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Mandal TK, Sarkar S, Haldar P, Mondal S, Chatterjee SS, Paul P, Ray R, Ghosh RR, Saha S, Dan U. Prevalence of HIV, hepatitis B and hepatitis C infections among patients with thalassemia attending a tertiary care (rural) hospital. J Family Med Prim Care 2024; 13:1780-1786. [PMID: 38948618 PMCID: PMC11213440 DOI: 10.4103/jfmpc.jfmpc_1751_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Revised: 12/22/2023] [Accepted: 01/02/2024] [Indexed: 07/02/2024] Open
Abstract
Introduction The Sunderban area of West Bengal is home to tribal and religious minorities inhabiting various islands. There is a high prevalence of thalassemia among poverty-stricken residents of this region living with meagre health care facilities. This work was planned to determine the proportion of four viral transfusion-transmitted infections (TTIs): HIV-1, HIV-2, hepatitis B virus (HBV) and hepatitis C virus (HCV) among thalassemia patients attending the sole rural medical college in the region. Materials and Methods Thalassemia patients (n = 359, age ranging from 1 year to 60 years) attending the thalassemia clinic or being admitted to the indoor facilities for better management were included in the study. Only patients diagnosed with high-performance liquid chromatography (HPLC) and with classical clinical features were included in the study. Blood samples of these patients were tested for HIV as per NACO protocol. For HBV and HCV, samples were first tested serologically; reactive samples were collected and sent in the cold chain to a higher centre for nucleic acid amplification testing (NAAT) for qualitative and quantitative estimation. Clinical and laboratory data was collected, patients were followed up for complications and hospitalisation during the study period, and statistical analysis was performed. Results Majority of our patients had E-beta-thalassemia (245, 59.81%), followed by beta-thalassemia major (102, 28.30%). NAAT-confirmed HCV infection (14.21%) infection was the most common, followed by HBV (2.51%), and lastly by HIV-1 (0.58%) infection. Among infected thalassemia patients, the mean HCV RNA was 741063 ± 438514.67 IU/ml while the mean HBV DNA level was 4082863 ± 7298514 IU/ml. Co-infections of HIV-1 and HCV and that of HBV and HCV were noted in one patient each (0.28%). HCV-related liver disease (14.21%) and growth retardation (10.31%) were the most typical complication noted, and death occurred in five patients (1.39%) during the study period. Conclusion Primary care physicians should know HCV infection is the most common TTI among thalassemia patients in rural eastern India.
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Affiliation(s)
| | - Sumantra Sarkar
- Paediatric Medicine, DHGMCH, Diamond Harbour, West Bengal, India
| | - Piyali Haldar
- Microbiology, DHGMCH, Diamond Harbour, West Bengal, India
| | - Subhasis Mondal
- Medical Officer In-Charge, Thalassemia Unit, DHGMCH, Diamond Harbour, West Bengal, India
| | - Shiv S. Chatterjee
- Microbiology, All India Institute of Medical Sciences, Kalyani, West Bengal, India
| | | | - Raja Ray
- Department of Microbiology, IPGMER, Kolkata, West Bengal, India
| | - Reena R. Ghosh
- Microbiology, DHGMCH, Diamond Harbour, West Bengal, India
| | - Santanu Saha
- Department of General Medicine, DHGMCH, Diamond Harbour, West Bengal, India
| | - Utpal Dan
- Microbiology, DHGMCH, Diamond Harbour, West Bengal, India
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Acharya D, Gaussen A, Poder TG, Lambert G, Renaud C, Nawej K, Lewin A. Associated criteria used in investigating suspected septic transfusion reactions: A scoping review. Vox Sang 2023; 118:1029-1037. [PMID: 37691585 DOI: 10.1111/vox.13521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 08/01/2023] [Accepted: 08/17/2023] [Indexed: 09/12/2023]
Abstract
BACKGROUND AND OBJECTIVES Septic transfusion reactions (STRs) occur as a result of bacterial contamination of blood or blood products, resulting in sepsis. This scoping review aimed to identify, explore and map the available literature on the STR criteria triggering the investigation of STR. MATERIALS AND METHODS Four electronic databases (MEDLINE, Web of Science, Science Direct, Embase) were searched to retrieve scientific literature reporting such criteria, published from 1 January 2000 to 5 May 2022. Grey literature was also searched from open web sources. RESULTS Of 1052 references identified, 43 (21 peer-reviewed and 22 grey literature) met the eligibility criteria for inclusion and data extraction after full article screening. Of them, most (27/43, 62.79%) were found to report a single set of criteria, and only two reported four or more sets of criteria. The analysis of 66 sets of criteria collected from the selected references revealed 57 different sets. A few sets of criteria used only one sign and symptom (s/s) (12.12%, n = 8), whereas 16 sets used 7-15 s/s (n = 16/66; 24.24%). Of the total 319 occurrences of s/s associated with the 66 sets of criteria, post-transfusion hyperthermia, body temperature increase and hypotension were the most common s/s categories. Of all the literature available, only one study tested the diagnostic accuracy of the STR criteria. CONCLUSION This scoping review revealed a substantial variation in criteria used to identify suspected STR. Consequently, conducting further studies to enhance the diagnostic accuracy of these criteria, which trigger STR investigations, is imperative for advancing clinical practice.
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Affiliation(s)
- Dilaram Acharya
- Department of Management, Evaluation and Health Policy, School of Public Health, Université de Montréal, Montréal, Québec, Canada
- Medical Affairs and Innovation, Héma-Québec, Montréal, Québec, Canada
| | - Amaury Gaussen
- Medical Affairs and Innovation, Héma-Québec, Montréal, Québec, Canada
| | - Thomas G Poder
- Department of Management, Evaluation and Health Policy, School of Public Health, Université de Montréal, Montréal, Québec, Canada
- Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal, CIUSSS de l'Est-de-L'île-de-Montréal, Montréal, Québec, Canada
| | - Gilles Lambert
- Direction régionale de santé publique, Centre intégré universitaire de santé et de services sociaux du Centre-Sud-de-l'Île-de-Montréal du Québec, Montréal, Québec, Canada
- Direction des risques biologiques et de la santé au travail, Institut national de santé publique du Québec, Montréal, Québec, Canada
| | - Christian Renaud
- Medical Affairs and Innovation, Héma-Québec, Montréal, Québec, Canada
| | - Karlitaj Nawej
- Direction des risques biologiques et de la santé au travail, Institut national de santé publique du Québec, Montréal, Québec, Canada
| | - Antoine Lewin
- Medical Affairs and Innovation, Héma-Québec, Montréal, Québec, Canada
- Faculty of Medicine and Health Science, Université de Sherbrooke, Sherbrooke, Québec, Canada
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Fontana S, Ripellino P, Niederhauser C, Widmer N, Gowland P, Petrini O, Aprile M, Merlani G, Bihl F. Epidemiology of HEV Infection in Blood Donors in Southern Switzerland. Microorganisms 2023; 11:2375. [PMID: 37894033 PMCID: PMC10609445 DOI: 10.3390/microorganisms11102375] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 09/15/2023] [Accepted: 09/19/2023] [Indexed: 10/29/2023] Open
Abstract
From 2014 to 2016, the number of hepatitis E virus (HEV) infections in southern Switzerland increased dramatically and suggested food as a potential infection reservoir. We evaluated the effects of food control measures introduced to limit HEV infections, assessing anti-HEV IgG and IgM rates in blood donors before and after the implementation of food control measures in 2017. From 2012 to 2013, we screened 1283, and from 2017 to 2019, we screened 1447 donors for IgG and IgM antibodies. No statistically significant differences were detected for IgG (32.8% from 2012 to 2013 vs. 31.1% from 2017 to 2019, p = 0.337) or IgM rates (2.0% from 2012 to 2013 vs. 2.8% from 2017 to 2019, p = 0.21). Rural provenience and age > 66 are predictors for positive IgG serology. A total of 5.9% of 303 donors included in both groups lost IgG positivity. We also determined nucleic acid testing (NAT) rates after the introduction of this test in 2018, comparing 49,345 donation results from southern Switzerland with those of 625,559 Swiss donor controls, and only 9 NAT-positive donors were found from 2018 to 2023. The high HEV seroprevalence in southern Switzerland may depend on different food supply chains in rural and urban areas. Local preventive measures probably have a limited impact on blood HEV risk; thus, continuous NAT testing is recommended.
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Affiliation(s)
- Stefano Fontana
- Servizio Trasfusionale CRS della Svizzera Italiana, 6900 Lugano, Switzerland;
- Blood Transfusion Unit, Faculty of Biology and Medicine, University of Lausanne, 1015 Lausanne, Switzerland
| | - Paolo Ripellino
- Department of Neurology, Neurocenter of Southern Switzerland EOC, 6900 Lugano, Switzerland;
- Faculty of Biomedical Sciences, Università della Svizzera Italiana, 6900 Lugano, Switzerland
| | - Christoph Niederhauser
- Interregional Blood Transfusion SRC, 3008 Berne, Switzerland (N.W.); (P.G.)
- Institute for Infectious Diseases, University of Berne, 3008 Berne, Switzerland
| | - Nadja Widmer
- Interregional Blood Transfusion SRC, 3008 Berne, Switzerland (N.W.); (P.G.)
| | - Peter Gowland
- Interregional Blood Transfusion SRC, 3008 Berne, Switzerland (N.W.); (P.G.)
| | - Orlando Petrini
- Institute of Microbiology, University of Applied Sciences and Arts of Southern Switzerland, 6500 Bellinzona, Switzerland;
| | - Manuela Aprile
- Servizio Trasfusionale CRS della Svizzera Italiana, 6900 Lugano, Switzerland;
| | - Giorgio Merlani
- Chief Medical Officer Office, Division of Public Health, Department for Health and Social Affairs, 6500 Bellinzona, Switzerland;
| | - Florian Bihl
- Epatocentro Ticino, Via Soldino 5, 6900 Lugano, Switzerland;
- Division of Gastroenterology and Hepatology, University Hospital Geneva, 1200 Geneva, Switzerland
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Limothai U, Tachaboon S, Dinhuzen J, Singh J, Jirawannaporn S, Leewongworasingh A, Thongpin M, Brameld S, Watanaboonyongcharoen P, Sitprija V, Tantawichien T, Thisyakorn U, Srisawat N. Seroprevalence of leptospirosis among blood donors in an endemic area. Sci Rep 2023; 13:12336. [PMID: 37524788 PMCID: PMC10390486 DOI: 10.1038/s41598-023-39461-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 07/25/2023] [Indexed: 08/02/2023] Open
Abstract
Thailand is known to be endemic for leptospirosis. This bacterium may pose a potential risk to transfusion safety. This study was a cross-sectional study examining the seroprevalence of leptospirosis among Thai blood donors. A total of 1053 serum specimens collected from blood donors residing in 5 regions of Thailand during March to September 2020 were included in this study. All samples were tested for the presence of antibodies to 22 leptospiral serovars using the microscopic agglutination test (MAT) and anti-Leptospira IgG antibodies using commercially available enzyme immunoassay. We found no evidence of recent exposure to Leptospira spp. in sera of healthy Thai blood donors by MAT, including those in higher-risk areas. However, in this same group, we did find small numbers of past exposure (1.7%) to Leptospira spp. by IgG ELISA. According to the findings of this study, there is currently no evidence for implementing new blood banking procedures to identify possible carriers in Thailand, however these should be continually monitored and revised according to the infectious disease burden in each country. It should be noted that there was a difference in the occupation rate between the general population reported in Thailand and blood donors in this study; it may not reflect the actual situation in the country.
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Affiliation(s)
- Umaporn Limothai
- Excellence Center for Critical Care Nephrology, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
- Center of Excellence in Critical Care Nephrology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Tropical Medicine Cluster, Chulalongkorn University, Bangkok, Thailand
| | - Sasipha Tachaboon
- Excellence Center for Critical Care Nephrology, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
- Center of Excellence in Critical Care Nephrology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Tropical Medicine Cluster, Chulalongkorn University, Bangkok, Thailand
| | - Janejira Dinhuzen
- Excellence Center for Critical Care Nephrology, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
- Center of Excellence in Critical Care Nephrology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Tropical Medicine Cluster, Chulalongkorn University, Bangkok, Thailand
| | - Jasleen Singh
- Tropical Medicine Cluster, Chulalongkorn University, Bangkok, Thailand
- School of Global Health, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Thailand Public Health Research Fellowship, Health Education England, London, UK
| | - Sirawit Jirawannaporn
- Excellence Center for Critical Care Nephrology, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
- Center of Excellence in Critical Care Nephrology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Tropical Medicine Cluster, Chulalongkorn University, Bangkok, Thailand
| | - Akarathep Leewongworasingh
- Excellence Center for Critical Care Nephrology, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
- Center of Excellence in Critical Care Nephrology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Tropical Medicine Cluster, Chulalongkorn University, Bangkok, Thailand
| | | | | | - Phandee Watanaboonyongcharoen
- Department of Laboratory Medicine, Faculty of Medicine, Chulalongkorn University and Transfusion Medicine Unit, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - Visith Sitprija
- Thai Red Cross, Queen Saovabha Memorial Institute, Bangkok, Thailand
| | - Terapong Tantawichien
- Tropical Medicine Cluster, Chulalongkorn University, Bangkok, Thailand
- Division of Infectious Diseases, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Usa Thisyakorn
- Tropical Medicine Cluster, Chulalongkorn University, Bangkok, Thailand
| | - Nattachai Srisawat
- Excellence Center for Critical Care Nephrology, King Chulalongkorn Memorial Hospital, Bangkok, Thailand.
- Center of Excellence in Critical Care Nephrology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
- Tropical Medicine Cluster, Chulalongkorn University, Bangkok, Thailand.
- Division of Nephrology, Department of Medicine, Faculty of Medicine, King Chulalongkorn Memorial Hospital, Bangkok, Thailand.
- Center for Critical Care Nephrology, The CRISMA Center, Department of Critical Care Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
- Academy of Science, Royal Society of Thailand, Bangkok, Thailand.
- Excellence Center for Critical Care Nephrology, Thai Red Cross Society, King Chulalongkorn Memorial Hospital, 1873, Rama 4 Rd., Lumphini, Pathumwan, Bangkok, 10330, Thailand.
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Thakur SK, Singh S, Negi DK, Sinha AK. Prevalence of TTI among Indian blood donors. Bioinformation 2023; 19:582-589. [PMID: 37886140 PMCID: PMC10599668 DOI: 10.6026/97320630019582] [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: 05/01/2023] [Revised: 05/31/2023] [Accepted: 05/31/2023] [Indexed: 10/28/2023] Open
Abstract
Transfusion Transmissible Infections (TTIs) such as human immune-deficiency virus (HIV-I/II), hepatitis B virus (HBV), Hepatitis C virus (HCV), Malaria parasite (MP) and syphilis can spread through contaminated blood or blood products. The present study was designed to analyze the prevalence of TTIs and their association with blood group, among the blood donors of Delhi. Blood group was determined by hem-agglutination using Gel card. HIV, HBV, and HCV test was performed by ELISA, syphilis by RPR and MP rapid card method. A total Transfusion Transmissible Infections (TTIs) such as human immune-deficiency virus (HIV-I/II), hepatitis B virus (HBV), Hepatitis C virus (HCV), Malaria parasite (MP) and syphilis can spread through contaminated blood or blood products. The present study was designed to analyze the prevalence of TTIs and their association with blood group, among the blood donors of Delhi. Blood group was determined by hem-agglutination using Gel card. HIV, HBV, and HCV test was performed by ELISA, syphilis by RPR and MP rapid card method. A total of 345(2.038%) blood donors were positive for TTIs. Prevalence of HBV, HCV, HIV-I/II, syphilis and MP were 188(1.111%), 73(0.431%), 34(0.201%), 49(0.29%) and 1(0.006%) respectively. Our result shows a trend of decrease in prevalence of TTIs; 2.267%, 2.111% and 1.614% between the year 2020, 2021 and 2022 respectively. Significant association of syphilis infection (P=0.036) and HCV infection (P=0.012) with ABO blood group antigen was observed. Blood group O donors were 1.81 times more infected with syphilis compared to donor having A and B antigen. Donors having blood group antigen B were 1.80 times more infected with HCV compared to donor not having B antigen. HBV and HIV prevalence found to be not associated with ABO and Rh blood group antigens. A low prevalence of TTIs positivity was observed among blood donors. Public awareness, proper counseling, medical examination and testing can help to minimize TTIs. Our study results shows ABO blood group has an association with HCV and VDRL infection.
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Affiliation(s)
- Sanjay Kumar Thakur
- P.G. Department of Zoology, Veer Kunwar Singh University, Ara, Bihar, India - 802301
- Department of Regional Blood Transfusion Centre, Hindu Rao Hospital and NDMC Medical College, Delhi, India – 110007
| | - Sompal Singh
- Department of Regional Blood Transfusion Centre, Hindu Rao Hospital and NDMC Medical College, Delhi, India – 110007
| | - Dinesh Kumar Negi
- Department of Regional Blood Transfusion Centre, Hindu Rao Hospital and NDMC Medical College, Delhi, India – 110007
| | - Anil Kumar Sinha
- P.G. Department of Zoology, Veer Kunwar Singh University, Ara, Bihar, India - 802301
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Namazi Bayegi S, Ali Hamidieh A, Behfar M, Saghazadeh A, Bozorgmehr M, Tajik N, Delbandi AA, Delavari S, Shekarabi M, Rezaei N. Unbalanced T-cell subsets in pediatric patients with beta-thalassemia. Hum Immunol 2023; 84:224-234. [PMID: 36604193 DOI: 10.1016/j.humimm.2022.12.003] [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: 10/15/2022] [Revised: 12/20/2022] [Accepted: 12/21/2022] [Indexed: 01/07/2023]
Abstract
BACKGROUND Beta-thalassemia major is an autosomal recessive disorder in hemoglobin synthesis. Ineffective erythropoiesis is the main characteristic of the disease, which results in anemia following the extensive destruction of red blood cells. Chronic antigenic stimulation following frequent blood transfusions lead to immune abnormalities, especially regarding T cells, which is one of the reasons for the high susceptibility to infection in beta-thalassemia. METHODS Six pediatric patients and six age- and sex-matched healthy children were selected. Immunophenotyping of functional T-cells was performed using flow cytometry with staining for surface and intracellular markers. The proliferative response of T lymphocytes was also investigated after labeling with CFSE and following stimulation with anti-CD3 and anti-CD28. RESULTS Examination of T lymphocyte subpopulations showed a significant increase in regulatory T cells (Tregs) in beta-thalassemia patients. Hence, the Treg:Tcons (conventional T cells) and Treg:CD8 ratios were significantly increased. In addition, a significant increase in CD8 T cell proliferation activity was observed. Multivariate analysis showed a significant association of central memory cells with serum ferritin levels and the duration of transfusion. In particular, patients with cytomegalovirus (CMV) infection exhibited a significant increase in CD4 central memory cells. CONCLUSION Patients with beta-thalassemia have functionally distinct CD4 and CD8 T cell subsets imbalances, and this may contribute to their high susceptibility to infections and immune dysregulation.
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Affiliation(s)
- Shideh Namazi Bayegi
- Department of Immunology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran; Pediatric Cell and Gene Therapy Research Center, Gene, Cell and Tissue Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Ali Hamidieh
- Pediatric Cell and Gene Therapy Research Center, Gene, Cell and Tissue Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Behfar
- Pediatric Cell and Gene Therapy Research Center, Gene, Cell and Tissue Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Amene Saghazadeh
- Research Center for Immunodeficiencies, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran; Systematic Review and Meta-analysis Expert Group (SRMEG), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Mahmood Bozorgmehr
- Oncopathology Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Nader Tajik
- Department of Immunology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran; Immunology Research Center, Institute of Immunology and Infectious Diseases, Iran University of Medical Sciences, Tehran, Iran
| | - Ali-Akbar Delbandi
- Department of Immunology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran; Immunology Research Center, Institute of Immunology and Infectious Diseases, Iran University of Medical Sciences, Tehran, Iran
| | - Samaneh Delavari
- Research Center for Immunodeficiencies, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran; Primary Immunodeficiency Diseases Network (PIDNet), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Mehdi Shekarabi
- Immunology Research Center, Institute of Immunology and Infectious Diseases, Iran University of Medical Sciences, Tehran, Iran.
| | - Nima Rezaei
- Research Center for Immunodeficiencies, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran; Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran; Network of Immunity in Infection, Malignancy, and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran
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Drews SJ, Wendel S, Leiby DA, Tonnetti L, Ushiro-Lumb I, O'Brien SF, Lieshout-Krikke RW, Bloch EM. Climate change and parasitic risk to the blood supply. Transfusion 2023; 63:638-645. [PMID: 36565251 DOI: 10.1111/trf.17234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 12/02/2022] [Accepted: 12/04/2022] [Indexed: 12/25/2022]
Affiliation(s)
- Steven J Drews
- Canadian Blood Services, Microbiology, Donation Policy and Studies, Edmonton, Alberta, Canada
- Division of Diagnostic and Applied Microbiology, Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta, Canada
| | - Silvano Wendel
- Blood Bank, Hospital Sírio-Libanês Blood Bank, São Paulo, Brazil
| | - David A Leiby
- Department of Microbiology, Immunology, & Tropical Medicine, George Washington University, Washington, DC, USA
| | - Laura Tonnetti
- American Red Cross, Scientific Affairs, Holland Laboratories for the Biomedical Sciences, Rockville, Maryland, USA
| | | | - Sheila F O'Brien
- Canadian Blood Services, Epidemiology and Surveillance, Microbiology, Ottawa, Ontario, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Ryanne W Lieshout-Krikke
- Department of Medical Affairs, Corporate Staff, Sanquin Blood Supply Foundation, Amsterdam, the Netherlands
| | - Evan M Bloch
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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Rasool G, Khan AM, Malik IR, Riaz M, Tahir IM, Rehman AU, Abbas M. Reported Seroprevalence of Transfusion-Transmitted Infections in Voluntary and Replacement Donors. Transfus Med Rev 2023:S0887-7963(23)00002-0. [PMID: 36959032 DOI: 10.1016/j.tmrv.2023.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Revised: 01/24/2023] [Accepted: 01/24/2023] [Indexed: 02/10/2023]
Affiliation(s)
- Ghulam Rasool
- Department of Biotechnology, University of Sargodha, Sargodha, Punjab, Pakistan
| | - Arif Muhammad Khan
- Department of Allied Health Sciences, University of Sargodha, Sargodha, Punjab, Pakistan
| | - Imran Riaz Malik
- Department of Allied Health Sciences, University of Sargodha, Sargodha, Punjab, Pakistan
| | - Muhammad Riaz
- Department of Biotechnology, University of Sargodha, Sargodha, Punjab, Pakistan.
| | - Imtiaz Mahmood Tahir
- College of Allied Health Professionals, Faculty of Medical Sciences, Government College University Faisalabad, Faisalabad, Punjab, Pakistan
| | - Aziz Ur Rehman
- Department of Pathobiology, University of Veterinary and Animal Sciences, Jhang, Punjab, Pakistan
| | - Mazhar Abbas
- Department of Basic Sciences (Section Biochemistry), University of Veterinary and Animal Sciences, Jhang, Punjab, Pakistan
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Himmelsbach K, Mueller S, Kress J, Fiedler SA, Miskey C, Ivics Z, Patek A, Chudy M. Second hepatitis C virus transmission by blood components since introduction of mandatory NAT screening in Germany. Transfusion 2023; 63:339-347. [PMID: 36515262 DOI: 10.1111/trf.17224] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 11/08/2022] [Accepted: 11/08/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND Viral safety of blood products in Germany has improved significantly over the last two decades. We describe the second documented transfusion-transmitted (TT) episode for the hepatitis C virus (HCV) in Germany since mandatory nucleic acid amplification techniques (NAT) screening was introduced in 1999. STUDY DESIGN AND METHODS When a repeat donor who had tested negative for anti-HCV tested positive for HCV RNA by NAT in a minipool (MP) of eight, a look-back procedure was initiated. Qualitative, quantitative and genotyping assays were used to investigate the titers of the quarantined fresh frozen plasma (FFP) from the donor and a serum sample from the recipient of the pooled platelet concentrate (PPC). Amplified products of 5'UTR and HVR1 were used for sequence comparison to characterize the HCV genomic identity of donor and recipient samples. RESULTS All NAT tests utilized in this procedure were able to detect a low HCV RNA titer (~15 IU/ml) in the FFP from the donation. Dilution of FFP by factor 8 was performed to mimic an MP, and the detection rate correlated well with the claimed sensitivity of the tests. Analysis of donor and recipient samples revealed genotype 3a viral transmission confirmed by sequence analysis. CONCLUSION This TT HCV case could have been prevented by individual donation (ID) NAT. However, a low titer blood donation in the window period (WP) is very rare. Residual risk calculation for TT HCV in the WP revealed that, compared to MP-NAT testing, ID-NAT would improve blood safety only marginally.
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Affiliation(s)
| | - Susanne Mueller
- Department Safety of Medicinal Products and Medical Devices, Paul-Ehrlich-Institut, Langen, Germany
| | - Julia Kress
- Department of Virology, Paul-Ehrlich-Institut, Langen, Germany
| | - Sarah A Fiedler
- Department Safety of Medicinal Products and Medical Devices, Paul-Ehrlich-Institut, Langen, Germany
| | - Csaba Miskey
- Department of Medical Biotechnology, Paul-Ehrlich-Institut, Langen, Germany
| | - Zoltan Ivics
- Department of Medical Biotechnology, Paul-Ehrlich-Institut, Langen, Germany
| | - Alexander Patek
- Blood Donation Service Saar-Pfalz, Klinikum Saarbruecken, Saarbruecken, Germany
| | - Michael Chudy
- Department of Virology, Paul-Ehrlich-Institut, Langen, Germany
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Benítez-Arvizu G, Campos-Aguirre E. [Molecular biology in a blood bank]. REVISTA MEDICA DEL INSTITUTO MEXICANO DEL SEGURO SOCIAL 2023; 61:S46-S51. [PMID: 36378106 PMCID: PMC10395919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 07/11/2022] [Indexed: 06/16/2023]
Abstract
Medicine has had a vertiginous advance in the last two centuries. After the first successful transfusions, transfusional medicine and blood banks arose. The ladder perform vital functions, from donor screening to the studies for the analysis of blood that are carried out before its use for transfusion and the follow-up of patients who receive blood components. Molecular biology is highly relevant in these activities, since it has allowed the reduction of window periods for the detection of diseases transmissible by blood; it has allowed the complete study of the typing of blood groups and HLA molecules, and it has allowed the adequate phenotypic interpretation of patients and donors by being able to have their genotype. The most relevant impact of the implementation of molecular biology techniques was the screening for the detection of transfusion-transmissible diseases in blood donors, which has allowed improving the safety of the components obtained. Molecular biology techniques applied in the study of the donor-recipient have allowed better care of patients who have required a transfusion or transplant. In this work, it is reviewed the importance of molecular biology in blood banks, with which the care for the Instituto Mexicano del Seguro Social beneficiaries has improved, as well as for the blood donors who are mostly not insured.
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Affiliation(s)
- Gamaliel Benítez-Arvizu
- Instituto Mexicano del Seguro Social, Centro Médico Nacional Siglo XXI, Hospital de Especialidades “Dr. Bernardo Sepúlveda Gutiérrez”, Unidad Complementaria Banco de Sangre. Ciudad de México, MéxicoInstituto Mexicano del Seguro SocialMéxico
| | - Esmeralda Campos-Aguirre
- Instituto Mexicano del Seguro Social, Centro Médico Nacional Siglo XXI, Hospital de Especialidades “Dr. Bernardo Sepúlveda Gutiérrez”, Unidad Complementaria Banco de Sangre. Ciudad de México, MéxicoInstituto Mexicano del Seguro SocialMéxico
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11
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Geng Y, Shi T, Wang Y. Transmission of Hepatitis E Virus. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2023; 1417:73-92. [PMID: 37223860 DOI: 10.1007/978-981-99-1304-6_6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Transmission of hepatitis E virus (HEV) occurs predominantly by the fecal-oral route. Large epidemics of hepatitis E in the developing countries of Asia and Africa are waterborne and spread through contaminated drinking water. The reservoir of HEV in developed countries is believed to be in animals with zoonotic transmission to humans, possibly through direct contact or the consumption of undercooked contaminated meat. And HEV transmission through blood transfusion, organ transplantation, and vertical transmission has been reported.
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Affiliation(s)
- Yansheng Geng
- Key Laboratory of Public Health Safety of Hebei Province, School of Public Health, Hebei University, Baoding, China
| | - Tengfei Shi
- Key Laboratory of Public Health Safety of Hebei Province, School of Public Health, Hebei University, Baoding, China
| | - Youchun Wang
- Institute of Medical Biology, Chinese Academy of Medical Science & Peking Union Medical College, Kunming, China.
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12
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Boyd FA, O’Leary MF, Benson K, Baluch A. A Case of Fatal Clostridium perfringens Sepsis with Massive Hemolysis in the Setting of a Coincidental Platelet Transfusion. Lab Med 2022:6758539. [DOI: 10.1093/labmed/lmac135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Abstract
A 62-year-old woman with acute myeloid leukemia (AML) died of shock and massive hemolysis shortly after receiving two platelet transfusions at a routine clinic visit. Subsequent investigation into what was initially believed to be an acute hemolytic transfusion reaction secondary to platelet transfusions revealed that the patient died of Clostridium perfringens sepsis leading to massive hemolysis. Further investigation ruled out bacterially-contaminated platelets since a patient blood sample from 2 days prior had Clostridium species. The unusual findings and management considerations for this oncology patient are reviewed and compared with previously reported cases of C. perfringens transfusion-transmitted infections. Oncology patients may be especially susceptible to unusual presentations involving unusual pathogens.
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Affiliation(s)
- Frank A Boyd
- Department of Pathology & Cell Biology, University of South Florida Morsani College of Medicine , Tampa, FL , USA
| | - Mandy F O’Leary
- Department of Pathology, H. Lee Moffitt Cancer Center and Research Institute , Tampa, FL , USA
| | - Kaaron Benson
- Department of Pathology, H. Lee Moffitt Cancer Center and Research Institute , Tampa, FL , USA
| | - Aliyah Baluch
- Division of Infectious Diseases, H. Lee Moffitt Cancer Center and Research Institute , Tampa, FL , USA
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13
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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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14
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Mastrorilli G, Fiorentino F, Tucci C, Lombardi G, Aghemo A, Colombo GL. Cost Analysis of Platelet Transfusion in Italy for Patients with Chronic Liver Disease and Associated Thrombocytopenia Undergoing Elective Procedures. Clinicoecon Outcomes Res 2022; 14:205-220. [PMID: 35422645 PMCID: PMC9005228 DOI: 10.2147/ceor.s354470] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 03/23/2022] [Indexed: 11/23/2022]
Abstract
Purpose Platelet transfusions (PT) are commonly used as prophylaxis in patients with chronic liver disease (CLD) and severe thrombocytopenia (TCP) before invasive procedures, in order to reduce risk of bleeding. The aim of this cost analysis was to generate a comprehensive estimate of costs of platelet transfusions in Italy, focusing on patients with severe TCP due to CLD undergoing an elective procedure. Methods The research was conducted in different phases: 1) assessment of a pre-specified framework for the identification of processes related to PT; 2) estimation of resource consumption through Delphi technique and collection of unit costs through literature; 3) development of a cost analysis to estimate the overall average costs per PT, focusing on a representative patient with CLD and severe TCP. Robustness of results was tested in a sensitivity analysis. Results Despite the lack of some cost components estimation and uncertainty related to event probability, the analysis showed a total cost of 5297 € for each PT in patients with CLD and severe TCP. The total cost was largely driven by direct costs (4863 €) associated with platelet collection, transfusion, and management of refractoriness, which accounted for 92% of total. Conclusion In an environment of limited resources, it is crucial for the healthcare service to have accurate and inclusive information on transfusion costs, incorporating not only the cost of blood products but also those related to collection and management. The analysis showed that platelet collection and administration costs add substantially to the cost of platelet products themselves. As expected, the highest cost was the transfusion process itself (44% of total), followed by refractoriness (43% of total). Since limited literature exists concerning these cost estimates, this analysis represents a step forward in understanding the economic burden of patients with CLD and severe TCP scheduled to undergo an invasive procedure.
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Affiliation(s)
| | | | - Carmen Tucci
- Real World Solutions, IQVIA Solutions Italy s.r.l., Milan, Italy
| | - Gloria Lombardi
- Real World Solutions, IQVIA Solutions Italy s.r.l., Milan, Italy
- Correspondence: Gloria Lombardi, Real World Solutions, IQVIA Solutions Italy s.r.l., Via Fabio Filzi 29, Milan, 20124, Italy, Tel +39 331 6801813, Email
| | - Alessio Aghemo
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
- Division of Internal Medicine and Hepatology, Department of Gastroenterology, Humanitas Research Hospital IRCCS, Rozzano, Italy
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15
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Tsegaye W, Bitew A, Gize A. Bacterial Contamination and Susceptibility Pattern Among Blood and Blood Components Using Divergent and Non-Divergent Collection Methods at Armed Forces Comprehensive Specialized Hospital, Addis Ababa, Ethiopia. Infect Drug Resist 2022; 15:1677-1686. [PMID: 35422636 PMCID: PMC9004673 DOI: 10.2147/idr.s360515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Accepted: 03/25/2022] [Indexed: 11/23/2022] Open
Affiliation(s)
- Wondwossen Tsegaye
- Department of Diagnostic Medical Laboratory and Radiology, Defense University, Bishoftu, Ethiopia
| | - Adane Bitew
- Department of Medical Laboratory Sciences, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Addisu Gize
- Department of Microbiology, St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia
- Correspondence: Addisu Gize, Email
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16
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Hofmann A, Aapro M, Fedorova TA, Zhiburt YB, Snegovoy AV, Kaganov OI, Ognerubov NA, Lyadov VK, Moiseenko VM, Trofimova OP, Ashrafyan LA, Khasanov RS, Poddubnaya IV. Patient blood management in oncology in the Russian Federation: Resolution to improve oncology care. J Cancer Policy 2022; 31:100315. [DOI: 10.1016/j.jcpo.2021.100315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 08/31/2021] [Accepted: 12/07/2021] [Indexed: 11/16/2022]
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17
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Oguayo C, Helal A, Dawkins J, Bhimani A, Nimmons SJB, Jones AL, Rizkalla JM. Relation of tranexamic acid therapy to length of stay in the hip fracture population. Proc AMIA Symp 2022; 35:301-304. [DOI: 10.1080/08998280.2022.2028347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Affiliation(s)
- Chris Oguayo
- Department of Orthopedics, Baylor University Medical Center, Dallas, Texas
| | - Asad Helal
- Department of Orthopedics, Baylor University Medical Center, Dallas, Texas
| | - Jonathan Dawkins
- Department of Orthopedics, Baylor University Medical Center, Dallas, Texas
| | - Aamir Bhimani
- Department of Orthopedics, Baylor University Medical Center, Dallas, Texas
| | | | - Alan L. Jones
- Department of Orthopedics, Baylor University Medical Center, Dallas, Texas
| | - James M. Rizkalla
- Department of Orthopedics, Baylor University Medical Center, Dallas, Texas
- Coptic Medical Association of North America (CMANA) Research Institute, Dallas, Texas
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18
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Kumar A, Sharma E, Marley A, Samaan MA, Brookes MJ. Iron deficiency anaemia: pathophysiology, assessment, practical management. BMJ Open Gastroenterol 2022; 9:e000759. [PMID: 34996762 PMCID: PMC8744124 DOI: 10.1136/bmjgast-2021-000759] [Citation(s) in RCA: 43] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 12/20/2021] [Indexed: 02/07/2023] Open
Abstract
The WHO has recognised iron deficiency anaemia (IDA) as the most common nutritional deficiency in the world, with 30% of the population being affected with this condition. Although the most common causes of IDA are gastrointestinal bleeding and menstruation in women, decreased dietary iron and decreased iron absorption are also culpable causes. Patients with IDA should be treated with the aim of replenishing iron stores and returning the haemoglobin to a normal level. This has shown to improve quality of life, morbidity, prognosis in chronic disease and outcomes in pregnancy. Iron deficiency occurs in many chronic inflammatory conditions, including congestive cardiac failure, chronic kidney disease and inflammatory bowel disease. This article will provide an updated overview on diagnosis and management of IDA in patients with chronic conditions, preoperative and in pregnancy. We will discuss the benefits and limitations of oral versus intravenous iron replacement in each cohort, with an overview on cost analysis between the different iron formulations currently on the market.
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Affiliation(s)
- Aditi Kumar
- Department of Gastroenterology, The Royal Wolverhampton NHS Trust, Wolverhampton, UK
| | - Esha Sharma
- Inflammatory Bowel Disease Unit, Guys and St Thomas' NHS Foundation Trust, London, UK
| | - Alexandra Marley
- Department of Gastroenterology, The Royal Wolverhampton NHS Trust, Wolverhampton, UK
| | - Mark A Samaan
- Inflammatory Bowel Disease Unit, Guys and St Thomas' NHS Foundation Trust, London, UK
| | - Matthew James Brookes
- Department of Gastroenterology, The Royal Wolverhampton NHS Trust, Wolverhampton, UK
- Research Institue, Faculty of Science and Engineering, University of Wolverhampton, Wolverhampton, UK
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19
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Wagner T, Stadlbauer V, Stöger K, Schorna K, Zink M. Criminal and Civil Responsibility of the Donor in a Case of Transmission of Malaria by a Blood Transfusion in a Nonendemic Country. Transfus Med Hemother 2022; 49:230-233. [PMID: 36159958 PMCID: PMC9421670 DOI: 10.1159/000525103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 05/09/2022] [Indexed: 11/19/2022] Open
Abstract
Introduction The blood donation process is strictly regulated by law. The process includes the necessity of a medical history taken to determine if a donor is suitable to donate, which shall guarantee both donor and recipient safety. Supplementary screening for a limited number of infections is performed by antibody (HIV, HCV, syphilis) or antigen (HBV) tests or NAT (HIV, HCV, HBV). Case Presentation With regard to a possible infection due to (sexual) risk behavior or foreign travel, blood donation facilities are predominantly dependent on information provided by the donor. This is especially true for malaria in nonendemic areas such as Europe. Transmission of malaria by a blood transfusion in a nonendemic country that led to fulminant septic shock and death of the patient happened. Discussion From a legal perspective, the donor thus assumes a high level of responsibility with regard to the accuracy and completeness of the information provided on the donor questionnaire. Incorrect information may, as in this Austrian case reported, result in civil or criminal responsibility of the donor.
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Affiliation(s)
- Thomas Wagner
- Department of Blood Group Serology and Transfusion Medicine, Medical University of Graz, Graz, Austria
- *Thomas Wagner,
| | - Vanessa Stadlbauer
- Department of Gastroenterology and Hepatology, Medical University of Graz, Graz, Austria
| | - Karl Stöger
- Department of Constitutional and Administrative Law, Chair of Medical Law, University of Vienna, Vienna, Austria
| | - Karin Schorna
- Department of Anesthesiology and Intensive Care Medicine, Hospital of the Elisabethinen Klagenfurt, Klagenfurt, Austria
| | - Michael Zink
- Department of Anesthesiology and Intensive Care Medicine, Hospital of the Elisabethinen Klagenfurt, Klagenfurt, Austria
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20
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Sebastian R, Ahmed MI. Blood Conservation and Hemostasis Management in Pediatric Cardiac Surgery. Front Cardiovasc Med 2021; 8:689623. [PMID: 34490364 PMCID: PMC8416772 DOI: 10.3389/fcvm.2021.689623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 05/17/2021] [Indexed: 11/13/2022] Open
Abstract
Pediatric cardiac surgery is associated with significant perioperative blood loss needing blood product transfusion. Transfusion carries serious risks and implications on clinical outcomes in this vulnerable population. The need for transfusion is higher in children and is attributed to several factors including immaturity of the hemostatic system, hemodilution from the CPB circuit, excessive activation of the hemostatic system, and preoperative anticoagulant drugs. Other patient characteristics such as smaller relative size of the patient, higher metabolic and oxygen requirements make successful blood transfusion management extremely challenging in this population and require meticulous planning and multidisciplinary teamwork. In this narrative review we aim to summarize risks and complications associated with blood transfusion in pediatric cardiac surgery and also to summarize perioperative coagulation management and blood conservation strategies.
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Affiliation(s)
- Roby Sebastian
- Department of Anesthesiology and Pain Management, UT Southwestern Medical Center, Children's Medical Center, Dallas, TX, United States
| | - M Iqbal Ahmed
- Department of Anesthesiology and Pain Management, UT Southwestern Medical Center, Children's Medical Center, Dallas, TX, United States
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21
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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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22
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Emadi B, Ghahraman Rezaieh M, Sedighi M. Seroprevalence and trends of transfusion transmissible infections among retrospective blood donors in Western Azerbaijan Regional Blood Transfusion Center, Iran: A ten-years evaluation. Transfus Apher Sci 2021; 60:103132. [PMID: 33846093 DOI: 10.1016/j.transci.2021.103132] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 03/16/2021] [Accepted: 03/25/2021] [Indexed: 10/21/2022]
Abstract
Transfusion transmissible infections (TTIs) have been a public health challenge for the accessibility, quality and safety of blood transfusion. The present study aimed to consider the prevalence and the trends of hepatitis B virus (HBV), hepatitis C virus (HCV), Human T-cell leukemia virus type 1 (HTLV-1), human immunodeficiency virus (HIV) and syphilis across the ten years among retrospective blood donors. A retrospective investigation of blood donors' data covering the period from 22 May 2009 to 22 May 2019 was done. Data was accumulated and analyzed from Blood Transfusion Center records, pertaining to all donors who were screened for various TTIs using respective immunological techniques. Out of the 682,171 screened donors in the 2009-2019 study period, 2470 (0.36 %) were infected with at least one infectious agent. The overall prevalence of HBV, HCV, HTLV-1, HIV and syphilis were 1700 (0.25 %), 184 (0.027 %), 335 (0.05 %), 4 (0.0.05 %) and 247 (0.036 %), respectively. The study showed male dominated donor pool (96.79 %) with higher prevalence (0.34 %) of TTIs compared to female donors (0.02 %) with 3.21 % population. Despite the low prevalence of TTIs in our study, HBV, HCV, syphilis and HIV have remained a big threat to safe blood transfusion in Iran. Strict adherence to selection criteria, algorithm of donor screening, use of highly sensitive and specific methods for detection of TTIs, regular consultation and health education programs, prevention and sanitization strategies to reduce the risk of TTIs are recommended to reduce the risk of TTIs and ensure the safety of blood transfusion for recipient.
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Affiliation(s)
- Behzad Emadi
- Azarbaijan-Gharbi Regional Blood Transfusion Center, Urmia, Iran.
| | | | - Mansour Sedighi
- Azarbaijan-Gharbi Regional Blood Transfusion Center, Urmia, Iran; Department of Microbiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
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23
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Kostin AI, Lundgren MN, Bulanov AY, Ladygina EA, Chirkova KS, Gintsburg AL, Logunov DY, Dolzhikova IV, Shcheblyakov DV, Borovkova NV, Godkov MA, Bazhenov AI, Shustov VV, Bogdanova AS, Kamalova AR, Ganchin VV, Dombrovskiy EA, Volkov SE, Drozdova NE, Petrikov SS. Impact of pathogen reduction methods on immunological properties of the COVID-19 convalescent plasma. Vox Sang 2021; 116:665-672. [PMID: 33734455 PMCID: PMC8250394 DOI: 10.1111/vox.13056] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 11/28/2020] [Accepted: 11/29/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND AND OBJECTIVES COVID-19 convalescent plasma is an experimental treatment against SARS-CoV-2. The aim of this study is to assess the impact of different pathogen reduction methods on the levels and virus neutralizing activity of the specific antibodies against SARS-CoV2 in convalescent plasma. MATERIALS AND METHODS A total of 140 plasma doses collected by plasmapheresis from COVID-19 convalescent donors were subjected to pathogen reduction by three methods: methylene blue (M)/visible light, riboflavin (R)/UVB and amotosalen (A)/UVA. To conduct a paired comparison, individual plasma doses were divided into 2 samples that were subjected to one of these methods. The titres of SARS-CoV2 neutralizing antibodies (NtAbs) and levels of specific immunoglobulins to RBD, S- and N-proteins of SARS-CoV-2 were measured before and after pathogen reduction. RESULTS The methods reduced NtAbs titres differently: among units with the initial titre 80 or above, 81% of units remained unchanged and 19% decreased by one step after methylene blue; 60% were unchanged and 40% decreased by one step after amotosalen; after riboflavin 43% were unchanged and 50% (7%, respectively) had a one-step (two-step, respectively) decrease. Paired two-sample comparisons (M vs. A, M vs. R and A vs. R) revealed that the largest statistically significant decrease in quantity and activity of the specific antibodies resulted from the riboflavin treatment. CONCLUSION Pathogen reduction with methylene blue or with amotosalen provides the greater likelihood of preserving the immunological properties of the COVID-19 convalescent plasma compared to riboflavin.
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Affiliation(s)
- Alexander I Kostin
- Moscow Department of Healthcare, N.V. Sklifosovsky Research Institute of Emergency Medicine, Moscow, Russia
| | - Maria N Lundgren
- Department of Clinical Immunology and Transfusion Medicine, Office of Medical Services, Lund, Sweden
| | - Andrey Y Bulanov
- Moscow Department of Healthcare, N.V. Sklifosovsky Research Institute of Emergency Medicine, Moscow, Russia
| | - Elena A Ladygina
- Moscow Department of Healthcare, N.V. Sklifosovsky Research Institute of Emergency Medicine, Moscow, Russia
| | - Karina S Chirkova
- Moscow Department of Healthcare, N.V. Sklifosovsky Research Institute of Emergency Medicine, Moscow, Russia
| | - Alexander L Gintsburg
- The Federal State Budgetary Institution 'National Research Center of Epidemiology and Microbiology N.F. Gamaleya' of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - Denis Y Logunov
- The Federal State Budgetary Institution 'National Research Center of Epidemiology and Microbiology N.F. Gamaleya' of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - Inna V Dolzhikova
- The Federal State Budgetary Institution 'National Research Center of Epidemiology and Microbiology N.F. Gamaleya' of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - Dmitry V Shcheblyakov
- The Federal State Budgetary Institution 'National Research Center of Epidemiology and Microbiology N.F. Gamaleya' of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - Natalia V Borovkova
- Moscow Department of Healthcare, N.V. Sklifosovsky Research Institute of Emergency Medicine, Moscow, Russia
| | - Mikhail A Godkov
- Moscow Department of Healthcare, N.V. Sklifosovsky Research Institute of Emergency Medicine, Moscow, Russia
| | - Alexey I Bazhenov
- Moscow Department of Healthcare, N.V. Sklifosovsky Research Institute of Emergency Medicine, Moscow, Russia
| | - Valeriy V Shustov
- Moscow Department of Healthcare, N.V. Sklifosovsky Research Institute of Emergency Medicine, Moscow, Russia
| | - Alina S Bogdanova
- Moscow Department of Healthcare, N.V. Sklifosovsky Research Institute of Emergency Medicine, Moscow, Russia
| | - Alina R Kamalova
- Healthcare Ministry of Russia, N.I. Pirogov Federal Russian National Research Medical University, Moscow, Russia
| | - Vladimir V Ganchin
- Autonomous Non-Commercial Organization «Center of Analytical Development of the Social Sector», Moscow, Russia
| | - Eugene A Dombrovskiy
- Autonomous Non-Commercial Organization «Center of Analytical Development of the Social Sector», Moscow, Russia
| | | | - Nataliya E Drozdova
- Moscow Department of Healthcare, N.V. Sklifosovsky Research Institute of Emergency Medicine, Moscow, Russia
| | - Sergey S Petrikov
- Moscow Department of Healthcare, N.V. Sklifosovsky Research Institute of Emergency Medicine, Moscow, Russia
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Gillies MA, Ghaffar S, Moppett IK, Docherty AB, Clarke S, Rea N, Stephen J, Keerie C, Ray DC, White TO, MacLullich AMJ, Mills NM, Rowley MR, Murthy K, Pearse RM, Stanworth SJ, Walsh TS. A restrictive versus liberal transfusion strategy to prevent myocardial injury in patients undergoing surgery for fractured neck of femur: a feasibility randomised trial (RESULT-NOF). Br J Anaesth 2021; 126:77-86. [PMID: 32703548 DOI: 10.1016/j.bja.2020.06.048] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 04/30/2020] [Accepted: 06/26/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The optimum transfusion strategy in patients with fractured neck of femur is uncertain, particularly if there is coexisting cardiovascular disease. METHODS We conducted a prospective, single-centre, randomised feasibility trial of two transfusion strategies. We randomly assigned patients undergoing surgery for fractured neck of femur to a restrictive (haemoglobin, 70-90 g L-1) or liberal (haemoglobin, 90-110 g L-1) transfusion strategy throughout their hospitalisation. Feasibility outcomes included: enrolment rate, protocol compliance, difference in haemoglobin, and blood exposure. The primary clinical outcome was myocardial injury using troponin estimations. Secondary outcomes included major adverse cardiac events, postoperative complications, duration of hospitalisation, mortality, and quality of life. RESULTS We enrolled 200 (22%) of 907 eligible patients, and 62 (31%) showed decreased haemoglobin (to 90 g L-1 or less) and were thus exposed to the intervention. The overall protocol compliance was 81% in the liberal group and 64% in the restrictive group. Haemoglobin concentrations were similar preoperatively and at postoperative day 1 but lower in the restrictive group on day 2 (mean difference [MD], 7.0 g L-1; 95% confidence interval [CI], 1.6-12.4). Lowest haemoglobin within 30 days/before discharge was lower in the restrictive group (MD, 5.3 g L-1; 95% CI, 1.7-9.0). Overall, 58% of patients in the restrictive group received no transfusion compared with 4% in the liberal group (difference in proportion, 54.5%; 95% CI, 36.8-72.2). The proportion with the primary clinical outcome was 14/26 (54%, liberal) vs 24/34 (71%, restrictive), and the difference in proportion was -16.7% (95% CI, -41.3 to 7.8; P=0.18). CONCLUSION A clinical trial of two transfusion strategies in hip fracture with a clinically relevant cardiac outcome is feasible. CLINICAL TRIAL REGISTRATION NCT03407573.
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Affiliation(s)
- Michael A Gillies
- Department of Anaesthesia, Critical Care and Pain Medicine, Royal Infirmary Edinburgh, Edinburgh, UK; Edinburgh Critical Care Research Group, University of Edinburgh, Edinburgh, UK.
| | - Sadia Ghaffar
- Department of Anaesthesia, Critical Care and Pain Medicine, Royal Infirmary Edinburgh, Edinburgh, UK; Edinburgh Critical Care Research Group, University of Edinburgh, Edinburgh, UK
| | - Iain K Moppett
- Anaesthesia and Critical Care Section, Division of Clinical Neuroscience, Queen's Medical Centre, University of Nottingham, Nottingham, UK
| | - Annemarie B Docherty
- Department of Anaesthesia, Critical Care and Pain Medicine, Royal Infirmary Edinburgh, Edinburgh, UK; Edinburgh Critical Care Research Group, University of Edinburgh, Edinburgh, UK
| | - Sarah Clarke
- Edinburgh Critical Care Research Group, University of Edinburgh, Edinburgh, UK
| | - Nicola Rea
- Edinburgh Critical Care Research Group, University of Edinburgh, Edinburgh, UK
| | - Jacqueline Stephen
- Edinburgh Clinical Trials Unit, Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Catriona Keerie
- Edinburgh Clinical Trials Unit, Usher Institute, University of Edinburgh, Edinburgh, UK
| | - David C Ray
- Department of Anaesthesia, Critical Care and Pain Medicine, Royal Infirmary Edinburgh, Edinburgh, UK
| | - Timothy O White
- Department of Trauma and Orthopaedics, Royal Infirmary Edinburgh, Edinburgh, UK
| | | | - Nicholas M Mills
- BHF Centre for Cardiovascular Sciences, University of Edinburgh, Edinburgh, UK
| | - Megan R Rowley
- Scottish National Blood Transfusion Service, Royal Infirmary Edinburgh, Edinburgh, UK
| | - Krishna Murthy
- Department of Emergency Medicine, Royal Infirmary Edinburgh, Edinburgh, UK
| | - Rupert M Pearse
- William Harvey Research Institute, Queen Mary University of London, London, UK
| | - Simon J Stanworth
- Department of Haematology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK; Radcliffe Department of Medicine, University of Oxford, Oxford BRC Haematology Theme, Oxford, UK; Transfusion Medicine, NHS Blood and Transplant, Oxford, UK
| | - Timothy S Walsh
- Department of Anaesthesia, Critical Care and Pain Medicine, Royal Infirmary Edinburgh, Edinburgh, UK; Edinburgh Critical Care Research Group, University of Edinburgh, Edinburgh, UK
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25
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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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26
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Ferreira LMR, Mostajo-Radji MA. Plasma-based COVID-19 treatments in low- and middle-income nations pose a high risk of an HIV epidemic. NPJ Vaccines 2020; 5:58. [PMID: 32655899 PMCID: PMC7338534 DOI: 10.1038/s41541-020-0209-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 06/24/2020] [Indexed: 11/09/2022] Open
Abstract
Convalescent plasma therapy holds promise as a transient treatment for COVID-19. Yet, blood products are important sources of HIV infection in low- and middle-income nations. Great care must be taken to prevent plasma therapy from fueling HIV epidemics in the developing world.
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Affiliation(s)
- Leonardo M R Ferreira
- Clubes de Ciencia Bolivia Foundation, Santa Cruz de la Sierra, Bolivia.,Department of Surgery, University of California San Francisco, San Francisco, CA 94143 USA.,Diabetes Center, University of California San Francisco, San Francisco, CA 94143 USA.,Ajax Biomedical Foundation, Newton, MA 02458 USA
| | - Mohammed A Mostajo-Radji
- Clubes de Ciencia Bolivia Foundation, Santa Cruz de la Sierra, Bolivia.,The Eli and Edythe Broad Center of Regeneration Medicine and Stem Cell Research, University of California San Francisco, San Francisco, CA 94143 USA.,Embassy of Science, Technology and Innovation, Ministry of Foreign Affairs of Bolivia, La Paz, Bolivia.,Permanent Mission of Bolivia to the United Nations, New York, NY 10017 USA
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27
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Gonuguntla K, Patil S, Cowden RG, Kumar M, Rojulpote C, Bhattaru A, Tiu JG, Robinson P. Predictors of in-hospital mortality in patients with left ventricular assist device. Ir J Med Sci 2020; 189:1275-1281. [DOI: 10.1007/s11845-020-02246-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 04/28/2020] [Indexed: 01/09/2023]
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28
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Ahmed AMA, Temerk HA, Galal HR, Bazeed SES, Sultan S. The seropervelance of infectious hepatitis viruses (HBV, HCV and HEV) among blood donors and their correlation to risk factors in Qena governorate, Upper Egypt. Virusdisease 2020; 31:292-298. [PMID: 32904769 DOI: 10.1007/s13337-020-00589-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Accepted: 04/24/2020] [Indexed: 12/13/2022] Open
Abstract
This study was performed to determine the prevalence of HBV and HCV infection among blood donors and the occurrence of HEV in hepatitis viruses seropositive blood donors. Also, to investigate the correlation between the occurrence of hepatitis viruses and other risk factors (gender, age, occupation, educational level, residency and donors' types). A total of 11,604 blood samples from apparently healthy blood donors of age range 18-60 years old were collected. The blood donors were categorized as voluntary and replacement donors. Blood samples from donors were tested for the presence of HBsAg, HCV and HEV antibodies by using Enzyme-linked immunosorbent assay. The overall results indicated that 671 out of 11,604 blood donors; 370 persons (3.188%) HCV, 295 persons (2.542%) HBV and 6 persons (0.052%) HCV and HBV; were hepatitis viruses seropositive donors. The prevalence of HEV were 193 (28.76%) among these seropositive blood donors. There is a highly significant correlation among HCV, HBV and other risk factors. Also, the HEV showed high significant with age and educational level and significant with donor types and locations. All investigated virus combinations (HEV/HCV, HEV/HBV and HEV/HCV/HBV) were highly significant with the risk factors except for occupation. In conclusion, the HEV is significantly correlated to HCV and HBV seropositive donors and should be screened among blood donors.
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Affiliation(s)
- Azza Masoud Abdelbaky Ahmed
- Department of Microbiology, Virology Division, Faculty of Veterinary Medicine, South Valley University, 83523 Qena, Egypt.,National Blood Bank Services, Qena, Egypt.,Department of Botany, Faculty of Science, South Valley University, 83523 Qena, Egypt
| | | | - Hamdi Ramdan Galal
- Department of Botany, Faculty of Science, South Valley University, 83523 Qena, Egypt
| | - Shamardan Ezzeldin S Bazeed
- Department of Tropical Medicine and Gastroenterology, Faculty of Medicine, South Valley University, 83523 Qena, Egypt
| | - Serageldeen Sultan
- Department of Microbiology, Virology Division, Faculty of Veterinary Medicine, South Valley University, 83523 Qena, Egypt
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29
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Hawkins LM, Sinha CB, Ross D, Yee MEM, Quarmyne MO, Krishnamurti L, Bakshi N. Patient and family experience with chronic transfusion therapy for sickle cell disease: A qualitative study. BMC Pediatr 2020; 20:172. [PMID: 32305060 PMCID: PMC7165370 DOI: 10.1186/s12887-020-02078-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Accepted: 04/07/2020] [Indexed: 11/25/2022] Open
Abstract
Background There is a limited understanding of the patient and family experience of Chronic Transfusion Therapy (CTT) for prevention of complications of Sickle Cell Disease (SCD). We sought to understand patient and family experience with CTT using qualitative methods. Methods Fifteen parents of children < 18 years old and nine children 12–18 years old with SCD who were receiving CTT for > 1 year were interviewed using a semi-structured interview format, and interviews were analyzed using open coding methods. Results Four themes created a narrative of the patient and family experience of CTT: 1) Burden of CTT, 2) Coping with CTT, 3) Perceived benefits and risks of CTT, and 4) Decision making regarding CTT. Participants reported substantial burden of CTT, including the impact of CTT on daily life and family, distress about venous access, burden of chelation therapy, and anxiety about CTT complications. Participants described how they coped with CTT. Participants reported increased energy, decreased pain, fewer hospitalizations, and stroke prevention with CTT, but also recognized complications of CTT, though awareness was limited in adolescents. Parents described sharing in the informed decision-making process with their healthcare provider about CTT, but adolescent patient participants reported that they were not involved in this process. Conclusions CTT is associated with significant patient and family burden. Support from family, healthcare providers and school may help individuals cope with some of this burden. These findings provide the basis for future studies to identify strategies to mitigate the burden of CTT and improve the patient experience with this therapy. Future studies should also systematically assess patient knowledge about the key components of CTT and chelation using quantitative assessments.
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Affiliation(s)
| | - Cynthia B Sinha
- Division of Pediatric Hematology-Oncology-BMT, Emory University School of Medicine, Atlanta, GA, USA
| | - Diana Ross
- Division of Pediatric Hematology-Oncology-BMT, Emory University School of Medicine, Atlanta, GA, USA
| | - Marianne E M Yee
- Division of Pediatric Hematology-Oncology-BMT, Emory University School of Medicine, Atlanta, GA, USA.,Aflac Cancer and Blood Disorders, Children's Healthcare of Atlanta, Atlanta, GA, USA
| | - Maa-Ohui Quarmyne
- Division of Pediatric Hematology-Oncology-BMT, Emory University School of Medicine, Atlanta, GA, USA.,Aflac Cancer and Blood Disorders, Children's Healthcare of Atlanta, Atlanta, GA, USA
| | - Lakshmanan Krishnamurti
- Division of Pediatric Hematology-Oncology-BMT, Emory University School of Medicine, Atlanta, GA, USA.,Aflac Cancer and Blood Disorders, Children's Healthcare of Atlanta, Atlanta, GA, USA
| | - Nitya Bakshi
- Division of Pediatric Hematology-Oncology-BMT, Emory University School of Medicine, Atlanta, GA, USA. .,Aflac Cancer and Blood Disorders, Children's Healthcare of Atlanta, Atlanta, GA, USA.
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30
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Maegele M. Challenges to improving patient outcome following massive transfusion in severe trauma. Expert Rev Hematol 2020; 13:323-330. [PMID: 32075445 DOI: 10.1080/17474086.2020.1733404] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Introduction: Uncontrolled hemorrhage with trauma-induced coagulopathy (TIC) still represents the most common cause of preventable death after trauma. Timely diagnosis and treatment including bleeding control and hemostatic resuscitation to correct TIC are important, as death from exsanguination occurs rapidly. Recognizing who requires an early massive transfusion together with the initiation of corresponding massive transfusion protocols (MTPs) is key to outcome.Areas covered: This expert review summarizes the current state of MT including the activation and termination of MTPs, complications of MT, and strategies for refinement in the administration of blood products in order to avoid harmful over-transfusion.Expert opinion: MTPs should be initiated and continued until normal physiologic parameters are reached and definitive control of bleeding is achieved. Hospitals should develop their own MTPs, guided by evidence, and according to local infrastructure, logistics, needs and patient populations. Massive transfusion, defined as > 10 units of packed red blood cell concentrates (pRBCs) within the first 24 hours of hospital admission, can be life-saving, but is not without complications. MTPs are currently being refined through targeted and early goal-directed approaches which include functional coagulation testing assays to better guide the administration of blood products and hemostatic agents once the patient is stabilized.
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Affiliation(s)
- Marc Maegele
- Department of Traumatology and Orthopedic Surgery, Cologne-Merheim Medical Center (CMMC) Institute for Research in Operative Medicine (IFOM), University Witten-Herdecke, Cologne, Germany
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31
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North AK, Mufti N, Sullivan T, Corash L. Preclinical safety assessment of pathogen reduced red blood cells treated with amustaline and glutathione. Transfusion 2020; 60:358-366. [PMID: 31930533 PMCID: PMC7027779 DOI: 10.1111/trf.15662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Revised: 12/05/2019] [Accepted: 12/06/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND The nucleic acid targeted pathogen reduction (PR) system utilizing amustaline (S-303) and glutathione (GSH) is designed to inactivate blood-borne pathogens and leukocytes in red blood cell concentrates (PR-RBCC). Inactivation is attained after amustaline intercalates and forms covalent nucleic acid adducts preventing replication, transcription, and translation. After pathogen inactivation, amustaline spontaneously hydrolyzes to S-300, the primary negatively charged reaction product; amustaline is below quantifiable levels in PR-RBCC. GSH quenches free unreacted amustaline. STUDY DESIGN AND METHODS The genotoxic and carcinogenic potential of PR-RBCC, the reaction by-products, and S-300 were assessed in accordance with the International Conference on Harmonization (ICH) guidelines and performed in compliance with the Food and Drug Administration (FDA) good laboratory practice standards, 21 CFR Part 58. in vitro bacterial reverse mutagenicity and chromosomal aberration assays were performed with and without exogenous S9 metabolic activation, and in in vivo clastogenicity and carcinogenic assays using validated murine models. RESULTS PR-RBCCs were not genotoxic in vitro and in vivo and were non-carcinogenic in p53+/- transgenic mice transfused over 26 weeks. Estimated safety margins for human exposure ranged from >90 to >36 fold for 2 to 5 PR-RBCCs per day, respectively. PR-RBCCs and S-300 did not induce chromosome aberration in the in vivo murine bone marrow micronucleus assay at systemically toxic doses. CONCLUSIONS PR-RBCCs did not demonstrate genotoxicity in vitro or in vivo and were not carcinogenic in vivo. These studies support the safety of PR-RBCCs and suggest that there is no measurable genotoxic hazard associated with transfusion of PR-RBCCs.
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32
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Jackson Chornenki NL, James TE, Barty R, Liu Y, Rochwerg B, Heddle NM, Siegal DM. Blood loss from laboratory testing, anemia, and red blood cell transfusion in the intensive care unit: a retrospective study. Transfusion 2019; 60:256-261. [DOI: 10.1111/trf.15649] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Revised: 11/08/2019] [Accepted: 11/22/2019] [Indexed: 02/04/2023]
Affiliation(s)
| | - Tyler E. James
- Department of Medicine McMaster University Hamilton Ontario Canada
| | - Rebecca Barty
- Department of Medicine McMaster University Hamilton Ontario Canada
- McMaster Centre for Transfusion Research McMaster University Hamilton Ontario Canada
| | - Yang Liu
- Department of Medicine McMaster University Hamilton Ontario Canada
- McMaster Centre for Transfusion Research McMaster University Hamilton Ontario Canada
| | - Bram Rochwerg
- Department of Medicine McMaster University Hamilton Ontario Canada
- Department of Health Research Methods Evidence and Impact at McMaster Hamilton Ontario Canada
| | - Nancy M. Heddle
- Department of Medicine McMaster University Hamilton Ontario Canada
- McMaster Centre for Transfusion Research McMaster University Hamilton Ontario Canada
| | - Deborah M. Siegal
- Department of Medicine McMaster University Hamilton Ontario Canada
- Population Health Research Institute McMaster University Hamilton Ontario Canada
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33
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Ito H, Yamamoto T, Morita S. The type-reproduction number of sexually transmitted infections through heterosexual and vertical transmission. Sci Rep 2019; 9:17408. [PMID: 31758036 PMCID: PMC6874657 DOI: 10.1038/s41598-019-53841-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Accepted: 11/06/2019] [Indexed: 01/20/2023] Open
Abstract
Multiple sexually transmitted infections (STIs) have threatened human health for centuries. Most STIs spread not only through sexual (horizontal) transmission but also through mother-to-child (vertical) transmission. In a previous work (Ito et al. 2019), we studied a simple model including heterosexual and mother-to-child transmission and proposed a formulation of the basic reproduction number over generations. In the present study, we improved the model to take into account some factors neglected in the previous work: adult mortality from infection, infant mortality caused by mother-to-child transmission, infertility or stillbirth caused by infection, and recovery with treatment. We showed that the addition of these factors has no essential effect on the theoretical formulation. To study the characteristics of the epidemic threshold, we derived analytical formulas for three type-reproduction numbers for adult men, adult women and juveniles. Our result indicates that if an efficient vaccine exists for a prevalent STI, vaccination of females is more effective for containment of the STI than vaccination of males, because the type-reproduction number for adult men is larger than that for adult women when they are larger than one.
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Affiliation(s)
- Hiromu Ito
- Department of International Health and Medical Anthropology, Institute of Tropical Medicine, Nagasaki University, Nagasaki, 852-8523, Japan.,Department of Environmental Sciences, Zoology, University of Basel, 4051, Basel, Switzerland
| | - Taro Yamamoto
- Department of International Health and Medical Anthropology, Institute of Tropical Medicine, Nagasaki University, Nagasaki, 852-8523, Japan
| | - Satoru Morita
- Department of Mathematical and Systems Engineering, Shizuoka University, Hamamatsu, Shizuoka, 432-8561, Japan. .,Department of Environment and Energy Systems, Graduate School of Science and Technology, Shizuoka University, Hamamatsu, Shizuoka, 432-8561, Japan.
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34
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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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35
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Yao Y, Cifuentes J, Zheng B, Yan M. Computer algorithm can match physicians' decisions about blood transfusions. J Transl Med 2019; 17:340. [PMID: 31601245 PMCID: PMC6785926 DOI: 10.1186/s12967-019-2085-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Accepted: 09/23/2019] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Checking appropriateness of blood transfusion for quality assurance required enormous usage of time and human resources from the healthcare system. We report here a new machine learning algorithm for checking blood transfusion quality. MATERIALS AND METHODS The multilayer perceptron neural network (MLPNN) was designed to learn an expert's judgement from 4946 clinical cases. The accuracy in predicting the blood transfusion was then reported. RESULTS We achieved a 96.8% overall accuracy rate, with a 99% match rate to the experts' judgement on those appropriate cases and 90.9% on the inappropriate cases. CONCLUSIONS Machine learning algorithm can accurately match to human judgement by feeding in pre-surgical information and key laboratory variables.
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Affiliation(s)
- Yuanyuan Yao
- Department of Anesthesiology, The Second Affiliated Hospital of Zhejiang University, Hangzhou, China
| | - Jenny Cifuentes
- Program of Electrical Engineering, Universidad De La Salle, Bogotá, Colombia
| | - Bin Zheng
- Department of Surgery, University of Alberta, Edmonton, Canada
| | - Min Yan
- Department of Anesthesiology, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310009, China.
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36
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Bahar B, Schulz WL, Gokhale A, Spencer BR, Gehrie EA, Snyder EL. Blood utilisation and transfusion reactions in adult patients transfused with conventional or pathogen-reduced platelets. Br J Haematol 2019; 188:465-472. [PMID: 31566724 PMCID: PMC7003815 DOI: 10.1111/bjh.16187] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Accepted: 06/27/2019] [Indexed: 01/23/2023]
Abstract
Pathogen-reduced (PR) platelets are routinely used in many countries. Some studies reported changes in platelet and red blood cell (RBC) transfusion requirements in patients who received PR platelets when compared to conventional (CONV) platelets. Over a 28-month period we retrospectively analysed platelet utilisation, RBC transfusion trends, and transfusion reaction rates data from all transfused adult patients transfused at the Yale-New Haven Hospital, New Haven, CT, USA. We determined the number of RBC and platelet components administered between 2 and 24, 48, 72 or 96 h. A total of 3767 patients received 21 907 platelet components (CONV = 8912; PR = 12 995); 1,087 patients received only CONV platelets (1578 components) and 1,466 patients received only PR platelets (2604 components). The number of subsequently transfused platelet components was slightly higher following PR platelet components (P < 0·05); however, fewer RBCs were transfused following PR platelet administration (P < 0·05). The mean time-to-next platelet component transfusion was slightly shorter following PR platelet transfusion (P = 0·002). The rate of non-septic transfusion reactions did not differ (all P > 0·05). Septic transfusion reactions (N = 5) were seen only after CONV platelet transfusions (P = 0·011). These results provide evidence for comparable clinical efficacy of PR and CONV platelets. PR platelets eliminated septic transfusion reactions without increased risk of other types of transfusions with only slight increase in platelet utilisation.
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Affiliation(s)
- Burak Bahar
- Department of Laboratory Medicine, Yale University School of Medicine, New Haven, CT, USA
| | - Wade L Schulz
- Department of Laboratory Medicine, Yale University School of Medicine, New Haven, CT, USA.,Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, CT, USA
| | - Amit Gokhale
- Department of Laboratory Medicine, Yale University School of Medicine, New Haven, CT, USA
| | | | - Eric A Gehrie
- Department of Pathology and Laboratory Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Edward L Snyder
- Department of Laboratory Medicine, Yale University School of Medicine, New Haven, CT, USA
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Gupta A, Patel P, Manvar K, Kellner T, Guevara E. Splenic infarction in babesiosis: A rare presentation. Clin Case Rep 2019; 7:1591-1595. [PMID: 31428398 PMCID: PMC6692990 DOI: 10.1002/ccr3.2301] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2019] [Accepted: 06/06/2019] [Indexed: 02/01/2023] Open
Abstract
Babesiosis is a protozoan parasitic infection transmitted by the Ixodes tick. Splenic infarction is a rare, but potentially life-threatening complication of babesiosis; it is therefore vital that this complication is recognized.
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Affiliation(s)
- Ashish Gupta
- Internal MedicineThe Brooklyn Hospital CenterNew YorkNYUSA
| | - Poras Patel
- Hematology OncologyThe Brooklyn Hospital CenterNew YorkNYUSA
| | - Kapil Manvar
- Internal MedicineThe Brooklyn Hospital CenterNew YorkNYUSA
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Current Advances in Red Blood Cell Generation Using Stem Cells from Diverse Sources. Stem Cells Int 2019; 2019:9281329. [PMID: 31467565 PMCID: PMC6701316 DOI: 10.1155/2019/9281329] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Revised: 06/02/2019] [Accepted: 07/01/2019] [Indexed: 12/29/2022] Open
Abstract
Blood transfusions hold an indispensable part in the modern healthcare system. Up to date, the blood supply is largely dependent on donations. Unfortunately, collecting the clinical-grade blood products has become a challenging mission due to accelerated population aging, which not only increases the need for blood transfusions but also decreases the number of healthy donors. Moreover, individuals with severe hematological abnormalities or rare blood phenotypes need alternative therapeutic approaches instead of conventional blood transfusion. In these aspects, the concept of in vitro/ex vivo production of blood cells has been emerging and many attempts have been focused on manufacturing mature erythrocytes, so-called red blood cells (RBCs), the most common and important component among the blood derivatives. In this review, we provide a general overview regarding the current strategies for generating RBCs from various stem cell sources including pluripotent stem cells (PSCs) as well as circulating blood stem cells and the remaining challenges that must be overcome prior to their practical application.
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Cho H, Kumar N. Cold agglutinin disease and its implications for dental treatment. SPECIAL CARE IN DENTISTRY 2019; 39:435-440. [PMID: 31120566 DOI: 10.1111/scd.12388] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Revised: 03/29/2019] [Accepted: 05/17/2019] [Indexed: 11/28/2022]
Abstract
Cold agglutinin disease (CAD) is a rare variant of autoimmune hemolytic anemia, characterized by the destruction of red blood cells by autoantibodies following exposure to cold temperatures. This case is of a 75-year-old male who presented to a dedicated hematology dental clinic. The dental management over a 3-year period is described, whereby the patient had extraction and periodontal disease management with considerations for medical, social and dental risk assessments and treatment modifications. The principles are applicable to patients with other hematological disorders.
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Affiliation(s)
- Hana Cho
- Special Care Dentistry Department, Eastman Dental Hospital, University College London Hospitals NHS Foundation Trust
| | - Navdeep Kumar
- Special Care Dentistry Department, Eastman Dental Hospital, University College London Hospitals NHS Foundation Trust
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Ataro Z, Urgessa F, Wasihun T. Prevalence and Trends of Major Transfusion Transmissible Infections among Blood Donors in Dire Dawa Blood bank, Eastern Ethiopia: Retrospective Study. Ethiop J Health Sci 2019; 28:701-710. [PMID: 30607086 PMCID: PMC6308748 DOI: 10.4314/ejhs.v28i6.4] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Background Acquisition of transfusion transmissible infections in the process of therapeutic blood transfusion is a major global health challenge in transfusion medicine. This study aimed to determine the prevalence and trends of major transfusion transmissible infections among blood donors. Method A retrospective analysis of consecutive blood donors' records covering the period between July 2010 and June 2013 was conducted at Dire Dawa Blood Bank, Eastern Ethiopia. Result A total of 6376 blood donors were tested, out of which 5647(88.57%) were replacement donors and 729(11.43%) were voluntary donors. The majority of them were male, 5430(85.16%), and aged between 18–32 years, 4492(70.45%). A total of 450(7.06%) donors had serological evidence of infection with at least one pathogen. The overall positivity rates of HBV, HIV, HCV and syphilis were 4.67%, 1.24%, 0.96%, and 0.44% respectively. Trends for transfusion-transmissible infections showed a significant decrease from 9.51% in 2010 to 6.95% in 2013 with the least prevalence in 2012 (5.90%) (P = 0.004). The prevalence of transfusion transmissible infections was significantly higher among male blood donors compared to female donors, among the age group of 25–32 years and 33–40 years compared to the age group of 18–24 years old, and among unemployed and private workers compared to students. Conclusion A significant percentage of the blood donors harbor transfusion-transmissible infections. Stringent donor selection using standard methods is highly recommended to ensure the safety of blood for the recipient. Furthermore, efforts on motivating and creating awareness in the community are required to increase voluntary blood donors.
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Affiliation(s)
- Zerihun Ataro
- Department of Medical Laboratory Sciences, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Fekadu Urgessa
- School of Medical Laboratory Sciences, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Tagesachew Wasihun
- Department of Medical Laboratory Sciences, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia.,School of Medical Laboratory Sciences, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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Pathogenic mechanisms and current epidemiological status of HEV infection in asymptomatic blood donors and patients with chronic diseases. Eur J Clin Microbiol Infect Dis 2019; 38:1203-1209. [DOI: 10.1007/s10096-019-03534-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Accepted: 03/08/2019] [Indexed: 12/15/2022]
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Haass KA, Sapiano MRP, Savinkina A, Kuehnert MJ, Basavaraju SV. Transfusion-Transmitted Infections Reported to the National Healthcare Safety Network Hemovigilance Module. Transfus Med Rev 2019; 33:84-91. [PMID: 30930009 DOI: 10.1016/j.tmrv.2019.01.001] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Revised: 12/04/2018] [Accepted: 01/02/2019] [Indexed: 11/29/2022]
Abstract
Transfusion-transmitted infections (TTIs) can be severe and result in death. Transfusion-transmitted viral pathogen transmission has been substantially reduced, whereas sepsis due to bacterial contamination of platelets and transfusion-transmitted babesiosis may occur more frequently. Quantifying the burden of TTI is important to develop targeted interventions. From January 1, 2010, to December 31, 2016, health care facilities participating in the National Healthcare Safety Network Hemovigilance Module monitored transfusion recipients for evidence of TTI and recorded the total number of units transfused. Facilities use standard criteria to report TTIs. Incidence rates of TTIs, including for bacterial contamination of platelets and transfusion-transmitted babesiosis, are presented. One hundred ninety-five facilities reported 111 TTIs and 7.9 million transfused components to the National Healthcare Safety Network Hemovigilance Module. Of these 111 reports, 54 met inclusion criteria. The most frequently reported pathogens were Babesia spp in RBCs (16/23, 70%) and Staphylococcus aureus in platelets (12/30, 40%). There were 1.95 (26 apheresis, 4 whole blood derived) TTIs per 100 000 transfused platelet units and 0.53 TTI per 100 000 transfused RBC components, compared to 0.68 TTI per 100 000 all transfused components. Bacterial contamination of platelets and transfusion-transmitted babesiosis were the most frequently reported TTIs. Interventions that reduce the burden of bacterial contamination of platelets, particularly collected by apheresis, and Babesia transmission through RBC transfusion would reduce transfusion recipient morbidity and mortality. These analyses demonstrate the value and importance of facility participation in national recipient hemovigilance using standard reporting criteria.
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Affiliation(s)
- Kathryn A Haass
- Office of Blood, Organ, and Other Tissue Safety, Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention.
| | - Mathew R P Sapiano
- Surveillance Branch, Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, US Centers for Disease Control and Prevention
| | - Alexandra Savinkina
- Office of Blood, Organ, and Other Tissue Safety, Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention; Oak Ridge Institute for Science and Education
| | - Matthew J Kuehnert
- Office of Blood, Organ, and Other Tissue Safety, Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention
| | - Sridhar V Basavaraju
- Office of Blood, Organ, and Other Tissue Safety, Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention
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Ansari S, Rashid N, Hanifa A, Siddiqui S, Kaleem B, Naz A, Perveen K, Hussain Z, Ansari I, Jabbar Q, Khan T, Nadeem M, Shamsi T. Laboratory diagnosis for thalassemia intermedia: Are we there yet? J Clin Lab Anal 2019; 33:e22647. [PMID: 30221402 PMCID: PMC6430353 DOI: 10.1002/jcla.22647] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Revised: 07/12/2018] [Accepted: 07/20/2018] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Differentiation between thalassemia major and thalassemia intermedia at presentation is not uniformly characterized, for which an absolute criteria needs to be developed. This study investigated the primary and secondary genetic modifiers to develop a laboratory finding by forming different genetic mutational combinations seen among thalassemia intermedia patients and comparing them with thalassemia major. METHODS This cross-sectional study analyzed 315 thalassemia intermedia patients. One hundred and five thalassemia major patients were recruited on the basis of documented evidence of diagnosis and were receiving blood transfusion therapy regularly. Various mutational combinations were identified, and comparison was performed between thalassemia intermedia and major using statistical software STATA 11.1. RESULTS The mean age of the total population was 5.9 ± 5.32 years of which 165 (52%) were males. Of the two groups (thalassemia intermedia and thalassemia major), IVSI-5, IVSI-1, and Fr 8-9 were more prevalent among the thalassemia intermedia cohort. When comparison was performed between the thalassemia intermedia and thalassemia major patients, it showed significant results for the presence of Xmn-1 polymorphism. CONCLUSION The presence of IVSI-5 homozygous with Xmn-1, IVSI-5 heterozygous with Xmn-1, Cd 30 homozygous with or without Xmn-1 and IVSI-1 homozygous or heterozygous either with or without Xmn-1 prove to be strong indicators towards diagnosis of thalassemia intermedia.
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Affiliation(s)
- Saqib Ansari
- Department of HaematologyNational Institute of Blood Diseases & BMTKarachiPakistan
- Department of ResearchNational Institute of Blood Diseases & BMTKarachiPakistan
| | - Nabil Rashid
- Department of ResearchNational Institute of Blood Diseases & BMTKarachiPakistan
| | - Anny Hanifa
- Department of HaematologyNational Institute of Blood Diseases & BMTKarachiPakistan
| | - Saima Siddiqui
- Department of HaematologyNational Institute of Blood Diseases & BMTKarachiPakistan
| | - Bushra Kaleem
- Department of ResearchNational Institute of Blood Diseases & BMTKarachiPakistan
| | - Arshi Naz
- Department of ResearchNational Institute of Blood Diseases & BMTKarachiPakistan
| | - Kousar Perveen
- Department of ResearchNational Institute of Blood Diseases & BMTKarachiPakistan
| | - Zeeshan Hussain
- Department of HaematologyNational Institute of Blood Diseases & BMTKarachiPakistan
| | - Iqra Ansari
- Department of ResearchNational Institute of Blood Diseases & BMTKarachiPakistan
| | - Qammar Jabbar
- Department of ResearchNational Institute of Blood Diseases & BMTKarachiPakistan
| | - Tahir Khan
- Department of ResearchNational Institute of Blood Diseases & BMTKarachiPakistan
| | - Muhammad Nadeem
- Department of ResearchNational Institute of Blood Diseases & BMTKarachiPakistan
| | - Tahir Shamsi
- Department of HaematologyNational Institute of Blood Diseases & BMTKarachiPakistan
- Department of ResearchNational Institute of Blood Diseases & BMTKarachiPakistan
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Budget impact of implementing platelet pathogen reduction into the Italian blood transfusion system. BLOOD TRANSFUSION = TRASFUSIONE DEL SANGUE 2018; 16:483-489. [PMID: 30201081 DOI: 10.2450/2018.0115-18] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Accepted: 07/26/2018] [Indexed: 02/08/2023]
Abstract
BACKGROUND Despite improvements in blood donor selection and screening procedures, transfusion recipients can still develop complications related to infections by known and emerging pathogens. Pathogen reduction technologies (PRT) have been developed to reduce such risks. The present study, developed whithin a wider health technology assessment (HTA) process, was undertaken to estimate the costs of the continuing increase in the use of platelet PRT in Italy. MATERIALS AND METHODS A multidisciplinary team was established to perform the HTA and conduct a budget impact analysis. Quantitative data on platelet use were derived from the 2015 national blood transfusion report and from the Italian Platelets Transfusion Assessment Study (IPTAS). The current national fee of 60 Euro per platelet PRT procedure was used to quantify the costs to the Italian National Health Service (INHS). The analysis adopts a 3-year time-frame. In order to identify the impact on budget we compared a scenario representing an increased use of PRT platelets over time with a control scenario in which standard platelets are used. RESULTS Progressive implementation of PRT for 20%, 40% and 66% of annual adult platelet doses could generate an increase in annual costs for the INHS amounting to approximately 7, 14 and 23 million Euros, respectively. Use of kits and devices suitable for the treatment of multiple adult platelet doses in one PRT procedure could lower costs. DISCUSSION In order to fully evaluate the societal perspective of implementing platelet PRT, the increase in costs must be balanced against the expected benefits (prevention of transfusion-transmissible infections, white cell inactivation, extension of platelet storage, discontinuation of pathogen detection testing). Further studies based on actual numbers of platelet transfusion complications and their societal cost at a local level are needed to see the full cost to benefit ratio of platelet PRT implementation in Italy, and to promote equal treatment for all citizens.
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Comparison of Decompression, Decompression Plus Fusion, and Decompression Plus Stabilization for Degenerative Spondylolisthesis: A Prospective, Randomized Study. Clin Spine Surg 2018; 31:E347-E352. [PMID: 29877872 PMCID: PMC6072383 DOI: 10.1097/bsd.0000000000000659] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
STUDY DESIGN This is a prospective, randomized controlled trial. OBJECTIVE To prospectively assess the long-term clinical results of decompression alone, decompression plus fusion, and decompression plus stabilization for degenerative spondylolisthesis. SUMMARY OF BACKGROUND DATA Symptoms of lumbar spinal stenosis due to degenerative spondylolisthesis originate from compression of the dural sac or nerve root. Essentially, this condition is treated by performing a decompression of neural structures. Posterolateral lumbar fusion and posterior pedicle-based dynamic stabilization are additional techniques performed to ensure improved prognosis. However, to date, the selection of a surgical procedure for lumbar spinal stenosis due to degenerative spondylolisthesis remains debatable, especially in terms of the addition of instrumentation because of the few available prospective, randomized studies. MATERIALS AND METHODS We randomly assigned patients who had 1 level lumbar spinal stenosis due to degenerative spondylolisthesis at the L4/5 level to undergo either decompression alone (decompression group), decompression plus fusion (fusion group), or decompression plus stabilization (stabilization group). Outcomes were assessed using the Japanese Orthopaedic Association and Visual Analogue Scale scores. RESULTS In total, 85 patients underwent randomization. The follow-up rate at 5 years was 86.4%. The fusion and stabilization groups showed higher blood loss and a longer operative time than the decompression group. The fusion group showed longer postoperative hospital stay than the decompression group. In terms of clinical outcomes, all scores significantly improved postoperatively, and these outcomes were maintained at 5 years postoperatively in each group. There were no significant differences among the groups at 1 and 5 years postoperatively. CONCLUSIONS Additional instrumentation operation for low-grade (<30%) degenerative spondylolisthesis did not result in superior results to decompression alone at 1 and 5 years postoperatively. LEVEL OF EVIDENCE Level II.
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Barnett CL, Mladsi D, Vredenburg M, Aggarwal K. Cost estimate of platelet transfusion in the United States for patients with chronic liver disease and associated thrombocytopenia undergoing elective procedures. J Med Econ 2018; 21:827-834. [PMID: 29912593 DOI: 10.1080/13696998.2018.1490301] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
AIMS This study aimed to estimate the cost of platelet transfusion in patients with chronic liver disease (CLD)-associated thrombocytopenia undergoing an elective procedure in the United States. MATERIALS AND METHODS The study was conducted in two parts: development of a conceptual framework identifying direct, indirect and intangible costs of platelet transfusion, followed by the estimation of the total cost of platelet transfusion in patients with CLD-associated thrombocytopenia before an elective procedure in the United States using the conceptual framework and cost data obtained from a literature search. The cost of the entire care required to raise a patient's platelet count before the procedure was considered. RESULTS The final conceptual framework included the costs of generating the supply of platelets, the platelet transfusion itself, adverse events associated with platelet transfusion and refractoriness to platelet transfusion. When costs were accounted for in all the framework cost categories, the total direct cost of a platelet transfusion in a patient with CLD and associated thrombocytopenia was estimated to be in the range of $5258 to $13,117 (2017 US dollars) in the United States. The largest portion of costs was incurred by the transfusion event itself ($3723 to $4436) and the cost of refractoriness ($874 to $7578), which included the opportunity cost of a delayed procedure and subsequent platelet transfusions with human leukocyte antigen-matched platelets. LIMITATIONS AND CONCLUSIONS Although we were unable to include all cost components identified in the conceptual framework in our total cost estimate, thus likely underestimating the true total cost, and despite the data gaps and challenges limiting our estimate of the full cost of a platelet transfusion in patients with CLD-associated thrombocytopenia undergoing an elective procedure in the United States, this study outlines a comprehensive conceptual framework for estimating the cost elements of a platelet transfusion in these patients.
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Affiliation(s)
| | - Deirdre Mladsi
- a RTI Health Solutions, Research Triangle Park , NC , USA
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Kim G, Karbaschi M, Cooke M, Gaitas A. Light-based methods for whole blood bacterial inactivation enabled by a recirculating flow system. Photochem Photobiol 2018; 94:744-751. [PMID: 29418006 PMCID: PMC6136252 DOI: 10.1111/php.12899] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Accepted: 01/03/2018] [Indexed: 12/25/2022]
Abstract
Light of certain wavelengths can be used to inactivate pathogens. Whole blood is opaque; thus, the penetration of light is reduced. Here, we overcame this limitation using a thin transparent tube that is illuminated from all angles. Three light-based techniques were evaluated: photodynamic therapy (PDT) using a 660-nm light and antibody-photosensitizer conjugates, ultraviolet, and violet light. We observed a reduction of 55-71% of Staphylococcus aureus after 5 h of exposure (starting concentration 107 CFU mL-1 ) and an 88-97% reduction in methicillin-resistant Staphylococcus aureus (MRSA) (starting 104 CFU mL-1 ). An 83-92% decrease for S. aureus and 98-99.9% decrease for MRSA were observed when combined with an immunocapture approach. Complete blood count with differential analysis did not reveal any significant changes in the blood cell numbers. Genotoxicity studies showed that violet and ultraviolet did not induce any significant level of single strand breaks and alkali labile sites in the peripheral blood mononuclear cells (PBMC). In contrast, ultraviolet did induce a very low level of cyclobutane pyrimidine dimers, a UV damage indicator. PDT generated a significant level of single strand breaks and 8-oxoGua in these cells. The approaches showed promise for whole blood pathogen inactivation with minimal collateral damage to PBMC.
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Affiliation(s)
- Gwangseong Kim
- Kytaro, Inc., Miami, FL 33199
- Department of Electrical Engineering, Florida International University, Miami, FL 33199
| | - Mahsa Karbaschi
- Oxidative Stress Group, Department of Environmental Health Sciences, Florida International University, Miami, FL 33199
| | - Marcus Cooke
- Oxidative Stress Group, Department of Environmental Health Sciences, Florida International University, Miami, FL 33199
| | - Angelo Gaitas
- Kytaro, Inc., Miami, FL 33199
- Department of Electrical Engineering, Florida International University, Miami, FL 33199
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Kengne M, Tsata DCW, Ndomgue T, Nwobegahay JM. Prevalence and risk factors of HTLV-1/2 and other blood borne infectious diseases among blood donors in Yaounde Central Hospital, Cameroon. Pan Afr Med J 2018; 30:125. [PMID: 30374371 PMCID: PMC6201601 DOI: 10.11604/pamj.2018.30.125.14802] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Accepted: 05/11/2018] [Indexed: 11/11/2022] Open
Abstract
Introduction Transfusion-transmissible infectious microorganisms including bacteria and viruses are among the greatest threats to blood safety for the recipient. The prevalence and risk factors of HTLV-1/2 and other blood borne infectious diseases were determined among blood donors in Yaounde Central Hospital, Cameroon. Methods Design: cross sectional study. Setting: The blood bank unit of Yaounde Central Hospital, Cameroon. Subjects: a consecutive sample of 265 apparently healthy adult blood donors. Investigations: Search for the presence of hepatitis B surface antigen (AgHBs) and antibodies to human T-lymphotropic virus type 1 (anti-HTLV-1/2), human immunodeficiency virus (anti-HIV), hepatitis C virus (anti-HCV) and syphilis and to determine the epidemiological correlates, if any, in the occurrence of HTLV infection. Results 77 (29.05%) of the blood donors had serological evidence of infection with at least one pathogen and 4 (5.2%) had dual infections with HTLV-1/2. The overall prevalence of HTLV-1/2, HIV, HCV, HBV and syphilis were 5.7%, 5.3%, 2.6%, 11.7%, 3.8% respectively. Surgical history (Chi2=4.785; P=0.029), scarification (Chi2=6.359; P = 0.012), piercing (Chi2 = 16.353; P = 0.000) and intravenous drug use (Chi2 = 15.660; P = 0.000) were identified as risk factors for HTLV-1/2 infection. Conclusion A relative high prevalence of viral infections and syphilis was recorded among the study participants especially for HTLV-1/2 for which none blood donation is routine screened in our set up. Therefore, a routine screen of blood prior to transfusion should include anti-HTLV-1/2 tests.
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Affiliation(s)
- Michel Kengne
- Department of Medical Microbiology and Immunology, School of Health Sciences-Catholic University of Central Africa, Yaoundé Cameroon
| | - Dorine Carol Wouado Tsata
- Department of Medical Microbiology and Immunology, School of Health Sciences-Catholic University of Central Africa, Yaoundé Cameroon
| | - Thérèse Ndomgue
- Department of Medical Microbiology and Immunology, School of Health Sciences-Catholic University of Central Africa, Yaoundé Cameroon.,Assistant Laboratory Technicians School, Yaoundé, Cameroon
| | - Julius Mbekem Nwobegahay
- Department of Medical Microbiology and Immunology, School of Health Sciences-Catholic University of Central Africa, Yaoundé Cameroon.,Military Health Research Center (CRESAR), Yaounde, Cameroon
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Charoenphol P, Oswalt K, Bishop CJ. Therapeutics incorporating blood constituents. Acta Biomater 2018; 73:64-80. [PMID: 29626699 DOI: 10.1016/j.actbio.2018.03.046] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Revised: 02/01/2018] [Accepted: 03/28/2018] [Indexed: 12/17/2022]
Abstract
Blood deficiency and dysfunctionality can result in adverse events, which can primarily be treated by transfusion of blood or the re-introduction of properly functioning sub-components. Blood constituents can be engineered on the sub-cellular (i.e., DNA recombinant technology) and cellular level (i.e., cellular hitchhiking for drug delivery) for supplementing and enhancing therapeutic efficacy, in addition to rectifying dysfunctioning mechanisms (i.e., clotting). Herein, we report the progress of blood-based therapeutics, with an emphasis on recent applications of blood transfusion, blood cell-based therapies and biomimetic carriers. Clinically translated technologies and commercial products of blood-based therapeutics are subsequently highlighted and perspectives on challenges and future prospects are discussed. STATEMENT OF SIGNIFICANCE Blood-based therapeutics is a burgeoning field and has advanced considerably in recent years. Blood and its constituents, with and without modification (i.e., combinatorial), have been utilized in a broad spectrum of pre-clinical and clinically-translated treatments. This review article summarizes the most up-to-date progress of blood-based therapeutics in the following contexts: synthetic blood substitutes, acellular/non-recombinant therapies, cell-based therapies, and therapeutic sub-components. The article subsequently discusses clinically-translated technologies and future prospects thereof.
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Saleh RM, Zefarina Z, Che Mat NF, Chambers GK, Edinur HA. Transfusion Medicine and Molecular Genetic Methods. Int J Prev Med 2018; 9:45. [PMID: 29899883 PMCID: PMC5981227 DOI: 10.4103/ijpvm.ijpvm_232_16] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2016] [Accepted: 08/05/2017] [Indexed: 02/07/2023] Open
Abstract
Transfusion procedures are always complicated by potential genetic mismatching between donor and recipient. Compatibility is determined by several major antigens, such as the ABO and Rhesus blood groups. Matching for other blood groups (Kell, Kidd, Duffy, and MNS), human platelet antigens, and human leukocyte antigens (HLAs) also contributes toward the successful transfusion outcomes, especially in multitransfused or highly immunized patients. All these antigens of tissue identity are highly polymorphic and thus present great challenges for finding suitable donors for transfusion patients. The ABO blood group and HLA markers are also the determinants of transplant compatibility, and mismatched antigens will cause graft rejection or graft-versus-host disease. Thus, a single and comprehensive registry covering all of the significant transfusion and transplantation antigens is expected to become an important tool in providing an efficient service capable of delivering safe blood and quickly locating matching organs/stem cells. This review article is intended as an accessible guide for physicians who care for transfusion-dependent patients. In particular, it serves to introduce the new molecular screening methods together with the biology of these systems, which underlies the tests.
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Affiliation(s)
| | - Zulkafli Zefarina
- School of Health Sciences, Health Campus, Universiti Sains Malaysia, Kelantan, Malaysia
| | - Nor Fazila Che Mat
- School of Health Sciences, Health Campus, Universiti Sains Malaysia, Kelantan, Malaysia
| | | | - Hisham Atan Edinur
- School of Health Sciences, Health Campus, Universiti Sains Malaysia, Kelantan, Malaysia
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