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Ouadghiri S, El Morabit K, Elansari N, Atouf O, Elkababri M, Hessissen L, Essakalli M. Human leukocyte antigen immunization in transfusion-dependent Moroccan patients with beta-thalassemia major: prevalence and risk factors. Hematol Transfus Cell Ther 2023:S2531-1379(23)00086-X. [PMID: 37244818 DOI: 10.1016/j.htct.2023.03.023] [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: 09/28/2022] [Revised: 12/22/2022] [Accepted: 03/30/2023] [Indexed: 05/29/2023] Open
Abstract
INTRODUCTION Beta-thalassemia major patients need a regular blood transfusion to have an initial normal growth. However, these patients have an increased risk of developing alloantibodies. Our main goal was to study HLA alloimmunization in Moroccan Beta-thalassemia patients by confronting it with transfusion and demographic criteria, exploring the involvement of HLA typing profile in the development of HLA antibodies and in turn determining risk factors for their development. METHODS The study consisted of 53 Moroccan pediatric patients with Beta-thalassemia major. Screening for HLA alloantibodies was performed using Luminex technology Whereas HLA genotyping was done with sequence-specific primers (PCR-SSP). RESULTS In this study, 50.9% of patients have been identified as positive for HLA antibodies, with 59.3% having both HLA Class I and Class II antibodies. A significant increase frequency of DRB1*11 allele was revealed in non-immunized patients (34.6% vs. 0%, p = 0.001). Our results also revealed that the majority of our HLA immunized patients were women (72.4% vs. 27.6%, p = 0.001), and transfused with more than 300 units of RBC units (66.7% vs. 33.3%, p = 0.02). There were statistically significant differences when comparing these frequencies. CONCLUSIONS This paper revealed that the transfusion dependent Beta-thalassemia major patients are exposed to risk of developing HLA antibodies following transfusions with leukoreduced RBC units. The HLA DRB1*11 was a protective factor against HLA alloimmunization in our beta-thalassemia major patients.
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Affiliation(s)
- Sanae Ouadghiri
- Blood Transfusion, Ibn Sina University Hospital, Rabat, Morocco; Faculty of Medicine and Pharmacy, Mohamed V University, Rabat, Morocco.
| | | | - Naoual Elansari
- Pediatric Oncology center of the children's Hospital, Ibn Sina University Hospital, Rabat, Morocco
| | - Ouafae Atouf
- Blood Transfusion, Ibn Sina University Hospital, Rabat, Morocco; Faculty of Medicine and Pharmacy, Mohamed V University, Rabat, Morocco
| | - Maria Elkababri
- Pediatric Oncology center of the children's Hospital, Ibn Sina University Hospital, Rabat, Morocco; Faculty of Medicine and Pharmacy, Mohamed V University, Rabat, Morocco
| | - Laila Hessissen
- Pediatric Oncology center of the children's Hospital, Ibn Sina University Hospital, Rabat, Morocco; Faculty of Medicine and Pharmacy, Mohamed V University, Rabat, Morocco
| | - Malika Essakalli
- Blood Transfusion, Ibn Sina University Hospital, Rabat, Morocco; Faculty of Medicine and Pharmacy, Mohamed V University, Rabat, Morocco
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Bougar S, Atouf O, Ouadghiri S, Bourhanbour AD, Brick C, Essakalli M. Collection, cryopreservation and thawing of stem cells for children weighing less than 25 Kg with high-risk neuroblastoma: A single center results in Morocco. Hematol Transfus Cell Ther 2022; 44:535-541. [PMID: 35216961 PMCID: PMC9605889 DOI: 10.1016/j.htct.2021.11.014] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 06/07/2021] [Accepted: 11/02/2021] [Indexed: 11/29/2022] Open
Abstract
Introduction An important component of the advances made in neuroblastoma treatment has been the use of peripheral blood stem cells to support high-dose chemotherapy. In this study, we report our experience on a series of small children who have undergone standard and large volume leukaphersis (LVL) procedures, provide an update on a single institution's experience with cryopreservation of autologous peripheral blood stem cells (PBSCs), using 10% dimethyl sulfoxide (DMSO) and applying post-thaw DMSO depletion and analyze a number of variables that may affect viability. Methods A total of 36 aphereses were performed on 29 children weighing less than 25 kg between July 2016 and October 2019 at the Ibn Sina university hospital. Results Seven females and twenty-two males, median bodyweight 14 kg (9 - 22). A single apheresis was sufficient to obtain at least 3 × 10⁶/kg body weight (BW) of CD34+ cells in 82.8% of the cases. The LVL was performed in 22 aphereses. A median number of 5.9 × 10⁶/kg CD34 cells were collected per apheresis. A total of 60 PBSC samples were cryopreserved and 46 samples were infused. The mean cell viability percentage decreased from 94.75 ± 1.14% before freezing to 70.84 ± 8.6% after thawing (p < 0.001). No correlation was found between post-thaw viability and storage time (r = -0.233; p = 0.234) or number of total nucleated cells (r = 0.344; p = 0.073). Conclusion Leukapheresis is safe and feasible in small pediatric patients if the appropriate measures are used. Cryopreservation poses numerous challenges, especially a decrease in cell viability after thawing.
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Affiliation(s)
- Sara Bougar
- Ibn Sina University Hospital, Tissue and Stem cell Bank, Rabat, Morocco.
| | - Ouafa Atouf
- Ibn Sina University Hospital, Tissue and Stem cell Bank, Rabat, Morocco; University Mohamed V, Faculty of Medicine and Pharmacy, UPR of Immunology, Rabat, Morocco
| | - Sanae Ouadghiri
- Ibn Sina University Hospital, Tissue and Stem cell Bank, Rabat, Morocco; University Mohamed V, Faculty of Medicine and Pharmacy, UPR of Immunology, Rabat, Morocco
| | | | - Chehrazade Brick
- Ibn Sina University Hospital, Tissue and Stem cell Bank, Rabat, Morocco
| | - Malika Essakalli
- Ibn Sina University Hospital, Tissue and Stem cell Bank, Rabat, Morocco; University Mohamed V, Faculty of Medicine and Pharmacy, UPR of Immunology, Rabat, Morocco
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Bourhanbour AD, Ouadghiri S, Bougar S, Atouf O, Brick C, Yakhlef I, Atiifis K, Morabit KE, Essakalli M. [Husband to wife renal transplantatation and pretransplant HLA immunization: about two cases]. Pan Afr Med J 2021; 40:92. [PMID: 34909080 PMCID: PMC8607941 DOI: 10.11604/pamj.2021.40.92.18744] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Accepted: 05/11/2020] [Indexed: 11/24/2022] Open
Abstract
La transplantation rénale est la meilleure thérapeutique pour l'insuffisance rénale terminale. Cette transplantation est possible grâce au don de rein à partir d'un donneur vivant ou d'un donneur en état de mort encéphalique (EME). L'immunisation des receveurs est une vraie problématique de la greffe car elle est responsable de difficultés particulières de choix d'un donneur et surtout expose au risque de rejet de greffon. Nous allons présenter deux observations de greffe rénale entre époux, ou les deux receveurs avaient des taux faibles d'anticorps dirigés contre des antigènes HLA du donneur mais dont l'issue en post-greffe immédiat était différente selon le sexe du receveur. En effet l'immunisation anti-HLA des femmes suite aux grossesses est un vrai obstacle à leur greffe par le rein de leur époux. Malgré la faible compatibilité HLA qui caractérise la transplantation rénale entre les époux, car le donneur est ici non apparenté, cette transplantation offre une bonne alternative aux greffes de reins à partir de donneurs en EME, qui font cruellement défaut au Maroc.
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Affiliation(s)
- Asmaa Drissi Bourhanbour
- Service d'Immunologie et de Transfusion, Centre Hospitalier Universitaire Ibn Sina de Rabat, Rabat, Maroc.,Faculté de Médecine et de Pharmacie, Université de Hassan II, Casablanca, Maroc
| | - Sanae Ouadghiri
- Service d'Immunologie et de Transfusion, Centre Hospitalier Universitaire Ibn Sina de Rabat, Rabat, Maroc.,UPR d'Immunologie, Faculté de Médecine et de Pharmacie, Université Mohamed V de Rabat, Rabat, Maroc
| | - Sara Bougar
- Service d'Immunologie et de Transfusion, Centre Hospitalier Universitaire Ibn Sina de Rabat, Rabat, Maroc
| | - Ouafae Atouf
- Service d'Immunologie et de Transfusion, Centre Hospitalier Universitaire Ibn Sina de Rabat, Rabat, Maroc.,Faculté de Médecine et de Pharmacie, Université de Hassan II, Casablanca, Maroc
| | - Chahrazade Brick
- Service d'Immunologie et de Transfusion, Centre Hospitalier Universitaire Ibn Sina de Rabat, Rabat, Maroc
| | - Imane Yakhlef
- Service d'Immunologie et de Transfusion, Centre Hospitalier Universitaire Ibn Sina de Rabat, Rabat, Maroc.,Faculté de Médecine et de Pharmacie, Université de Hassan II, Casablanca, Maroc
| | - Kaoutar Atiifis
- Service d'Immunologie et de Transfusion, Centre Hospitalier Universitaire Ibn Sina de Rabat, Rabat, Maroc.,Faculté de Médecine et de Pharmacie, Université de Hassan II, Casablanca, Maroc
| | - Kaoutar El Morabit
- Service d'Immunologie et de Transfusion, Centre Hospitalier Universitaire Ibn Sina de Rabat, Rabat, Maroc.,Faculté de Médecine et de Pharmacie, Université de Hassan II, Casablanca, Maroc
| | - Malika Essakalli
- Service d'Immunologie et de Transfusion, Centre Hospitalier Universitaire Ibn Sina de Rabat, Rabat, Maroc.,Faculté de Médecine et de Pharmacie, Université de Hassan II, Casablanca, Maroc
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Brick C, Atouf O, Ouadghiri S, Drissi Bourhanbour A, Bougar S, Yakhlef I, Essakalli M. HLA typing and haematopoietic stem cell transplantation in the histocompatibility unit of the Ibn Sina University Hospital in Rabat (Morocco). Transfus Clin Biol 2018; 26:293-298. [PMID: 30366818 DOI: 10.1016/j.tracli.2018.09.002] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Accepted: 09/27/2018] [Indexed: 11/17/2022]
Abstract
PURPOSE OF STUDY This study focuses on the search for a suitable related HLA-matched donor of haematopoietic stem cells in the context of allogeneic transplantation in Morocco. The aim of this work is to establish whether the related donor can meet graft needs in Moroccan patients. PATIENTS AND METHODS 429 families (429 recipients and 965 donors) benefited from HLA typing, using microlymphocytotoxicity, polymerase chain reaction-sequence specific primer and/or high-resolution polymerase chain reaction-specific sequence oligonucleotide. RESULTS The recipients and donors are mostly men over 18 years of age. In total, 86.8% of the recipients have between 1 and 3 donors who are 96% of the collaterals. Malignant haemopathies account for 54% of allograft indications. Benign haemopathies are more frequent than malignant in children, whereas the profile is reversed in adults. Fifty percent of recipients have an HLA identical donor in their siblings and 42% and HLA haplo identical donor. The HLA typing of the recipients and the donors reveals very large polymorphism of the population. CONCLUSION The related donor of haematopoietic stem cells represents an important source of grafts but will not be able to satisfy all the needs of Morocco. The creation of national unrelated voluntary donors will open up new possibilities for recipients who do not have a compatible donor within his relatives.
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Affiliation(s)
- C Brick
- Department of immunology and transfusion, CHU Ibn Sina Rabat, Rabat, Morocco.
| | - O Atouf
- Department of immunology and transfusion, CHU Ibn Sina Rabat, Rabat, Morocco; UPR of immunology, faculty of medicine and pharmacy, university Mohamed V Rabat, Rabat, Morocco
| | - S Ouadghiri
- Department of immunology and transfusion, CHU Ibn Sina Rabat, Rabat, Morocco
| | | | - S Bougar
- Department of immunology and transfusion, CHU Ibn Sina Rabat, Rabat, Morocco
| | - I Yakhlef
- Department of immunology and transfusion, CHU Ibn Sina Rabat, Rabat, Morocco; UPR of immunology, faculty of medicine and pharmacy, university Mohamed V Rabat, Rabat, Morocco
| | - M Essakalli
- Department of immunology and transfusion, CHU Ibn Sina Rabat, Rabat, Morocco; UPR of immunology, faculty of medicine and pharmacy, university Mohamed V Rabat, Rabat, Morocco
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Zerrouki A, Ouadghiri S, Benseffaj N, Razine R, Essakalli M. Reason and Resolution of High Negative Control Beads in Solid-Phase Immunoassay. EXP CLIN TRANSPLANT 2017; 16:38-43. [PMID: 28540842 DOI: 10.6002/ect.2016.0239] [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] [Indexed: 11/05/2022]
Abstract
OBJECTIVES The Luminex technology is the most sensitive diagnostic method for HLA antibody detection and identification. However, the interpretation of immunoassays is commonly affected by the artifact, and non-specific background. Sera from some patients show high negative control bead (NC) value, which makes assessing and interpretation of HLA antibodies difficult. In this study, we evaluated the effect of Adsorb Out reagent, dithiothreitol (DTT), and Ethylenediaminetetraacetic acid (EDTA) on the NC median fluorescence intensity value by comparing treated versus untreated patient sera. In addition, we wanted to identify whether kidney disease and administered medication influenced high NC median fluorescence intensity values by comparing patient versus control results. MATERIALS AND METHODS HLA antibody screening was performed on 3500 serum samples. Sera were analyzed using the standard protocol for Luminex antibody screening. Sera with high NC values were preincubated with Adsorb Out, DTT, and EDTA. Screening of these sera was then performed. RESULTS We found that 4% of samples showed high NC values. Adsorb Out, DTT, and EDTA decreased the NC values at 723.5 (299.25-1443) versus 85 (34-218; P < .001), at 723.5 (299.25-1443) versus 184 (106-597; P < .001), and at 723.5 (299.25-1443) versus 455 (131-1177; P = .004). These succeeded in bringing back NC values to normal range in 69.2%, 43%, and 30% of treated sera, respectively. In addition, the differences of corticoids, immunosuppressive, and heparin drugs between patients and controls were statistically significant (P < .001, < .001, and = .043). However, presence of kidney disease was not significant between these groups. CONCLUSIONS All pretreatments had an important effect in decreasing negative control values, with Adsorb Out having highest efficiency. Serum-specific components could contribute to high negative control bead median fluorescence intensity values. Further studies are needed to determine the adequate pretreatment of patient sera.
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Affiliation(s)
- Asmae Zerrouki
- From the UPR d'immunologie, Faculté de médecine et de pharmacie de Rabat, Université Mohamed V, Rabat, Morocco
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Benseffaj N, Ouadghiri S, Bourhanbour AD, Zerrouki AN, Essakalli M. [Cytotoxicity of natural anti-HLA antibodies in Moroccan patients awaiting for kidney transplantation]. Nephrol Ther 2016; 13:26-29. [PMID: 27914916 DOI: 10.1016/j.nephro.2016.07.449] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Revised: 07/01/2016] [Accepted: 07/04/2016] [Indexed: 11/15/2022]
Abstract
The presence of anti-HLA antibodies in the serum of a patient result from an immune response produced during an immunizing event as transfusion, pregnancy or graft. These antibodies can be cytotoxic by activating the complement pathway via C1q and may cause organ rejection during the transplant. Some male patients awaiting kidney transplantation are seropositive for anti-HLA antibodies when they have no immunizing antecedent event. These antibodies are qualified as natural antibodies. Our work is to assess the cytotoxicity of natural anti-HLA antibodies in patients followed at the immunology laboratory of the blood transfusion service and hemovigilance (STSH) as part of the kidney transplant. PATIENTS AND METHODS We evaluated the cytotoxicity of HLA antibodies detected in male Moroccan patients without immunization history using C1qScreen One Lambda reagent for Luminex™. RESULTS Non-immunized men were positive for HLA antibodies screening in 25.4%. These antibodies are not cytotoxic. CONCLUSION Our study showed a positivity rate of natural HLA antibody low than the literature (25.4% against 63%). It appears that these natural antibodies are not cytotoxic and their involvement in renal transplant remains to be determined.
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Affiliation(s)
- Nadia Benseffaj
- Unité d'immunologie, service de transfusion sanguine et d'hémovigilance du CHU Ibn Sina, rue Lamfadel Cherkaoui, BP 6527, Rabat, Maroc; UPR d'immunologie, faculté de médecine et de pharmacie, université Mohamed V, avenue Mohamed Belarbi El Alaoui, BP 6203, Rabat, Maroc.
| | - Sanae Ouadghiri
- Unité d'immunologie, service de transfusion sanguine et d'hémovigilance du CHU Ibn Sina, rue Lamfadel Cherkaoui, BP 6527, Rabat, Maroc
| | - Asmaa Drissi Bourhanbour
- Unité d'immunologie, service de transfusion sanguine et d'hémovigilance du CHU Ibn Sina, rue Lamfadel Cherkaoui, BP 6527, Rabat, Maroc
| | - Asmae Noor Zerrouki
- UPR d'immunologie, faculté de médecine et de pharmacie, université Mohamed V, avenue Mohamed Belarbi El Alaoui, BP 6203, Rabat, Maroc
| | - Malika Essakalli
- Unité d'immunologie, service de transfusion sanguine et d'hémovigilance du CHU Ibn Sina, rue Lamfadel Cherkaoui, BP 6527, Rabat, Maroc; UPR d'immunologie, faculté de médecine et de pharmacie, université Mohamed V, avenue Mohamed Belarbi El Alaoui, BP 6203, Rabat, Maroc
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Bhallil O, Ibrahimi A, Ouadghiri S, Ouzeddoun N, Benseffaj N, Bayahia R, Essakalli M. HLA Class II with Lupus Nephritis in Moroccan Patients. Immunol Invest 2016; 46:1-9. [DOI: 10.1080/08820139.2016.1208218] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Bourhanbour AD, Ouadghiri S, Benseffaj N, Essakalli M. [Serological tests for celiac disease in Moroccan patients with type 1 diabetes]. Pan Afr Med J 2016; 24:103. [PMID: 27642442 PMCID: PMC5012834 DOI: 10.11604/pamj.2016.24.103.8555] [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] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2015] [Accepted: 04/03/2016] [Indexed: 12/18/2022] Open
Abstract
La maladie cœliaque (MC) est l'une des maladies auto-immunes les plus fréquemment associées au diabète de type 1 (DT1). La prévalence de MC dans DT1 varie de 3 à 6%. La présentation clinique de MC dans DT1 est classé comme asymptomatiques dans environ la moitié des cas. L'objectif de notre étude est de déterminer la fréquence des auto-anticorps anti-transglutaminase tissulaire (AtTG) et anti-gliadines (AAG) chez les patients diabétiques de type 1 dans le but de recommander une éventuelle biopsie jéjunale et d'instaurer un régime sans gluten précocement avant l'installation des signes cliniques et des complications de la maladie cœliaque. Les sujets inclus dans cette étude sont des patients atteints de DT1 non traités pour la MC et qui ne présentent pas de signes en faveur de cette pathologie. La détection des AtTG de classe IgG et IgA et AAG classe IgG et IgA a été réalisée par technologie Luminex. Nous avons inclus 31 patients. Il s'agit de 16 hommes et 15 femmes. Les AAG de classe IgA étaient positifs chez 4(13%) patients et chez 7(22,5%) patients pour les IgG. Les AtTG de classe IgA étaient positifs chez 3(10%) patients et chez une patiente (3%) pour les IgG. Dans notre étude l'association du diabète type 1 et des marqueurs biologiques de la MC n'est pas rare d'où l'intérêt de son dépistage systématique chez des diabétiques de type 1. Le diagnostic de cette forme atypique et silencieuse de la MC est important compte tenu du risque de complications sérieuses à type de malabsorption et de cancers digestifs.
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Affiliation(s)
- Asmaa Drissi Bourhanbour
- Service de Transfusion Sanguine et d'Hémovigilance, Hôpital d'Enfants, CHU Rabat, UPR d'Immunologie, Faculté de Médecine et de Pharmacie de Rabat, Université Mohammed V Souissi, Maroc
| | - Sanae Ouadghiri
- Service de Transfusion Sanguine et d'Hémovigilance, Hôpital d'Enfants, CHU Rabat, UPR d'Immunologie, Faculté de Médecine et de Pharmacie de Rabat, Université Mohammed V Souissi, Maroc
| | - Nadia Benseffaj
- Service de Transfusion Sanguine et d'Hémovigilance, Hôpital d'Enfants, CHU Rabat, UPR d'Immunologie, Faculté de Médecine et de Pharmacie de Rabat, Université Mohammed V Souissi, Maroc
| | - Malika Essakalli
- Service de Transfusion Sanguine et d'Hémovigilance, Hôpital d'Enfants, CHU Rabat, UPR d'Immunologie, Faculté de Médecine et de Pharmacie de Rabat, Université Mohammed V Souissi, Maroc
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Ouadghiri S, Benseffaj N, Bougar S, Essakalli M. Connaissances et pratiques transfusionnelles du personnel infirmier de l’hôpital Ibn Sina de Rabat. Transfus Clin Biol 2015. [DOI: 10.1016/j.tracli.2015.06.182] [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: 12/01/2022]
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Bougar S, Ouadghiri S, Benseffaj N, Essakalli M. Amélioration de la gestion des produits sanguins labiles, des demandes de sang et des analyses pré-transfusionnels au service de transfusion sanguine et d’hémovigilance à Rabat. Transfus Clin Biol 2015. [DOI: 10.1016/j.tracli.2015.06.088] [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: 10/22/2022]
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Bougar S, Benseffaj N, Ouadghiri S, Essakalli M. La cytaphérèse : indications, sélection médicale, mobilisation, modalités et incidents de prélèvement. Expérience du centre hospitalier de Rabat. Transfus Clin Biol 2015. [DOI: 10.1016/j.tracli.2015.06.015] [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: 11/27/2022]
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Ouadghiri S, El Alaoui Toussi K, Brick C, Ait Benhaddou E, Benseffaj N, Benomar A, El Yahyaoui M, Essakalli M. Genetic factors and multiple sclerosis in the Moroccan population: A role for HLA class II. ACTA ACUST UNITED AC 2013; 61:259-63. [DOI: 10.1016/j.patbio.2013.05.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2013] [Accepted: 05/22/2013] [Indexed: 11/12/2022]
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Essakalli M, Atouf O, Ouadghiri S, Bouayad A, Drissi A, Sbain K, Sakri L, Benseffaj N, Brick C. [Management by objectives: an experience by transfusion and immunology service in Rabat]. Transfus Clin Biol 2013; 20:440-7. [PMID: 23871462 DOI: 10.1016/j.tracli.2013.04.108] [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: 03/02/2013] [Accepted: 04/24/2013] [Indexed: 10/26/2022]
Abstract
The management by objectives method has become highly used in health management. In this context, the blood transfusion and haemovigilance service has been chosen for a pilot study by the Head Department of the Ibn Sina Hospital in Rabat. This study was conducted from 2009 to 2011, in four steps. The first one consisted in preparing human resources (information and training), identifying the strengths and weaknesses of the service and the identification and classification of the service's users. The second step was the elaboration of the terms of the contract, which helped to determine two main strategic objectives: to strengthen the activities of the service and move towards the "status of reference." Each strategic objective had been declined in operational objectives, then in actions and the means required for the implementation of each action. The third step was the implementation of each action (service, head department) so as to comply with the terms of the contract as well as to meet the deadlines. Based on assessment committees, the last step consisted in the evaluation process. This evaluation was performed using monitoring indicators and showed that management by objectives enabled the Service to reach the "clinical governance level", to optimize its human and financial resources and to reach the level of "national laboratory of reference in histocompatibility". The scope of this paper is to describe the four steps of this pilot study and to explain the usefulness of the management by objectives method in health management.
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Affiliation(s)
- M Essakalli
- Université Mohammed V Souissi, faculté de médecine et de pharmacie, Rabat, Maroc; Service de transfusion et d'hémovigilance, centre hospitalier Ibn Sina, Rabat, Maroc.
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Nadia B, Chehrazade B, Ouafa A, Asmaa DB, Ouadghiri S, Malika E. Human leukocyte antigen (HLA) polymorphism and type 1 diabetes in the Moroccan population. ACTA ACUST UNITED AC 2012. [DOI: 10.5897/ajb12.1863] [Citation(s) in RCA: 4] [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: 10/31/2022]
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Ouadghiri S, Atouf O, Brick C, Benseffaj N, Essakalli M. [Traceability of labile blood products in Morocco: experience of the Ibn-Sina hospital of Rabat between 1999 and 2010]. Transfus Clin Biol 2012; 19:1-4. [PMID: 22269085 DOI: 10.1016/j.tracli.2011.06.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2011] [Accepted: 06/26/2011] [Indexed: 10/14/2022]
Abstract
PURPOSE OF STUDY The blood transfusion and haemovigilance service of the Ibn-Sina hospital in Rabat (Morocco) was created 1997. This unit manages the pretransfusional tests, distribution of blood products, traceability and haemovigilance. The objective of this study was to analyze, over a period of 12years, the traceability of blood products delivered in our hospital and the measures used to improve feedback information. PATIENTS AND METHODS This is a retrospective study conducted between 1999 and 2010. Traceability rate was calculated from the feedback of traceability forms supplied with blood products (number of blood products noted on traceability forms on the total number of delivered product). To improve traceability rate, several actions were undertaken: one-time training, awareness campaigns and call phones asking for feedback information. RESULTS Between 1999 and 2010, the service has delivered 173,858 blood products. The average rate of traceability during this period was 13.4 %. Traceability rate varies widely over time (5.2 % in 1999, 15.5 % in 2010) and shows a maximum value of 27.2 % in 2005. Feedback information is lower in emergency departments than in medical and surgical services. CONCLUSION Feedback information about traceability in Ibn-Sina hospital remains very poor despite the measures used. Other actions, such as continuous education courses, low enforcement and informatisation should be considered.
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Affiliation(s)
- S Ouadghiri
- Service de transfusion sanguine et d'hémovigilance, hôpital Ibn-Sina, Rabat, Maroc.
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Essakalli M, Brick C, Bennani N, Benseffaj N, Ouadghiri S, Atouf O. [The latest TH17 lymphocyte in the family of T CD4+ lymphocytes]. Pathol Biol (Paris) 2010; 58:437-43. [PMID: 19299092 DOI: 10.1016/j.patbio.2009.01.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2008] [Accepted: 01/15/2009] [Indexed: 11/30/2022]
Abstract
In recent years the T CD4+ lymphocyte family has grown. In the initial two components TH1 and TH2 lymphocytes were added the TH17 lymphocyte and T cell regulator (Treg). Under the influence of transforming growth factor β, interleukin 6 (IL6), IL21 and IL23, the naive lymphocyte T CD4+ differentiates in TH17. Currently, the TH17 is recognized as the leading actor of local inflammation through the pro-inflammatory cytokines (interleukins 17, 21, 22) that secretes and the expansion and recruitment of neutrophils that leads. Therefore, it is involved in chronic inflammatory processes, autoimmune diseases (rheumatoid arthritis, systemic lupus erythematosus), allergy and rejection of allogeneic transplants. TH17 lymphocyte opens up new therapeutic prospects for these pathologies.
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Affiliation(s)
- M Essakalli
- Service de transfusion et d'hémovigilance de l'hôpital Ibn Sina, CHU Rabat, BP 2014, Rabat Ryad, Rabat, Maroc.
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Essakalli M, Atouf O, Bennani N, Benseffaj N, Ouadghiri S, Brick C. [Toll-like receptors]. ACTA ACUST UNITED AC 2008; 57:430-8. [PMID: 18513891 DOI: 10.1016/j.patbio.2008.04.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2008] [Accepted: 04/11/2008] [Indexed: 11/16/2022]
Abstract
The toll-like receptors are innate immunity receptors which recognise particular exogenous structures in the microorganisms pathogen associated molecular pattern (PAMP) and endogenous structures damage-associated molecular patterns (DAMP). Eleven TLR have been identified among human beings. These are danger receptors located in the cells of the immune system but also in other cells. Their primary function is the recognition of pathogens and the activation of the cell that holds them. It follows from it an action on the cells environment, inflammation cells and an activation of the adaptive immunity. The knowledge of the intracellular signalisation ways of the TLR has allowed us to understand the physiopathology of certain diseases. Thus, several works use the agonists of TLR to stimulate them: vaccines against infectious diseases, allergies and cancers. The antagonists are used to block the TLR in autoimmune and chronic inflammatory diseases. It is clear that the border between innate and adaptive immunity fades and that these two components of the immune response are closely related, thus opening up new prospects diagnostic and therapeutic procedures.
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Affiliation(s)
- M Essakalli
- Service de transfusion et d'hémovigilance, hôpital Ibn-Sina, CHU de Rabat, B.P. 2014, Rabat-Ryad, 10000 Rabat, Maroc.
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