is with the Weill Cornell School of Medicine, New York, NY. Ipsita Subudhi and Elizabeth F. Gorodetsky are with the New York University Grossman School of Medicine, New York, NY
| | - Girish Nadkarni
- Christopher Park, Caroline Gellman, Madeline O'Brien, Benjamin Asriel, Andrew Furlow, Michael Mullen, Girish Nadkarni, Sulaiman Somani, Keith Sigel, and David L. Reich are with the Icahn School of Medicine at Mount Sinai, New York, NY. Andrew Eidelberg is with the Weill Cornell School of Medicine, New York, NY. Ipsita Subudhi and Elizabeth F. Gorodetsky are with the New York University Grossman School of Medicine, New York, NY
| | - Sulaiman Somani
- Christopher Park, Caroline Gellman, Madeline O'Brien, Benjamin Asriel, Andrew Furlow, Michael Mullen, Girish Nadkarni, Sulaiman Somani, Keith Sigel, and David L. Reich are with the Icahn School of Medicine at Mount Sinai, New York, NY. Andrew Eidelberg is with the Weill Cornell School of Medicine, New York, NY. Ipsita Subudhi and Elizabeth F. Gorodetsky are with the New York University Grossman School of Medicine, New York, NY
| | - Keith Sigel
- Christopher Park, Caroline Gellman, Madeline O'Brien, Benjamin Asriel, Andrew Furlow, Michael Mullen, Girish Nadkarni, Sulaiman Somani, Keith Sigel, and David L. Reich are with the Icahn School of Medicine at Mount Sinai, New York, NY. Andrew Eidelberg is with the Weill Cornell School of Medicine, New York, NY. Ipsita Subudhi and Elizabeth F. Gorodetsky are with the New York University Grossman School of Medicine, New York, NY
| | - David L Reich
- Christopher Park, Caroline Gellman, Madeline O'Brien, Benjamin Asriel, Andrew Furlow, Michael Mullen, Girish Nadkarni, Sulaiman Somani, Keith Sigel, and David L. Reich are with the Icahn School of Medicine at Mount Sinai, New York, NY. Andrew Eidelberg is with the Weill Cornell School of Medicine, New York, NY. Ipsita Subudhi and Elizabeth F. Gorodetsky are with the New York University Grossman School of Medicine, New York, NY
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22
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Roman MA, Abbasciano RG, Pathak S, Oo S, Yusoff S, Wozniak M, Qureshi S, Lai FY, Kumar T, Richards T, Yao G, Estcourt L, Murphy GJ. Patient blood management interventions do not lead to important clinical benefits or cost-effectiveness for major surgery: a network meta-analysis. Br J Anaesth 2020; 126:149-156. [PMID: 32620259 PMCID: PMC7844348 DOI: 10.1016/j.bja.2020.04.087] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 04/22/2020] [Accepted: 04/25/2020] [Indexed: 01/28/2023] Open
Abstract
Background Patient blood management (PBM) interventions aim to improve clinical outcomes by reducing bleeding and transfusion. We assessed whether existing evidence supports the routine use of combinations of these interventions during and after major surgery. Methods Five systematic reviews and a National Institute of Health and Care Excellence health economic review of trials of common PBM interventions enrolling participants of any age undergoing surgery were updated. The last search was on June 1, 2019. Studies in trauma, burns, gastrointestinal haemorrhage, gynaecology, dentistry, or critical care were excluded. The co-primary outcomes were: risk of receiving red cell transfusion and 30-day or hospital all-cause mortality. Treatment effects were estimated using random-effects models and risk ratios (RR) with 95% confidence intervals (CIs). Heterogeneity assessments used I2. Network meta-analyses used a frequentist approach. The protocol was registered prospectively (PROSPERO CRD42018085730). Results Searches identified 393 eligible randomised controlled trials enrolling 54 917 participants. PBM interventions resulted in a reduction in exposure to red cell transfusion (RR=0.60; 95% CI 0.57, 0.63; I2=77%), but had no statistically significant treatment effect on 30-day or hospital mortality (RR=0.93; 95% CI 0.81, 1.07; I2=0%). Treatment effects were consistent across multiple secondary outcomes, sub-groups and sensitivity analyses that considered clinical setting, type of intervention, and trial quality. Network meta-analysis did not demonstrate additive benefits from the use of multiple interventions. No trial demonstrated that PBM was cost-effective. Conclusions In randomised trials, PBM interventions do not have important clinical benefits beyond reducing bleeding and transfusion in people undergoing major surgery.
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Affiliation(s)
- Marius A Roman
- Department of Cardiovascular Sciences and National Institute for Health Research Leicester Biomedical Research Unit in Cardiovascular Medicine, College of Life Sciences, University of Leicester, Leicester, UK.
| | - Riccardo G Abbasciano
- Department of Cardiovascular Sciences and National Institute for Health Research Leicester Biomedical Research Unit in Cardiovascular Medicine, College of Life Sciences, University of Leicester, Leicester, UK
| | - Suraj Pathak
- Department of Cardiovascular Sciences and National Institute for Health Research Leicester Biomedical Research Unit in Cardiovascular Medicine, College of Life Sciences, University of Leicester, Leicester, UK
| | - Shwe Oo
- Department of Cardiac Surgery, Liverpool Heart and Chest Hospital NHS Foundation Trust, Liverpool, UK
| | - Syabira Yusoff
- Department of Cardiovascular Sciences and National Institute for Health Research Leicester Biomedical Research Unit in Cardiovascular Medicine, College of Life Sciences, University of Leicester, Leicester, UK
| | - Marcin Wozniak
- Department of Cardiovascular Sciences and National Institute for Health Research Leicester Biomedical Research Unit in Cardiovascular Medicine, College of Life Sciences, University of Leicester, Leicester, UK
| | - Saqib Qureshi
- Department of Cardiothoracic Surgery, University Hospitals of Nottingham, Nottingham, UK
| | - Florence Y Lai
- Department of Cardiovascular Sciences and National Institute for Health Research Leicester Biomedical Research Unit in Cardiovascular Medicine, College of Life Sciences, University of Leicester, Leicester, UK
| | - Tracy Kumar
- Department of Cardiovascular Sciences and National Institute for Health Research Leicester Biomedical Research Unit in Cardiovascular Medicine, College of Life Sciences, University of Leicester, Leicester, UK
| | - Toby Richards
- Faculty of Health and Medical Sciences, University of Western Australia, Perth, Australia
| | - Guiqing Yao
- Biostatistics Research Group, Department of Health Sciences, College of Life Sciences, University of Leicester, Leicester, UK
| | - Lise Estcourt
- Haematology/Transfusion Medicine, NHS Blood, and Transplant, John Radcliffe Hospital, Headington, Oxford, UK
| | - Gavin J Murphy
- Department of Cardiovascular Sciences and National Institute for Health Research Leicester Biomedical Research Unit in Cardiovascular Medicine, College of Life Sciences, University of Leicester, Leicester, UK
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23
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New strategies for the control of infectious and parasitic diseases in blood donors: the impact of pathogen inactivation methods. EUROBIOTECH JOURNAL 2020. [DOI: 10.2478/ebtj-2020-0007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Abstract
Around 70 infectious agents are possible threats for blood safety.
The risk for blood recipients is increasing because of new emergent agents like West Nile, Zika and Chikungunya viruses, or parasites such as Plasmodium and Trypanosoma cruzi in non-endemic regions, for instance.
Screening programmes of the donors are more and more implemented in several Countries, but these cannot prevent completely infections, especially when they are caused by new agents.
Pathogen inactivation (PI) methods might overcome the limits of the screening and different technologies have been set up in the last years.
This review aims to describe the most widely used methods focusing on their efficacy as well as on the preservation integrity of blood components.
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24
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Seroprevalence and factors associated with hepatitis B virus infection in blood donors in Ethiopia: a systematic review and meta-analysis. Arch Virol 2020; 165:1039-1048. [PMID: 32219546 DOI: 10.1007/s00705-020-04591-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Accepted: 02/13/2020] [Indexed: 01/05/2023]
Abstract
Hepatitis B virus (HBV) can be transmitted during blood donation. This study estimated the pooled prevalence of hepatitis B and associated risk factors in blood donors in Ethiopia. The study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. PubMed, African Journals Online (AJOL), the Excerpta Medica database (EMBASE), SCOPUS, Web of Science, Google Scholar, and JSTOR were accessed. Articles were searched from the Addis Ababa University research repository. The core search terms and phrases were "Hepatitis", "Hepatitis B", "Blood Donation", "Blood Donor", "Transfusion", "Transfusion Transmissible Infections", "Ethiopia", "Addis Ababa", "Adama", "Bahirdar", "Dire Dawa", "Gondar", "Mekelle", "Hawassa". The data were analyzed based on a DerSimonian-Laird random-effects model using STATA 14 and Review Manager version 5.3. I2 was used to quantify between-study heterogeneity. Leave-one-out sensitivity analysis was done. Twenty-seven articles with 308,188 samples were included in the meta-analysis. The studies used HBsAg to diagnose hepatitis B. The pooled prevalence of HBV infection among blood donors was 4.91% (95% CI: 4.21-5.60; I2 = 99%). Male sex (p < 0.001), replacement donors (p = 0.007), history of tooth extraction (p < 0.001), and sharp material sharing (p < 0.001) were associated with increased risk, while being a repetitive blood donor was associated with a decreased risk of being infected with HBV (p = 0.02).
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25
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Dean CL, Hooper JW, Dye JM, Zak SE, Koepsell SA, Corash L, Benjamin RJ, Kwilas S, Bonds S, Winkler AM, Kraft CS. Characterization of Ebola convalescent plasma donor immune response and psoralen treated plasma in the United States. Transfusion 2020; 60:1024-1031. [PMID: 32129478 DOI: 10.1111/trf.15739] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Revised: 02/04/2020] [Accepted: 02/05/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND In 2014, passive immunization by transfusion of Ebola convalescent plasma (ECP) was considered for treating patients with acute Ebola virus disease (EVD). Early Ebola virus (EBOV) seroconversion confers a survival advantage in natural infection, hence transfusion of ECP plasma with high levels of neutralizing EBOV antibodies is a potential passive immune therapy. Techniques to reduce the risk of other transfusion-transmitted infections (TTIs) are warranted as recent ECP survivors are ineligible as routine blood donors. As part of an ongoing clinical trial to evaluate the safety and effectiveness of ECP, the impact of amotosalen/UVA pathogen reduction technology (PRT) on EBOV antibody characteristics was examined. STUDY DESIGN AND METHODS Serum and plasma samples were collected from EVD-recovered subjects at multiple timepoints and evaluated by ELISA for antibodies to recombinant EBOV glycoprotein (GP) and irradiated whole EBOV antigen, as well as for EBOV microneutralization, classic plaque reduction neutralization test (PRNT) and EBOV pseudovirion neutralization assay (PsVNA) activity. RESULTS Six subjects donated 40 individual ECP units. Substantial antibody titers and neutralizing activity results were demonstrated but were generally lower for the ACD plasma samples compared to the serum samples. Anti-EBOV titers by all assays remained essentially unchanged after PRT. CONCLUSION Treatment of ECP with PRT to reduce the risk of TTI did not significantly reduce EBOV IgG antibody titers or neutralizing activity. Although ECP was used in the treatment of repatriated patients, no PRT units from this study were transfused to EVD patients. This inventory of PRT-treated ECP is currently available for future clinical evaluation.
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Affiliation(s)
- Christina L Dean
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Jay W Hooper
- Division of Virology, US Army Medical Research Institute for Infectious Diseases, Fort Detrick, Maryland, USA
| | - John M Dye
- Division of Virology, US Army Medical Research Institute for Infectious Diseases, Fort Detrick, Maryland, USA
| | - Samantha E Zak
- Division of Virology, US Army Medical Research Institute for Infectious Diseases, Fort Detrick, Maryland, USA
| | - Scott A Koepsell
- Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | | | | | - Steve Kwilas
- Division of Virology, US Army Medical Research Institute for Infectious Diseases, Fort Detrick, Maryland, USA
| | - Shannon Bonds
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia, USA
| | | | - Colleen S Kraft
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia, USA
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26
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Deng X, Zang L, Wang X, Chen H, Liu J, Gao Y, Xu S, Wang L, Fan Y, Candotti D, Liang X. Follow-up program for blood donors with unconfirmed screening results reveals a high false-positive rate in Dalian, China. Transfusion 2020; 60:334-342. [PMID: 31909495 DOI: 10.1111/trf.15656] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Revised: 11/13/2019] [Accepted: 11/13/2019] [Indexed: 12/28/2022]
Abstract
BACKGROUND Chinese blood donors with unconfirmed serological and/or molecular screening results are deferred permanently. This study investigated the implementation and performance of a follow-up program aiming to improve the notification and management of deferred donors in Dalian, China. STUDY DESIGN AND METHODS From January 2013 to February 2018, 411,216 donations were tested for HBsAg, anti-HCV, anti-HIV/HIV antigen, and antibodies to Treponema pallidum. HBV, HCV, and HIV nucleic acid testing (NAT) was performed in mini-pools of six or in individual donations (IDs). Reactive donations were evaluated further with alternative serological assays and ID-NAT re-testing. A follow-up procedure was developed to evaluate a subset of deferred donors that were either potential NAT yield cases, serology non-reactive and NAT non-repeated reactive (NRR), or serology NRR irrespective of NAT result. RESULTS Serological and molecular routine, plus supplemental testing, identified HBV, HCV, HIV, and TP in 503 (0.12%), 392 (0.09%), 156 (0.04%), and 2041 (0.49%) donations, respectively. Overall, 683 of 4156 (16.4%) eligible donors and 205 donors deferred prior 2013 participated in the program. They included 664 serology NRR and 224 NAT yield cases, and 58.8% repeat donors. All markers combined, follow-up documented false reactivity, primary acute infections, and OBI in 61.9% (550/888), 3.3% (29/888), and 12.8% (114/888) of these donors, respectively. Isolated anti-HBc or anti-HBs reactivity was observed in 22% of cases. CONCLUSION Follow-up testing refined infection status in 78.0% (693/888) of deferred donors with unconfirmed screening results. This high false-positive rate encouraged to reevaluate the current screening strategies and to consider donor reentry.
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Affiliation(s)
| | | | | | - Hui Chen
- Dalian Blood Center, Dalian, China
| | | | - Yong Gao
- Dalian Blood Center, Dalian, China
| | | | - Li Wang
- Dalian Blood Center, Dalian, China
| | | | - Daniel Candotti
- Department of Blood Transmitted Agents, National Institute of Blood Transfusion, Paris, France
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27
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Sousa V, Gomes ATPC, Freitas A, Faustino MAF, Neves MGPMS, Almeida A. Photodynamic Inactivation of Candida albicans in Blood Plasma and Whole Blood. Antibiotics (Basel) 2019; 8:antibiotics8040221. [PMID: 31766190 PMCID: PMC6963715 DOI: 10.3390/antibiotics8040221] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Revised: 11/10/2019] [Accepted: 11/11/2019] [Indexed: 11/17/2022] Open
Abstract
The few approved disinfection techniques for blood derivatives promote damage in the blood components, representing risks for the transfusion receptor. Antimicrobial photodynamic therapy (aPDT) seems to be a promising approach for the photoinactivation of pathogens in blood, but only three photosensitizers (PSs) have been approved, methylene blue (MB) for plasma and riboflavin and amotosalen for plasma and platelets. In this study, the efficiency of the porphyrinic photosensitizer Tri-Py(+)-Me and of the porphyrinic formulation FORM was studied in the photoinactivation of Candida albicans in plasma and in whole blood and the results were compared to the ones obtained with the already approved PS MB. The results show that FORM and Tri-Py(+)-Me are promising PSs to inactivate C. albicans in plasma. Although in whole blood the inactivation rates obtained were higher than the ones obtained with MB, further improvements are required. None of these PSs had promoted hemolysis at the isotonic conditions when hemolysis was evaluated in whole blood and after the addition of treated plasma with these PSs to concentrates of red blood cells.
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Affiliation(s)
- Vera Sousa
- Department of Biology & CESAM, University of Aveiro, Aveiro 3810-193, Portugal;
| | - Ana T. P. C. Gomes
- Department of Biology & CESAM, University of Aveiro, Aveiro 3810-193, Portugal;
- Correspondence: (A.T.P.C.G.); (M.A.F.F.); (A.A.)
| | - Américo Freitas
- Clinical Analysis Laboratory Avelab, Rua Cerâmica do Vouga, Aveiro 3800-011, Portugal;
| | - Maria A. F. Faustino
- Department of Chemistry & QOPNA and LAQV-REQUIMTE, University of Aveiro, Aveiro 3810-193, Portugal;
- Correspondence: (A.T.P.C.G.); (M.A.F.F.); (A.A.)
| | - Maria G. P. M. S. Neves
- Department of Chemistry & QOPNA and LAQV-REQUIMTE, University of Aveiro, Aveiro 3810-193, Portugal;
| | - Adelaide Almeida
- Department of Biology & CESAM, University of Aveiro, Aveiro 3810-193, Portugal;
- Correspondence: (A.T.P.C.G.); (M.A.F.F.); (A.A.)
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29
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Marks P, Verdun N. Toward universal pathogen reduction of the blood supply (Conference Report, p. 3002). Transfusion 2019; 59:3026-3028. [PMID: 31218709 DOI: 10.1111/trf.15410] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Accepted: 06/04/2019] [Indexed: 12/31/2022]
Affiliation(s)
- Peter Marks
- Center for Biologics Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, Maryland
| | - Nicole Verdun
- Center for Biologics Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, Maryland
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30
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Park CE. Evaluation of the Effectiveness of Surveillance on Improving the Detection of Healthcare Associated Infections. KOREAN JOURNAL OF CLINICAL LABORATORY SCIENCE 2019. [DOI: 10.15324/kjcls.2019.51.1.15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- Chang-Eun Park
- Department of Biomedical Laboratory Science, Molecular Diagnostics Research Institute, Namseoul University, Cheonan, Korea
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