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Pozzo di Borgo A, Germain M, O'Brien SF, Delage G, Renaud C, Lewin A. Risk of variant Creutzfeldt-Jakob disease in a simulated cohort of Canadian blood donors. Vox Sang 2023; 118:738-745. [PMID: 37463691 DOI: 10.1111/vox.13493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 06/02/2023] [Accepted: 06/20/2023] [Indexed: 07/20/2023]
Abstract
BACKGROUND AND OBJECTIVES No transfusion-associated cases of variant Creutzfeldt-Jakob disease (vCJD) have occurred in more than 20 years. Yet, many countries have maintained blood donor deferral criteria for vCJD. We developed a risk simulation model to reassess the need for vCJD-related deferral criteria in Canada. MATERIALS AND METHODS The model provides results separately for Héma-Québec (HQ) and Canadian Blood Services (CBS). The model used a Monte Carlo simulation approach to estimate the risk of having a vCJD-contaminated blood donation ('risk of vCJD') in a simulated cohort of 10 million donors followed for up to 85 years. The model assumed current deferral criteria for vCJD were lifted, which would allow new 'at-risk' donors to give blood. The model accounted for disease prevalence, donors' travel/immigration history, PRNP genotype at codon 129, demographics and the type of labile blood product. RESULTS In the base case, the risk of vCJD was estimated at zero at both blood services. In the most pessimistic scenario, the risk of vCJD was 6.4 × 10-9 (i.e., 1 in 157 million donations) at HQ, or ≤1 in 77 million based on the upper bound of the 95% confidence interval (CI). At CBS, this risk was 4.8 × 10-8 (i.e., 1 in 21 million donations), or ≤1 in 16 million based on the upper bound of the 95% CI. CONCLUSION vCJD poses minimal risks to the Canadian blood supply. Current vCJD deferral criteria may, therefore, be lifted with virtually no impact on safety, while significantly expanding the donor base.
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Affiliation(s)
| | - Marc Germain
- Medical Affairs and Innovation, Héma-Québec, Québec, Québec, Canada
| | - Sheila F O'Brien
- Epidemiology and Surveillance, Canadian Blood Services, Ottawa, Ontario, Canada
| | - Gilles Delage
- Medical Affairs and Innovation, Héma-Québec, Montréal, Québec, Canada
| | - Christian Renaud
- Medical Affairs and Innovation, Héma-Québec, Montréal, Québec, Canada
| | - Antoine Lewin
- Medical Affairs and Innovation, Héma-Québec, Montréal, Québec, Canada
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2
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Lewin A, De Serres G, Grégoire Y, Perreault J, Drouin M, Fournier MJ, Tremblay T, Beaudoin J, Boivin A, Goyette G, Finzi A, Bazin R, Germain M, Delage G, Renaud C. Seroprevalence of SARS-CoV-2 antibodies among blood donors in Québec: an update from a serial cross-sectional study. Can J Public Health 2022; 113:385-393. [PMID: 35380364 PMCID: PMC8982303 DOI: 10.17269/s41997-022-00622-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 02/24/2022] [Indexed: 12/14/2022]
Abstract
Objectives We previously estimated the seroprevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibodies following the first pandemic wave at 2.23% in Québec, Canada. Following the much bigger second wave in fall 2020 and early 2021, we estimated the seroprevalence of anti-SARS-CoV-2 in Québec during the first months of 2021. Methods Blood samples from regular, asymptomatic (for ≥ 14 days) donors were collected between January 25, 2021 and March 11, 2021. Anti-SARS-CoV-2 seropositivity was assessed using an enzyme-linked immunosorbent assay that captures antibodies directed against the receptor binding domain of the SARS-CoV-2 spike (and hence cannot discriminate between infection- and vaccine-induced seropositivity). Seroprevalence estimates were adjusted for regional distribution, age, and sex. Results Samples from 7924 eligible donors were analyzed, including 620 (7.8%) vaccinated donors and 7046 (88.9%) unvaccinated donors (vaccination status unknown for 258 (3.3%) donors). Overall, median age was 51 years; 46.4% of donors were female. The adjusted seroprevalence was 10.5% (95% CI = 9.7–11.3) in the unvaccinated population and 14.7% (95% CI = 13.8–15.6) in the overall population. Seroprevalence gradually decreased with age and was higher among donors who self-identified as having a racial/ethnic background other than white, both in the overall and in the unvaccinated populations. Conclusion The seroprevalence of SARS-CoV-2 antibodies significantly increased in Québec since spring 2020, with younger persons and ethnic minorities being disproportionately affected. When compared with the cumulative incidence rate reported by public health authorities (i.e., 3.3% as of March 11, 2021), these results suggest that a substantial proportion of infections remain undetected despite improvements in access to COVID-19 testing. Supplementary Information The online version contains supplementary material available at 10.17269/s41997-022-00622-y.
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Affiliation(s)
- Antoine Lewin
- Affaires Médicales et Innovation, Héma-Québec, Montréal, QC, Canada.,Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Gaston De Serres
- Institut National de Santé Publique du Québec, Québec, QC, Canada.,Centre de recherche du CHU de Québec-Université Laval, Québec, QC, Canada
| | - Yves Grégoire
- Affaires Médicales et Innovation, Héma-Québec, Québec, QC, Canada
| | - Josée Perreault
- Affaires Médicales et Innovation, Héma-Québec, Québec, QC, Canada
| | - Mathieu Drouin
- Affaires Médicales et Innovation, Héma-Québec, Québec, QC, Canada
| | | | - Tony Tremblay
- Affaires Médicales et Innovation, Héma-Québec, Québec, QC, Canada
| | - Julie Beaudoin
- Qualité et développement, Héma-Québec, Montréal, QC, Canada
| | - Amélie Boivin
- Affaires Médicales et Innovation, Héma-Québec, Montréal, QC, Canada
| | - Guillaume Goyette
- Centre de Recherche du CHUM, Montréal, QC, Canada.,Département de Microbiologie, Infectiologie et Immunologie, Université de Montréal, Montréal, QC, Canada
| | - Andrés Finzi
- Centre de Recherche du CHUM, Montréal, QC, Canada.,Département de Microbiologie, Infectiologie et Immunologie, Université de Montréal, Montréal, QC, Canada
| | - Renée Bazin
- Affaires Médicales et Innovation, Héma-Québec, Québec, QC, Canada
| | - Marc Germain
- Affaires Médicales et Innovation, Héma-Québec, Québec, QC, Canada
| | - Gilles Delage
- Affaires Médicales et Innovation, Héma-Québec, Montréal, QC, Canada
| | - Christian Renaud
- Affaires Médicales et Innovation, Héma-Québec, Montréal, QC, Canada.
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3
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Grégoire Y, Delage G, Custer B, Rochette S, Renaud C, Lewin A, Germain M. Cost-effectiveness of pathogen reduction technology for plasma and platelets in Québec: A focus on potential emerging pathogens. Transfusion 2022; 62:1208-1217. [PMID: 35560238 DOI: 10.1111/trf.16926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 03/28/2022] [Accepted: 03/28/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND The last economic evaluation of pathogen reduction technology (PRT) in Canada was conducted in 2007. We reassessed the cost-effectiveness of PRT in the province of Québec (which has its own blood supplier) and included an evaluation of the potential impact of emerging pathogens on cost-effectiveness. STUDY DESIGN AND METHODS Decision analytic Markov models were developed to simulate the costs and quality-adjusted life-years (QALY) associated with PRT as an addition to existing safety measures for plasma and platelet products (except for bacterial culture). Models accounted for several infectious and noninfectious transfusion reactions, recipients' productivity losses ensuing from these reactions, and the impact of PRT on platelet function. Scenario analyses were conducted to evaluate the impact of a new highly contagious human immunodeficiency virus (HIV)-like or West Nile virus (WNV)-like pathogen, assuming various epidemiological scenarios. RESULTS In the base case, the incremental cost-effectiveness ratio (ICER) of PRT was estimated at $8,088,974/QALY gained. Assuming the presence of an HIV-like pathogen, the ICER was $265,209/QALY gained in the "average transmission" scenario, $1,274,445/QALY gained in the "rapid testing scenario," and $123,063/QALY gained in the "highly contagious" scenario. Assuming the presence of a WNV-like pathogen, the ICER was $7,469,167/QALY gained in the "average transmission" scenario and $6,652,769/QALY gained in the "highly contagious" scenario. CONCLUSION The cost-effectiveness of PRT may substantially improve in the event of a new, blood-borne pathogen. Given their significant impact on cost-effectiveness, the emergence of new pathogens should be considered when deciding whether to adopt PRT.
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Affiliation(s)
- Yves Grégoire
- Medical Affairs and Innovation, Héma-Québec, Québec city, Canada
| | | | - Brian Custer
- Vitalant Research Institute, San Francisco, California, USA.,Department of Laboratory Medicine, University of California, San Francisco (UCSF), San Francisco, California, USA
| | | | | | | | - Marc Germain
- Medical Affairs and Innovation, Héma-Québec, Québec city, Canada
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4
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Lewin A, Grégoire Y, Delage G, Thibeault C, Viau C, Milot C, Parent É, Renaud C. Reported non-compliance with pre-donation screening among blood donors in Québec, Canada: A focus on the 3-month deferral for men who have sex with men. Vox Sang 2022; 117:966-970. [PMID: 35377497 DOI: 10.1111/vox.13277] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 03/08/2022] [Accepted: 03/12/2022] [Indexed: 01/31/2023]
Abstract
BACKGROUND AND OBJECTIVES In Québec (Canada), the donation deferral for men who have sex with men (MSM) has recently been shortened to 3 months. Whether this change impacted compliance with pre-donation screening is unknown. We assessed compliance with the disclosure of male-to-male sex and other behavioural risk factors for HIV amid this change. MATERIALS AND METHODS Québec residents who donated from 14 July 2020 to 30 November 2020 were invited to participate in an online survey. Donors were informed that the survey was optional and anonymous. Survey questions were those used for routine pre-donation screening. Rates of reported non-compliance were weighted based on several characteristics. RESULTS Of 21,918 contacted donors, 7113 (32.45%) participated. Among male participants (N = 3347), six (0.27% [95% confidence interval (CI) = 0.09%-0.44%]) were not compliant with a 3-month MSM deferral. Among female participants (N = 3766), two (0.06% [95% CI = 0.00%-0.13%]) were not compliant with a 3-month deferral for sex with a man who had male-to-male sex ≤12 months. Other risk factors exhibited similar or lower rates of reported non-compliance. CONCLUSION Reported non-compliance with a 3-month MSM deferral and the disclosure of other HIV behavioural risk factors was low. These results warrant the investigation of behavioural donor risk assessment approaches to further improve the inclusiveness of blood donation.
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Affiliation(s)
- Antoine Lewin
- Héma-Québec, Medical Affairs and Innovation, Montréal, Québec, Canada.,Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - Yves Grégoire
- Héma-Québec, Medical Affairs and Innovation, Québec, Québec, Canada
| | - Gilles Delage
- Héma-Québec, Medical Affairs and Innovation, Montréal, Québec, Canada
| | | | | | | | - Éric Parent
- Héma-Québec, Regulatory Affairs, Montréal, Québec, Canada
| | - Christian Renaud
- Héma-Québec, Medical Affairs and Innovation, Montréal, Québec, Canada
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5
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Delage G, Bernier F. Bacterial culture of platelets with the large volume delayed sampling approach: a narrative review. ACTA ACUST UNITED AC 2021. [DOI: 10.21037/aob-21-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Lewin A, Therrien R, De Serres G, Grégoire Y, Perreault J, Drouin M, Fournier MJ, Tremblay T, Beaudoin J, Beaudoin-Bussières G, Prévost J, Gendron-Lepage G, Finzi A, Bernier F, Bazin R, Germain M, Delage G. SARS-CoV-2 seroprevalence among blood donors in Québec, and analysis of symptoms associated with seropositivity: a nested case-control study. Can J Public Health 2021; 112:576-586. [PMID: 33999398 PMCID: PMC8127462 DOI: 10.17269/s41997-021-00531-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 04/15/2021] [Indexed: 12/26/2022]
Abstract
OBJECTIVES A substantial proportion of individuals infected with SARS-CoV-2 do not experience noticeable symptoms typical of COVID-19. Our objectives were to evaluate the impact of the first wave of the pandemic in Québec by measuring SARS-CoV-2 antibody seroprevalence in a convenience sample of healthy blood donors and to study the association between seropositivity and the occurrence of COVID-19 symptoms. METHODS The study design was a cross-sectional serological survey with a nested case-control study. Residual blood samples from donations collected between May 25 and July 9, 2020 (well before vaccination rollout) in the province of Québec were tested for anti-Spike RBD antibodies by ELISA. Seropositive donors and a control group of seronegative donors were questioned about prior COVID-19 symptoms. All qualified blood donors were eligible for participation. RESULTS A total of 7691 blood donors were included in the study. After adjustments, the seroprevalence rate was 2.2% (95% CI 1.9-2.6). Seropositive donors reported one or more symptoms in a proportion of 52.2% (95% CI 44.2-60.1); this proportion was 19.1% (95% CI 13.4-26.1) among seronegative donors, suggesting that approximately 50-66% of all infections were asymptomatic. Univariate analysis of associations between symptoms and seropositivity revealed that except for rhinorrhea, all symptoms were significantly associated with seropositivity. CONCLUSION Assuming that blood donors are fairly representative of the general adult population, this study shows that less than 3% of 18-69-year-olds have been infected during the first wave of the pandemic in the province of Québec. Our data also confirm that many infections escaped detection, including a substantial proportion that were asymptomatic.
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Affiliation(s)
- Antoine Lewin
- Héma-Québec, Affaires Médicales et Innovation, 4045 Blvd. de la Côte-Vertu, Saint-Laurent, Montréal, QC, H4R 2W7, Canada
- Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, QC, J1H 5N4, Canada
| | - Roseline Therrien
- Héma-Québec, Qualité et développement, Montréal, QC, H4R 2W7, Canada
| | - Gaston De Serres
- Institut National de Santé Publique du Québec, Québec, QC, H2P 1E2, Canada
- Centre de recherche du CHU de Québec-Université Laval, Québec, QC, G1E 6W2, Canada
| | - Yves Grégoire
- Héma-Québec, Affaires Médicales et Innovation, Québec, QC, G1V 5C3, Canada
| | - Josée Perreault
- Héma-Québec, Affaires Médicales et Innovation, Québec, QC, G1V 5C3, Canada
| | - Mathieu Drouin
- Héma-Québec, Affaires Médicales et Innovation, Québec, QC, G1V 5C3, Canada
| | | | - Tony Tremblay
- Héma-Québec, Affaires Médicales et Innovation, Québec, QC, G1V 5C3, Canada
| | - Julie Beaudoin
- Héma-Québec, Qualité et développement, Montréal, QC, H4R 2W7, Canada
| | - Guillaume Beaudoin-Bussières
- Centre de Recherche du CHUM, Montréal, QC, H2X 0A9, Canada
- Département de Microbiologie, Infectiologie et Immunologie, Université de Montréal, Montréal, QC, H2X 0A9, Canada
| | - Jérémie Prévost
- Centre de Recherche du CHUM, Montréal, QC, H2X 0A9, Canada
- Département de Microbiologie, Infectiologie et Immunologie, Université de Montréal, Montréal, QC, H2X 0A9, Canada
| | | | - Andrés Finzi
- Centre de Recherche du CHUM, Montréal, QC, H2X 0A9, Canada
- Département de Microbiologie, Infectiologie et Immunologie, Université de Montréal, Montréal, QC, H2X 0A9, Canada
| | - France Bernier
- Héma-Québec, Qualité et développement, Montréal, QC, H4R 2W7, Canada
| | - Renée Bazin
- Héma-Québec, Affaires Médicales et Innovation, Québec, QC, G1V 5C3, Canada
| | - Marc Germain
- Héma-Québec, Affaires Médicales et Innovation, Québec, QC, G1V 5C3, Canada
| | - Gilles Delage
- Héma-Québec, Affaires Médicales et Innovation, 4045 Blvd. de la Côte-Vertu, Saint-Laurent, Montréal, QC, H4R 2W7, Canada.
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7
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O'Brien SF, Drews SJ, Yi QL, Bloch EM, Ogden NH, Koffi JK, Lindsay LR, Gregoire Y, Delage G. Risk of transfusion-transmitted Babesia microti in Canada. Transfusion 2021; 61:2958-2968. [PMID: 34272882 DOI: 10.1111/trf.16595] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 07/05/2021] [Accepted: 07/06/2021] [Indexed: 01/21/2023]
Abstract
BACKGROUND Babesia microti has gained a foothold in Canada as tick vectors become established in broader geographic areas. B. microti infection is associated with mild or no symptoms in healthy individuals but is transfusion-transmissible and can be fatal in immunocompromised individuals. This is the first estimate of clinically significant transfusion-transmitted babesiosis (TTB) risk in Canada. STUDY DESIGN AND METHODS The proportion of B. microti-antibody (AB)/nucleic acid amplification test (NAT)-positive whole blood donations was estimated at 5.5% of the proportion of the general population with reported Lyme Disease (also tick-borne) based on US data. Monte Carlo simulation estimated the number and proportion of infectious red cell units for three scenarios: base, localized incidence (risk in Manitoba only), and donor study informed (prevalence from donor data). The model simulated 1,029,800 donations repeated 100,000 times for each. RESULTS In the base scenario 0.5 (0.01, 1.75), B. microti-NAT-positive donations would be expected per year, with 0.08 (0, 0.38) recipients suffering clinically significant TTB (1 every 12.5 years). In the localized incidence scenario, there were 0.21(0, 0.7) B. microti-NAT-positive donations, with 0.04 (0, 0.14) recipient infections (about 1 every 25 years). In the donor study informed scenario, there were 4.6 (0.3, 15.8) B. microti-NAT-positive donations expected, and 0.81 (0.05, 3.14) clinically significant TTB cases per year. DISCUSSION The likelihood of clinically relevant TTB is low. Testing would have very little utility in Canada at this time. Ongoing pathogen surveillance in tick vectors is important as B. microti prevalence appears to be slowly increasing in Canada.
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Affiliation(s)
- Sheila F O'Brien
- Epidemiology & Surveillance, Canadian Blood Services, Ottawa, Ontario, Canada.,School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Steven J Drews
- Department of Microbiology, Canadian Blood Services, Edmonton, Alberta, Canada.,Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta, Canada
| | - Qi-Long Yi
- Epidemiology & Surveillance, Canadian Blood Services, Ottawa, Ontario, Canada
| | - Evan M Bloch
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Nicholas H Ogden
- Public Health Risk Sciences Division, National Microbiology Laboratory, Public Health Agency of Canada, Saint-Hyacinthe, Quebec, Canada
| | - Jules K Koffi
- Public Health Risk Sciences Division, National Microbiology Laboratory, Public Health Agency of Canada, Saint-Hyacinthe, Quebec, Canada
| | - Leslie Robbin Lindsay
- Zoonotic Diseases & Special Pathogens, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - Yves Gregoire
- Epidemiology and Statistics, Héma-Québec, Quebec City, Quebec, Canada
| | - Gilles Delage
- Medical Microbiology, Héma-Québec, Montreal, Quebec, Canada
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8
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Gaussen A, Hornby L, Rockl G, O'Brien S, Delage G, Sapir-Pichhadze R, Drews SJ, Weiss MJ, Lewin A. Evidence of SARS-CoV-2 Infection in Cells, Tissues, and Organs and the Risk of Transmission Through Transplantation. Transplantation 2021; 105:1405-1422. [PMID: 33724248 DOI: 10.1097/tp.0000000000003744] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The emergence of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus responsible for the coronavirus disease 2019 (COVID-19) pandemic has raised concerns for programs overseeing donation and transplantation of cells, tissues, and organs (CTO) that this virus might be transmissible by transfusion or transplantation. Transplant recipients are considered particularly vulnerable to pathogens because of immunosuppression, and SARS-CoV-2 is likely to generate complications if contracted. Several signs and symptoms observed in COVID-19 positive patients reflect damage to multiple organs and tissues, raising the possibility of extrapulmonary SARS-CoV-2 infections and risk of transmission. At the beginning of the pandemic, a consensus has emerged not to consider COVID-19 positive patients as potential living or deceased donors, resulting in a global decrease in transplantation procedures. Medical decision-making at the time of organ allocation must consider safely alongside the survival advantages offered by transplantation. To address the risk of transmission by transplantation, this review summarizes the published cases of transplantation of cells or organs from donors infected with SARS-CoV-2 until January 2021 and assesses the current state of knowledge for the detection of this virus in different biologic specimens, cells, tissues, and organs. Evidence collected to date raises the possibility of SARS-CoV-2 infection and replication in some CTO, which makes it impossible to exclude transmission through transplantation. However, most studies focused on evaluating transmission under laboratory conditions with inconsistent findings, rendering the comparison of results difficult. Improved standardization of donors and CTO screening practices, along with a systematic follow-up of transplant recipients could facilitate the assessment of SARS-CoV-2 transmission risk by transplantation.
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Affiliation(s)
- Amaury Gaussen
- Medical Affairs and Innovation, Héma-Québec, Québec, QC, Canada
| | - Laura Hornby
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
- Canadian Blood Services, Ottawa, ON, Canada
| | - Gary Rockl
- Medical Affairs and Innovation, Héma-Québec, Québec, QC, Canada
| | | | - Gilles Delage
- Medical Affairs and Innovation, Héma-Québec, Saint-Laurent, QC, Canada
| | - Ruth Sapir-Pichhadze
- Centre for Outcomes Research and Evaluation (CORE), Research Institute of McGill University Health Centre, Montréal, QC, Canada
- Division of Nephrology and the Multi Organ Transplant Program, Royal Victoria Hospital, McGill University Health Centre, Montréal, QC, Canada
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, QC, Canada
| | - Steven J Drews
- Canadian Blood Services, Edmonton, AB, Canada
- Laboratory Medicine and Pathology, University of Alberta, Edmonton, AB, Canada
| | - Matthew J Weiss
- Population Health and Optimal Health Practices Research Unit, Trauma-Emergency-Critical Care Medicine, CHU de Québec, Université Laval Research Center, Québec, QC, Canada
- Pediatrics Department, Intensive Care Division, Faculté de Médecine, Université Laval, Québec, QC, Canada
- Transplant Québec, Montréal, QC, Canada
| | - Antoine Lewin
- Medical Affairs and Innovation, Héma-Québec, Saint-Laurent, QC, Canada
- Faculty of Medicine and Health Sciences, University of Sherbrooke, Sherbrooke, QC, Canada
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9
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Crowder LA, Wendel S, Bloch EM, O'Brien SF, Delage G, Sauleda S, Leiby DA. International survey of strategies to mitigate transfusion-transmitted Trypanosoma cruzi in non-endemic countries, 2016-2018. Vox Sang 2021; 117:58-63. [PMID: 34111301 DOI: 10.1111/vox.13164] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 05/20/2021] [Accepted: 05/22/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND OBJECTIVES Chagas disease, caused by Trypanosoma cruzi, is endemic to Mexico, Central and South America. While initially limited to the Americas, emigration of infected persons triggered geographically broader blood safety challenges. To mitigate transfusion-transmitted Chagas (TTC), transfusion services implemented approaches including risk factor questions and serologic testing. We sought to understand and compare strategies in non-endemic countries. MATERIALS AND METHODS Transfusion services in International Society of Blood Transfusion (ISBT)-affiliated organizations and members of the ISBT Working Party on Transfusion-Transmitted Infectious Diseases were invited to complete an online survey on T. cruzi mitigation strategies. The survey queried about cases of TTC, risk factors, testing methodology, educational materials, pathogen reduction, donor/product management, donor deferral and perceived public health concerns surrounding TTC. RESULTS Responses were received from 27 institutions in 22 countries. Most countries (77.3%) reported no historical TTC cases, while 18.2% reported 1-5 cases and 4.5% reported 6-10 cases. Concern about Chagas among the general public and public health authorities was low, but 12 of 25 blood centres reported moderate/high concern. Overall, 17 countries mitigated for TTC: 15 used risk factor questions and 10tested for T. cruzi antibodies. Ten countries used pathogen reduction but not specifically to prevent TTC. CONCLUSION While Chagas is rarely cited as a public health concern, blood centres in many non-endemic countries, including those outside the Americas, implemented measures to mitigate risk. Mitigation focussed on risk factors associated with Latin American immigrants and serologic testing. Thus, despite the rarity of TTC, many non-endemic countries continue to address it as an ongoing blood safety risk.
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Affiliation(s)
- Lauren A Crowder
- American Red Cross, Scientific Affairs, Rockville, Maryland, USA
| | | | - Evan M Bloch
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Sheila F O'Brien
- Epidemiology and Surveillance, Canadian Blood Services, Ottawa, Ontario, Canada
| | - Gilles Delage
- Medical Affairs - Microbiology, Héma-Québec, Montreal, Quebec, Canada
| | - Silvia Sauleda
- Transfusion Safety Laboratory, Catalonian Blood Bank (Banc de Sang i Teixits de Catalunya), Barcelona, Spain
| | - David A Leiby
- US Food and Drug Administration, CBER/OBRR, Silver Spring, Maryland, USA
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10
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Enok Bonong PR, Buteau C, Delage G, Tanner JE, Lacroix J, Duval M, Laporte L, Tucci M, Robitaille N, Spinella PC, Cuvelier G, Vercauteren S, Lewis V, Fearon M, Drews SJ, Alfieri C, Trottier H. Transfusion-related Epstein-Barr virus (EBV) infection: A multicenter prospective cohort study among pediatric recipients of hematopoietic stem cell transplants (TREASuRE study). Transfusion 2020; 61:144-158. [PMID: 33089891 DOI: 10.1111/trf.16149] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Revised: 08/31/2020] [Accepted: 09/11/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND Epstein-Barr virus (EBV) is carried in the blood of most adults, and transfusion-related infections have been reported. EBV is particularly deleterious in immunosuppressed transplant patients. The aim was to determine if EBV transmission occurred through leukodepleted blood product transfusion in pediatric recipients of hematopoietic stem cell transplants (HSCT). STUDY DESIGN AND METHODS This prospective Canadian multi-center cohort study includes 156 allogeneic HSCT pediatric recipients. The association between EBV and transfusion was analyzed using Cox regressions. EBV infection, defined by a PCR+ test in the blood of seronegative recipients of an EBV-negative graft, was monitored in order to correlate the recipient EBV strain with that of the blood donors. EBV genotypes were determined by PCR amplification followed by DNA sequencing at two loci (EBNA3b and LMP1). RESULTS No statistically significant associations were found between transfusions and EBV. One case of post-transplant EBV infection was identified among the 21 EBV-seronegative recipients receiving an EBV-negative graft. A total of 22 blood donors were retraced to determine whether the recipient's EBV strain matched that of a donor. One donor strain showed 100% sequence homology at the EBNA3b locus, but differed by one or two point mutations and by a 132-bp deletion at the LMP1 locus. The blood donor in question was alone among the 22 donors to show amplifiable virus in plasma. Blood from this donor readily produced an immortalized lymphoblastoid cell line in culture. CONCLUSION While considered a rare event, EBV transmission through transfusion may occur in the context of severe immunosuppression.
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Affiliation(s)
- Pascal R Enok Bonong
- Department of Social and Preventive Medicine, Université de Montréal, Sainte-Justine University Hospital, Montreal, Quebec, Canada
| | - Chantal Buteau
- Division of Infectious Diseases, Department of Pediatrics, Sainte-Justine University Hospital, Université de Montréal, Montreal, Quebec, Canada
| | - Gilles Delage
- Medical Affairs, Microbiology, Héma-Québec, Ville St-Laurent, Quebec, Canada
| | - Jerome E Tanner
- Sainte-Justine University Hospital, Montreal, Quebec, Canada
| | - Jacques Lacroix
- Division of Pediatric Intensive Care Medicine, Department of Pediatrics, Sainte-Justine University Hospital, Université de Montréal, Montreal, Quebec, Canada
| | - Michel Duval
- Division of Hematology-Oncology, Department of Pediatrics, Sainte-Justine University Hospital, Université de Montréal, Montreal, Quebec, Canada
| | - Louise Laporte
- Sainte-Justine University Hospital, Montreal, Quebec, Canada
| | - Marisa Tucci
- Division of Pediatric Intensive Care Medicine, Department of Pediatrics, Sainte-Justine University Hospital, Université de Montréal, Montreal, Quebec, Canada
| | - Nancy Robitaille
- Division of Hematology-Oncology, Department of Pediatrics, Sainte-Justine University Hospital, Université de Montréal and Medical Affairs, Transfusion Medicine, Héma-Québec, Ville Saint-Laurent, Quebec, Canada
| | - Philip C Spinella
- St. Louis Children's Hospital, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Geoffrey Cuvelier
- Department of Pediatrics and Child Health, CancerCare Manitoba, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Suzanne Vercauteren
- Department of Pathology and Laboratory Medicine, BC Children's Hospital, University of British Colombia, Vancouver, British Columbia, Canada
| | - Victor Lewis
- Department of Pediatrics and Department of Oncology, Alberta Children's Hospital, University of Calgary, Calgary, Alberta, Canada
| | - Margaret Fearon
- Medical Microbiology, Canadian Blood Services, Toronto, Ontario, Canada
| | - Steven J Drews
- Medical Affairs and Innovation, Microbiology, Canadian Blood Services and University of Alberta, Laboratory Medicine and Pathology, Edmonton, Alberta, Canada
| | - Carolina Alfieri
- Department of Microbiology, Infectiology and Immunology, Université de Montréal, Sainte-Justine University Hospital Research Centre, Université de Montréal, Montreal, Quebec, Canada
| | - Helen Trottier
- Department of Social and Preventive Medicine, Université de Montréal, Sainte-Justine University Hospital, Montreal, Quebec, Canada
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11
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Leblanc JF, Germain M, Delage G, OʼBrien S, Drews SJ, Lewin A. Risk of transmission of severe acute respiratory syndrome coronavirus 2 by transfusion: A literature review. Transfusion 2020; 60:3046-3054. [PMID: 32798237 PMCID: PMC7461295 DOI: 10.1111/trf.16056] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 07/26/2020] [Accepted: 07/26/2020] [Indexed: 12/15/2022]
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) is a novel human coronavirus responsible for coronavirus disease 2019 (COVID‐19). The emergence of this virus in Wuhan, China, at the end of 2019 and its worldwide spread to reach the pandemic stage has raised concerns about the possible risk that it might be transmissible by transfusion. This theoretical risk is further supported by reports of the detection of viral RNA in the blood of some infected individuals. To further address this risk, a thorough PubMed literature search was performed to systematically identify studies reporting data on the detection of SARS‐CoV‐2 RNA in blood or its components. Complementary searches were done to identify articles reporting data on the in vitro infectivity of blood components. At least 23 articles presenting data on the detection of SARS‐CoV‐2 RNA in blood, plasma, or serum were identified. Of these, three studies reported on blood donors with COVID‐19 infection identified after donation, and no cases of transfusion transmission were identified. A few studies mentioned results of in vitro infectivity assays of blood components in permissive cell lines, none of which were able to detect infectious virus in blood or its components. Complementary searches have identified reports demonstrating that the correlation between the presence of viral RNA in a biologic sample and infectivity requires a minimal RNA load, which is rarely, if ever, observed in blood components. Overall, the available evidence suggests that the risk of transmission of SARS‐CoV‐2 by transfusion remains theoretical.
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Affiliation(s)
| | - Marc Germain
- Medical Affairs and Innovation, Héma-Québec, Québec, Québec, Canada
| | - Gilles Delage
- Medical Affairs and Innovation, Héma-Québec, Saint-Laurent, Québec, Canada
| | | | | | - Antoine Lewin
- Medical Affairs and Innovation, Héma-Québec, Saint-Laurent, Québec, Canada.,Faculty of Medicine and Health Sciences, University of Sherbrooke, Sherbrooke, Québec, Canada
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12
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Delage G, O’brien S, Grégoire Y, Germain M. Évaluation canadienne du risque transfusionnel associé au virus de l’hépatite E selon le modèle de décision basé sur le risque (‘Risk Based Decision Making’). Transfus Clin Biol 2019. [DOI: 10.1016/j.tracli.2019.06.320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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13
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Tonnetti L, O'Brien SF, Grégoire Y, Proctor MC, Drews SJ, Delage G, Fearon MA, Brès V, Linnen JM, Stramer SL. Prevalence of
Babesia
in Canadian blood donors: June–October 2018. Transfusion 2019; 59:3171-3176. [DOI: 10.1111/trf.15470] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 07/09/2019] [Accepted: 07/09/2019] [Indexed: 02/02/2023]
Affiliation(s)
- Laura Tonnetti
- Scientific Affairs, American Red Cross Rockville Maryland
- Scientific Affairs, American Red Cross Gaithersburg Maryland
| | - Sheila F. O'Brien
- Canadian Blood Services Ottawa Ontario Canada
- Canadian Blood Services Toronto Ontario Canada
- Canadian Blood Services Edmonton Alberta Canada
| | - Yves Grégoire
- Medical Affairs and Innovation, Héma‐Québec Saint‐Laurent Quebec Canada
| | | | - Steven J. Drews
- Canadian Blood Services Ottawa Ontario Canada
- Canadian Blood Services Toronto Ontario Canada
- Canadian Blood Services Edmonton Alberta Canada
| | - Gilles Delage
- Medical Affairs and Innovation, Héma‐Québec Saint‐Laurent Quebec Canada
| | - Margaret A. Fearon
- Canadian Blood Services Ottawa Ontario Canada
- Canadian Blood Services Toronto Ontario Canada
- Canadian Blood Services Edmonton Alberta Canada
| | - Vanessa Brès
- Grifols Diagnostic Solutions Inc. San Diego California
| | | | - Susan L. Stramer
- Scientific Affairs, American Red Cross Rockville Maryland
- Scientific Affairs, American Red Cross Gaithersburg Maryland
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14
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Seed CR, Allain J, Lozano M, Laperche S, Gallian P, Gross S, Kwon S, Oh E, Kim J, Chua SS, Lam S, Ang AL, Tsoi W, Hewitt PE, Davison KL, Tettmar K, O'Flaherty N, Boland F, Williams P, Pomeroy L, Wendel S, Fachini R, Scuracchio P, Carminato P, Fearon M, O'Brien SF, Delage G, Kiely P, Hoad V, Matsubayashi K, Satake M, Taira R, Stramer SL, Sauleda S, Bes M, Piron M, El Ekiaby M, Vermeulen M, Levičnik Stezinar S, Nograšek P, Jarvis LM, Petrik J, Charlewood R, Flanagan P, Grabarczyk P, Kopacz A, Łętowska M, Seifried E, Schmidt M. International Forum on Occult hepatitis B infection and transfusion safety. Vox Sang 2019; 114:e1-e35. [DOI: 10.1111/vox.12743] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
| | | | | | - Syria Laperche
- Institut National de la Transfusion Sanguine Département des agents transmissibles par le sang Centre National de Référence Risques Infectieux Transfusionnels 6 rue Alexandre Cabanel Paris 75015 France
| | - Pierre Gallian
- Etablissement Français du Sang 20 Avenue du Stade de France La Plaine Saint‐Denis 93218 France
| | - Sylvie Gross
- Etablissement Français du Sang 20 Avenue du Stade de France La Plaine Saint‐Denis 93218 France
| | - So‐Yong Kwon
- Jungbu Blood Laboratory Center Korean Red Cross 22 Songchonam‐ro, Daedeok‐gu Daejeon Korea
| | - E.Y. Oh
- Jungbu Blood Laboratory Center Korean Red Cross 22 Songchonam‐ro, Daedeok‐gu Daejeon Korea
| | - J.N. Kim
- Division of Human Blood Safety Surveillance Korea Centers for Disease Control and Prevention Osong Korea
| | - Sze Sze Chua
- Health Sciences Authority Blood Services Group 11 Outram Road Singapore 169078 Singapore
| | - Sally Lam
- Health Sciences Authority Blood Services Group 11 Outram Road Singapore 169078 Singapore
| | - Ai Leen Ang
- Health Sciences Authority Blood Services Group 11 Outram Road Singapore 169078 Singapore
| | - Wai‐Chiu Tsoi
- Hong Kong Red Cross Blood Transfusion Service 15 King's Park Rise Kowloon Hong Kong China
| | | | - Katy L. Davison
- NHS Blood and Transplant Public Health England Epidemiology Unit Colindale Avenue Colindale UK
| | - Kate Tettmar
- NHS Blood and Transplant Colindale Centre Charcot Road Colindale UK
| | - Niamh O'Flaherty
- Irish Blood Transfusion Service National Blood Centre St. James's Gate Dublin 8 Ireland
| | - Fiona Boland
- Irish Blood Transfusion Service National Blood Centre St. James's Gate Dublin 8 Ireland
| | - Padraig Williams
- Irish Blood Transfusion Service National Blood Centre St. James's Gate Dublin 8 Ireland
| | - Louise Pomeroy
- Irish Blood Transfusion Service National Blood Centre St. James's Gate Dublin 8 Ireland
| | - Silvano Wendel
- Hospital Sirio Libanês Rua Adma Jafet 91 São Paulo 01308‐050 Brasil
| | - Roberta Fachini
- Hospital Sirio Libanês Rua Adma Jafet 91 São Paulo 01308‐050 Brasil
| | | | | | | | | | - Gilles Delage
- Héma Québec 4045 boul. Cote‐Vertu ville Saint Laurent QC Canada
| | - Philip Kiely
- Australian Red Cross Blood Service 100‐154 Batman Street West Melbourne VIC 3003 Australia
| | - Veronica Hoad
- Australian Red Cross Blood Service 290 Wellington Street Perth WA 6000 Australia
| | - Keiji Matsubayashi
- Central Blood Institute Blood Service Headquarters Japanese Red Cross Society 2‐1‐67 Tatsumi, Koto‐ku Tokyo Japan
| | - Masahiro Satake
- Central Blood Institute Blood Service Headquarters Japanese Red Cross Society 2‐1‐67 Tatsumi, Koto‐ku Tokyo Japan
| | - Rikizo Taira
- Technical Department Blood Service Headquarters Japanese Red Cross Society 1‐2‐1 Shibakoen, Minato‐ku Tokyo Japan
| | | | - Silvia Sauleda
- Transfusion Safety Laboratory Banc de Sang i Teixits Doctor Frederic Duran i Jorda Building, Passeig Taulat, 116 08005 Barcelona Spain
| | - Marta Bes
- Transfusion Safety Laboratory Banc de Sang i Teixits Doctor Frederic Duran i Jorda Building, Passeig Taulat, 116 08005 Barcelona Spain
| | - Maria Piron
- Transfusion Safety Laboratory Banc de Sang i Teixits Doctor Frederic Duran i Jorda Building, Passeig Taulat, 116 08005 Barcelona Spain
| | - Magdy El Ekiaby
- Shabrawishi Hospital Blood Transfusion Centre Finni Square Dokki, Giza Egypt
| | - Marion Vermeulen
- The South African National Blood Service 1 Constantia Boulevard, ConstantiaKloof Roodepoort, Gauteng South Africa
| | | | - Polona Nograšek
- Blood Transfusion Centre of Slovenia Šlajmerjeva 6 SI‐1000 Ljubljana Slovenia
| | - Lisa M. Jarvis
- Scottish National Blood Transfusion Service The Jack Copland Centre 52 Research Avenue North Edinburgh EH14 4BE UK
| | - Juraj Petrik
- Scottish National Blood Transfusion Service The Jack Copland Centre 52 Research Avenue North Edinburgh EH14 4BE UK
| | - Richard Charlewood
- New Zealand Blood Service 71 Great South Road Epsom, Auckland New Zealand
| | - Peter Flanagan
- New Zealand Blood Service 71 Great South Road Epsom, Auckland New Zealand
| | - Piotr Grabarczyk
- Department of Virology Institute of Hematology and Transfusion Medicine Gandhi Str. 14th 02 776 Warsaw Poland
| | - Aneta Kopacz
- Department of Virology Institute of Hematology and Transfusion Medicine Gandhi Str. 14th 02 776 Warsaw Poland
| | - Magdalena Łętowska
- Department of Transfusion Institute of Hematology and Transfusion Medicine Gandhi Str. 14th 02 776 Warsaw Poland
| | - Erhard Seifried
- German Red Cross Institute for Transfusion medicine and Immunohematology German Red Cross Baden‐Wuerrtemberg – Hesse Goethe University Frankfurt Sandhof Street 1 60528 Frankfurt
| | - Michael Schmidt
- German Red Cross Institute for Transfusion medicine and Immunohematology German Red Cross Baden‐Wuerrtemberg – Hesse Goethe University Frankfurt Sandhof Street 1 60528 Frankfurt
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15
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Leiby DA, O'Brien SF, Wendel S, Nguyen ML, Delage G, Devare SG, Hardiman A, Nakhasi HL, Sauleda S, Bloch EM. International survey on the impact of parasitic infections: frequency of transmission and current mitigation strategies. Vox Sang 2018; 114:17-27. [PMID: 30523642 DOI: 10.1111/vox.12727] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 10/25/2018] [Accepted: 10/29/2018] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND OBJECTIVES Globally, blood safety interventions have been successful in mitigating risk of the major transfusion-transmitted (TT) viruses. However, strategies that address risk from parasites are comparatively limited. TT parasites are often regional in nature, posing unique challenges; we sought to understand their impact on blood safety. MATERIALS AND METHODS An electronic questionnaire was distributed to transfusion medicine leaders in 100 countries. The survey focused on specific questions pertaining to four parasitic diseases: babesiosis, Chagas, leishmaniasis and malaria. Respondents provided data on historical TT cases, local epidemiology, policies to mitigate risk and an assessment of public health perceptions for each aetiologic agent. RESULTS Twenty-eight (28%) surveys were returned from countries in Europe (n = 13), the Americas (n = 6), Africa (n = 4), Asia (n = 3) and Oceana (n = 2). Historically, no cases of TT leishmaniasis were reported, TT babesiosis was exclusive to Canada and the USA, TT Chagas was limited to the Americas and Spain, while TT malaria was cosmopolitan. Mitigation efforts varied widely; malaria was the most frequently tested parasitic disease. The public's perception of risk for parasitic agents was low, while that of health authorities in endemic countries was higher. CONCLUSION The global impact of parasitic infections on blood safety and related mitigation efforts varied widely by parasite epidemiology, test availability, public health priorities and socioeconomic constraints. While parasites continue to pose a risk to blood safety, the successful mitigation of viral risk has elevated the prominence of TT parasites in many locations, thereby requiring consideration of mitigation efforts.
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Affiliation(s)
- David A Leiby
- Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, MD, USA
| | - Sheila F O'Brien
- Epidemiology and Surveillance, Canadian Blood Services, Ottawa, ON, USA
| | | | - Megan L Nguyen
- Transmissible Diseases Department, American Red Cross Holland Laboratory, Rockville, MD, USA
| | - Gilles Delage
- Medical Affairs, Microbiology, Héma-Quebec, Montreal, Quebec, Canada
| | | | | | - Hira L Nakhasi
- Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, MD, USA
| | - Silvia Sauleda
- Transfusion Safety Laboratory, Catalonian Blood Bank (Banc de Sang i Teixits de Catalunya), Barcelona, Spain
| | - Evan M Bloch
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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16
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O'Brien SF, Yi QL, Goldman M, Grégoire Y, Delage G. Human T-cell lymphotropic virus: A simulation model to estimate residual risk with universal leucoreduction and testing strategies in Canada. Vox Sang 2018; 113:750-759. [DOI: 10.1111/vox.12722] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Revised: 09/27/2018] [Accepted: 09/27/2018] [Indexed: 10/27/2022]
Affiliation(s)
- Sheila F. O'Brien
- Canadian Blood Services; Ottawa ON Canada
- School of Epidemiology & Public Health; University of Ottawa; Ottawa ON Canada
| | - Qi-Long Yi
- Canadian Blood Services; Ottawa ON Canada
- School of Epidemiology & Public Health; University of Ottawa; Ottawa ON Canada
| | - Mindy Goldman
- Canadian Blood Services; Ottawa ON Canada
- Department of Pathology & Laboratory Medicine; University of Ottawa; Ottawa ON Canada
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17
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Grégoire Y, Germain M, Delage G. Factors associated with a second deferral among donors eligible for re-entry after a false-positive screening test for syphilis, HCV, HBV and HIV. Vox Sang 2018; 113:339-344. [PMID: 29508402 DOI: 10.1111/vox.12644] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Revised: 02/02/2018] [Accepted: 02/04/2018] [Indexed: 12/31/2022]
Abstract
BACKGROUND AND OBJECTIVES Since 25 May 2010, all donors at our blood centre who tested false-positive for HIV, HBV, HCV or syphilis are eligible for re-entry after further testing. Donors who have a second false-positive screening test, either during qualification for or after re-entry, are deferred for life. This study reports on factors associated with the occurrence of such deferrals. MATERIALS AND METHODS Rates of second false-positive results were compared by year of deferral, transmissible disease marker, gender, age, donor status (new or repeat) and testing platform (same or different) both at qualification for re-entry and afterwards. Chi-square tests were used to compare proportions. Cox regression was used for multivariate analyses. RESULTS Participation rates in the re-entry programme were 42·1%: 25·6% failed to qualify for re-entry [different platform: 2·7%; same platform: 42·9% (P < 0·0001)]. After re-entry, rates of deferral for second false-positive results were 8·4% after 3 years [different platform: 1·8%; same platform: 21·4% (P < 0·0001)]. Deferral rates were higher for HIV and HCV than for HBV at qualification when tested on the same platform. The risk, when analysed by multivariate analyses, of a second deferral for a false-positive result, both at qualification and 3 years after re-entry, was lower for donors deferred on a different platform; this risk was higher for HIV, HCV and syphilis than for HBV and for new donors if tested on the same platform. CONCLUSION Re-entry is more often successful when donors are tested on a testing platform different from the one on which they obtained their first false-positive result.
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Affiliation(s)
| | - M Germain
- Héma-Québec, Quebec City, QC, Canada
| | - G Delage
- Héma-Québec, Montréal, QC, Canada
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18
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Girard M, Laforce-Lavoie A, de Grandmont MJ, Cayer MP, Fournier D, Delage G, Thibault L. Optimization of cord blood unit sterility testing: impact of dilution, analysis delay, and inhibitory substances. Transfusion 2017; 57:1956-1967. [PMID: 28474347 DOI: 10.1111/trf.14147] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Revised: 03/22/2017] [Accepted: 03/27/2017] [Indexed: 12/17/2022]
Abstract
BACKGROUND Different methods are used by cord blood banks to prepare samples for sterility testing. Suboptimal methods can result in the release of contaminated products. In our organization, samples are prepared by diluting the final product in RPMI-1640 medium. In this work, we have compared our method with different approaches to verify whether optimization should be sought. STUDY DESIGN AND METHODS Cord blood units (n = 6 units per bacterial strain) characterized to contain inhibitory substances or not were inoculated (10 colony-forming units/mL) with Streptococcus agalactiae, Staphylococcus epidermidis, Klebsiella pneumoniae, Escherichia coli, or Bacteroides fragilis. After plasma and red blood cell removal, stem cell concentrates were diluted in RPMI-1640, thioglycollate, or the unit's plasma. These products, as well as final product, plasma, and red blood cell fractions, were held from 0 to 72 hours at 20 to 24°C before inoculation in culture bottles and detection using the BacT/ALERT 3D system. RESULTS Dilution of cell concentrates in RPMI-1640 allowed bacterial detection in 93.3% of noninhibitory cord blood samples after a 24-hour storage period. Thioglycollate medium better promoted bacterial growth in inhibitory cord blood samples that were held for 72 hours before testing (66.7%) compared with RPMI-1640 (45.0%). Less than 33% of all spiked plasma samples were detected by the BacT/ALERT 3D system. CONCLUSION Diluting cord blood samples in culture medium containing bacterial growth promoting substances is a suitable option for sterility testing, whereas the use of plasma should be proscribed, because it might lead to false-negative results. Because inhibitory substances affect bacterial growth, inoculation of culture bottles should be done rapidly after sample preparation.
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Affiliation(s)
- Mélissa Girard
- Research and Development, Héma-Québec, Québec, Québec, Canada
| | | | | | | | | | - Gilles Delage
- Medical Affairs, Héma-Québec, Montréal, Québec, Canada
| | - Louis Thibault
- Research and Development, Héma-Québec, Québec, Québec, Canada
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19
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Germain M, Delage G, O'Brien SF, Grégoire Y, Fearon M, Devine D. Mitigation of the threat posed to transfusion by donors traveling to Zika-affected areas: a Canadian risk-based approach. Transfusion 2017; 57:2463-2468. [PMID: 28758222 DOI: 10.1111/trf.14247] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Revised: 05/30/2017] [Accepted: 05/30/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND The recent spread of the Zika virus to the Americas and the recognition that it can cause severe disease in the developing fetus has prompted the adoption of measures to mitigate the risk that this virus might pose to transfusion safety. In nonendemic countries, the risk to transfusion results from donors traveling to an endemic region. Canada implemented a 21-day temporary deferral for prospective donors who traveled to such regions. We present the rationale for this policy, including a quantitative risk assessment supported by a Monte Carlo simulation. STUDY DESIGN AND METHODS The model considered the following parameters, each with specified values and ranges: the probability that a donor recently returned from a Zika-endemic region, the duration of travel to this region, the daily risk of acquiring Zika while in an endemic region, and the incubation and viremic periods. We ran the simulation 20 times, each with 10 million iterations. RESULTS In the absence of any travel deferral, 32 donors (range, 20-46 donors) would be able to donate while still being at risk of transmitting Zika, corresponding to a rate of 1:312,500 (range, 1:217,000 to 1:500,000). None of these donors would be viremic beyond 21 days after returning from their travel, with a risk estimated at less than 1:200,000,000. CONCLUSIONS A 21-day temporary travel deferral offers an extremely wide margin of safety for the possible transmission of Zika by a donation obtained from someone who recently returned from a country where the virus is circulating.
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Affiliation(s)
- Marc Germain
- Medical Affairs, Héma-Québec, Montréal, Québec, Canada
| | - Gilles Delage
- Medical Affairs, Héma-Québec, Montréal, Québec, Canada
| | | | - Yves Grégoire
- Medical Affairs, Héma-Québec, Montréal, Québec, Canada
| | | | - Dana Devine
- Canadian Blood Services, Ottawa, Ontario, Canada
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20
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Fearon MA, O'Brien SF, Delage G, Scalia V, Bernier F, Bigham M, Weger S, Prabhu S, Andonov A. Hepatitis E in Canadian blood donors. Transfusion 2017; 57:1420-1425. [PMID: 28394029 DOI: 10.1111/trf.14089] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Revised: 01/19/2017] [Accepted: 01/19/2017] [Indexed: 12/25/2022]
Abstract
BACKGROUND Hepatitis E virus (HEV) is a virus of emerging importance to transfusion medicine as studies on blood donors and other populations demonstrate that the prevalence of endemic cases is higher than previously recognized and the risk to vulnerable transfusion recipients is not insignificant. STUDY DESIGN AND METHODS We carried out an HEV prevalence study on 13,993 Canadian blood donors with polymerase chain reaction (PCR) testing on all donors and antibody testing on a subset of 4102 donors. HEV antibody-positive and age- and sex-matched antibody-negative donors were invited to participate in a scripted telephone interview about risk factors. RESULTS There were no PCR-positive samples found (95% confidence interval [CI], 0%-0.026%). The seroprevalence of HEV in our tested population was 5.9% (95% CI, 5.16%-6.59%). HEV antibody positivity was associated with male sex and increasing age. In case-control analysis history of living outside Canada (odds ratio [OR], 2.9; 95% CI, 1.56-5.32) and contact with farm animals (OR, 1.5; 95% CI, 1.01-2.28) were associated with HEV seropositivity. CONCLUSION This is the largest data set to date on HEV infection in Canada. Results suggest low lifetime exposure to HEV and that infectious donations are rare.
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Affiliation(s)
- Margaret A Fearon
- Canadian Blood Services, Toronto, Ontario, Canada.,Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
| | - Sheila F O'Brien
- Canadian Blood Services, Ottawa, Ontario, Canada.,University of Ottawa, School of Epidemiology, Public Health and Preventative Medicine, Ottawa, Ontario, Canada
| | - Gilles Delage
- Microbiology, Héma-Québec, Saint-Laurent, Québec, Canada
| | - Vito Scalia
- Canadian Blood Services, Ottawa, Ontario, Canada
| | - France Bernier
- Microbiology, Héma-Québec, Saint-Laurent, Québec, Canada
| | - Mark Bigham
- Medical Department, Canadian Blood Services, BC and Yukon, Vancouver, British Columbia, Canada
| | - Steven Weger
- University of Manitoba, Winnipeg, Manitoba, Canada
| | - Sneha Prabhu
- Institute for Health Promotion Research, University of Texas Medical School at San Antonio, San Antonio, Texas
| | - Anton Andonov
- Molecular and Immunodiagnostics, Bloodborne Pathogens and Hepatitis, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
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21
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Delage G, Dubuc S, Grégoire Y, Lowe AM, Bernier F, Germain M. Determining the rate of underrecognition of West Nile virus neurologic disease in the province of Quebec in 2012. Transfusion 2017; 57:1294-1298. [PMID: 28301049 DOI: 10.1111/trf.14081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Revised: 01/09/2017] [Accepted: 01/28/2017] [Indexed: 11/30/2022]
Abstract
BACKGROUND During a major outbreak of West Nile virus (WNV) infection in the province of Quebec in 2012, public health authorities (PHAs) suspected underrecognition of West Nile neurologic disease (WNND). With data on acute infections detected in blood donors, an estimate of the degree of underrecognition was produced. STUDY DESIGN AND METHODS All 2012 donors were tested for WNV infection with the use of reverse transcription-polymerase chain reaction (RT-PCR). With the number of cases detected, the number of donors tested, our estimate of the duration of viremia, an estimate of the population at risk, and the ratio of WNND to total cases, an expected number of WNND cases was calculated. A Monte Carlo simulation was used to estimate the range of several of these variables. RESULTS Seventeen RT-PCR-positive donors were found among 52,309 donations tested. In the base case, the total number of cases was 16,095 and the expected number of WNND cases was 115. In the Monte Carlo simulation, the mean number of expected WNND cases was 136, and the median was 129. Since only 85 cases were reported to PHAs, it is estimated that between 26 and 37.5% of cases occurring in the province went undetected. CONCLUSION The observation that close to one-third of cases of WNND went undetected because of the omission of appropriate laboratory testing indicates the need for improvement in the investigation of acute neurologic syndrome of suspected infectious etiology in Québec.
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Affiliation(s)
| | | | | | - Anne-Marie Lowe
- Institut National de Santé Publique du Québec, Montréal, Québec, Canada
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Zeller MP, Arnold DM, Al Habsi K, Cserti‐Gazdewich C, Delage G, Lebrun A, Heddle NM. Paroxysmal cold hemoglobinuria: a difficult diagnosis in adult patients. Transfusion 2016; 57:137-143. [DOI: 10.1111/trf.13888] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Revised: 08/25/2016] [Accepted: 08/31/2016] [Indexed: 11/30/2022]
Affiliation(s)
- Michelle P. Zeller
- Department of MedicineMcMaster University
- Canadian Blood ServicesHamilton Ontario Canada
| | - Donald M. Arnold
- Department of MedicineMcMaster University
- Canadian Blood ServicesHamilton Ontario Canada
| | - Khalid Al Habsi
- Department of Blood Bank ServicesMinistry of HealthMuscat Oman
| | | | | | | | - Nancy M. Heddle
- Department of MedicineMcMaster University
- Canadian Blood ServicesHamilton Ontario Canada
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Goldman M, Magnussen K, Gorlin J, Lozano M, Speedy J, Keller A, Pink J, Leung JNS, Chu CCY, Lee CK, Faed J, Chay J, Tan HH, Teo D, Djoudi R, Woimant G, Fillet AM, Castrén J, Miflin G, Vandewalle GC, Compernolle V, Cardenas JM, Infanti L, Holbro A, Buser A, van den Hurk K, Yahalom VJ, Gendelman V, Shinar E, Eder AF, Steele WR, O'Neill EM, Kamel H, Vassallo R, Delage G, Lebrun A, Robillard P, Germain M, Gandhi M, West KA, Klein HG. International Forum regarding practices related to donor haemoglobin and iron. Vox Sang 2016; 111:449-455. [DOI: 10.1111/vox.12431] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- M. Goldman
- Medical Services and Innovation; Canadian Blood Services; Ottawa ON Canada
| | - K. Magnussen
- Clinical Immunology/Blood Centre; Copenhagen University Hospital; Hvidovre Denmark
| | - J. Gorlin
- Physician Services; Innovative Blood Centers; St. Paul MN USA
| | - M. Lozano
- Hospital Clinic; Department of Hemotherapy and Hemostasis; Barcelona Spain
| | - J. Speedy
- Australian Red Cross Blood Service; Adelaide South Australia Australia
| | - A. Keller
- Australian Red Cross; Perth Western Australia Australia
| | - J. Pink
- Australian Red Cross Blood Service; Stafford Queensland Australia
| | - J. N. S. Leung
- Blood Collection and Donor Recruitment Department; Hong Kong Red Cross Blood Transfusion Service; Kowloon Hong Kong
| | - C. C. Y. Chu
- Blood Collection and Donor Recruitment Department; Hong Kong Red Cross Blood Transfusion Service; Kowloon Hong Kong
| | - C.-K. Lee
- Blood Collection and Donor Recruitment Department; Hong Kong Red Cross Blood Transfusion Service; Kowloon Hong Kong
| | - J. Faed
- Otago Site, New Zealand Blood Service; Department of Haematology; University of Otago; Dunedin New Zealand
| | - J. Chay
- Blood Services Group; Health Sciences Authority; 11 Outram Road Singapore City 169078 Singapore
| | - H. H. Tan
- Blood Services Group; Health Sciences Authority; 11 Outram Road Singapore City 169078 Singapore
| | - D. Teo
- Centre for Transfusion Medicine; Singapore City Singapore
| | - R. Djoudi
- Qualification Biologique du Don; Etablissement Français du Sang; St. Denis France
| | - G. Woimant
- EFS, Médecine, la Recherche et l'Innovation; La Plaine Saint-Denis France
| | - A.-M. Fillet
- Medical Department; Etablisement Français du Sang; 20 Avenue du Stade de France La Plaine Saint-Denis 93218 France
| | - J. Castrén
- Medical Support in Blood Donation; Finnish Red Cross Blood Service; Kivihaantie 7 Helsinki FI-00310 Finland
| | - G. Miflin
- NHS Blood and Transplant; Watford UK
| | | | - V. Compernolle
- Blood Services; Belgian Red Cross; Ottergemsesteenweg 413 Ghent B-9000 Belgium
| | - J. M. Cardenas
- Tejidos Humanos; Centro Vasco de Transfusion y Tejidos Humanos; Labeaga s/n Galdakao 48960 Spain
| | - L. Infanti
- Blood Donation Center; Swiss Red Cross; Hebelstrasse 10 Basel CH-4031 Switzerland
| | - A. Holbro
- Blood Transfusion Centre; Swiss Red Cross; Hebelstrasse 10 Basel CH-4031 Switzerland
- Department of Hematology; University Hospital Basel; Basel Switzerland
| | - A. Buser
- Blood Transfusion Centre; Swiss Red Cross; Hebelstrasse 10 Basel CH-4031 Switzerland
- Department of Hematology; University Hospital Basel; Basel Switzerland
| | - K. van den Hurk
- Donor Studies; Sanquin Research; Plesmanlaan 125 Amsterdam 1066 CX The Netherlands
| | - V. J. Yahalom
- National Blood Services; Magen David Adom-National Blood Services; Ramat Gan 5262100 Israel
| | - V. Gendelman
- National Blood Services; Magen David Adom-National Blood Services; Ramat Gan 5262100 Israel
| | - E. Shinar
- National Blood Services; Magen David Adom-National Blood Services; Ramat Gan 5262100 Israel
| | - A. F. Eder
- Biomedical Headquarters; American Red Cross; 15601 Crabbs Branch Way Rockville MD 20855 USA
| | - W. R. Steele
- Transmissible Disease Department; American Red Cross; 15601 Crabbs Branch Way Rockville MD 20855 USA
| | - E. M. O'Neill
- National Headquarters; Biomedical Services; American Red Cross; 15601 Crabbs Branch Way Rockville MD 20855 USA
| | - H. Kamel
- Medical Affairs; Blood Systems, Inc.; 6210 E. Oak Street Scottsdale AZ 85257 USA
| | - R. Vassallo
- Blood Systems, Inc.; 6210 E. Oak Street Scottsdale AZ 85257 USA
| | - G. Delage
- Medical Affairs; Héma-Quebec; 4045 boul. Cote-Vertu, Ville Saint-Laurent Montreal QC Canada
| | - A. Lebrun
- Medical Affairs; Héma-Quebec; 4045 boul. Cote-Vertu, Ville Saint-Laurent Montreal QC Canada
| | - P. Robillard
- Medical Affairs; Héma-Quebec; 4045 boul. Cote-Vertu, Ville Saint-Laurent Montreal QC Canada
| | - M. Germain
- Medical Affairs; Héma-Quebec; 4045 boul. Cote-Vertu, Ville Saint-Laurent Montreal QC Canada
| | - M. Gandhi
- Laboratory of Medicine and Pathology; Mayo Clinic Minnesota; 200 1st Street SW Rochester MN 55905 USA
| | - K. A. West
- Department of Transfusion Medicine; National Institutes of Health Clinical Center; 10 Center Drive, Room 1N226 Bethesda MD 20892 USA
| | - H. G. Klein
- Department of Transfusion Medicine; National Institute of Health; Warren G. Magnuson Clinical Center; 10 Center Drive, Room IC711 Bethesda MD 20892 USA
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Germain M, Delage G, Robillard P, Katz LM, Grégoire Y. The association between frequency of blood donation and the occurrence of low birthweight, preterm delivery, and stillbirth: a retrospective cohort study. Transfusion 2016; 56:2760-2767. [PMID: 27515226 DOI: 10.1111/trf.13762] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Revised: 06/21/2016] [Accepted: 06/21/2016] [Indexed: 12/27/2022]
Abstract
BACKGROUND Women who donate blood on a regular basis are at high risk of becoming iron depleted. Iron deficiency anemia has been shown to increase the risk of low birthweight and possibly preterm birth. Therefore, there is a concern that regular blood donation by female donors might adversely impact the well-being of their offspring. This retrospective cohort study examined the association between blood donation and the occurrence of adverse pregnancy outcomes. STUDY DESIGN AND METHODS The study sample included 18,483 female blood donors in their childbearing years (age 18 to 45 years) who delivered during the period 2001 to 2011 in the province of Québec (Canada). The occurrence of low birthweight (<2500 g), preterm delivery (<37 weeks of gestation), and stillbirth was ascertained by linking the donor information with provincial birth and stillbirth registries. RESULTS There was no association between the frequency of donation in the 2-year period before pregnancy and adverse pregnancy outcomes; compared to women who did not donate during that period, those who donated three or more donations (mean, 3.9 donations) had a relative risk of 0.83 (95% confidence interval [CI], 0.65-1.06) for low birthweight, 0.91 (95% CI, 0.75-1.11) for preterm birth, and 0.62 (95% CI, 0.18-2.12) for stillbirth. These associations remained unchanged after adjusting for baseline characteristics. CONCLUSION Women who donate blood on a regular but moderate basis do not appear to be at higher risk of adverse pregnancy outcomes. These findings, while reassuring, will need to be replicated in different settings.
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Affiliation(s)
- Marc Germain
- Medical Affairs, Héma-Québec, Montréal, Québec, Canada
| | - Gilles Delage
- Medical Affairs, Héma-Québec, Montréal, Québec, Canada
| | | | - Louis M Katz
- America's Blood Centers, Washington, DC.,Carver College of Medicine Division of Infectious Diseases, Iowa City, Iowa
| | - Yves Grégoire
- Medical Affairs, Héma-Québec, Montréal, Québec, Canada
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25
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O'Brien SF, Delage G, Scalia V, Lindsay R, Bernier F, Dubuc S, Germain M, Pilot G, Yi QL, Fearon MA. Seroprevalence of Babesia microti infection in Canadian blood donors. Transfusion 2015; 56:237-43. [PMID: 26426217 DOI: 10.1111/trf.13339] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2015] [Revised: 07/29/2015] [Accepted: 07/30/2015] [Indexed: 12/24/2022]
Abstract
BACKGROUND Human babesiosis, caused by the intraerythrocytic protozoan parasite Babesia microti, is primarily transmitted by tick bites and is also transmitted by transfusion. Infections have been identified in U.S. blood donors close to Canadian borders. We aimed to assess the risk of transfusion-transmitted babesiosis in Canada by examining infections in ticks and seroprevalence in blood donors. STUDY DESIGN AND METHODS Passive surveillance (receipt of ticks submitted by the public) was used to identify regions for tick drag sampling (active surveillance, 2009-2014). All ticks were tested for B. microti using an indirect immunofluorescent antibody assay (Imugen, Inc.). Between July and December 2013, blood donations from selected sites (southern Manitoba, Ontario, Québec, New Brunswick, and Nova Scotia) near endemic U.S. regions were tested for antibody to B. microti. Donors completed a questionnaire about risk travel and possible tick exposure. RESULTS Of approximately 12,000 ticks submitted, 14 were B. microti positive (10 in Manitoba, one in Ontario, one in Québec, two in New Brunswick). From active tick surveillance, six of 361 ticks in Manitoba were positive (1.7%), three of 641 (0.5%) in Québec, and none elsewhere. There were 26,260 donors at the selected sites of whom 13,993 (53%) were tested. None were positive for antibody to B. microti. In 2013, 47% of donors visited forested areas in Canada, and 41% traveled to the United States. CONCLUSION The data do not suggest that laboratory-based testing is warranted at this time. However, there are indicators that B. microti may be advancing into Canada and ongoing monitoring of tick populations and donor seroprevalence is indicated.
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Affiliation(s)
| | | | - Vito Scalia
- Canadian Blood Services, Ottawa, Ontario, Canada
| | - Robbin Lindsay
- Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | | | | | | | - Gerry Pilot
- Canadian Blood Services, Ottawa, Ontario, Canada
| | - Qi-Long Yi
- Canadian Blood Services, Ottawa, Ontario, Canada
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26
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Trottier H, Delage G, Hu J, Robitaille N, Buteau C, Tucci M, Lacroix J, Alfieri C. Detection of Epstein-Barr virus in leucoreduced blood products. Vox Sang 2015; 110:199-201. [PMID: 26383177 DOI: 10.1111/vox.12330] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2015] [Revised: 08/10/2015] [Accepted: 08/10/2015] [Indexed: 12/01/2022]
Abstract
This study examined the prevalence of three human herpesviruses (HHV), namely HHV-4 (Epstein-Barr virus/EBV), HHV-6b and HHV-7 in leucoreduced blood products obtained from the Sainte-Justine Hospital blood bank. A total of 100 specimens, including 34 red blood cell concentrates, 33 platelet bags and 33 plasma units, were collected and screened by a sensitive PCR assay using virus-specific primers. Positive units were then retested by quantitative PCR. Of the 100 specimens, one platelet unit tested positive for EBV.
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Affiliation(s)
- H Trottier
- Department of Social and Preventive Medicine, Université de Montréal, Sainte-Justine Hospital, Montreal, QC, Canada
| | - G Delage
- Medical Affairs, Héma-Québec, Ville Saint-Laurent, QC, Canada
| | - J Hu
- Research Center, Sainte-Justine Hospital, Montreal, QC, Canada
| | - N Robitaille
- Department of Pediatrics, Division of Hematology-Oncology, Sainte-Justine Hospital, Université de Montréal, Montreal, QC, Canada
| | - C Buteau
- Department of Pediatrics, Division of Infectious Diseases, Sainte-Justine Hospital, Université de Montréal, Montreal, QC, Canada
| | - M Tucci
- Department of Pediatrics, Division of Pediatric Intensive Care Medicine, Sainte-Justine Hospital, Université de Montréal, Montreal, QC, Canada
| | - J Lacroix
- Department of Pediatrics, Division of Pediatric Intensive Care Medicine, Sainte-Justine Hospital, Université de Montréal, Montreal, QC, Canada
| | - C Alfieri
- Department of Pediatrics, Division of Infectious Diseases, Sainte-Justine Hospital, Université de Montréal, Montreal, QC, Canada
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27
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Petrik J, Lozano M, Seed CR, Faddy HM, Keller AJ, Prado Scuracchio PS, Wendel S, Andonov A, Fearon M, Delage G, Zhang J, Shih JWK, Gallian P, Djoudi R, Tiberghien P, Izopet J, Dreier J, Vollmer T, Knabbe C, Aggarwal R, Goel A, Ciccaglione AR, Matsubayashi K, Satake M, Tadokoro K, Jeong SH, Zaaijer HL, Zhiburt E, Chay J, Teo D, Chua SS, Piron M, Sauleda S, Echevarría JM, Dalton H, Stramer SL. Hepatitis E. Vox Sang 2015. [PMID: 26198159 DOI: 10.1111/vox.12285] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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28
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Delage G, Grégoire Y, Lebrun A. Double red blood cell donors with increased ferritin levels: a descriptive study. Transfusion 2015; 55:2842-6. [PMID: 26174004 DOI: 10.1111/trf.13234] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Revised: 06/09/2015] [Accepted: 06/09/2015] [Indexed: 11/27/2022]
Abstract
BACKGROUND One of the measures proposed to mitigate iron loss in blood donors is monitoring of their ferritin levels. Occasionally, high ferritin levels are found in monitored donors. We report the results of the clinical and laboratory investigation of 80 double red blood cell (DRBC) donors with high ferritin levels. STUDY DESIGN AND METHODS All DRBC donors' ferritin levels were measured during each visit for a donation. Donors with high ferritin levels who agreed to participate underwent a clinical and laboratory evaluation. RESULTS A total of 165 of 2757 DRBC donors had at least one high ferritin level. Five were already known to suffer from hemochromatosis. A full investigation was available for 80 other donors. A total of 61 of 80 donors had normalized their ferritin level at the time of their laboratory evaluation. Only 16 donors had high serum iron levels, of whom four had increased saturation index. Genetic analysis gave the following results: C282Y homozygous, two; H63D homozygous, six; C282Y/HC3D double heterozygote, six; C282Y heterozygote, six; H63D heterozygote, 19; and no mutations, 39. None of the other laboratory investigations contributed data explaining the high ferritin levels observed. CONCLUSION In most donors with high ferritin levels, the phenomenon was transient, with normal ferritin levels found in follow-up. Less than 10% of these donors had evidence of iron overload. Only eight were homozygous for mutations associated with hemochromatosis. An extensive laboratory investigation by the treating physician should only be recommended in donors with persistently high ferritin levels.
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Affiliation(s)
- Gilles Delage
- Medical Affairs, Héma-Québec, Saint-Laurent, Quebec, Canada
| | - Yves Grégoire
- Medical Affairs, Héma-Québec, Saint-Laurent, Quebec, Canada
| | - André Lebrun
- Medical Affairs, Héma-Québec, Saint-Laurent, Quebec, Canada
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29
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Delage G, Gingras S, Rhainds M. A population-based study on blood lead levels in blood donors. Transfusion 2015; 55:2633-40. [DOI: 10.1111/trf.13199] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2015] [Revised: 05/14/2015] [Accepted: 05/14/2015] [Indexed: 10/23/2022]
Affiliation(s)
| | - Suzanne Gingras
- Institut National de Santé Publique du Québec; Québec City Québec
| | - Marc Rhainds
- Institut National de Santé Publique du Québec; Québec City Québec
- Unité d’Évaluation des Technologies et des Modes d'Intervention en Santé (UETMIS)-CHU De Québec-Université Laval; Québec Québec Canada
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30
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Germain M, Delage G. Models used to predict the impact of having less stringent deferral policies for men who had sex with men: can we validate these predictions? ACTA ACUST UNITED AC 2015. [DOI: 10.1111/voxs.12111] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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31
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Lieberman L, Devine DV, Reesink HW, Panzer S, Wong J, Raison T, Benson S, Pink J, Leitner GC, Horvath M, Compernolle V, Scuracchio PSP, Wendel S, Delage G, Nahirniak S, Dongfu X, Krusius T, Juvonen E, Sainio S, Cazenave JP, Guntz P, Kientz D, Andreu G, Morel P, Seifried E, Hourfar K, Lin CK, O'Riordan J, Raspollini E, Villa S, Rebulla P, Flanagan P, Teo D, Lam S, Ang AL, Lozano M, Sauleda S, Cid J, Pereira A, Ekermo B, Niederhauser C, Waldvogel S, Fontana S, Desborough MJ, Pawson R, Li M, Kamel H, Busch M, Qu L, Triulzi D. Prevention of transfusion-transmitted cytomegalovirus (CMV) infection: Standards of care. Vox Sang 2014; 107:276-311. [DOI: 10.1111/vox.12103] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Cayer MP, Girard M, Fournier D, Delage G, Thibault L. Antimicrobial activity in cord blood units: occurrence and levels of antibiotics. Transfusion 2014; 54:2505-13. [PMID: 24724982 DOI: 10.1111/trf.12655] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2013] [Revised: 02/17/2014] [Accepted: 02/18/2014] [Indexed: 11/28/2022]
Abstract
BACKGROUND Antibiotic prophylaxis treatment at delivery is highly recommended for reducing the risk of infection for mothers positive for group B streptococcus. It is therefore expected that some cord blood (CB) products will contain residual antibiotics. This study aimed to determine the incidence and level of β-lactam antibiotics in CB products. STUDY DESIGN AND METHODS The antimicrobial activity of 60 CB plasma by-products was evaluated using disk diffusion assays on 10 bacteria species. Plasma samples showing antimicrobial activity were either treated with β-lactamase enzyme to inhibit β-lactam antibiotics or heated to 56°C for 30 minutes to inhibit complement proteins. β-Lactam antibiotic concentrations were determined by comparison with a standard curve obtained with known concentrations of antibiotics. RESULTS Antimicrobial activity against mostly Gram-positive microorganisms was observed in 33% of CB units. The β-lactamase enzyme abolished the antimicrobial activity in the majority of these CB products. Up to 5 μg/mL penicillin and 14 μg/mL ampicillin were measured in these products. CONCLUSION Approximately one-third of CB products contain significant amounts of plasma with residual antibiotics, which can affect the survival and growth of bacterial contaminants when performing the sterility test and potentially lead to false-negative results. Additional work is required to better understand whether residual antibiotics in CB affect penicillin-allergic patients.
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Pietersz RNI, Reesink HW, Panzer S, Oknaian S, Kuperman S, Gabriel C, Rapaille A, Lambermont M, Deneys V, Sondag D, Ramírez-Arcos S, Goldman M, Delage G, Bernier F, Germain M, Vuk T, Georgsen J, Morel P, Naegelen C, Bardiaux L, Cazenave JP, Dreier J, Vollmer T, Knabbe C, Seifried E, Hourfar K, Lin CK, Spreafico M, Raffaele L, Berzuini A, Prati D, Satake M, de Korte D, van der Meer PF, Kerkhoffs JL, Blanco L, Kjeldsen-Kragh J, Svard-Nilsson AM, McDonald CP, Symonds I, Moule R, Brailsford S, Yomtovian R, Jacobs MR. Bacterial contamination in platelet concentrates. Vox Sang 2014; 106:256-83. [DOI: 10.1111/vox.12098] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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34
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Delage G, Myhal G, Grégoire Y, Simmons-Coley GM. Donors' psychological reactions to deferral following false-positive screening test results. Vox Sang 2014; 107:132-9. [DOI: 10.1111/vox.12143] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2013] [Revised: 02/05/2014] [Accepted: 02/11/2014] [Indexed: 12/01/2022]
Affiliation(s)
- G. Delage
- Medical Affairs; Héma-Québec; Montreal QC Canada
| | - G. Myhal
- Medical Affairs; Héma-Québec; Montreal QC Canada
| | - Y. Grégoire
- Medical Affairs; Héma-Québec; Montreal QC Canada
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Abstract
Although multiple critical steps are taken to minimize the risk of infection from transfusion of blood or blood products in developed countries, this risk can never be entirely eliminated. In Canada, the risks of noninfectious transfusion reactions, such as transfusion-related acute lung injury and major allergic or anaphylactic reactions, are greater than that of infection. This updated practice point provides an overview of transfusion infection risks in Canada. Infectious agents, systemic conditions, donor and recipient factors, and collection and infusion techniques are considered. Suggestions are offered to improve both system and process, and to help practitioners who are discussing informed consent with patients and parents before administering blood or a blood product.
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36
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Germain M, Robillard P, Delage G, Goldman M. Allowing blood donation from men who had sex with men more than 5 years ago: a model to evaluate the impact on transfusion safety in Canada. Vox Sang 2013; 106:372-5. [DOI: 10.1111/vox.12109] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
| | | | - G. Delage
- Héma-Québec; Saint-Laurent QC Canada
| | - M. Goldman
- Canadian Blood Services; Ottawa ON Canada
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37
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Apparicio P, Cloutier MS, Chadillon-Farinacci V, Charbonneau J, Delage G. Blood donation clusters in Québec, Canada (2003-2008): spatial variations according to sex and age. Vox Sang 2013; 106:297-306. [PMID: 24025034 DOI: 10.1111/vox.12082] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2012] [Revised: 07/16/2013] [Accepted: 08/13/2013] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND OBJECTIVES The detection of spatial clusters of blood donation rate is an important issue, especially for targeting spatial units with significantly low rates, where it could be possible to increase the numbers of donors. The objective of this study is to detect spatial clusters of high or low blood donation rate in Québec according to sex and age of the donors. MATERIALS AND METHODS Blood donation data were obtained from Héma-Québec over a period of 5 years. We aggregated these data for each of 101 municipalités regionales de comté (i.e. counties) for men, women and four age groups. To detect spatial high/low donation rate areas, we used the Kulldorff's scan statistics. Kappa coefficient was used to assess discordance between clusters obtained for the different groups (18-29, 30-39, 40-49, 50-59, 60-69 years old). T-test analyses were conducted to identify significant associations between spatial clusters and socio-economic variables. RESULTS The results indicate the presence of several geographical areas with high or low blood donation rates for each group. The size, the location and the socio-demographic profiles of low/high clusters vary according to sex and age categories. CONCLUSION The Kulldorff's scan statistics are an efficient tool to assess the blood donation performance across a country or even a specific region over a period of several years. In terms of strategic planning and monitoring, it can be used as a fully operational tool to target areas with significantly low rates (for all donors or specific demographic groups) in future blood donation campaigns.
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Affiliation(s)
- P Apparicio
- Centre Urbanisation Culture Société, Institut National de la Recherche Scientifique, Montréal, QC, Canada
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Godin G, Germain M, Conner M, Delage G, Sheeran P. Promoting the return of lapsed blood donors: a seven-arm randomized controlled trial of the question-behavior effect. Health Psychol 2013; 33:646-55. [PMID: 23957902 DOI: 10.1037/a0033505] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE This study tested key variations in the question-behavior effect against a control condition or an implementation intention condition on returning to give blood among lapsed donors (individuals who had not given blood in the past 2 years). DESIGN At baseline, 7,000 lapsed donors were randomized to 1 of 6 experimental conditions or to a control condition. Participants in the experimental conditions were asked to complete a 6-item postal questionnaire assessing intentions only, interrogative intention, moral norm plus intention, anticipated regret plus intention, positive self-image plus intention, or implementation intentions. OBJECTIVE measures of behavior were obtained 6 and 15 months later. The frequency of registrations to give blood over the next 6 and 15 months was measured. RESULTS Intention-to-treat analysis of the frequency of registrations (GENMOD procedure, Poisson distribution) indicated main effects for condition (experimental vs. control) at both 6 months, χ²(1) = 4.64, p < .05, and 15 months, χ²(1) = 5.88, p < .05. Positive self-image and implementation intention interventions outperformed the control condition at 6 months. At 15 months, standard intention, interrogative intention, and regret plus intention conditions showed more frequent registrations compared with control and were just as effective as implementation intention formation. Moderation analysis showed that the moral norm and positive self-image conditions were significant for first-time (1 previous donation) but not repeat (2 or more previous donations) donors. CONCLUSION The question-behavior effect can be used to reinvigorate blood donation among lapsed donors, and can be as effective as forming implementation intentions.
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Affiliation(s)
- Gaston Godin
- Research Group on Behavior and Health, Laval University
| | | | - Mark Conner
- Institute of Psychological Sciences, University of Leeds
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Ditto B, Gilchrist PT, Holly CD, Dubuc S, Delage G, France CR. The effects of leg crossing and applied tension on blood donor return. Vox Sang 2013; 105:299-304. [DOI: 10.1111/vox.12055] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2013] [Revised: 04/26/2013] [Accepted: 04/30/2013] [Indexed: 11/29/2022]
Affiliation(s)
- B. Ditto
- Department of Psychology; McGill University; Montreal; QC; Canada
| | - P. T. Gilchrist
- Department of Psychology; McGill University; Montreal; QC; Canada
| | - C. D. Holly
- Department of Psychology; McGill University; Montreal; QC; Canada
| | - S. Dubuc
- Héma-Québec; Montreal; QC; Canada
| | | | - C. R. France
- Department of Psychology; Ohio University; Athens; OH; USA
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Germain M, Delage G, Robillard P, Goldman M. Interdiction temporaire au don de sang des hommes ayant eu des relations sexuelles avec d’autres hommes : impact sur le risque de transmission du VIH par transfusion au Canada. Transfus Clin Biol 2013. [DOI: 10.1016/j.tracli.2013.03.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Germain M, Delage G, Blais C, Maunsell E, Décary F, Grégoire Y. Iron and cardiac ischemia: a natural, quasi-random experiment comparing eligible with disqualified blood donors. Transfusion 2013; 53:1271-9. [PMID: 23320537 DOI: 10.1111/trf.12081] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2012] [Revised: 06/20/2012] [Accepted: 07/23/2012] [Indexed: 11/26/2022]
Abstract
BACKGROUND The theory that elevated iron stores can induce vascular injury and ischemia remains controversial. We conducted a cohort study of the effect of blood donation on the risk of coronary heart disease (CHD) by taking advantage of the quasi-random exclusion of donors who obtained a falsely reactive test for a transmissible disease (TD) marker. STUDY DESIGN AND METHODS Whole blood donors who were permanently disqualified because of a false-reactive test between 1990 and 2007 in the province of Quebec were compared to donors who remained eligible, matched for baseline characteristics. The incidence of CHD after entry into the study was determined through hospitalization and death records. We compared eligible and disqualified donors using an "intention-to-treat" framework. RESULTS Overall, 12,357 donors who were permanently disqualified were followed for 124,123 person-years of observation, plus 50,889 donors who remained eligible (516,823 person-years). On average, donors who remained eligible made 0.36 donation/year during follow-up and had an incidence of hospitalizations or deaths attributable to CHD of 3.60/1000 person-years, compared to 3.52 among permanently disqualified donors (rate ratio, 1.02; 95% confidence interval, 0.92-1.13). CONCLUSION Donors who remained eligible did not have a lower risk of CHD, compared to donors who were permanently disqualified due to a false-reactive TD marker. Because of the quasi-random nature of false-reactive screening tests, this natural experiment has a level of validity approaching that of a randomized trial evaluating the effect of regular blood donation on CHD risk. These results do not support the iron hypothesis.
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Blake JT, Hardy M, Delage G, Myhal G. Déjà-vu all over again: using simulation to evaluate the impact of shorter shelf life for red blood cells at Héma-Québec. Transfusion 2012; 53:1544-58. [PMID: 23145802 DOI: 10.1111/j.1537-2995.2012.03947.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2012] [Revised: 09/18/2012] [Accepted: 09/18/2012] [Indexed: 11/29/2022]
Abstract
BACKGROUND Since the 1970s red blood cells (RBCs) have had a rated shelf life of 42 days. Recently, studies have suggested poorer patient outcomes when older blood is transfused. However, shortening the shelf life of RBCs may increase costs and lead to greater instances of outdates and shortages. STUDY DESIGN AND METHODS A simulation method to evaluate the impact of a shorter shelf life for RBCs on a regional blood network was developed. A network model of the production and distribution system in the province of Quebec was built and validated. RESULTS The model suggests that a shelf life of 21 or 28 days will have modest impact on outdate and shortage rates. A shelf life of 14 days will create significant challenges for both blood suppliers and hospitals and will result in systemwide outdate rates of 6.64% and shortage rates of 2.75%. The impact of a shorter shelf life for RBCs will disproportionately affect smaller and midsize hospitals. CONCLUSION A shelf life of 28 or 21 days is feasible without excessive increases to systemwide outdate, shortage, or emergency ordering rates. Large hospitals will see minimal impact; smaller hospitals will see larger increases and may be unable to find inventory policies that maintain both low outdate and shortage rates. Reducing the shelf life to 14 days, or lower, results in significant challenges for suppliers and hospitals of all sizes. All hospitals will see an impact on outdate and shortage rates; overall systemwide outdate rates (6% or more) will reach levels that would currently be considered unacceptably high.
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Affiliation(s)
- John T Blake
- Dalhousie University, Halifax, Nova Scotia, Canada.
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Germain M, Delage G, Grégoire Y, Robillard P. Donation by donors with an atypical pulse rate does not increase the risk of cardiac ischaemic events. Vox Sang 2012; 104:309-16. [DOI: 10.1111/vox.12002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Godin G, Amireault S, Vézina-Im LA, Sheeran P, Conner M, Germain M, Delage G. Implementation intentions intervention among temporarily deferred novice blood donors. Transfusion 2012; 53:1653-60. [DOI: 10.1111/j.1537-2995.2012.03939.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2012] [Revised: 09/17/2012] [Accepted: 09/17/2012] [Indexed: 12/01/2022]
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Gauvin F, Robillard P, Hume H, Grenier D, Whyte RK, Webert KE, Fergusson D, Lau W, Froese N, Delage G. Transfusion-related acute lung injury in the Canadian paediatric population. Paediatr Child Health 2012; 17:235-239. [PMID: 23633895 PMCID: PMC3381913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/11/2011] [Indexed: 06/02/2023] Open
Abstract
BACKGROUND The incidence of transfusion-related acute lung injury (TRALI) in adults is approximately one per 5000 transfusions. The Canadian Paediatric Surveillance Program undertook the present study to determine the incidence of TRALI in the paediatric population and to describe the characteristics and outcomes of children with TRALI. METHODS The present surveillance study was conducted over a three-year period. RESULTS Four TRALI cases were reported, yielding an incidence rate of 1.8 per 100,000 transfusions. The degree of severity varied: in two patients, only supplemental oxygen was necessary, while the other two required mechanical ventilation. CONCLUSION TRALI was reported much less often in the present study compared with adult studies; therefore, it needs to be determined whether TRALI occurs less frequently in children, or alternatively, whether TRALI is recognized less often in children. The possibility that neonates who undergo cardiac surgery are at greater risk of TRALI than other patients should be addressed in future studies.
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Affiliation(s)
- France Gauvin
- Department of Paediatrics, CHU Sainte-Justine, Université de Montréal
| | - Pierre Robillard
- Institut national de santé publique du Québec, Hemovigilance Research Unit and Department of Epidemiology, McGill University, Montréal, Québec
| | - Heather Hume
- Department of Paediatrics, CHU Sainte-Justine, Université de Montréal
- Canadian Blood Services
| | - Danielle Grenier
- Department of Paediatrics, Children’s Hospital of Eastern Ontario, Ottawa University, Ottawa, Ontario
| | - Robin K Whyte
- Department of Pediatrics, Dalhousie University, Halifax, Nova Scotia
| | - Kathryn E Webert
- Departments of Medicine/Molecular Medicine and Pathology, McMaster University, Hamilton
| | - Dean Fergusson
- Ottawa Hospital Research Institute, Clinical Epidemiology Program, Ottawa
| | - Wendy Lau
- Department of Paediatric Laboratory Medicine, The Hospital for Sick Children; University of Toronto, Toronto, Ontario
| | - Norbert Froese
- Departments of Anaesthesia and Paediatrics, University of British Columbia, Vancouver, British Columbia
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Gauvin F, Robillard P, Hume H, Grenier D, Whyte RK, Webert KE, Fergusson D, Lau W, Froese N, Delage G. Transfusion-related acute lung injury in the Canadian paediatric population. Paediatr Child Health 2012. [DOI: 10.1093/pch/17.5.235] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
| | - France Gauvin
- Department of Paediatrics, CHU Sainte-Justine, Université de Montréal
| | - Pierre Robillard
- Institut national de santé publique du Québec, Hemovigilance Research Unit and Department of Epidemiology, McGill University, Montréal, Québec
| | - Heather Hume
- Department of Paediatrics, CHU Sainte-Justine, Université de Montréal
- Canadian Blood Services
| | - Danielle Grenier
- Department of Paediatrics, Children’s Hospital of Eastern Ontario, Ottawa University, Ottawa, Ontario
| | - Robin K Whyte
- Department of Pediatrics, Dalhousie University, Halifax, Nova Scotia
| | - Kathryn E Webert
- Departments of Medicine/Molecular Medicine and Pathology, McMaster University, Hamilton
| | - Dean Fergusson
- Ottawa Hospital Research Institute, Clinical Epidemiology Program, Ottawa
| | - Wendy Lau
- Department of Paediatric Laboratory Medicine, The Hospital for Sick Children; University of Toronto, Toronto, Ontario
| | - Norbert Froese
- Departments of Anaesthesia and Paediatrics, University of British Columbia, Vancouver, British Columbia
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Coste J, Prowse C, Grabmer C, Schennach H, Santos Prado Scuracchio P, Wendel SN, Germain M, Delage G, Krusius T, Ekblom-Kullberg S, Tiberghien P, O’Riordan J, Murphy WG, Flesland Ø, Turner M, Williamson L, Gregori L, Epstein J, Asher D, Panzer S, Reesink HW. Prion reduction of red-blood-cells. Vox Sang 2012; 103:260-72. [DOI: 10.1111/j.1423-0410.2012.01597.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Cloutier MS, Apparicio P, Dubé J, Charbonneau J, Delage G. Regional variation in the modeling of donation frequency: the case of Héma-Québec, Canada. Transfusion 2012; 52:2329-38. [DOI: 10.1111/j.1537-2995.2012.03604.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Abstract
BACKGROUND A strategy used by blood centers to retain donors is to place phone call reminders. However, among first-time donors, no studies have tested the effect of this strategy. This was the aim of this study among individuals who had recently given their first lifetime blood donation. STUDY DESIGN AND METHODS A quasi-experimental study using a nonequivalent control group was adopted; participants in the control group were donors with blood types B+ and AB+, since these individuals are not phoned by the blood agency. A total of 1604 first-time donors aged 18 to 70 years from the province of Quebec, Canada, were assigned to the experimental (n = 870) or the control (n = 734) group. Participants in the experimental group were phoned a few days before they had a new opportunity to give blood while those in the control condition were not phoned. RESULTS In the experimental condition, 48.3% of the donors attempted to give blood during the 12-month follow-up period compared to 38.0% in the control condition. The hazards of the first blood donation attempt among donors who were phoned were 32% higher compared to the hazards of those who were not phoned (p = 0.0004). CONCLUSION The results of this study indicate that a first phone call reminder about the upcoming opportunity to give blood again has a significant positive effect on return rates among first-time donors.
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Affiliation(s)
- Gaston Godin
- Research Group on Behavior and Health, Laval University, Héma-Québec, Québec, Canada.
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