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Mitra B, Jorgensen M, Reade MC, Keegan A, Holley A, Farmer S, Harvey N, Winearls J, Parr M, French CJ. Patient blood management guideline for adults with critical bleeding. Med J Aust 2024; 220:211-216. [PMID: 38282333 DOI: 10.5694/mja2.52212] [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: 07/22/2023] [Accepted: 11/09/2023] [Indexed: 01/30/2024]
Abstract
INTRODUCTION The management of patients with critical bleeding requires a multidisciplinary approach to achieve haemostasis, optimise physiology, and guide blood component use. The 2011 Patient blood management guidelines: module 1 - critical bleeding/massive transfusion were updated and published. Systematic reviews were conducted for pre-specified research questions, and recommendations were based on meta-analyses of included studies. MAIN RECOMMENDATIONS The critical bleeding/massive transfusion guideline includes seven recommendations and 11 good practice statements addressing: major haemorrhage protocols (MHPs) facilitating a multidisciplinary approach to haemorrhage control, correction of coagulopathy and normalisation of physiological derangement; measurement of physiological, biochemical and metabolic parameters in critical bleeding/massive transfusion; the optimal ratio of red blood cells to other blood components; the use of tranexamic acid; viscoelastic haemostatic assays; and cell salvage. CHANGES IN MANAGEMENT AS A RESULT OF THE GUIDELINE The new guideline recommends MHPs be established as standard of care in all institutions managing patients with critical bleeding. In addition to routine physiological markers, the new guideline recommends temperature, biochemistry and coagulation profiles be measured early and frequently, providing parameters that define critical derangements. Ratio-based MHPs should include no fewer than four units of fresh frozen plasma and one adult unit of platelets for every eight units of red blood cells. In the setting of trauma and obstetric haemorrhage, administration of tranexamic acid within three hours of bleeding onset is recommended. The use of recombinant activated factor VII (rFVIIa) is not recommended. There was insufficient evidence to make recommendations on the use of viscoelastic haemostatic assays or cell salvage as part of MHPs.
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Affiliation(s)
- Biswadev Mitra
- Emergency and Trauma Centre, Alfred Health, Melbourne, VIC
- Monash University, Melbourne, VIC
| | | | - Michael C Reade
- Joint Health Command, Australian Defence Force, Canberra, ACT
- Royal Brisbane and Women's Hospital, Brisbane, QLD
| | - Anastazia Keegan
- PathWest Laboratory Medicine, King Edward Memorial Hospital, Perth, WA
- Australia Red Cross Lifeblood, Perth, WA
| | - Anthony Holley
- Joint Health Command, Australian Defence Force, Canberra, ACT
- Royal Brisbane and Women's Hospital, Brisbane, QLD
| | - Shannon Farmer
- University of Western Australia, Perth, WA
- Royal Perth Hospital, Perth, WA
| | | | - James Winearls
- Monash University, Melbourne, VIC
- Gold Coast University Hospital, Gold Coast, QLD
| | - Michael Parr
- Liverpool Hospital, Sydney, NSW
- University of New South Wales, Sydney, NSW
- Macquarie University Hospital, Sydney, NSW
- Macquarie University, Sydney, NSW
| | - Craig J French
- Western Health, Melbourne, VIC
- University of Melbourne, Melbourne, VIC
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Urs GM, Krishna Kumar P, Kamath Y, Zadey S. Indexing blood banking performance in India: A retrospective cross-sectional analysis of states and districts. Dialogues Health 2023; 3:100160. [PMID: 38515806 PMCID: PMC10953889 DOI: 10.1016/j.dialog.2023.100160] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 10/26/2023] [Accepted: 11/16/2023] [Indexed: 03/23/2024]
Abstract
Background Multiple international assessments have highlighted gaps in blood banking globally. However, there is a dearth of subnational assessments. We applied a thematic framework with multiple composite indices to assess blood bank performance across Indian states and districts. Methods In this retrospective cross-sectional analysis, data for 2493 blood banks in 35 states/union territories (UTs) and 616 districts was extracted from the National Blood Transfusion Council for 2016. The framework involved seven themes (accreditation, ownership, safety, volume, infrastructure, regulation, and workforce) with several indicators nested under them. Composite thematic indices and an overall index (0-100, with 100 being the best performance) were constructed using the adjusted Mazziotta-Pareto index method that can provide composite indices that are partially non-compensatory and easily interpretable. Results The state-level median [interquartile range] value of the overall index was 59.61 [46.35, 71.67]. Chandigarh had the highest values for safety, regulation, workforce, and ownership indices, Maharashtra for volume and infrastructure indices, and Manipur for accreditation index. Districts in southern and western states performed well on the overall index with inter- and intra-state variations for themes. District-level correlations depicted positive associations among indices with the strongest correlation between ownership and accreditation indices (n=616, R=0.92, p<0.001). Conclusion Blood banking in India is fragmented, with variations in themes across geographies. The northern and northeastern states require more attention for volume, accreditation, infrastructure, and ownership. While the southern and western-central regions need to prioritize safety. The framework with thematic indices, when applied to routine data, can be useful for monitoring and evaluation to decide local policies and resource allocations.
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Affiliation(s)
- Gaurav M. Urs
- Association for Socially Applicable Research (ASAR), Pune, Maharashtra, India
| | - Padmavathy Krishna Kumar
- Association for Socially Applicable Research (ASAR), Pune, Maharashtra, India
- Adichunchanagiri Institute of Medical Sciences, BG Nagara, Karnataka, India
| | - Yash Kamath
- Association for Socially Applicable Research (ASAR), Pune, Maharashtra, India
- Seth Gordhandas Sunderdas Medical College and KEM Hospital, Mumbai, Maharashtra, India
| | - Siddhesh Zadey
- Association for Socially Applicable Research (ASAR), Pune, Maharashtra, India
- Dr. D. Y. Patil Medical College, Hospital, and Research Centre, Dr. D. Y. Patil Vidyapeeth, Pune, Maharashtra, India
- GEMINI Research Center, Duke University School of Medicine, Durham, North Carolina, USA
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Monteiro TH, Ferreira ÍDJDR, Junior ACFP, Chocair HS, Ferreira JD. Barriers and motivations for blood donation: an integrative review. Hematol Transfus Cell Ther 2023:S2531-1379(23)02583-X. [PMID: 38008595 DOI: 10.1016/j.htct.2023.09.2366] [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: 03/20/2023] [Revised: 07/24/2023] [Accepted: 09/05/2023] [Indexed: 11/28/2023] Open
Abstract
INTRODUCTION It has been estimated that the proportion of blood donors in Brazil is below 2.0 %, lower than that recommended by the World Health Organization, which is between 3 % and 5 % of the population. OBJECTIVE The aim of this study was to analyze the factors that can influence blood donation. METHOD This is an integrative review, whose bibliographic search was carried out through the Virtual Health Library, considering scientific articles indexed in the Latin American and Caribbean Literature in the Health Sciences database. RESULTS This process was performed in July 2022 with term "blood donors" and 901 publications were identified, without delimitation of the study period or any other aspects. After applying the inclusion and exclusion criteria, 40 articles were fully reviewed. The studies were categorized according to the main content discussed in "characteristics and perspectives of donors", "perspective of health professionals and services" and "loyalty strategies: marketing and communication in health". Access to coherent information about the donation process was the motivational aspect evidenced in the three categories of analysis, that is, indispensable from the perspective of users, health professionals who work in blood therapy services and for marketing and communication in health. It is through the knowledge of the procedure that uncertainties and fear are decreased and loyal donors are increased. CONCLUSION Altruism was the most frequent driving feeling in the consulted literature, whereas the lack of time and fear were the routine obstacles. The campaigns were identified as communication and health education actions relevant to attracting and retaining the donor, as well as applications and social networks.
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Valente JD, Silva NDS, Vasconcelos de Sousa S, Amaral CEDM, Pinto LC. Seroprevalence of Trypanosoma cruzi infection among blood donors in the state of Pará, Brazil. Transfus Apher Sci 2023; 62:103756. [PMID: 37357058 DOI: 10.1016/j.transci.2023.103756] [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: 02/13/2023] [Revised: 06/07/2023] [Accepted: 06/20/2023] [Indexed: 06/27/2023]
Abstract
INTRODUCTION Chagas disease (CD) is a neglected pathology worldwide, considered a public health problem due to the high morbidity and mortality rate and its social impact. Thus, the objective was to estimate the prevalence of reactive serology for T. cruzi in blood donors in the units of the public blood network in the state of Pará (Brazil), as well as to describe the epidemiological profile of these donors. METHODS This is a retrospective and descriptive study carried out at the Pará State Center for Hematology and Hemotherapy (HEMOPA) between 2016 and 2021, with analysis of secondary data (epidemiological and serological) of inapt blood donors for CD. RESULTS Among the 533,674 screened samples, the reactivity for anti-T. cruzi was detected in 0.1% (548), of which 0.03% (166) were inconclusive and 0.07% (382) were positive. The hemonucleus of the city of Abaetetuba had the highest seroprevalence (0.6%). Regarding epidemiological characteristics, most blood donors were men (63.7%), aged between 31 and 45 (44.7%), racially mixed (79.2%), high school graduate (45.8%), single/widowed/divorced (62%), first-time donors (69%), spontaneous donations (58%) and from the state's countryside (69.9%). CONCLUSION Over the years analyzed, we observed an increase in seroprevalence for T. cruzi emphasizing the need to maintain epidemiological control in the region and the application of more accurate serological tests in the screening of donor blood bags.
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Affiliation(s)
- Jade Dias Valente
- Department of Biomedicine, Centro Universitário Metropolitano da Amazônia, Belém, Pará, Brazil
| | - Natália da Silva Silva
- Department of Biomedicine, Centro Universitário Metropolitano da Amazônia, Belém, Pará, Brazil
| | | | - Carlos Eduardo de Melo Amaral
- Department of Biomedicine, Centro Universitário Metropolitano da Amazônia, Belém, Pará, Brazil; Center for Hemotherapy and Hematology of Para, Belém, Pará, Brazil
| | - Laine Celestino Pinto
- Department of Biomedicine, Centro Universitário Metropolitano da Amazônia, Belém, Pará, Brazil; Laboratory of Experimental Neuropathology, Federal University of Pará, Biological Science Institute, Belém, Pará, Brazil.
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Swan CD, Seed CR, Styles CE, Gosbell IB. Unusual hepatitis B virus results in blood donors. Med J Aust 2023. [PMID: 37280180 DOI: 10.5694/mja2.52001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Affiliation(s)
| | | | | | - Iain B Gosbell
- Australian Red Cross Blood Lifeblood, Sydney, NSW
- Western Sydney University, Sydney, NSW
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Kiely P, Hoad VC, Styles CE, Gosbell IB. Mpox outbreak in 2022: implications for blood component and donor human milk safety in Australia. Med J Aust 2023; 218:206-208. [PMID: 36841546 DOI: 10.5694/mja2.51863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 02/02/2023] [Accepted: 02/08/2023] [Indexed: 02/27/2023]
Affiliation(s)
- Philip Kiely
- Australian Red Cross Lifeblood, Melbourne, VIC
- Monash University, Melbourne, VIC
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Yang L, Sun Y, Chen T, Miao F, Cong Y, Zhao J. Comment on: Hepatitis E virus in blood donors from Argentina: A possible source of viral infection? Travel Med Infect Dis 2023; 51:102474. [PMID: 36307009 DOI: 10.1016/j.tmaid.2022.102474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 10/12/2022] [Indexed: 11/06/2022]
Affiliation(s)
- Lihua Yang
- College of Life Science, Changchun Sci-Tech University, Changchun, 130600, China
| | - Yixue Sun
- Jilin Research & Development Center of Biomedical Engineering, Changchun University, Changchun, 130022, China
| | - Teng Chen
- Changchun Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Changchun, 130122, China
| | - Faming Miao
- Changchun Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Changchun, 130122, China
| | - Yanlong Cong
- Laboratory of Infectious Diseases, College of Veterinary Medicine, Key Laboratory of Zoonosis Research, Ministry of Education, Jilin University, Changchun, 130062, China.
| | - Jinghui Zhao
- College of Life Science, Changchun Sci-Tech University, Changchun, 130600, China; Jilin DaBeiNong Agriculture and Animal Husbandry Technology Co., Ltd, Changchun, 130102, China; State Key Laboratory of Direct-Fed Microbial Engineering, Beijing DaBeiNong Science and Technology Group Co., Ltd, (DBN), Beijing, 100192, China.
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Pisano MB, Blanco S, Di Cola G, Fantilli AC, Martínez Wassaf MG, Carrizo LH, Ré VE, Gallego SV. Hepatitis E virus in blood donors from Argentina: A possible source of viral infection? Travel Med Infect Dis 2022; 48:102355. [PMID: 35561878 DOI: 10.1016/j.tmaid.2022.102355] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 04/23/2022] [Accepted: 05/04/2022] [Indexed: 01/14/2023]
Abstract
BACKGROUND The hepatitis E virus (HEV) causes acute hepatitis, which can progress to chronicity in immunosuppressed patients. It is transmitted mainly by the fecal-oral or zoonotic routes, but there is current evidence that it can be transmitted by blood transfusions. The objective of the study was to investigate HEV infections in blood donors in Argentina, within the framework of a hemovigilance program. METHODS A total of 547 samples from Argentinean blood donors, collected in 2016, 2019 and 2020 was studied for IgG and IgM anti-HEV by ELISA (Diapro) and RNA HEV by RT-real time PCR and RT-Nested-PCR. RESULTS The prevalence of IgG anti-HEV was 3.47% (19/547). No significant differences were registered according to the year studied, sex or age. The presence of RNA HEV was observed in 0.18% (1/547) of the donors studied without serological evidence of infection. CONCLUSIONS This is the first molecular detection in blood donors from Argentina, showing a molecular prevalence within the range described for RNA-HEV in blood donors from other non-endemic countries, in which immunocompetent RNA-HEV positive donors without serological evidence of infection were identified. The presence of viraemic donors could imply transfusion transmission, which deserves further attention and study.
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Peña-Carillo HI, Rosa-Zamboni DDL, López-Victoria AB, López-Martínez B, Guerrero-Díaz AC. Strategies to recover blood donors during the COVID-19 pandemic: a tertiary level hospital experience. Bol Med Hosp Infant Mex 2022; 79:300-309. [PMID: 36264890 DOI: 10.24875/bmhim.21000237] [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: 12/16/2021] [Accepted: 04/20/2022] [Indexed: 06/16/2023] Open
Abstract
BACKGROUND The SARS-CoV-2 pandemic has challenged blood banks. In Mexico, donors decreased 22% between April and May 2020 compared to the same months in 2019. This study analyzed the effect of the strategies to recover donors (altruistic and family) in a tertiary pediatric care center during the pandemic. METHODS The Blood Bank of the Hospital Infantil de México Federico Gómez implemented strategies to obtain blood components to ensure self-sufficiency. The effect of these strategies on donor recovery was analyzed. RESULTS There were 7,315 eligible donors in 2019 and 5,070 in 2020. Blood component requirements decreased from 10,037 units in 2019 to 8,619 in 2020. The strategies aimed at attracting altruistic donors managed to increase the percentage of this type of donor when comparing the months in which these strategies were applied with the same months in 2019. In addition, it was observed that the greater the number of methods used simultaneously, the higher the percentage of altruistic donors (rho = 0.846, p = 0.002). In contrast, strategies aimed at attracting family donors did not increase the number of this type of donor. CONCLUSIONS Actions to recruit altruistic donors increased the number of this type of donor to meet the hospital's needs.
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Affiliation(s)
| | | | | | | | - Ana C Guerrero-Díaz
- Departamento de Epidemiología, Hospital Infantil de México Federico Gómez. Mexico City, Mexico
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Aguilar G, Ortiz N, Gonzales D, Loyola S, Paredes JA. High titers of anti-A1 and anti-B antibodies among Peruvian group O platelet donors. Transfus Apher Sci 2021; 61:103341. [PMID: 34916156 DOI: 10.1016/j.transci.2021.103341] [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: 06/30/2021] [Revised: 11/22/2021] [Accepted: 12/08/2021] [Indexed: 11/15/2022]
Abstract
Critical antibody titers have been described as factors associated with hemolysis in ABO plasma-incompatible platelet (PLT) transfusions. This study was carried out to describe the frequency of high-titers anti-A and antiB IgM and IgG antibodies in group O apheresis platelet donors, and to explore differences according to the donor characteristics. A cross-sectional study was carried out at the Blood Bank of a National Hospital in Peru from January to March 2019. IgM and IgG antibodies against A1 and B antigens were quantified in 339 platelet donors using the direct hemagglutination technique and the solid-phase adherence technique, respectively. For analysis purposes, two cut-off points; ≥128 and ≥64, were used to define a critical titer for IgM due to a lack of consensus. An IgG titer of ≥256 was also defined as critical. Of the donors, 22.1 % had critical IgM titers when the cut-off point was defined as ≥128. However, when the IgM cut-off was ≥64, the frequency of platelet donors with critical titers increased to 54.0 %. The frequency of donors with critical IgG titers was 23.5 %. Higher IgG titers were associated with female donors while higher IgM titers were negative associated with age. One in two or three platelet donors, depending on the cutoff point used to define a critical IgM titer, had at least one critical titer of anti-A or anti-B antibodies. Early identification of platelet donors with critical antibody titers could prevent passive transfusion of ABO antibodies to non-isogroup recipients.
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Affiliation(s)
- Gissel Aguilar
- Facultad de Medicina, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | - Nathalie Ortiz
- Facultad de Medicina, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Donna Gonzales
- Facultad de Medicina, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Steev Loyola
- Facultad de Medicina, Universidad Peruana Cayetano Heredia, Lima, Peru; Doctorado en Medicina Tropical, Facultad de Medicina, Universidad de Cartagena, Cartagena de Indias, Colombia; Grupo de Investigación UNIMOL, Facultad de Medicina, Universidad de Cartagena, Cartagena de Indias, Colombia
| | - José A Paredes
- Facultad de Medicina, Universidad Nacional Mayor de San Marcos, Lima, Peru; Servicio de Hemoterapia y Banco de Sangre, Hospital Nacional Edgardo Rebagliati Martins, Lima, Peru.
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Duarte da Silva EH, Cordeiro A, de Souza Saboia A, Soares de Souza TC, Azevedo Silva F. Shared surgery blood reserve reduces surgery suspension rate due to blood unavailability. Transfus Apher Sci 2021;:103305. [PMID: 34772628 DOI: 10.1016/j.transci.2021.103305] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 11/01/2021] [Accepted: 11/02/2021] [Indexed: 11/23/2022]
Abstract
The hemotherapy service in health units with high surgical demand has been pointed out as a challenge, especially concerning storage management simultaneously with transfusion demand attendance. The objective of this study is to analyze service efficacy after the implementation of a new strategy to meet storage and transfusion demands. The present study analyzed the records of the hemotherapy service related to blood components management in surgeries where blood reserve was necessary for RhD positive patients at the National Institute of Traumatology and Orthopedics. A shared compatibility test and surgery reserve from the first semester of 2018 was compared to an equivalent period in 2017, prior to its implementation, under an individualized protocol to each patient scheduled on the surgery map. After the implementation of the shared protocol, the transfusion demand was higher, due to an increase in the percentage of surgeries that required transfusion, as well as to the augmented number of blood components used in the surgeries. Even in the presence of a slight decrease in storage, the hemotherapy assistance was considered efficient, since the percentage of surgery suspension reduced from 2 % to 0.2 % after the implementation of the shared protocol. This improvement resulted in an adjustment in the classification of reasons for surgical procedure cancellations, so that the reason "blood shortage" was repositioned from the first to the seventeenth position. This is the first record of a shared compatibility protocol and surgery reserve and we hope to contribute to the development of the hemotherapy service and surgical patient healthcare.
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de Oliveira M, Antunes M, Amil M. Plasma lipemia: When the blood donor becomes a patient. Transfus Apher Sci 2021; 61:103294. [PMID: 34686443 DOI: 10.1016/j.transci.2021.103294] [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: 10/12/2020] [Revised: 10/10/2021] [Accepted: 10/12/2021] [Indexed: 11/26/2022]
Abstract
Lipemic plasma donations are not a strange phenomenon to blood bankers. According to quality standards for plasma fractionation, lipemic plasma donations must be discarded. Beyond quality control and inventory aspects, plasma lipemia is also an important risk factor for cardiovascular diseases, acute pancreatitis and is associated with overall mortality, however little attention is given to the management of these donors in the literature. A retrospective analysis of every whole blood donation that yielded lipemic plasma between January 1st 2018 and December 31st 2019 was made. The medical examination and donor history for the respective donation was reviewed and the available data was collected regarding hour of donation, gender, age, drugs and coexisting pathologies. Whether the donor was called back for a follow up evaluation regarding the lipemic plasma was also noted. Our blood center received 18274 whole blood donations of which 115 (0,63 %) were reported as having plasma lipemia, in the period of this study. Of these 115 donors, 103 (89,57 %) were male. The average age was 47,63 ± 10,65 years. A clear peak in lipemic plasma donations 4 hours after the classic lunch hours is visible. For 88,70 % of the donors, this was the first time their hypertriglyceridemia was identified. The nonfasting elevation of plasma triglycerides in these donors represents a true metabolic derangement. This is a golden opportunity for early intervention and follow up evaluation is indicated. More attention must be given during the medical evaluation to properly identify donors at risk of lipemic donations.
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Affiliation(s)
- Miguel de Oliveira
- Serviço de Hematologia Clínica, Centro Hospitalar e Universitário do Porto, Portugal.
| | - Marika Antunes
- Serviço de Hematologia Clínica, Centro Hospitalar e Universitário do Porto, Portugal
| | - Margarida Amil
- Serviço de Hematologia Clínica, Centro Hospitalar e Universitário do Porto, Portugal
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Kluppel GPZ, de Oliveira JBF, Skare TL, Favero KB, Almeida PTR, Nisihara RM. Seropositivity for syphilis among Brazilian blood donors. A retrospective study 2015-2020. Transfus Apher Sci 2021; 61:103286. [PMID: 34629312 DOI: 10.1016/j.transci.2021.103286] [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: 06/29/2021] [Revised: 09/21/2021] [Accepted: 09/24/2021] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Syphilis is a transfusion-transmitted infection and the disease re-emerged in many countries, including Brazil, as a public health risk. OBJECTIVE Evaluate the prevalence of positive serology in blood donations rejected by Hemobanco (Curitiba- PR) from January 2015 to December 2020, with special focus in syphilis. METHODOLOGY In the studied period, we analyzed the number of blood donations discarded annually for each serological test performed on blood donors' samples, according to gender and donors age. RESULTS Within the studied period, 134,741 blood donation were analyzed. 54.5 % of sample were male. Otherwise, it was observed a significant increase in the number of donations by females (P < 0.0001). There was an increase of 437 % in the prevalence of syphilis positive serology made by donors with ≥ 60 years. Besides that, it was noticed a significant increase in donations by aged people throughout these six years (P < 0.0001). The percentage of total blood donation deferred had a significant reduction, although it was observed an increase in the rate of discarded blood bags due to positive serology in the first 4 studied years. It was observed an increase of 20 % in positive syphilis serology. CONCLUSION The greatest cause of discard of blood donations changed during the analyzed 5-years; there was an increase in seropositivity donations from donors with ≥ 60 years old. In 2015, Hepatitis B (0.8 %) was the most prevalent and in 2020, syphilis became more prevalent (0.82 %). The medical community should be aware of the rising number of cases of syphilis infection. There is an urgent need to implement actions against the dissemination of this disease.
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Affiliation(s)
| | | | | | - Karla B Favero
- Instituto de Hematologia, Hemobanco, Curitiba, PR, Brazil.
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Shmookler AD, Nichols TL, Perrotta PL. A Tertiary Academic Medical Center Blood Bank's Experience With Four-Factor Prothrombin Complex Concentrate. Am J Clin Pathol 2021; 156:246-252. [PMID: 33609094 DOI: 10.1093/ajcp/aqaa226] [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] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES The role of transfusion medicine consultative services in prospectively auditing (PA) orders for four-factor prothrombin complex concentrate (4F-PCC) was evaluated at an academic medical center. METHODS Data from 4 years of 4F-PCC orders were obtained from the laboratory information system, and electronic health records of patients receiving concentrate were reviewed. RESULTS 4F-PCC was ordered for 427 patients with warfarin-, apixaban-, or rivaroxaban-associated hemorrhage. Turnaround time (TAT) to prepare 4F-PCC was longer when PA-recommended dose adjustments were needed (85 vs 66 minutes, P = .03). There was no difference in TAT between patients who died and those who were ultimately discharged (60 vs 70, P = .22). TAT was shortest for orders originating in the emergency department (ED) compared with other locations (64 vs 85, P < .001), and ED TAT was not associated with patient outcomes in ED patients. PA and dose adjustments reduced amounts of concentrate issued by 27 IU per dose (P = .01). Median international normalized ratio less than 1.3 after 4F-PCC transfusion was achieved for all anticoagulants after dose adjustments. PA did not affect order cancellation or product wastage rates. CONCLUSIONS PA can ensure 4F-PCC is dosed appropriately without affecting patient outcomes.
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Pisula A, Sienicka A, Stachyra K, Kacperczyk-Bartnik J, Bartnik P, Dobrowolska-Redo A, Romejko-Wolniewicz E. Women's attitude towards umbilical cord blood banking in Poland. Cell Tissue Bank 2021; 22:587-596. [PMID: 33751309 PMCID: PMC8558205 DOI: 10.1007/s10561-021-09914-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 03/08/2021] [Indexed: 11/28/2022]
Abstract
Umbilical cord blood (UCB) is considered as a valuable potential source of hematopoietic stem and progenitor cells. A process of collecting and storing UCB in the immediate period after the birth is called UCB banking. The study was conducted in order to determine women's knowledge, awareness, preferences and attitude towards UCB banking in Poland, considering the sociodemographic and obstetric factors. A cross-sectional, self-administered, online questionnaire-based study including mostly multiple choice questions concerning attitude and awareness regarding UCB banking was conducted entirely online among Facebook female users in Poland. A total of 1077 participants correctly completed the survey. Most participants (n = 911, 84.6%) were aware of the possibility of UCB banking. Social media were considered as the main source of information (47.5%). However, the participants mostly indicated the doctor as their preferred source of reliable information (86.8%). The majority of women (61.8%) assessed their level of knowledge of UCB banking as still insufficient. Among the participants who supported UCB banking (70%), the following reasons were considered as the most vital: potential possibility of helping their child (93.9%) and helping other relatives (64.4%). More than half of the respondents (66.9%), who have not stored and are not willing to store their children's UCB, indicated the high cost of UCB banking as the main reason of this decision. The knowledge and awareness of UCB storage and banking possibilities amongst women in Poland could be improved. The professional medical personnel should be a source of reliable information.
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Affiliation(s)
- Agata Pisula
- Students' Scientific Group Affiliated to 2nd Department of Obstetrics and Gynecology, Medical University of Warsaw, Warsaw, Poland
| | - Agnieszka Sienicka
- Students' Scientific Group Affiliated to 2nd Department of Obstetrics and Gynecology, Medical University of Warsaw, Warsaw, Poland
| | - Karolina Stachyra
- Students' Scientific Group Affiliated to 2nd Department of Obstetrics and Gynecology, Medical University of Warsaw, Warsaw, Poland
| | - Joanna Kacperczyk-Bartnik
- 2nd Department of Obstetrics and Gynecology, Medical University of Warsaw, Karowa 2 St., 00-315, Warsaw, Poland.
| | - Paweł Bartnik
- 2nd Department of Obstetrics and Gynecology, Medical University of Warsaw, Karowa 2 St., 00-315, Warsaw, Poland
| | - Agnieszka Dobrowolska-Redo
- 2nd Department of Obstetrics and Gynecology, Medical University of Warsaw, Karowa 2 St., 00-315, Warsaw, Poland
| | - Ewa Romejko-Wolniewicz
- 2nd Department of Obstetrics and Gynecology, Medical University of Warsaw, Karowa 2 St., 00-315, Warsaw, Poland
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Waheed U, Abdella YE, Saba NE, Arshad M, Wazeer A, Farooq A, Usman J, Arshad A, Zaheer HA. Evaluation of screening effectiveness of hepatitis B surface antigen and anti-HCV rapid test kits in Pakistan. J Lab Physicians 2019; 11:369-372. [PMID: 31929706 PMCID: PMC6943868 DOI: 10.4103/jlp.jlp_172_19] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [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: 11/07/2019] [Accepted: 11/16/2019] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVE The current study was conducted to evaluate the performance and screening effectiveness of commercially available rapid screening kits in comparison with chemiluminescence immunoassay (CLIA) and polymerase chain reaction (PCR). MATERIALS AND METHODS This single-center, cross-sectional study was conducted at the Department of Pathology and Blood Transfusion Services, Shaheed Zulfiqar Ali Bhutto Medical University, PIMS, Islamabad, from January to April 2019. A total of 10 commercially available immunochromatographic test (ICT) devices and one CLIA kit (LIAISON XL) were tested for their sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy using 100 positive and 100 negative samples each for HBV and HCV, respectively. RESULTS The sensitivities and specificities of ICT kits for hepatitis B surface antigen were 65% and 70% (Hightop), 67% and 85% (RightSign), 62% and 73% (Wondfo), 70% and 80% (Accu-Chek), 68% and 77% (Fastep), 73% and 85% (Abon), 77% and 83% (ImmuMed), 80% and 90% (Insta-Answer), 67% and 81% (BioCheck), and 72% and 83% CTK Biotech, respectively. Similarly, the sensitivities and specificities of different ICT kits for HCV were 69% and 80% (Hightop), 76% and 83% (RightSign), 69% and 81% (Wondfo), 78% and 79% (Accu-Check), 68% and 68% (Fastep), 63% and 73% (Abon), 71% and 70% (ImmuMed), 79% and 68% (Insta-Answer), 62% and 66% (BioChek), and 69% and 78% CTK Biotech, respectively. The sensitivity and specificity of Diasorin Liaison Murex assay for both HBV and HCV were found to be 100% when compared with PCR. The PPV, NPV and Accuracy were determined accordingly. CONCLUSION Rapid testing ICT devices for both HBV and HCV available in Pakistan were found to have a variable degree of sensitivity and specificity when compared with CLIA and PCR. Comparatively expensive but quality methods are more reliable as compared to rapid devices.
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Affiliation(s)
- Usman Waheed
- Safe Blood Transfusion Programme, Ministry of National Health Services, Government of Pakistan, PIMS, Islamabad, Pakistan
- Department of Pathology and Blood Transfusion Services, Shaheed Zulfiqar Ali Bhutto Medical University, PIMS, Islamabad, Pakistan
| | | | - Noor e Saba
- Peshawar Regional Blood Centre, Department of Health, Khyber Pakhtunkhwa, Pakistan
| | - Muhammad Arshad
- Department of Biological Sciences, International Islamic University, Islamabad, Pakistan
| | - Akhlaaq Wazeer
- Department of Biological Sciences, International Islamic University, Islamabad, Pakistan
| | - Ahmad Farooq
- Department of Biological Sciences, International Islamic University, Islamabad, Pakistan
| | - Javaid Usman
- Department of Pathology, Army Medical College, Rawalpindi, Pakistan
| | - Abida Arshad
- Department of Biology, PMAS Arid Agriculture University, Rawalpindi, Pakistan
| | - Hasan Abbas Zaheer
- Safe Blood Transfusion Programme, Ministry of National Health Services, Government of Pakistan, PIMS, Islamabad, Pakistan
- Department of Pathology and Blood Transfusion Services, Shaheed Zulfiqar Ali Bhutto Medical University, PIMS, Islamabad, Pakistan
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Thyer J, Wong J, Thomson A, Bell B, Hyland C, Challis D. Fifty years of RhD immunoglobulin (anti-D) therapy in Australia: celebrating a public health success story. Med J Aust 2019; 209:336-339. [PMID: 30309307 DOI: 10.5694/mja17.01144] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Accepted: 04/20/2018] [Indexed: 11/17/2022]
Affiliation(s)
- James Thyer
- Australian Red Cross Blood Service, Melbourne, VIC
| | - Janet Wong
- Australian Red Cross Blood Service, Sydney, NSW
| | | | | | | | - Daniel Challis
- Pregnancy and Newborn Services Network, Sydney Children's Hospital, Randwick, Sydney, NSW
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Abstract
INTRODUCTION Infection by Trypanosoma cruzi is challenging to blood bank supplies in terms of accurate diagnosis, mostly due to its clinical complexity. Infected individuals may remain asymptomatic for years, albeit they may have circulating parasites potentially transferable to eventual receptors of a transfusion. OBJECTIVE Although risk donors are systematically excluded through a survey, an important residual risk for transmission remains, evidencing the need to implement additional actions for the detection of T. cruzi in blood banks. METHOD A review of the scientific literature is presented with the objective of identifying relevant publications on this subject. RESULTS We discuss the diagnostic considerations of this chronic infection on transfusion medicine and some recent advances in the processing of blood and derivatives units. CONCLUSION Finally, recommendations are made on how the transmission of T. cruzi can be avoided through the implementation of better diagnostic and pathogen control measures at blood banks.
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Affiliation(s)
- Lina Andrea Gómez
- Biomedical Research Center (CIBUS), School of Medicine, Universidad de la Sabana, Chía, Colombia.
| | - Fredy R S Gutierrez
- Laboratory of Immunology, School of Medicine, Antonio Nariño University, Bogotá, Colombia
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Abstract
Correct blood group typing is a prerequisite for transfusion. In most cases blood group determination is without problems; however, in individual cases various factors can complicate blood group determination and sometimes lead to confusing findings. For a better understanding the clinician should have basic knowledge of blood typing. Blood group determination usually covers the AB0 blood groups, Rhesus and Kell systems; in addition, a direct Coombs test and an antibody screening test for the detection of irregular antibodies in the recipient are performed. Confusion of patients, blood samples, results or preparations can lead to severe consequences due to incompatible transfusion and must be prevented. In this context, bedside blood type testing before transfusion is of utmost importance. Problems in laboratory analysis as well as patient-related factors, such as the existence of irregular antibodies against red blood cells can complicate the immunohematology diagnostics. Certain medications, such as daratumumab, lead to a significantly increased complexity in laboratory analyses. Massive transfusions can lead to chimerism with more than one population of circulating red blood cells. Hematopoetic stem cell transplantation can also lead to a change in blood groups as well as chimerism. In addition, there are various other rare causes that can result in difficulties in blood group determination, such as rare blood groups or rare disease-associated phenomena. In the case of problems in blood group determination, early and close cooperation with transfusion medicine is essential for the clinician.
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Affiliation(s)
- P Möhnle
- Abteilung für Transfusionsmedizin, Zelltherapeutika und Hämostaseologie, Klinik für Anaesthesiologie, Universität München (LMU), Marchioninistr. 15, 81377, München, Deutschland.
| | - A Humpe
- Abteilung für Transfusionsmedizin, Zelltherapeutika und Hämostaseologie, Klinik für Anaesthesiologie, Universität München (LMU), Marchioninistr. 15, 81377, München, Deutschland
| | - G Wittmann
- Abteilung für Transfusionsmedizin, Zelltherapeutika und Hämostaseologie, Klinik für Anaesthesiologie, Universität München (LMU), Marchioninistr. 15, 81377, München, Deutschland
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Bello-López JM, Castañeda-García C, Muñoz-Estrada C, Machorro-Peréz AJ. External quality control program in screening for infectious diseases at blood banks in Mexico. Transfus Apher Sci 2018; 57:97-101. [PMID: 29452838 DOI: 10.1016/j.transci.2018.01.004] [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: 07/27/2017] [Revised: 01/05/2018] [Accepted: 01/09/2018] [Indexed: 10/18/2022]
Abstract
INTRODUCTION Quality control for the detection of infectious markers in blood banks is a necessary activity to ensure the accuracy of donor screening results. Considering that in Mexico blood safety is one of the goals of the National Action Programs, it is essential to evaluate banks through an External Quality Control Program. OBJECTIVE To analyze one of the evaluations that showed the greatest participation (2014-2/lot46) of banks in the Mexican Republic in the detection of transfusion-transmitted diseases. MATERIALS AND METHODS A randomized panel of infectious markers of HIV, HCV, HBV, Treponema pallidum and Trypanosoma cruzi was manufactured under high quality standards. The evaluation criteria for each infectious marker were the identification of false positives and false negative results. Additionally, technologies used to detect infectious markers were requested for each bank. RESULTS Of the 503 banks, only 374 participated in the evaluation. Technologies based on chemiluminescence, immunofluorescence and immunocolorimetry were used to detect viral markers. Even rapid tests for T. pallidum continue to be the methods of choice with 42%. Trypanosoma cruzi was 20% with fast techniques versus 80% with automated tests. Highest incidence of false positives was identified for T. pallidum and HBV, followed by T. cruzi, HIV and HCV. Fourteen (3.74%) false negatives results were identified for T. cruzi, followed by T. pallidum (n = 5/1.33%), HCV (n = 4/1.06) and HVB/HIV (n = 2/0.53%). CONCLUSION False positive results identified for each infectious marker was considered high. This evidence will allow us to focus on areas of opportunity during serologic screening with greater emphasis on good laboratory practices.
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Affiliation(s)
- J Manuel Bello-López
- Centro Nacional de la Transfusión Sanguínea, Av. Othón de Mendizábal 195, Zacatenco, Gustavo A. Madero, 07360, Mexico City, Mexico; Research Unit in Microbiology and Toxicology, Hospital Juárez de México, Av. Instituto Politécnico Nacional 5160, Zacatenco, Gustavo A. Madero, 07360, Mexico City, Mexico.
| | - Cristina Castañeda-García
- Centro Nacional de la Transfusión Sanguínea, Av. Othón de Mendizábal 195, Zacatenco, Gustavo A. Madero, 07360, Mexico City, Mexico
| | - Celerino Muñoz-Estrada
- Centro Nacional de la Transfusión Sanguínea, Av. Othón de Mendizábal 195, Zacatenco, Gustavo A. Madero, 07360, Mexico City, Mexico
| | - Antonio José Machorro-Peréz
- Centro Nacional de la Transfusión Sanguínea, Av. Othón de Mendizábal 195, Zacatenco, Gustavo A. Madero, 07360, Mexico City, Mexico
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Silva SMND, Oliveira MBD, Martinez EZ. Distribution of serological screening markers at a large hematology and hemotherapy center in Minas Gerais, Southeastern Brazil. Rev Bras Hematol Hemoter 2016; 38:206-13. [PMID: 27521858 PMCID: PMC4997899 DOI: 10.1016/j.bjhh.2016.05.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2016] [Revised: 04/27/2016] [Accepted: 05/17/2016] [Indexed: 01/04/2023] Open
Abstract
Objective To assess the distribution of serological markers in blood donors at the blood banks of the Fundação Centro de Hematologia e Hemoterapia de Minas Gerais (Hemominas), Brazil, between January 2006 and December 2012. Methods This is a descriptive, retrospective study on blood donors screened using serological tests for markers of transmitted diseases at the state blood-banking network. Results Approximately 78.9% of the donors were considered eligible for the study after clinical screening. Repeat donors represented 68.2% of the total sample, with males being predominant as blood donors (66.8%). Total serological ineligibility was 3.05%, with total anti-HBc being the most common marker (1.26%), followed by syphilis (0.88%) and human immunodeficiency virus (0.36%). The prevalences of the markers for hepatitis C, Human T-cell lymphotropic virus, Chagas disease and HBs-Ag were 0.15%, 0.09%, 0.13% and 0.18%, respectively. The blood bank of Governador Valadares had the highest percentage of positive anti-HBc donors (2.41%). With regard to human immunodeficiency virus, the blood bank of Além Paraíba had the lowest percentage of positive donors while the blood banks of Juiz de Fora and Betim had the highest percentages. The blood bank in the city of Montes Claros had the highest prevalence of the marker for Chagas disease (0.69%). Conclusions Data on the profile of serological ineligibility by the blood banks of the Fundação Hemominas highlights the particularities of each region thereby contributing to measures for health surveillance and helping the blood donation network in its donor selection procedures aimed at improving blood transfusion safety.
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Affiliation(s)
- Sônia Mara Nunes da Silva
- Fundação Centro de Hematologia e Hemoterapia de Minas Gerais (Hemominas), Belo Horizonte, MG, Brazil
| | | | - Edson Zangiacomi Martinez
- Universidade de São Paulo (USP), Faculdade de Medicina de Ribeirão Preto (FMRP), Ribeirão Preto, SP, Brazil.
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Domínguez-Morales SKI, Moreno-López LC, Gallardo JM, Paniagua JR. [Hematological changes induced by erythrocytapheresis]. Rev Med Inst Mex Seguro Soc 2015; 53:422-429. [PMID: 26177429] [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] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
BACKGROUND Although automated cell separators (apheresis) have undergone a lot of technical refinements, the effect of the procedure on hematological indices of donors is rarely taken into account. The purpose of this study is to identify potential hematologic changes in donors undergoing erythrocytapheresis. METHODS 30 apparently healthy adult donors were evaluated. Erythrocytapheresis procedure was performed using automated equipment. Hematologic measurements (hemoglobin, hematocrit, white blood cells counts and platelets) were analyzed before and after erythrocytapheresis in all donors. RESULTS We observed a significant decrease in the donors in hemoglobin (p <0.0001), hematocrit (p <0.0001), leukocytes (p <0.0001), lymphocytes (p = 0.0267), and platelets (p <0.0001). On the other hand, we found no changes in segmented, monocytes, eosinophils and basophils post erythrocytapheresis. CONCLUSION In this study we found a significant drop in complete blood count in blood donation procedure by erythrocytapheresis; there are hematological changes in both red and white cells in all donors; however, none of donors manifested symptoms of thrombocytopenia or anemia. This study demonstrates hematological changes post-donation and therefore requires larger multicenter studies, in order to establish guidelines for donors' safety in apheresis and also help in assessing donor suitability, especially given the present trend of double product apheresis collections.
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Nunes RD, Zandavalli FM. Association between maternal and fetal factors and quality of cord blood as a source of stem cells. Rev Bras Hematol Hemoter 2014; 37:38-42. [PMID: 25638766 PMCID: PMC4318845 DOI: 10.1016/j.bjhh.2014.07.023] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [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: 02/16/2014] [Accepted: 07/03/2014] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES To comparatively analyze maternal and fetal factors and quality markers of blood samples in a public umbilical cord blood bank. METHOD This is a cross-sectional descriptive study that revisited 458 records of donations from September 2009 to March 2013 at the Hemocentro de Santa Catarina. The means of markers were used to define cutoff points for the quality of cord blood. RESULTS Most donations came from women with ages between 18 and 29 years (62.8%), gestational age≥40 weeks (55.2%), vaginal delivery (51.3%), primiparous (41.4%), and with male newborns (54.4%) weighing between 3000 and 3499g (41.8%). The volume of the donations ranged from 71.6 to 275.2mL, the total nucleated cell count ranged from 4.77×10(8) to 31.0×10(8) cells and CD34(+) cells ranged from 0.05 to 1.23%. There were statistically significant differences in the volume with respect to gestation age>38 weeks (p-value=0.001), cesarean section (p-value<0.001) and birth weight>3500g (p-value<0.001). The total nucleated cell count was positively affected by cesarean section (p-value=0.022) and birth weight>3500g (p-value<0.001). There was no statistically significant difference between the variables and the percentage of CD34(+) cells. CONCLUSIONS Delivery route and birth weight influence the volume of cord blood and the total nucleated cell count. Gestational age influences only the volume of cord blood.
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Affiliation(s)
- Rodrigo Dias Nunes
- Universidade do Sul de Santa Catarina (UNISUL), Florianópolis, SC, Brazil.
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Freitas DRC, Duarte EC. Normative evaluation of blood banks in the Brazilian Amazon region in respect to the prevention of transfusion-transmitted malaria. Rev Bras Hematol Hemoter 2014; 36:394-402. [PMID: 25453648 PMCID: PMC4318476 DOI: 10.1016/j.bjhh.2014.09.002] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2013] [Accepted: 06/25/2014] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE To evaluate blood banks in the Brazilian Amazon region with regard to structure and procedures directed toward the prevention of transfusion-transmitted malaria (TTM). METHODS This was a normative evaluation based on the Brazilian National Health Surveillance Agency (ANVISA) Resolution RDC No. 153/2004. Ten blood banks were included in the study and classified as 'adequate' (≥80 points), 'partially adequate' (from 50 to 80 points), or 'inadequate' (<50 points). The following components were evaluated: 'donor education' (5 points), 'clinical screening' (40 points), 'laboratory screening' (40 points) and 'hemovigilance' (15 points). RESULTS The overall median score was 49.8 (minimum=16; maximum=78). Five blood banks were classified as 'inadequate' and five as 'partially adequate'. The median clinical screening score was 26 (minimum=16; maximum=32). The median laboratory screening score was 20 (minimum=0; maximum=32). Eight blood banks performed laboratory tests for malaria; six tested all donations. Seven used thick smears, but only one performed this procedure in accordance with Ministry of Health requirements. One service had a Program of External Quality Evaluation for malaria testing. With regard to hemovigilance, two institutions reported having procedures to detect cases of transfusion-transmitted malaria. CONCLUSION Malaria is neglected as a blood-borne disease in the blood banks of the Brazilian Amazon region. None of the institutions were classified as 'adequate' in the overall classification or with regard to clinical screening and laboratory screening. Blood bank professionals, the Ministry of Health and Health Surveillance service managers need to pay more attention to this matter so that the safety procedures required by law are complied with.
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Affiliation(s)
- Daniel Roberto Coradi Freitas
- Universidade de Brasília (UnB), Brasília, DF, Brazil; Agência Nacional de Vigilância Sanitária (ANVISA), Brasília, DF, Brazil.
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Diekamp U, Gneißl J, Rabe A, Kießig ST. Donor Hemovigilance during Preparatory Plasmapheresis. Transfus Med Hemother 2014; 41:123-33. [PMID: 24847188 PMCID: PMC4025159 DOI: 10.1159/000357991] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [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: 06/11/2013] [Accepted: 10/08/2013] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Reports on unexpected donor events (UEs) during preparatory plasmapheresis (PPP) are scarce, and rarely consider technical UEs. METHODS Defined local and systemic UEs were graded by severity; technical UEs were not graded. On January 1, 2008, E.B.P.S.-Logistics (EBPS) installed the UE module for plasma management software (PMS). Donor room physicians entered UEs daily into the PMS. Medical directors reviewed entries quarterly. EBPS compiled data on donors, donations and UEs from January 1, 2008 to June 30, 2011. RESULTS 66,822 UEs were observed during 1,107,846 PPPs for a corrected incidence of 6.55% (1.4% local, 0.55% systemic, 4.6% technical UEs). 3.36% of PPPs were accompanied by 1 UE and 1.18% by >1 UE (2-5). 13.7% of donors undergoing PPP for the first time, 9.7% of those having a second PPP and 4.0% of those having a third or more PPPs were associated with UEs. Most common UEs were repeated venipuncture, and broken-off collection due to venous access problems and small hematomas. Severe systemic UEs occurred at a rate of 36 per 100,000 PPPs. CONCLUSIONS Technical UEs were common with PPP. UEs accompanied first and second donations significantly more frequently than for subsequent donations.
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de Lima WMG, Esteves FAM, Torres MDCMR, Pires ESF. Prevalence of human T-cell lymphotropic virus types 1 and 2 in blood donors of the Caruaru Blood Center (Hemope). Rev Bras Hematol Hemoter 2013; 35:268-71. [PMID: 24106445 PMCID: PMC3789432 DOI: 10.5581/1516-8484.20130061] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2012] [Accepted: 12/29/2012] [Indexed: 11/27/2022] Open
Abstract
Background There is difficulty in gathering data on the prevalence of human T-cell
lymphotropic virus in blood donors as confirmatory testing is not mandatory in
Brazil. This suggests there may be an underreporting of the prevalence. Objective To estimate the prevalence of human T-cell lymphotropic virus types 1 and 2 in
donors of a blood bank in Caruaru, Brazil. Methods This was an observational, epidemiological, descriptive, longitudinal and
retrospective study with information about the serology of donors of the Caruaru
Blood Center, Fundação de Hematologia e Hemoterapia de Pernambuco (Hemope) from
May 2006 to December 2010. The data were analyzed using the Excel 2010 computer
program (Microsoft Office®). Results Of 61,881 donors, 60 (0.096%) individuals were identified as potential carriers of
human T-cell lymphotropic virus types 1 and 2. Of these, 28 (0.045%) were positive
and 32 (0.051%) had inconclusive results in the serological screening. Forty-five
(0.072%) were retested; 17 were positive (0.027%) and 3 inconclusive (0.005%).
After confirmatory tests, 8 were positive (0.013%). Six (75%) of the confirmed
cases were women. Conclusion Epidemiological surveys like this are very important in order to create campaigns
to attract donors and reduce the costs of laboratory tests.
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de Souza DA, Silva FGE, Costa PJMDS. Critical evaluation of justifications for the transfusion of red blood cells: the reality of a government emergency hospital. Rev Bras Hematol Hemoter 2013; 35:263-7. [PMID: 24106444 PMCID: PMC3789431 DOI: 10.5581/1516-8484.20130070] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [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: 08/06/2012] [Accepted: 04/17/2013] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Blood products and derivatives are indispensable resources in medical therapies. However, it is important to note that the number of donations is far from ideal. Despite constant campaign efforts, a deficit of 1 million units is expected by 2030. OBJECTIVES To determine the adequacy of the indications for red blood cell transfusion in an emergency hospital in Alagoas. METHODS This was a cross-sectional observational study conducted at the Alagoas Blood Center. Of a total of 2936 red blood cell transfusion requests in 2009, 334 were randomized and compared with transfusion parameters described in the literature (primary variable). After analysis, the transfusion requests were categorized as adequate, inadequate or inconclusive. This last group included all red blood cell transfusion requests with insufficient clinical information, rendering their classification as adequate or inadequate impossible. The secondary variable involved the reasons for red blood cell transfusion. A 95% confidence interval was used in the statistical analysis. RESULTS Forty-seven (14.07%) requests were adequate and 30 (8.98%) were inadequate. Most of the requests were classified as inconclusive (76.94%). The main indications for transfusion were upper gastrointestinal bleeding (26.95%), anemia (46.71%), hypovolemia/hypovolemic shock (10.78%) and sepsis/septic shock (3.29%). CONCLUSION It was not possible to reach a conclusion on the adequacy of the indication for transfusion in most of the cases. Therefore, it is important to adopt a transfusion protocol, rigorously analyze blood bank requests, to provide awareness campaigns on the rational use of blood and to implement strategies to use blood products more effectively.
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Affiliation(s)
- Diego Agra de Souza
- Universidade Estadual de Ciências da Saúde de Alagoas - UNCISAL, Maceió, AL, Brazil
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Oliveira CDL, de Almeida-Neto C, Liu EJ, Sabino EC, Leão SC, Loureiro P, Wright D, Custer B, Gonçalez TT, Capuani L, Busch M, Proietti ABDFC. Temporal distribution of blood donations in three Brazilian blood centers and its repercussion on the blood supply. Rev Bras Hematol Hemoter 2013; 35:246-51. [PMID: 24106441 PMCID: PMC3789428 DOI: 10.5581/1516-8484.20130071] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2012] [Accepted: 01/27/2013] [Indexed: 11/27/2022] Open
Abstract
Background Seasonal distribution of blood donation hinders efforts to provide a safe and
adequate blood supply leading to chronic and persistent shortages. This study
examined whether holidays, geographical area and donation type (community versus
replacement) has any impact on the fluctuation of donations. Methods The numbers of blood donations from 2007 through 2010 in three Brazilian
Retrovirus Epidemiological Donor Study II (REDS-II) participating centers were
analyzed according to the week of donation. The weeks were classified as holiday
or non-holiday. To compare donations performed during holiday versus non-holiday
weeks, tabulations and descriptive statistics for weekly donations by blood center
were examined and time series analysis was conducted. Results The average weekly number of donations varied according to the blood center and
type of week. The average number of donations decreased significantly during
Carnival and Christmas and increased during the Brazilian National Donor Week. The
fluctuation was more pronounced in Recife and Belo Horizonte when compared to
São Paulo and higher among community donors. Conclusion National bank holidays affect the blood supply by reducing available blood
donations. Blood banks should take into account these oscillations in order to
plan local campaigns, aiming at maintaining the blood supply at acceptable
levels.
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Coêlho MJD, Monteiro TDC, Vasquez FG, Silva KLT, Dos Santos KSB, de Oliveira VMA, Cavalcante FDO. Platelet aggregation and quality control of platelet concentrates produced in the Amazon Blood Bank. Rev Bras Hematol Hemoter 2013; 33:110-4. [PMID: 23284257 PMCID: PMC3520634 DOI: 10.5581/1516-8484.20110030] [Citation(s) in RCA: 11] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2010] [Accepted: 02/24/2011] [Indexed: 11/29/2022] Open
Abstract
Background The study of platelet aggregation is essential to assess in vitro platelet function by different platelet activation pathways. Objective To assess aggregation and biochemical parameters of random platelet concentrates produced at the Fundação HEMOAM using the quality control tests defined by law. Methods Whole blood samples from 80 donors and the respective platelet concentrate units were tested. Platelet concentrates were tested (platelet count, aggregation and pH) on days 1, 3 and 5 of storage. Additionally a leukocyte count was done only on day 1 and microbiological tests on day 5 of storage. Collagen and adenosine diphosphate were used as inducing agonists for platelet aggregation testing. Results Donor whole blood had normal aggregation (aggregation with adenosine diphosphate = 67% and with collagen = 78%). The median aggregation in platelet concentrates with adenosine diphosphate was low throughout storage (18% on day 1, 7% on day 3 and 6% on day 5) and the median aggregation with collagen was normal only on day 1 and low thereafter (54.4% on day 1, 20.5% on day 3 and 9% on day 5). Conclusion Although the results were within the norms required by law, platelet concentrates had low aggregation rates. We suggest the inclusion of a functional assessment test for the quality control of platelet concentrates for a more effective response to platelet replacement therapy.
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Affiliation(s)
- Maria José Dantas Coêlho
- Blood Cycle Department, Laboratório de Fracionamento, Fundação de Hematologia e Hemoterapia do Amazonas, Manaus, AM, Brazil
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Loureiro FCM, Oliveira CDL, Proietti ABFC, Proietti FA. Confidential donation confirmation as an alternative to confidential unit exclusion: 15 months experience of the HEMOMINAS foundation. Rev Bras Hematol Hemoter 2012; 33:263-7. [PMID: 23049316 PMCID: PMC3415759 DOI: 10.5581/1516-8484.20110074] [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] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2011] [Accepted: 03/01/2011] [Indexed: 11/27/2022] Open
Abstract
Background Confidential unit exclusion remains a controversial strategy to reduce the residual risk of transfusion-transmitted infections. Objective This study aimed to analyze confidential unit exclusion from its development in a large institution in light of confidential donation confirmation. Methods Data of individuals who donated from October 1, 2008 to December 31, 2009 were analyzed in a case-control study. The serological results and sociodemographic characteristics of donors who did not confirm their donations were compared to those who did. Variables with p-values < 0.20 in univariate analysis were included in a logistic multivariate analysis. Results In the univariate analysis there was a statically significant association between positive serological results and response to confidential donation confirmation of "No". Donation type, (firsttime or return donor - OR 1.69, CI 1.37-2.09), gender (OR 1.66, CI 1.35-2.04), education level (OR 2.82, CI 2.30-3.47) and ethnic background (OR 0.67, CI 0.55-0.82) were included in the final logistic regression model. In all logistic regression models analyzed, the serological suitability and confidential donation confirmation were not found to be statistically associated. The adoption of new measures of clinical classification such as audiovisual touch-screen computer-assisted self-administered interviews might be more effective than confidential unit exclusion in the identification of donor risk behavior. The requirement that transfusion services continue to use confidential unit exclusion needs to be debated in countries where more specific and sensitive clinical and serological screening methods are available. Conclusion Our findings suggest that there are not enough benefits to justify continued use of confidential donation confirmation in the analyzed institution.
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Ferreira AM, Brener S, de Carvalho RVF, do Valle MCR, Moraes-Souza H. Participation in proficiency programs and promotion of quality in transfusion services of Minas Gerais. Rev Bras Hematol Hemoter 2012; 34:21-4. [PMID: 23049379 PMCID: PMC3459603 DOI: 10.5581/1516-8484.20120009] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2011] [Accepted: 12/02/2011] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE This study aimed at identifying associations between the participation of transfusion services in immunohematology external quality control programs and their accuracy in immunohematology testing and adaptation to technical and legal operational procedures. METHODS From 2007 to 2009, a cross-sectional study was conducted in 219 transfusion services of the State of Minas Gerais who participated in this investigation by responding to a questionnaire and conducting a proficiency test comprising: ABO and RhD phenotyping, irregular RBC antibody screening and cross-matching. Frequencies and bivariate analysis followed by binary logistic regression were used for statistical analysis. RESULTS Transfusion services who participated in external quality control programs (32.4%) and those that did not (67.6%) obtained worrying error percentages in proficiency tests which may significantly increase blood transfusion risks. Shortfalls related to the establishment of protocols, standards and internal quality control were also significant. On comparing the two groups, transfusion services that participated in these programs had a 2.35 times higher chance of correct results in the proficiency panel testing, a 3.16 higher chance of having transfusional records and a 2.81 higher chance of performing preventive maintenance of equipment. CONCLUSION The study showed that independent factors associated to participation in external quality control programs suggest that more investment in internal quality control procedures is necessary and that more attention should be paid to current legislation.
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Affiliation(s)
- Angela Melgaço Ferreira
- Quality Control Department, Fundação Centro de Hematologia e Hemoterapia do Estado de Minas Gerais - Hemominas, Belo Horizonte, MG, Brazil
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Lourençon ADF, Almeida RGDS, Ferreira O, Martinez EZ. Evaluation of the return rate of volunteer blood donors. Rev Bras Hematol Hemoter 2012; 33:190-4. [PMID: 23049294 PMCID: PMC3415744 DOI: 10.5581/1516-8484.20110052] [Citation(s) in RCA: 10] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2010] [Accepted: 03/09/2011] [Indexed: 11/27/2022] Open
Abstract
Background To convert first-time blood donors into regular volunteer donors is a challenge to transfusion services. Objectives This study aims to estimate the return rate of first time donors of the Ribeirão Preto Blood Center and of other blood centers in its coverage region. Methods The histories of 115,553 volunteer donors between 1996 and 2005 were analyzed. Statistical analysis was based on a parametric long-term survival model that allows an estimation of the proportion of donors who never return for further donations. Results Only 40% of individuals return within one year after the first donation and 53% return within two years. It is estimated that 30% never return to donate. Higher return rates were observed among Black donors. No significant difference was found in non-return rates regarding gender, blood type, Rh blood group and blood collection unit. Conclusions The low percentage of first-time donors who return for further blood donation reinforces the need for marketing actions and strategies aimed at increasing the return rates.
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Affiliation(s)
- Adriana de Fátima Lourençon
- Social Medicine Department, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo - FMRP-USP, Ribeirão Preto, SP, Brazil
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de Carvalho RVF, Brener S, Ferreira AM, do Valle MCR, Moraes-Souza H. Transfusion Practices Committee of a public blood bank network in Minas Gerais, Brazil. Rev Bras Hematol Hemoter 2012; 34:416-20. [PMID: 23323064 PMCID: PMC3545427 DOI: 10.5581/1516-8484.20120104] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2011] [Accepted: 09/20/2012] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE This study aimed to verify the performance of blood transfusion committees in transfusion services linked to the public blood bank network of the state of Minas Gerais. METHODS A cross-sectional observational study was conducted between 2007 and 2008 using questionnaires and proficiency tests to evaluate the reporting and investigation of transfusion reactions comparing transfusion services with and without transfusion committees in the public transfusion services of the state of Minas Gerais. RESULTS Nineteen of Hemominas own transfusion services and 207 that contracted the services of the foundation located in 178 municipalities were visited between 2007 and 2008. Established transfusion committees were present in 63.4% of the services visited. Transfusion incidents were reported by 53 (36.8%) transfusion services with transfusion committees and by eight (9.6%) without transfusion committees (p < 0.001) with 543 (97.5%) and 14 (2.5%) notifications, respectively. Of the reported transfusion incidents, 40 (75.5%) transfusion services with transfusion committees and only two (25%) of those without transfusion committees investigated the causes. CONCLUSION The incidence of notification and investigation of the causes of transfusion reactions was higher in transfusion services where a transfusion committee was present. Despite these results, the performance of these committees was found to be incipient and a better organization and more effective operation are required.
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Affiliation(s)
| | - Stela Brener
- Fundação Centro de Hematologia e Hemoterapia de Minas Gerais - Fundação Hemominas, Belo Horizonte, MG, Brazil
| | - Angela Melgaço Ferreira
- Fundação Centro de Hematologia e Hemoterapia de Minas Gerais - Fundação Hemominas, Belo Horizonte, MG, Brazil
| | | | - Helio Moraes-Souza
- Fundação Centro de Hematologia e Hemoterapia de Minas Gerais - Fundação Hemominas, Belo Horizonte, MG, Brazil
- Universidade Federal do Triângulo Mineiro - UFTM, Uberaba, MG, Brazil
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Ferreira O, Passos ADC. Factors associated with failure of clinical screening among blood donors who have altered serological results in the Centro Regional de Hemoterapia de Ribeirão Preto. Rev Bras Hematol Hemoter 2012; 34:411-5. [PMID: 23323063 PMCID: PMC3545426 DOI: 10.5581/1516-8484.20120103] [Citation(s) in RCA: 5] [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: 10/06/2011] [Accepted: 08/20/2012] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE This study aimed to investigate the frequency of positive results for hepatitis B and C, HIV and syphilis in blood donations at the Centro Regional de Hemoterapia de Ribeirão Preto, to describe donors with positive results according to some demographic and socioeconomic variables, to identify risk factors associated to these donors and the reasons that they were not detected during clinical screening. METHODS A descriptive study was performed between July 1(st) 2005 and July 31(st) 2006 by interviewing 106 donorsafter medical consultations where they were informed of positive results for hepatitis B, hepatitis C, HIV or syphilis. RESULTS There was a predominance of first-time donors, males, under 50-year olds, married individuals, from Ribeirão Preto, with elementary education, low economic status and of people who donated at the request of friends or relatives. Hepatitis C was the most frequently detected infection (56.6%), followed by hepatitis B (20.7%), HIV (12.3%) and syphilis(10.4%). About 40% of donors had omitted risk factors for different reasons: because they trusted the results of serological tests, did not feel comfortable about talking of risk factors or did not consider them relevant. Other justifications were the duration of the interview, the interviewer was unskilled, embarrassment and doubts about confidentiality. CONCLUSION The results indicate the need for changes in the approach to clinical screening and a review of methods to attract and guide potential donors.
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Affiliation(s)
- Oranice Ferreira
- Centro Regional de Hemoterapia de Ribeirão Preto, Universidade de São Paulo - USP, Ribeirão Preto, SP, Brazil
| | - Afonso Dinis Costa Passos
- Faculdade de Medicina de Ribeirão Preto - Universidade de São Paulo - USP, Ribeirão Preto, SP, Brazil
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