1
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Guggenheim DS, Kurtzberg J, Shaz BH. Impact of FDA's HCT/P ZIKV Recommendations on Cord Blood Unit Eligibility and Utilization in a Large Public Cord Blood Bank. Stem Cells Transl Med 2024; 13:448-453. [PMID: 38521608 DOI: 10.1093/stcltm/szae008] [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: 10/28/2023] [Accepted: 01/05/2024] [Indexed: 03/25/2024] Open
Abstract
BACKGROUND Cord blood units (CBUs) that are ineligible for licensure due to incomplete compliance with FDA recommendations may be used for hematopoietic stem cell transplantation under urgent medical need and an Investigational Drug Application. The largest reason for CBU donor ineligibility is Zika virus (ZIKV) risk. The study's objective was to analyze the impact of current FDA recommendations for ZIKA risk on a large public cord blood bank and propose updated recommendations. METHODS We performed a retrospective analysis of Carolinas Cord Blood Bank (CCBB), an FDA licensed public CBB, using data from January 1, 2016 to November 21, 2023 and compared FDA recommendations for transfusion transmitted infections (TTI) for blood products and relevant communicable disease agents or diseases for human cell, tissue, or cellular or tissue-based products (HCT/Ps). RESULTS CCBB: 9057 (84.3% licensed) CBUs were banked. 984/1682 (58.5%) of unlicensed CBUs had ZIKV risk. 22.0% of CBUs with ZIKV risk were from Hispanic parents, compared to 16.1% of all units. 31 of IND CBUs (11 due to ZIKV risk without reported ZIKV transmission) were safely infused. FDA Guidance: HCT/P ZIKV, HIV, and vCJD recommendations have not been updated since 2018 in contrast to FDA removal of ZIKV as a relevant TTI in 2021 and updating HIV and vCJD guidance related to TTI in 2023 and 2022, respectively. DISCUSSION The FDA should consider new data to revise the HCT/P donor eligibility recommendations, which will increase the number of eligible HCT/P donors, and potentially improve access to therapies for a more diverse patient population.
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Bottiger B, Klapper J, Fessler J, Shaz BH, Levy JH. Examining Bleeding Risk, Transfusion-related Complications, and Strategies to Reduce Transfusions in Lung Transplantation. Anesthesiology 2024; 140:808-816. [PMID: 38345894 DOI: 10.1097/aln.0000000000004829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/13/2024]
Abstract
Blood product transfusions for bleeding management in lung transplantation affect recipient outcomes. Interventions are needed to reduce perioperative bleeding risk and optimize outcomes.
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Affiliation(s)
- Brandi Bottiger
- Department of Anesthesiology, Cardiothoracic Anesthesiology Division, Duke University Medical Center, Durham, North Carolina
| | - Jacob Klapper
- Department of Cardiothoracic Surgery, Duke University Medical Center, Durham, North Carolina
| | - Julien Fessler
- Department of Anesthesiology, Hôpital Foch, Suresnes, France
| | - Beth H Shaz
- Department of Pathology, Duke University Medical Center, Durham, North Carolina
| | - Jerrold H Levy
- Department of Anesthesiology, Cardiothoracic Anesthesiology Division, Duke University Medical Center, Durham, North Carolina
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3
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Maier CL, Brohi K, Curry N, Juffermans NP, Mora Miquel L, Neal MD, Shaz BH, Vlaar APJ, Helms J. Contemporary management of major haemorrhage in critical care. Intensive Care Med 2024; 50:319-331. [PMID: 38189930 DOI: 10.1007/s00134-023-07303-5] [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: 09/08/2023] [Accepted: 12/05/2023] [Indexed: 01/09/2024]
Abstract
Haemorrhagic shock is frequent in critical care settings and responsible for a high mortality rate due to multiple organ dysfunction and coagulopathy. The management of critically ill patients with bleeding and shock is complex, and treatment of these patients must be rapid and definitive. The administration of large volumes of blood components leads to major physiological alterations which must be mitigated during and after bleeding. Early recognition of bleeding and coagulopathy, understanding the underlying pathophysiology related to specific disease states, and the development of individualised management protocols are important for optimal outcomes. This review describes the contemporary understanding of the pathophysiology of various types of coagulopathic bleeding; the diagnosis and management of critically ill bleeding patients, including major haemorrhage protocols and post-transfusion management; and finally highlights recent areas of opportunity to better understand optimal management strategies for managing bleeding in the intensive care unit (ICU).
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Affiliation(s)
- Cheryl L Maier
- Department of Pathology and Laboratory Medicine, Center for Transfusion and Cellular Therapies, Emory University School of Medicine, Atlanta, GA, USA
| | - Karim Brohi
- Centre for Trauma Sciences, Queen Mary University of London, London, UK
| | - Nicola Curry
- Oxford Haemophilia and Thrombosis Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
- Nuffield Department of Clinical and Laboratory Sciences, Radcliffe Department of Medicine, Oxford University, Oxford, UK
| | - Nicole P Juffermans
- Department of Intensive Care and Laboratory of Translational Intensive Care, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Lidia Mora Miquel
- Department of Anaesthesiology, Intensive Care and Pain Clinic, Vall d'Hebron Trauma, Rehabilitation and Burns Hospital, Autonomous University of Barcelona, Passeig de La Vall d'Hebron 119-129, 08035, Barcelona, Spain
| | - Matthew D Neal
- Trauma and Transfusion Medicine Research Center, University of Pittsburgh, Pittsburgh, PA, USA
| | - Beth H Shaz
- Department of Pathology, Duke University School of Medicine, Durham, NC, USA
| | | | - Julie Helms
- Service de Médecine Intensive-Réanimation, Department of Intensive Care, Nouvel Hôpital Civil, Université de Strasbourg (UNISTRA), 1, Place de L'Hôpital, 67091, Strasbourg Cedex, France.
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4
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Maier CL, Brohi K, Curry N, Juffermans NP, Mora Miquel L, Neal MD, Shaz BH, Vlaar APJ, Helms J. Correction: Contemporary management of major haemorrhage in critical care. Intensive Care Med 2024; 50:490. [PMID: 38285053 DOI: 10.1007/s00134-024-07323-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2024]
Affiliation(s)
- Cheryl L Maier
- Department of Pathology and Laboratory Medicine, Center for Transfusion and Cellular Therapies, Emory University School of Medicine, Atlanta, GA, USA
| | - Karim Brohi
- Centre for Trauma Sciences, Queen Mary University of London, London, UK
| | - Nicola Curry
- Oxford Haemophilia and Thrombosis Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
- Nuffield Department of Clinical and Laboratory Sciences, Radcliffe Department of Medicine, Oxford University, Oxford, UK
| | - Nicole P Juffermans
- Department of Intensive Care and Laboratory of Translational Intensive Care, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Lidia Mora Miquel
- Department of Anaesthesiology, Intensive Care and Pain Clinic, Vall d'Hebron Trauma, Rehabilitation and Burns Hospital, Autonomous University of Barcelona, Passeig de La Vall d'Hebron 119-129, 08035, Barcelona, Spain
| | - Matthew D Neal
- Trauma and Transfusion Medicine Research Center, University of Pittsburgh, Pittsburgh, PA, USA
| | - Beth H Shaz
- Department of Pathology, Duke University School of Medicine, Durham, NC, USA
| | | | - Julie Helms
- Service de Médecine Intensive-Réanimation, Department of Intensive Care, Nouvel Hôpital Civil, Université de Strasbourg (UNISTRA), 1, Place de L'Hôpital, 67091, Strasbourg Cedex, France.
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Shaz BH, Schäfer R, Fontaine MJ, Norris PJ, McKenna DH, Jin P, Reems JA, Stroncek D, Tanashi M, Marks D, Geng H, Pati S. Local manufacturing processes contribute to variability in human mesenchymal stromal cell expansion while growth media supplements contribute to variability in gene expression and cell function: a Biomedical Excellence for Safer Transfusion (BEST) collaborative study. Cytotherapy 2023:S1465-3249(23)01101-5. [PMID: 38043052 DOI: 10.1016/j.jcyt.2023.11.003] [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: 10/07/2023] [Accepted: 11/15/2023] [Indexed: 12/04/2023]
Abstract
BACKGROUND AIMS Culture-derived mesenchymal stromal cells (MSCs) exhibit variable characteristics when manufactured using different methods, source material and culture media. The purpose of this multicenter study was to assess the impact on MSC expansion, gene expression and other characteristics when different laboratories expanded MSCs from cultures initiated with bone marrow-MSC aliquots derived from the same donor source material yet with different growth media. METHODS Eight centers expanded MSCs using four human platelet lysate (HPL) and one fetal bovine serum (FBS) products as media supplements. The expanded cells were taken through two passages then assessed for cell count, viability, doubling time, immunophenotype, cell function, immunosuppression and gene expression. Results were analyzed by growth media and by center. RESULTS Center methodologies varied by their local seeding density, feeding regimen, inoculation density, base media and other growth media features (antibiotics, glutamine, serum). Doubling times were more dependent on center than on media supplements. Two centers had appropriate immunophenotyping showing all MSC cultures were positive for CD105, CD73, CD90 and negative for CD34, CD45, CD14, HLA-DR. MSCs cultured in media supplemented with FBS compared with HPL featured greater T-cell inhibition potential. Gene expression analysis showed greater impact of the type of media supplement (HPL versus FBS) than the manufacturing center. Specifically, nine genes were decreased in expression and six increased when combining the four HPL-grown MSCs versus FBS (false discovery rate [FDR] <0.01), however, without significant difference between different sources of HPL (FDR <0.01). CONCLUSIONS Local manufacturing process plays a critical role in MSC expansion while growth media may influence function and gene expression. All HPL and FBS products supported cell growth.
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Affiliation(s)
- Beth H Shaz
- Department of Pathology, Duke University, Durham, North Carolina, USA.
| | - Richard Schäfer
- Institute for Transfusion Medicine and Immunohaematology, German Red Cross Blood Donor Service Baden-Württemberg-Hessen gGmbH, Goethe University Hospital, Frankfurt am Main, Germany; Institute for Transfusion Medicine and Gene Therapy, Medical Center University of Freiburg, Freiburg, Germany
| | - Magali J Fontaine
- University of Maryland School of Medical Science, Baltimore, Maryland, USA
| | - Philip J Norris
- Vitalant Research Institute, San Francisco, California, USA; Department of Lab Medicine, University of California San Francisco, San Francisco, California, USA
| | - David H McKenna
- Molecular and Cellular Therapeutics, University of Minnesota, Saint Paul, Minnesota, USA
| | - Ping Jin
- Cell Processing Section, Department of Transfusion Medicine, Clinical Center; National Institutes of Health, Bethesda, Maryland, USA
| | - Jo-Anna Reems
- Cell Therapy and Regenerative Medicine Facility, University of Utah, Salt Lake City, Utah, USA
| | - David Stroncek
- Cell Processing Section, Department of Transfusion Medicine, Clinical Center; National Institutes of Health, Bethesda, Maryland, USA
| | - Minoko Tanashi
- Japanese Red Cross Blood Service Headquarters, Tokyo, Japan
| | - Denese Marks
- Research and Development, Australian Red Cross Lifeblood, Sydney, NSW, Australia
| | - Huimin Geng
- Molecular and Cellular Therapeutics, University of Minnesota, Saint Paul, Minnesota, USA
| | - Shibani Pati
- Molecular and Cellular Therapeutics, University of Minnesota, Saint Paul, Minnesota, USA
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Abstract
This JAMA Insights summarizes best clinical practices for use of whole blood, plasma, cryoprecipitate, platelets, and red blood cells in the process of blood transfusion.
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Affiliation(s)
- Claudia S Cohn
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis
| | - Beth H Shaz
- Department of Pathology, Duke University, Durham, North Carolina
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Hotchkiss KM, Noldner P, Singh K, Patel A, Fecci P, Antonia S, Shaz BH, Khasraw M. Abstract 3193: Developing non-exhausted tumor infiltrating lymphocytes (TILs) as a therapy for glioblastoma. Cancer Res 2023. [DOI: 10.1158/1538-7445.am2023-3193] [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: 04/07/2023]
Abstract
Abstract
Glioblastoma is the most prevalent primary brain malignancy, with a median survival of less than 21 months despite treatment with surgery, radiation, and chemotherapy. Significant intra-tumoral heterogeneity, combined with the immunosuppressive micro-environment and the limited immune population present within the privileged CNS has resulted in the failure of immunotherapy approaches. We seek to address these challenges by isolating Tumor Infiltrating Lymphocytes (TILs) which are already neoantigen specific and expanding them ex vivo before re-administering them to the patient. This allows us to greatly increase the available pool of T cells which are specific for a diversity of tumor neoantigens in the patient, while also reversing exhaustion by the addition of stimulatory co-culturing agents. We report the successful expansion of glioblastoma associated TILs from both surgically resected tumors (5 of 7 samples, 71%) and liquid aspirate from the surgical field collected in Lukens traps (4 of 6 samples, 66%). TILs were expanded with high-dose IL2 initially in the presence of tumor digest (PreREP) followed by activation and expansion with CD3/CD28 nanobeads (REP). Flow cytometry performed on PreREP TILs revealed that 50-90% of the population consisted of effector memory T cells (CCR7-CD45RA-) with 5-40% consisting of central memory T cells (CCR7+CD45RA-). The addition of stimulatory agents such as anti-4-1BB (Urelumab) during the PreREP phase increased cell yields, as well as skewing the population towards a non-exhausted CD8+ phenotype (reduced expression of PD1, LAG3, TIM3). These cells have demonstrated tumor antigen specific activation based on IFNγ and TNFα secretion following stimulation with autologous tumor digests and patient matched neurosphere cultures. TIL expansion with Urelumab doubled CD8% in the product (16% to 31%) and reduced CD4% (78% to 65%). Expanded TILs had more potent cytotoxic CD8+ T cells responses characterized by significantly increased numbers of tumor antigen specific IFNγ+ (std: 1000, Ure: 6000) and TNFα+ (std:2000, Ure:20,000))cells compared to traditionally expanded TILs. We have demonstrated that TIL isolation from resected clinical glioma is feasible and can generate large quantities of immune cells whose functional status can be altered by the addition of stimulatory agents. And most importantly these TILs are reactive and specific for tumor antigens. Following additional assessment of in vitro cytotoxicity against matched tumor neurospheres in vitro we will evaluate safety and feasibility of our novel TIL approach in patients with glioblastoma.
Citation Format: Kelly M. Hotchkiss, Pamela Noldner, Kirit Singh, Anoop Patel, Peter Fecci, Scott Antonia, Beth H. Shaz, Mustafa Khasraw. Developing non-exhausted tumor infiltrating lymphocytes (TILs) as a therapy for glioblastoma [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 3193.
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Affiliation(s)
| | | | - Kirit Singh
- 1Duke University School of Medicine, Durham, NC
| | - Anoop Patel
- 1Duke University School of Medicine, Durham, NC
| | - Peter Fecci
- 1Duke University School of Medicine, Durham, NC
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8
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Shaz BH, Kraft BD, Troy JD, Poehlein E, Chen L, Cheatham L, Manyara R, Hanafy K, Brown L, Scott M, Palumbo R, Vrionis F, Kurtzberg J. Feasibility Study of Cord Tissue Derived Mesenchymal Stromal Cells in COVID-19-Related Acute Respiratory Distress Syndrome. Stem Cells Transl Med 2023; 12:185-193. [PMID: 36929827 PMCID: PMC10108718 DOI: 10.1093/stcltm/szad009] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [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: 11/19/2022] [Accepted: 02/06/2023] [Indexed: 03/18/2023] Open
Abstract
BACKGROUND Treatment options for patients with COVID-19-related acute respiratory distress syndrome (ARDS) are desperately needed. Allogeneic human umbilical cord derived mesenchymal stromal cells (hCT-MSCs) have potential therapeutic benefits in these critically ill patients, but feasibility and safety data are lacking. MATERIALS AND METHODS In this phase I multisite study, 10 patients with COVID-19-related ARDS were treated with 3 daily intravenous infusions of hCT-MSCs (1 million cells/kg, maximum dose 100 million cells). The primary endpoint assessed safety. RESULTS Ten patients (7 females, 3 males; median age 62 years (range 39-79)) were enrolled at 2 sites and received a total of 30 doses of study product. The average cell dose was 0.93 cells/kg (range 0.56-1.45 cells/kg and total dose range 55-117 million cells) with 5/30 (17%) of doses lower than intended dose. Average cell viability was 85% (range 63%-99%) with all but one meeting the >70% release criteria. There were no infusion-related reactions or study-related adverse events, 28 non-serious adverse events in 3 unique patients, and 2 serious adverse events in 2 unique patients, which were expected and unrelated to the study product. Five patients died: 3 by day 28 and 5 by day 90 of the study (median 27 days, range 7-76 days). All deaths were determined to be unrelated to the hCT-MSCs. CONCLUSION We were able to collect relevant safety outcomes for the use of hCT-MSCs in patients with COVID-19-related ARDS. Future studies to explore their safety and efficacy are warranted.
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Affiliation(s)
- Beth H Shaz
- Marcus Center for Cellular Cures, Duke University, Durham, NC, USA
| | - Bryan D Kraft
- Department of Medicine, Duke University, Durham, NC, USA
| | - Jesse D Troy
- Marcus Center for Cellular Cures, Duke University, Durham, NC, USA
| | - Emily Poehlein
- Marcus Center for Cellular Cures, Duke University, Durham, NC, USA
| | - Lingye Chen
- Department of Medicine, Duke University, Durham, NC, USA
| | - Lynn Cheatham
- Marcus Center for Cellular Cures, Duke University, Durham, NC, USA
| | - Raha Manyara
- Marcus Center for Cellular Cures, Duke University, Durham, NC, USA
| | | | - Linda Brown
- Marcus Center for Cellular Cures, Duke University, Durham, NC, USA
| | | | | | | | - Joanne Kurtzberg
- Marcus Center for Cellular Cures, Duke University, Durham, NC, USA
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Hod EA, Brittenham GM, Bitan ZC, Feit Y, Gaelen JI, La Carpia F, Sandoval LA, Zhou AT, Soffing M, Mintz A, Schwartz J, Eng C, Scotto M, Caccappolo E, Habeck C, Stern Y, McMahon DJ, Kessler DA, Shaz BH, Francis RO, Spitalnik SL. A randomized trial of blood donor iron repletion on red cell quality for transfusion and donor cognition and well-being. Blood 2022; 140:2730-2739. [PMID: 36069596 PMCID: PMC9837440 DOI: 10.1182/blood.2022017288] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 07/06/2022] [Accepted: 07/20/2022] [Indexed: 01/21/2023] Open
Abstract
Although altruistic regular blood donors are vital for the blood supply, many become iron deficient from donation-induced iron loss. The effects of blood donation-induced iron deficiency on red cell transfusion quality or donor cognition are unknown. In this double-blind, randomized trial, adult iron-deficient blood donors (n = 79; ferritin < 15 μg/L and zinc protoporphyrin >60 μMol/mol heme) who met donation qualifications were enrolled. A first standard blood donation was followed by the gold-standard measure for red cell storage quality: a 51-chromium posttransfusion red cell recovery study. Donors were then randomized to intravenous iron repletion (1 g low-molecular-weight iron dextran) or placebo. A second donation ∼5 months later was followed by another recovery study. Primary outcome was the within-subject change in posttransfusion recovery. The primary outcome measure of an ancillary study reported here was the National Institutes of Health Toolbox-derived uncorrected standard Cognition Fluid Composite Score. Overall, 983 donors were screened; 110 were iron-deficient, and of these, 39 were randomized to iron repletion and 40 to placebo. Red cell storage quality was unchanged by iron repletion: mean change in posttransfusion recovery was 1.6% (95% confidence interval -0.5 to 3.8) and -0.4% (-2.0 to 1.2) with and without iron, respectively. Iron repletion did not affect any cognition or well-being measures. These data provide evidence that current criteria for blood donation preserve red cell transfusion quality for the recipient and protect adult donors from measurable effects of blood donation-induced iron deficiency on cognition. This trial was registered at www.clinicaltrials.gov as NCT02889133 and NCT02990559.
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Affiliation(s)
- Eldad A. Hod
- Department of Pathology and Cell Biology, Columbia University College of Physicians and Surgeons, New York Presbyterian Hospital, New York, NY
| | - Gary M. Brittenham
- Department of Pediatrics, Columbia University College of Physicians and Surgeons, New York Presbyterian Hospital, New York, NY
- Department of Medicine, Columbia University College of Physicians and Surgeons, New York Presbyterian Hospital, New York, NY
| | - Zachary C. Bitan
- Department of Pathology and Cell Biology, Columbia University College of Physicians and Surgeons, New York Presbyterian Hospital, New York, NY
| | - Yona Feit
- Department of Pathology and Cell Biology, Columbia University College of Physicians and Surgeons, New York Presbyterian Hospital, New York, NY
| | - Jordan I. Gaelen
- Department of Pathology and Cell Biology, Columbia University College of Physicians and Surgeons, New York Presbyterian Hospital, New York, NY
| | - Francesca La Carpia
- Department of Pathology and Cell Biology, Columbia University College of Physicians and Surgeons, New York Presbyterian Hospital, New York, NY
| | - Luke A. Sandoval
- Department of Pathology and Cell Biology, Columbia University College of Physicians and Surgeons, New York Presbyterian Hospital, New York, NY
| | - Alice T. Zhou
- Department of Pathology and Cell Biology, Columbia University College of Physicians and Surgeons, New York Presbyterian Hospital, New York, NY
| | - Mark Soffing
- Department of Nuclear Medicine, Columbia University College of Physicians and Surgeons, New York Presbyterian Hospital, New York, NY
| | - Akiva Mintz
- Department of Nuclear Medicine, Columbia University College of Physicians and Surgeons, New York Presbyterian Hospital, New York, NY
| | - Joseph Schwartz
- Department of Pathology and Cell Biology, Columbia University College of Physicians and Surgeons, New York Presbyterian Hospital, New York, NY
| | - Connie Eng
- Department of Pharmacy, Columbia University College of Physicians and Surgeons, New York Presbyterian Hospital, New York, NY
| | - Marta Scotto
- Department of Pharmacy, Columbia University College of Physicians and Surgeons, New York Presbyterian Hospital, New York, NY
| | - Elise Caccappolo
- Department of Neurology, Division of Cognitive Neuroscience, Columbia University College of Physicians and Surgeons, New York Presbyterian Hospital, New York, NY
| | - Christian Habeck
- Department of Neurology, Division of Cognitive Neuroscience, Columbia University College of Physicians and Surgeons, New York Presbyterian Hospital, New York, NY
| | - Yaakov Stern
- Department of Neurology, Division of Cognitive Neuroscience, Columbia University College of Physicians and Surgeons, New York Presbyterian Hospital, New York, NY
| | - Donald J. McMahon
- Department of Medicine, Columbia University College of Physicians and Surgeons, New York Presbyterian Hospital, New York, NY
| | | | | | - Richard O. Francis
- Department of Pathology and Cell Biology, Columbia University College of Physicians and Surgeons, New York Presbyterian Hospital, New York, NY
| | - Steven L. Spitalnik
- Department of Pathology and Cell Biology, Columbia University College of Physicians and Surgeons, New York Presbyterian Hospital, New York, NY
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Stubbs JR, Shaz BH, Vassallo RR, Roback JD. Expanding the platelet inventory to mitigate the impact of severe shortages. Hematology Am Soc Hematol Educ Program 2022; 2022:424-429. [PMID: 36485081 PMCID: PMC9821291 DOI: 10.1182/hematology.2022000379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
The platelet collection and distribution system, based on volunteer nonremunerated donors, apheresis platelet collections, and primarily 1-directional distribution of platelets for up to 5-day room temperature storage at hospitals, typically performs well and provides therapeutic support for hundreds of thousands of patients annually. However, direct and indirect effects of the coronavirus disease 2019 pandemic, particularly during the Omicron wave, produced dramatic systemic failures and severe shortages. We propose 4 initiatives to reinforce the existing platelet pipeline and buffer the platelet supply against future unexpected disruptions.
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Affiliation(s)
- James R. Stubbs
- Division of Transfusion Medicine, Mayo Clinic, Rochester, MN
| | - Beth H. Shaz
- Department of Pathology, Duke University School of Medicine, Durham, NC
| | | | - John D. Roback
- Center for Transfusion and Cellular Therapies, Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, GA
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11
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France CR, France JL, Ysidron DW, Martin CD, Duffy L, Kessler DA, Rebosa M, Rehmani S, Frye V, Shaz BH. Blood donation motivators and barriers reported by young, first-time whole blood donors: Examining the association of reported motivators and barriers with subsequent donation behavior and potential sex, race, and ethnic group differences. Transfusion 2022; 62:2539-2554. [PMID: 36281204 PMCID: PMC9742189 DOI: 10.1111/trf.17162] [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: 09/12/2022] [Revised: 10/11/2022] [Accepted: 10/11/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND A greater understanding of young, first-time donor motivators and barriers is needed to address the ongoing challenge of retaining these essential donors. STUDY DESIGN AND METHODS Structured interviews conducted with 508 young, first-time whole blood donors [66.1% female; Mean Age = 19.4 (SD = 2.5) years] were coded to identify reported motivators and barriers. Reported motivators and barriers were then examined for their association with attempted donation behavior over a 14-month follow-up, and for potential sex, race, and ethnic group differences in the frequency of endorsement. RESULTS Prosocial motivation (e.g., altruism) was the most commonly reported motivator and fear (e.g., fainting, needles) was the most commonly reported barrier. Donation behavior was unrelated to reported motivators, but was significantly related to four reported barriers including fear of fainting/dizziness, fear of needles/pain, having personal commitments that conflict with donating, and perceiving oneself as unsuited to donate for health reasons. Sex, racial, and ethnic differences were noted with respect to the percentages of donors reporting several donation-related motivators and barriers. CONCLUSION The present findings identify donation-related barriers that could be important targets to address in the effort to encourage new young donors and to retain these new donors for the long term. Importantly, these data also highlight the importance of considering individual differences in donor motivation as a function of sex, race, and ethnicity.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Victoria Frye
- City University of New York School of Medicine, Community Health and Social Medicine, New York, NY, USA
| | - Beth H. Shaz
- Department of Pathology, Duke University School of Medicine, Durham, NC, USA
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12
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Estcourt LJ, Cohn CS, Pagano MB, Iannizzi C, Kreuzberger N, Skoetz N, Allen ES, Bloch EM, Beaudoin G, Casadevall A, Devine DV, Foroutan F, Gniadek TJ, Goel R, Gorlin J, Grossman BJ, Joyner MJ, Metcalf RA, Raval JS, Rice TW, Shaz BH, Vassallo RR, Winters JL, Tobian AAR. Clinical Practice Guidelines From the Association for the Advancement of Blood and Biotherapies (AABB): COVID-19 Convalescent Plasma. Ann Intern Med 2022; 175:1310-1321. [PMID: 35969859 PMCID: PMC9450870 DOI: 10.7326/m22-1079] [Citation(s) in RCA: 43] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
DESCRIPTION Coronavirus disease 2019 convalescent plasma (CCP) has emerged as a potential treatment of COVID-19. However, meta-analysis data and recommendations are limited. The Association for the Advancement of Blood and Biotherapies (AABB) developed clinical practice guidelines for the appropriate use of CCP. METHODS These guidelines are based on 2 living systematic reviews of randomized controlled trials (RCTs) evaluating CCP from 1 January 2019 to 26 January 2022. There were 33 RCTs assessing 21 916 participants. The results were summarized using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) method. An expert panel reviewed the data using the GRADE framework to formulate recommendations. RECOMMENDATION 1 (OUTPATIENT) The AABB suggests CCP transfusion in addition to the usual standard of care for outpatients with COVID-19 who are at high risk for disease progression (weak recommendation, moderate-certainty evidence). RECOMMENDATION 2 (INPATIENT) The AABB recommends against CCP transfusion for unselected hospitalized persons with moderate or severe disease (strong recommendation, high-certainty evidence). This recommendation does not apply to immunosuppressed patients or those who lack antibodies against SARS-CoV-2. RECOMMENDATION 3 (INPATIENT) The AABB suggests CCP transfusion in addition to the usual standard of care for hospitalized patients with COVID-19 who do not have SARS-CoV-2 antibodies detected at admission (weak recommendation, low-certainty evidence). RECOMMENDATION 4 (INPATIENT) The AABB suggests CCP transfusion in addition to the usual standard of care for hospitalized patients with COVID-19 and preexisting immunosuppression (weak recommendation, low-certainty evidence). RECOMMENDATION 5 (PROPHYLAXIS) The AABB suggests against prophylactic CCP transfusion for uninfected persons with close contact exposure to a person with COVID-19 (weak recommendation, low-certainty evidence). GOOD CLINICAL PRACTICE STATEMENT CCP is most effective when transfused with high neutralizing titers to infected patients early after symptom onset.
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Affiliation(s)
- Lise J Estcourt
- NHS Blood and Transplant and Radcliffe Department of Medicine, University of Oxford, United Kingdom (L.J.E.)
| | - Claudia S Cohn
- University of Minnesota, Department of Laboratory Medicine and Pathology, Minneapolis, Minnesota (C.S.C.)
| | - Monica B Pagano
- University of Washington, Department of Laboratory Medicine and Pathology, Seattle, Washington (M.B.P.)
| | - Claire Iannizzi
- Evidence-based Oncology, Department of Internal Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany (C.I., N.K., N.S.)
| | - Nina Kreuzberger
- Evidence-based Oncology, Department of Internal Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany (C.I., N.K., N.S.)
| | - Nicole Skoetz
- Evidence-based Oncology, Department of Internal Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany (C.I., N.K., N.S.)
| | - Elizabeth S Allen
- University of California San Diego, Department of Pathology, La Jolla, California (E.S.A.)
| | - Evan M Bloch
- The Johns Hopkins University School of Medicine, Department of Pathology, Baltimore, Maryland (E.M.B., R.G., A.A.R.T.)
| | | | - Arturo Casadevall
- The Johns Hopkins University School of Public Health, Department of Molecular Microbiology and Immunology, Baltimore, Maryland (A.C.)
| | - Dana V Devine
- Canadian Blood Services, Vancouver, British Columbia, Canada (D.V.D.)
| | - Farid Foroutan
- University Health Network, Ted Rogers Centre for Heart Research, Toronto, and Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada (F.F.)
| | - Thomas J Gniadek
- NorthShore University Health System, Department of Pathology and Laboratory Medicine, Evanston, Illinois (T.J.G.)
| | - Ruchika Goel
- The Johns Hopkins University School of Medicine, Department of Pathology, Baltimore, Maryland (E.M.B., R.G., A.A.R.T.)
| | - Jed Gorlin
- Innovative Blood Resources, Division of New York Blood Center Enterprises, St. Paul, Minnesota (J.G.)
| | - Brenda J Grossman
- Washington University in St. Louis School of Medicine, Department of Pathology and Immunology, St. Louis, Missouri (B.J.G.)
| | - Michael J Joyner
- Mayo Clinic, Department of Anesthesiology and Perioperative Medicine, Rochester, Minnesota (M.J.J.)
| | - Ryan A Metcalf
- University of Utah, Department of Pathology, Salt Lake City, Utah (R.A.M.)
| | - Jay S Raval
- University of New Mexico, Department of Pathology, Albuquerque, New Mexico (J.S.R.)
| | - Todd W Rice
- Vanderbilt University Medical Center, Division of Allergy, Pulmonary, and Critical Care Medicine, Nashville, Tennessee (T.W.R.)
| | - Beth H Shaz
- Duke University, Department of Pathology, Durham, North Carolina (B.H.S.)
| | | | - Jeffrey L Winters
- Mayo Clinic, Department of Laboratory Medicine and Pathology, Rochester, Minnesota (J.L.W.)
| | - Aaron A R Tobian
- The Johns Hopkins University School of Medicine, Department of Pathology, Baltimore, Maryland (E.M.B., R.G., A.A.R.T.)
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13
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Senefeld JW, Johnson PW, Kunze KL, Bloch EM, van Helmond N, Golafshar MA, Klassen SA, Klompas AM, Sexton MA, Diaz Soto JC, Grossman BJ, Tobian AAR, Goel R, Wiggins CC, Bruno KA, van Buskirk CM, Stubbs JR, Winters JL, Casadevall A, Paneth NS, Shaz BH, Petersen MM, Sachais BS, Buras MR, Wieczorek MA, Russoniello B, Dumont LJ, Baker SE, Vassallo RR, Shepherd JRA, Young PP, Verdun NC, Marks P, Haley NR, Rea RF, Katz L, Herasevich V, Waxman DA, Whelan ER, Bergman A, Clayburn AJ, Grabowski MK, Larson KF, Ripoll JG, Andersen KJ, Vogt MNP, Dennis JJ, Regimbal RJ, Bauer PR, Blair JE, Buchholtz ZA, Pletsch MC, Wright K, Greenshields JT, Joyner MJ, Wright RS, Carter RE, Fairweather D. Access to and safety of COVID-19 convalescent plasma in the United States Expanded Access Program: A national registry study. PLoS Med 2021; 18:e1003872. [PMID: 34928960 PMCID: PMC8730442 DOI: 10.1371/journal.pmed.1003872] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 01/05/2022] [Accepted: 11/18/2021] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND The United States (US) Expanded Access Program (EAP) to coronavirus disease 2019 (COVID-19) convalescent plasma was initiated in response to the rapid spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative agent of COVID-19. While randomized clinical trials were in various stages of development and enrollment, there was an urgent need for widespread access to potential therapeutic agents. The objective of this study is to report on the demographic, geographical, and chronological characteristics of patients in the EAP, and key safety metrics following transfusion of COVID-19 convalescent plasma. METHODS AND FINDINGS Mayo Clinic served as the central institutional review board for all participating facilities, and any US physician could participate as a local physician-principal investigator. Eligible patients were hospitalized, were aged 18 years or older, and had-or were at risk of progression to-severe or life-threatening COVID-19; eligible patients were enrolled through the EAP central website. Blood collection facilities rapidly implemented programs to collect convalescent plasma for hospitalized patients with COVID-19. Demographic and clinical characteristics of all enrolled patients in the EAP were summarized. Temporal patterns in access to COVID-19 convalescent plasma were investigated by comparing daily and weekly changes in EAP enrollment in response to changes in infection rate at the state level. Geographical analyses on access to convalescent plasma included assessing EAP enrollment in all national hospital referral regions, as well as assessing enrollment in metropolitan areas and less populated areas that did not have access to COVID-19 clinical trials. From April 3 to August 23, 2020, 105,717 hospitalized patients with severe or life-threatening COVID-19 were enrolled in the EAP. The majority of patients were 60 years of age or older (57.8%), were male (58.4%), and had overweight or obesity (83.8%). There was substantial inclusion of minorities and underserved populations: 46.4% of patients were of a race other than white, and 37.2% of patients were of Hispanic ethnicity. Chronologically and geographically, increases in the number of both enrollments and transfusions in the EAP closely followed confirmed infections across all 50 states. Nearly all national hospital referral regions enrolled and transfused patients in the EAP, including both in metropolitan and in less populated areas. The incidence of serious adverse events was objectively low (<1%), and the overall crude 30-day mortality rate was 25.2% (95% CI, 25.0% to 25.5%). This registry study was limited by the observational and pragmatic study design that did not include a control or comparator group; thus, the data should not be used to infer definitive treatment effects. CONCLUSIONS These results suggest that the EAP provided widespread access to COVID-19 convalescent plasma in all 50 states, including for underserved racial and ethnic minority populations. The study design of the EAP may serve as a model for future efforts when broad access to a treatment is needed in response to an emerging infectious disease. TRIAL REGISTRATION ClinicalTrials.gov NCT#: NCT04338360.
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Affiliation(s)
- Jonathon W. Senefeld
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Patrick W. Johnson
- Department of Quantitative Health Sciences, Mayo Clinic, Jacksonville, Florida, United States of America
| | - Katie L. Kunze
- Department of Quantitative Health Sciences, Mayo Clinic, Scottsdale, Arizona, United States of America
| | - Evan M. Bloch
- Division of Transfusion Medicine, Department of Pathology, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Noud van Helmond
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, United States of America
- Department of Anesthesiology, Cooper Medical School of Rowan University, Cooper University Health Care, Camden, New Jersey, United States of America
| | - Michael A. Golafshar
- Department of Quantitative Health Sciences, Mayo Clinic, Scottsdale, Arizona, United States of America
| | - Stephen A. Klassen
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Allan M. Klompas
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Matthew A. Sexton
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Juan C. Diaz Soto
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Brenda J. Grossman
- Department of Pathology and Immunology, Washington University School of Medicine in St. Louis, St. Louis, Missouri, United States of America
| | - Aaron A. R. Tobian
- Division of Transfusion Medicine, Department of Pathology, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Ruchika Goel
- Division of Transfusion Medicine, Department of Pathology, Johns Hopkins University, Baltimore, Maryland, United States of America
- ImpactLife, Davenport, Iowa, United States of America
| | - Chad C. Wiggins
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Katelyn A. Bruno
- Department of Cardiovascular Medicine, Mayo Clinic, Jacksonville, Florida, United States of America
| | - Camille M. van Buskirk
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, United States of America
| | - James R. Stubbs
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Jeffrey L. Winters
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Arturo Casadevall
- Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Nigel S. Paneth
- Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, East Lansing, Michigan, United States of America
- Department of Pediatrics and Human Development, College of Human Medicine, Michigan State University, East Lansing, Michigan, United States of America
| | - Beth H. Shaz
- Department of Pathology, Duke University, Durham, North Carolina, United States of America
| | - Molly M. Petersen
- Department of Quantitative Health Sciences, Mayo Clinic, Scottsdale, Arizona, United States of America
| | - Bruce S. Sachais
- New York Blood Center Enterprises, New York City, New York, United States of America
| | - Matthew R. Buras
- Department of Quantitative Health Sciences, Mayo Clinic, Scottsdale, Arizona, United States of America
| | - Mikolaj A. Wieczorek
- Department of Quantitative Health Sciences, Mayo Clinic, Jacksonville, Florida, United States of America
| | - Benjamin Russoniello
- Department of Quantitative Health Sciences, Mayo Clinic, Jacksonville, Florida, United States of America
| | - Larry J. Dumont
- Vitalant Research Institute, Denver, Colorado, United States of America
- University of Colorado School of Medicine, Aurora, Colorado, United States of America
- Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, United States of America
| | - Sarah E. Baker
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, United States of America
| | | | - John R. A. Shepherd
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Pampee P. Young
- American Red Cross, Washington, District of Columbia, United States of America
| | - Nicole C. Verdun
- Center for Biologics Evaluation and Research, U. S. Food and Drug Administration, Silver Spring, Maryland, United States of America
| | - Peter Marks
- Center for Biologics Evaluation and Research, U. S. Food and Drug Administration, Silver Spring, Maryland, United States of America
| | - N. Rebecca Haley
- Bloodworks Northwest, Seattle, Washington, United States of America
| | - Robert F. Rea
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Louis Katz
- ImpactLife, Davenport, Iowa, United States of America
| | - Vitaly Herasevich
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Dan A. Waxman
- Versiti, Indianapolis, Indiana, United States of America
| | - Emily R. Whelan
- Department of Cardiovascular Medicine, Mayo Clinic, Jacksonville, Florida, United States of America
| | - Aviv Bergman
- Department of Systems and Computational Biology, Albert Einstein College of Medicine, New York City, New York, United States of America
| | - Andrew J. Clayburn
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Mary Kathryn Grabowski
- Division of Transfusion Medicine, Department of Pathology, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Kathryn F. Larson
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Juan G. Ripoll
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Kylie J. Andersen
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Matthew N. P. Vogt
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Joshua J. Dennis
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Riley J. Regimbal
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Philippe R. Bauer
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Janis E. Blair
- Division of Infectious Diseases, Department of Internal Medicine, Mayo Clinic, Phoenix, Arizona, United States of America
| | - Zachary A. Buchholtz
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Michaela C. Pletsch
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Katherine Wright
- School of Sustainability, Arizona State University, Tempe, Arizona, United States of America
| | - Joel T. Greenshields
- Department of Kinesiology, Indiana University, Bloomington, Indiana, United States of America
| | - Michael J. Joyner
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, United States of America
| | - R. Scott Wright
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Rickey E. Carter
- Department of Quantitative Health Sciences, Mayo Clinic, Jacksonville, Florida, United States of America
| | - DeLisa Fairweather
- Department of Cardiovascular Medicine, Mayo Clinic, Jacksonville, Florida, United States of America
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14
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France JL, France CR, Rebosa M, Shaz BH, Kessler DA. Promoting awareness of donation-related iron depletion among high risk blood donors. Transfusion 2021; 61:3353-3360. [PMID: 34605554 DOI: 10.1111/trf.16694] [Citation(s) in RCA: 4] [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: 08/13/2021] [Revised: 09/24/2021] [Accepted: 09/24/2021] [Indexed: 01/14/2023]
Abstract
BACKGROUND The potential for iron deficiency is a known blood donor health concern and suggests the need to inform donors about the potential risks of low iron levels as well as strategies to address these risks. STUDY DESIGN AND METHODS Frequent (n = 904) and young (n = 629) donors were randomly assigned within risk group to either a control (n = 548) or an intervention (n = 985) group. The control group answered questions at baseline and 6-month follow-up regarding their awareness of the risk of donation-related iron depletion and whether they were taking actions to address their iron status. The intervention group answered the same questions at baseline and follow-up, but after completing the baseline survey, they received information regarding their risk of iron depletion and behaviors they could adopt to mitigate this risk. Intervention group participants were also offered the opportunity to develop an action plan to help them supplement their iron intake. RESULTS The intervention enhanced overall awareness of donation-related iron loss (OR = 1.5, 95% CI 1.171-1.864, p = .001), with no negative impact on retention. Reported iron health behaviors (iron supplementation, speaking with a doctor) showed significant increases when action planning was paired with the educational information. CONCLUSION These findings suggest that it is possible to increase awareness of donation-related risk for iron depletion without negatively influencing retention, and combining education with encouragement to develop an action plan may increase the likelihood of both retention and behavioral changes to promote healthy iron levels.
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Affiliation(s)
- Janis L France
- Department of Psychology, Ohio University, Athens, Ohio, USA
| | | | - Mark Rebosa
- New York Blood Center, New York, New York, USA
| | - Beth H Shaz
- Department of Pathology, Duke University School of Medicine, Durham, North Carolina, USA
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15
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France CR, France JL, Himawan LK, Duffy L, Kessler DA, Rebosa M, Rehmani S, Frye V, Shaz BH. Fear is associated with attrition of first-time whole blood donors: A longitudinal examination of donor confidence and attitude as potential mediators. Transfusion 2021; 61:3372-3380. [PMID: 34535897 DOI: 10.1111/trf.16671] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 08/04/2021] [Revised: 09/10/2021] [Accepted: 09/10/2021] [Indexed: 01/02/2023]
Abstract
BACKGROUND Elevated fear and anxiety regarding donation-related stimuli (e.g., needles, pain, blood, fainting) has been associated with reduced blood donor recruitment and retention. The present longitudinal study tests the notion that this inverse relationship may be accounted for by lower donation confidence and more negative donation attitudes among fearful first-time donors. STUDY DESIGN AND METHODS In a sample of 1479 first-time whole blood donors [67.9% female; mean age = 19.3 (standard deviation (SD) = 2.5) years], path analyses were conducted to examine relationships among donor ratings of fear of blood draw and donation anxiety obtained approximately 1 week after donation, donation confidence and attitudes assessed approximately 6 weeks later, and donation attempts over the 14 months following the original donation. RESULTS Path analyses indicated that both fear of blood draws and donation anxiety were associated with fewer attempted donations, and that these effects were indirectly mediated by a combination of lower donor confidence and more negative donation attitudes. CONCLUSION Because retention of new blood donors is essential to maintain a healthy blood supply, the results of the present study suggest that first-time donors should be assessed for fear and anxiety so that appropriate strategies can be provided to address their concerns, bolster their confidence and attitudes, and ultimately promote their long-term retention.
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Affiliation(s)
| | - Janis L France
- Department of Psychology, Ohio University, Athens, Ohio, USA
| | - Lina K Himawan
- Department of Psychology, Ohio University, Athens, Ohio, USA
| | | | | | - Mark Rebosa
- New York Blood Center, New York, New York, USA
| | | | - Victoria Frye
- Department of Community Health and Social Medicine, City University of New York School of Medicine, New York, New York, USA
| | - Beth H Shaz
- Department of Pathology, Duke University School of Medicine, Durham, North Carolina, USA
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16
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France CR, France JL, Himawan LK, Fox KR, Livitz IE, Ankawi B, Slepian PM, Kowalsky JM, Duffy L, Kessler DA, Rebosa M, Rehmani S, Frye V, Shaz BH. Results from the blood donor competence, autonomy, and relatedness enhancement (blood donor CARE) randomized trial. Transfusion 2021; 61:2637-2649. [PMID: 34224590 DOI: 10.1111/trf.16577] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [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: 05/05/2021] [Revised: 06/17/2021] [Accepted: 06/17/2021] [Indexed: 12/22/2022]
Abstract
BACKGROUND This study aimed to promote competence, autonomy, and relatedness among first-time whole blood donors to enhance intrinsic motivation and increase retention. STUDY DESIGN AND METHODS Using a full factorial design, first-time donors (N = 2002) were randomly assigned to a no-treatment control condition or to one of seven intervention conditions designed to promote donation competence, autonomy, relatedness, a combination of two (e.g., competence and autonomy), or all three constructs. Participants completed donor motivation measures before the intervention and 6 weeks later, and subsequent donation attempts were assessed for 1 year. RESULTS There was no significant group difference in the frequency of donation attempts or in the number of days to return. Significant effects of group were observed for 10 of the 12 motivation measures, although follow-up analyses revealed significant differences from the control group were restricted to interventions that included an autonomy component. Path analyses confirmed direct associations between interventions involving autonomy and donor motivation, and indirect mediation of donation attempts via stronger donation intentions and lower donation anxiety. CONCLUSION Among young, first-time, whole blood donors, brief interventions that include support for donor autonomy were associated with direct effects on donor motivation and indirect, but small, effects on subsequent donation behavior.
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Affiliation(s)
| | - Janis L France
- Department of Psychology, Ohio University, Athens, Ohio, USA
| | - Lina K Himawan
- Department of Psychology, Ohio University, Athens, Ohio, USA
| | - Kristen R Fox
- Center for Biobehavioral Health, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Irina E Livitz
- Department of Psychiatry, Cambridge Health Alliance, Cambridge, Massachusetts, USA
| | | | - P Maxwell Slepian
- Department of Anesthesia and Pain Management, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada
| | | | | | | | - Mark Rebosa
- New York Blood Center, New York, New York, USA
| | | | - Victoria Frye
- City University of New York School of Medicine, Community Health and Social Medicine, New York, New York, USA
| | - Beth H Shaz
- Department of Pathology, Duke University School of Medicine, Durham, North Carolina, USA
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17
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Goel R, Zhu X, Makhani S, Petersen MR, Josephson CD, Katz LM, Shaz BH, Austin R, Crowe EP, Ness PM, Gehrie EA, Frank SM, Bloch EM, Tobian AAR. Blood transfusions in gunshot-wound-related emergency department visits and hospitalizations in the United States. Transfusion 2021; 61:2277-2289. [PMID: 34213026 DOI: 10.1111/trf.16552] [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: 03/09/2021] [Accepted: 05/24/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND The United States (US) leads all high-income countries in gunshot wound (GSW) deaths. However, previous US studies have not evaluated the national blood transfusion utilization patterns in hospitalized GSW patients. METHODS Data from 2016 to 2017 were analyzed from the Nationwide Emergency Department Sample (NEDS) and Nationwide Inpatient Sample (NIS), the largest all-payer emergency department (ED) and inpatient databases, respectively. Using stratified probability sampling, weights were applied to generate nationally representative estimates. Multivariable Poisson-regression models were used to estimate prevalence ratios (PR) of blood transfusion. RESULTS There were 168,315 ED visits and 58,815 hospitalizations (age = 18-90 years) following a GSW. The majority of hospitalizations were men (88.5%), age 18-24 years (31.8%), and assault-related GSW (51.3%). Blacks had the largest proportion (48.7%) overall of all GSW hospitalizations; Whites accounted for the highest proportion of intentional self-harm injuries (72.4%). Blood transfusions occurred in 12.7% of hospitalizations (12.0% red blood cell [RBC], 4.9% plasma, and 2.5% platelet transfusions). Only 1.9% of cases were associated with transfusion of all three blood components. Hospitalizations with major/extreme severity of illness had significantly higher prevalence of transfusion versus those with mild/moderate severity [crude PR = 4.79 (95%CI:4.15-5.33, p < .001)]. Overall, 8.2% of hospitalizations with GSW died, of whom 26.8% required blood transfusions, which was significantly higher than survivors [crude PR = 2.34 (95%CI:2.10-2.61, p < .001)]. The vast majority (95%) of the transfusions among those who died were within 48 h since admission. CONCLUSIONS Gun-related violence is a public health emergency in the US, and GSWs are a source of significant mortality, blood utilization, and health care costs.
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Affiliation(s)
- Ruchika Goel
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.,Simmons Cancer Institute at SIU School of Medicine and Mississippi Valley Regional Blood Center, Springfield, Illinois, USA
| | - Xianming Zhu
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Sarah Makhani
- Herbert Wertheim College of Medicine at Florida International University, Miami, Florida, USA
| | - Molly R Petersen
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Cassandra D Josephson
- Departments of Pathology and Pediatrics, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Louis M Katz
- Mississippi Valley Regional Blood Center, Davenport, Iowa, USA
| | - Beth H Shaz
- Duke University, Durham, North Carolina, USA
| | - Richard Austin
- Department of Emergency Medicine, SIU School of Medicine, Springfield, Illinois, USA
| | - Elizabeth P Crowe
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Paul M Ness
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | | | - Steven M Frank
- Department of Anesthesiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Evan M Bloch
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Aaron A R Tobian
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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18
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Cohn CS, Estcourt L, Grossman BJ, Pagano MB, Allen ES, Bloch EM, Casadevall A, Devine DV, Dunbar NM, Foroutan F, Gniadek TJ, Goel R, Gorlin J, Joyner MJ, Metcalf RA, Raval JS, Rice TW, Shaz BH, Vassallo RR, Winters JL, Beaudoin G, Tobian AAR. COVID-19 convalescent plasma: Interim recommendations from the AABB. Transfusion 2021; 61:1313-1323. [PMID: 33586160 PMCID: PMC8014606 DOI: 10.1111/trf.16328] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 02/10/2021] [Indexed: 12/16/2022]
Affiliation(s)
- Claudia S Cohn
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, Minnesota, USA
| | - Lise Estcourt
- NHS Blood and Transplant, Oxford, UK.,Radcliffe Department of Medicine, University of Oxford, Oxford, UK
| | - Brenda J Grossman
- Department of Pathology and Immunology, Washington University in St. Louis School of Medicine, St Louis, Missouri, USA
| | - Monica B Pagano
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, Washington, USA
| | - Elizabeth S Allen
- Department of Pathology, University of California San Diego, La Jolla, California, USA
| | - Evan M Bloch
- Department of Pathology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Arturo Casadevall
- Department of Molecular Microbiology and Immunology, The Johns Hopkins University School of Public Health, Baltimore, Maryland, USA
| | - Dana V Devine
- Canadian Blood Services, Vancouver, British Columbia, Canada
| | - Nancy M Dunbar
- Department of Pathology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA
| | - Farid Foroutan
- University Health Network, Ted Rogers Centre for Heart Research, Toronto, Ontario, Canada
| | - Thomas J Gniadek
- Department of Pathology and Laboratory Medicine, NorthShore University HealthSystem, Evanston, Illinois, USA
| | - Ruchika Goel
- Mississippi Valley Regional Blood Center, Springfield, Illinois, USA
| | - Jed Gorlin
- Division of New York Blood Center Enterprises, Innovative Blood Resources, Saint Paul, Minnesota, USA
| | - Michael J Joyner
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Ryan A Metcalf
- Department of Pathology, University of Utah, Salt Lake City, Utah, USA
| | - Jay S Raval
- Department of Pathology, University of New Mexico, Albuquerque, New Mexico, USA
| | - Todd W Rice
- Vanderbilt University Medical Center, Division of Allergy, Pulmonary, and Critical Care Medicine, Nashville, Tennessee, USA
| | - Beth H Shaz
- Department of Pathology, Duke University, Durham, North Carolina, USA
| | | | - Jeffrey L Winters
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA
| | | | - Aaron A R Tobian
- Department of Pathology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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19
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20
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Nguyen FT, van den Akker T, Lally K, Lam H, Lenskaya V, Liu STH, Bouvier NM, Aberg JA, Rodriguez D, Krammer F, Strauss D, Shaz BH, Rudon L, Galdon P, Jhang JS, Arinsburg SA, Baine I. Transfusion reactions associated with COVID-19 convalescent plasma therapy for SARS-CoV-2. Transfusion 2020; 61:78-93. [PMID: 33125158 DOI: 10.1111/trf.16177] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [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: 08/05/2020] [Revised: 09/22/2020] [Accepted: 09/24/2020] [Indexed: 12/28/2022]
Abstract
BACKGROUND Convalescent plasma (CP) for treatment of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has shown preliminary signs of effectiveness in moderate to severely ill patients in reducing mortality. While studies have demonstrated a low risk of serious adverse events, the comprehensive incidence and nature of the spectrum of transfusion reactions to CP is unknown. We retrospectively examined 427 adult inpatient CP transfusions to determine incidence and types of reactions, as well as clinical parameters and risk factors associated with transfusion reactions. STUDY DESIGN AND METHODS Retrospective analysis was performed for 427 transfusions to 215 adult patients with coronavirus 2019 (COVID-19) within the Mount Sinai Health System, through the US Food and Drug Administration emergency investigational new drug and the Mayo Clinic Expanded Access Protocol to Convalescent Plasma approval pathways. Transfusions were blindly evaluated by two reviewers and adjudicated by a third reviewer in discordant cases. Patient demographics and clinical and laboratory parameters were compared and analyzed. RESULTS Fifty-five reactions from 427 transfusions were identified (12.9% incidence), and 13 were attributed to transfusion (3.1% incidence). Reactions were classified as underlying COVID-19 (76%), febrile nonhemolytic (10.9%), transfusion-associated circulatory overload (9.1%), and allergic (1.8%) and hypotensive (1.8%) reactions. Statistical analysis identified increased transfusion reaction risk for ABO blood group B or Sequential Organ Failure Assessment scores of 12 to 13, and decreased risk within the age group of 80 to 89 years. CONCLUSION Our findings support the use of CP as a safe, therapeutic option from a transfusion reaction perspective, in the setting of COVID-19. Further studies are needed to confirm the clinical significance of ABO group B, age, and predisposing disease severity in the incidence of transfusion reaction events.
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Affiliation(s)
- Freddy T Nguyen
- Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA.,Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA
| | - Tayler van den Akker
- Department of Pathology, Icahn School of Medicine at Mount Sinai West, New York, New York, USA
| | - Kimberly Lally
- Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Hansen Lam
- Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Volha Lenskaya
- Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Sean T H Liu
- Division of Infectious Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Nicole M Bouvier
- Division of Infectious Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA.,Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Judith A Aberg
- Division of Infectious Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Denise Rodriguez
- Icahn School of Medicine at Mount Sinai, Tisch Cancer Institute, New York, New York, USA
| | - Florian Krammer
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Donna Strauss
- New York Blood Center Enterprises, New York, New York, USA
| | - Beth H Shaz
- New York Blood Center Enterprises, New York, New York, USA
| | - Louella Rudon
- Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Patricia Galdon
- Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Jeffrey S Jhang
- Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Suzanne A Arinsburg
- Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Ian Baine
- Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
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21
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France JL, Hod EA, Caccappolo EA, Suhr JA, France CR, Kessler DA, Shaz BH. Examination of the relationship between iron status and cognitive function among healthy young women with and without a recent history of blood donation. Transfusion 2020; 60:2886-2895. [PMID: 32920826 DOI: 10.1111/trf.16069] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 07/28/2020] [Accepted: 07/30/2020] [Indexed: 12/22/2022]
Abstract
BACKGROUND With growing awareness of the prevalence of nonanemic iron deficiency among blood donors, there is a need to explore the extent of potential negative consequences. This study examined the relationship between various measures of iron status, blood donation history, and neuropsychological and psychosocial functioning in healthy young women. STUDY DESIGN AND METHODS Using a cross-sectional design, 160 female undergraduates completed neuropsychology tests and measures of sleep, fatigue, quality of life, and depression before providing a blood sample. Correlational analyses examined the relationship between iron status (ferritin, iron, hemoglobin, and zinc protoporphyrin) and cognitive and psychosocial functioning. Performance on these measures was also examined as a function of recent blood donation history (zero, one, more than one donation in the past year). RESULTS Iron status (low ferritin, iron, or hemoglobin or high zinc protoporphyrin) was not associated with poorer performance on the cognitive tasks. Further, participants who reported donating once in the previous year performed better, rather than worse, than those with no recent donation history on several measures of executive function, even when controlling for ferritin levels. Although there was some evidence of greater fatigue among those who had donated more than once in the past year, this effect was not accounted for by ferritin levels. CONCLUSION The present findings are consistent with prior evidence that nonanemic iron deficiency is not associated with cognitive impairment or psychosocial dysfunction in healthy young females. Because these results are based on cross-sectional evidence, further study using longitudinal research is needed to confirm these findings.
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Affiliation(s)
- Janis L France
- Department of Psychology, Ohio University, Athens, Ohio, USA
| | - Eldad A Hod
- Department of Pathology and Cell Biology, Columbia University Irving Medical Center, New York, New York, USA
| | - Elise A Caccappolo
- Department of Neurology, Columbia University Irving Medical Center, New York, New York, USA
| | - Julie A Suhr
- Department of Psychology, Ohio University, Athens, Ohio, USA
| | - Christopher R France
- Department of Psychology, Ohio University, Athens, Ohio, USA.,Ohio Musculoskeletal and Neurological Institute (OMNI), Ohio University, Athens, Ohio, USA
| | | | - Beth H Shaz
- New York Blood Center Enterprises, New York, New York, USA
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22
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Ragnesola B, Jin D, Lamb CC, Shaz BH, Hillyer CD, Luchsinger LL. COVID19 antibody detection using lateral flow assay tests in a cohort of convalescent plasma donors. BMC Res Notes 2020; 13:372. [PMID: 32762746 PMCID: PMC7407441 DOI: 10.1186/s13104-020-05212-0] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [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: 06/30/2020] [Accepted: 07/28/2020] [Indexed: 01/07/2023] Open
Abstract
Objective COVID19 has caused a global and ongoing pandemic. The need for population seroconversion data is apparent to monitor and respond to the pandemic. Using a lateral flow assay (LFA) testing platform, the seropositivity in 63 New York Blood Center (NYBC) Convelescent Plasma (CP) donor samples were evaluated for the presence of COVID19 specific IgG and IgM. Results CP donors showed diverse antibody result. Convalescent donor plasma contains SARS-CoV-2 specific antibodies. Weak antibody bands may identify low titer CP donors. LFA tests can identify antibody positive individuals that have recovered from COVID19. Confirming suspected cases using antibody detection could help inform the patient and the community as to the relative risk to future exposure and a better understanding of disease exposure.
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Affiliation(s)
- Brett Ragnesola
- New York Blood Center Lindsley F. Kimball Research Institute, 310 E 67th Street, New York, NY, 10065, USA
| | - Daniel Jin
- New York Blood Center Lindsley F. Kimball Research Institute, 310 E 67th Street, New York, NY, 10065, USA
| | - Christopher C Lamb
- BioSolutions Services, 92 Irving Avenue, Englewood Cliffs, NJ, 07632, USA. .,Department of Management and Entrepreneurship, Silberman College of Business, Fairleigh Dickinson University, Teaneck, NJ, USA. .,Weatherhead School of Management, Case Western Reserve University, Cleveland, OH, USA.
| | - Beth H Shaz
- New York Blood Center Lindsley F. Kimball Research Institute, 310 E 67th Street, New York, NY, 10065, USA
| | - Christopher D Hillyer
- New York Blood Center Lindsley F. Kimball Research Institute, 310 E 67th Street, New York, NY, 10065, USA
| | - Larry L Luchsinger
- New York Blood Center Lindsley F. Kimball Research Institute, 310 E 67th Street, New York, NY, 10065, USA.
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23
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Whitaker BI, Walderhaug M, Hinkins S, Steele WR, Custer B, Kessler D, Leparc G, Gottschall JL, Bialkowski W, Stramer SL, Dodd RY, Crowder L, Vahidnia F, Shaz BH, Kamel H, Rebosa M, Stern M, Anderson SA. Use of a rapid electronic survey methodology to estimate blood donors' potential exposure to emerging infectious diseases: Application of a statistically representative sampling methodology to assess risk in US blood centers. Transfusion 2020; 60:1987-1997. [PMID: 32743798 PMCID: PMC7436713 DOI: 10.1111/trf.15941] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 10/10/2019] [Revised: 05/14/2020] [Accepted: 05/15/2020] [Indexed: 12/24/2022]
Abstract
Risk assessments of transfusion-transmitted emerging infectious diseases (EIDs) are complicated by the fact that blood donors' demographics and behaviors can be different from the general population. Therefore, when assessing potential blood donor exposure to EIDs, the use of general population characteristics, such as U.S. travel statistics, may invoke uncertainties that result in inaccurate estimates of blood donor exposure. This may, in turn, lead to the creation of donor deferral policies that do not match actual risk. STUDY DESIGN AND METHODS This article reports on the development of a system to rapidly assess EID risks for a nationally representative portion of the U.S. blood donor population. To assess the effectiveness of this system, a test survey was developed and deployed to a statistically representative sample frame of blood donors from five blood collecting organizations. Donors were directed to an online survey to ascertain their recent travel and potential exposure to Middle East respiratory syndrome coronavirus (MERS-CoV). RESULTS A total of 7128 responses were received from 54 256 invitations. The age-adjusted estimated total number of blood donors potentially exposed to MERS-CoV was approximately 15 640 blood donors compared to a lower U.S. general population-based estimate of 9610 blood donors. CONCLUSION The structured donor demographic sample-based data provided an assessment of blood donors' potential exposure to an emerging pathogen that was 63% larger than the U.S. population-based estimate. This illustrates the need for tailored blood donor-based EID risk assessments that provide more specific demographic risk intelligence and can inform appropriate regulatory decision making.
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Affiliation(s)
- Barbee I Whitaker
- U.S. Food and Drug Administration/Center for Biologics Evaluation and Research/Office of Biostatistics and Epidemiology, Silver Spring, Maryland, USA
| | - Mark Walderhaug
- U.S. Food and Drug Administration/Center for Biologics Evaluation and Research/Office of Biostatistics and Epidemiology, Silver Spring, Maryland, USA
| | - Susan Hinkins
- NORC at the University of Chicago, Chicago, Illinois, USA
| | | | - Brian Custer
- Vitalant Research Institute, Scottsdale, Arizona, USA
| | | | | | | | - Walter Bialkowski
- Blood Research Institute, Versiti Wisconsin, Milwaukee, Wisconsin, USA
| | | | | | | | | | - Beth H Shaz
- New York Blood Center, New York, New York, USA
| | - Hany Kamel
- Vitalant Research Institute, Scottsdale, Arizona, USA
| | - Mark Rebosa
- New York Blood Center, New York, New York, USA
| | - Michael Stern
- NORC at the University of Chicago, Chicago, Illinois, USA
| | - Steven A Anderson
- U.S. Food and Drug Administration/Center for Biologics Evaluation and Research/Office of Biostatistics and Epidemiology, Silver Spring, Maryland, USA
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24
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Budhai A, Wu AA, Hall L, Strauss D, Paradiso S, Alberigo J, Hillyer CD, Jett B, Tobian AAR, Bloch EM, Sachais BS, Shaz BH. How did we rapidly implement a convalescent plasma program? Transfusion 2020; 60:1348-1355. [PMID: 32449169 PMCID: PMC7283779 DOI: 10.1111/trf.15910] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [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: 05/11/2020] [Revised: 05/16/2020] [Accepted: 05/16/2020] [Indexed: 12/28/2022]
Abstract
Since the beginning of the COVID-19 pandemic, the use of convalescent plasma as a possible treatment has been explored. Here we describe our experience as the first U.S. organization creating a COVID-19 convalescent plasma program to support its use through the single-patient emergency investigational new drug, the National Expanded Access Program, and multiple randomized controlled trials. Within weeks, we were able to distribute more than 8000 products, scale up collections to more than 4000 units per week, meet hospital demand, and support randomized controlled trials to evaluate the efficacy of convalescent plasma treatment. This was through strategic planning; redeployment of staff; and active engagement of hospital, community, and public health partners. Our partners helped with donor recruitment, testing, patient advocacy, and patient availability. The program will continue to evolve as we learn more about optimizing the product. Remaining issues to be resolved are antibody titers, dose, and at what stage of disease to transfuse.
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Affiliation(s)
| | - Annie A Wu
- The Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Lucette Hall
- New York Blood Center Enterprises, New York, New York, USA
| | - Donna Strauss
- New York Blood Center Enterprises, New York, New York, USA
| | - Sarai Paradiso
- New York Blood Center Enterprises, New York, New York, USA
| | - Jill Alberigo
- New York Blood Center Enterprises, New York, New York, USA
| | | | - Betsy Jett
- New York Blood Center Enterprises, New York, New York, USA
| | | | - Evan M Bloch
- The Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | | | - Beth H Shaz
- New York Blood Center Enterprises, New York, New York, USA
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25
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Stone EF, Shaz BH. Zika virus and its implications on cord blood banking and transplantation. Transfusion 2020; 60:889-891. [PMID: 32208533 DOI: 10.1111/trf.15771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Accepted: 03/06/2020] [Indexed: 11/30/2022]
Abstract
Umbilical cord blood is an important cellular therapy product used for hematopoietic stem cell transplantation, but the US Food and Drug Administration guidance regarding donor screening to reduce the risk of Zika transmission has decreased the number of licensed, eligible cord blood units available for transplantation. There is a crucial need for updated travel risk assessment for Zika virus transmission, validated screening tests for Zika virus in umbilical cord blood, and further research on Zika virus transmissibility due to umbilical cord blood products to ensure that umbilical cord blood and related tissues are safe and available for transplantation.
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Affiliation(s)
| | - Beth H Shaz
- New York Blood Center, New York, New York, USA
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26
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Francis RO, D’Alessandro A, Eisenberger A, Soffing M, Yeh R, Coronel E, Sheikh A, Rapido F, La Carpia F, Reisz JA, Gehrke S, Nemkov T, Thomas T, Schwartz J, Divgi C, Kessler D, Shaz BH, Ginzburg Y, Zimring JC, Spitalnik SL, Hod EA. Donor glucose-6-phosphate dehydrogenase deficiency decreases blood quality for transfusion. J Clin Invest 2020; 130:2270-2285. [PMID: 31961822 PMCID: PMC7191001 DOI: 10.1172/jci133530] [Citation(s) in RCA: 60] [Impact Index Per Article: 15.0] [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: 09/16/2019] [Accepted: 01/14/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUNDGlucose-6-phosphate dehydrogenase (G6PD) deficiency decreases the ability of red blood cells (RBCs) to withstand oxidative stress. Refrigerated storage of RBCs induces oxidative stress. We hypothesized that G6PD-deficient donor RBCs would have inferior storage quality for transfusion as compared with G6PD-normal RBCs.METHODSMale volunteers were screened for G6PD deficiency; 27 control and 10 G6PD-deficient volunteers each donated 1 RBC unit. After 42 days of refrigerated storage, autologous 51-chromium 24-hour posttransfusion RBC recovery (PTR) studies were performed. Metabolomics analyses of these RBC units were also performed.RESULTSThe mean 24-hour PTR for G6PD-deficient subjects was 78.5% ± 8.4% (mean ± SD), which was significantly lower than that for G6PD-normal RBCs (85.3% ± 3.2%; P = 0.0009). None of the G6PD-normal volunteers (0/27) and 3 G6PD-deficient volunteers (3/10) had PTR results below 75%, a key FDA acceptability criterion for stored donor RBCs. As expected, fresh G6PD-deficient RBCs demonstrated defects in the oxidative phase of the pentose phosphate pathway. During refrigerated storage, G6PD-deficient RBCs demonstrated increased glycolysis, impaired glutathione homeostasis, and increased purine oxidation, as compared with G6PD-normal RBCs. In addition, there were significant correlations between PTR and specific metabolites in these pathways.CONCLUSIONBased on current FDA criteria, RBCs from G6PD-deficient donors would not meet the requirements for storage quality. Metabolomics assessment identified markers of PTR and G6PD deficiency (e.g., pyruvate/lactate ratios), along with potential compensatory pathways that could be leveraged to ameliorate the metabolic needs of G6PD-deficient RBCs.TRIAL REGISTRATIONClinicalTrials.gov NCT04081272.FUNDINGThe Harold Amos Medical Faculty Development Program, Robert Wood Johnson Foundation grant 71590, the National Blood Foundation, NIH grant UL1 TR000040, the Webb-Waring Early Career Award 2017 by the Boettcher Foundation, and National Heart, Lung, and Blood Institute grants R01HL14644 and R01HL148151.
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Affiliation(s)
- Richard O. Francis
- Department of Pathology and Cell Biology, Columbia University Vagelos College of Physicians and Surgeons and NewYork-Presbyterian Hospital, New York, New York, USA
| | - Angelo D’Alessandro
- University of Colorado Denver-Anschutz Medical Campus, Aurora, Colorado, USA
| | | | - Mark Soffing
- Department of Nuclear Medicine, Columbia University Vagelos College of Physicians and Surgeons and NewYork-Presbyterian Hospital, New York, New York, USA
| | - Randy Yeh
- Department of Nuclear Medicine, Columbia University Vagelos College of Physicians and Surgeons and NewYork-Presbyterian Hospital, New York, New York, USA
| | - Esther Coronel
- Department of Nuclear Medicine, Columbia University Vagelos College of Physicians and Surgeons and NewYork-Presbyterian Hospital, New York, New York, USA
| | - Arif Sheikh
- Division of Nuclear Medicine and Molecular Imaging, Icahn School of Medicine at Mount Sinai Hospital, New York, New York, USA
| | - Francesca Rapido
- Department of Anesthesia and Critical Care Medicine, Montpellier University Hospital Gui de Chauliac, Montpellier, France
| | - Francesca La Carpia
- Department of Pathology and Cell Biology, Columbia University Vagelos College of Physicians and Surgeons and NewYork-Presbyterian Hospital, New York, New York, USA
| | - Julie A. Reisz
- University of Colorado Denver-Anschutz Medical Campus, Aurora, Colorado, USA
| | - Sarah Gehrke
- University of Colorado Denver-Anschutz Medical Campus, Aurora, Colorado, USA
| | - Travis Nemkov
- University of Colorado Denver-Anschutz Medical Campus, Aurora, Colorado, USA
| | - Tiffany Thomas
- Department of Pathology and Cell Biology, Columbia University Vagelos College of Physicians and Surgeons and NewYork-Presbyterian Hospital, New York, New York, USA
| | - Joseph Schwartz
- Department of Pathology and Cell Biology, Columbia University Vagelos College of Physicians and Surgeons and NewYork-Presbyterian Hospital, New York, New York, USA
| | - Chaitanya Divgi
- Department of Nuclear Medicine, Columbia University Vagelos College of Physicians and Surgeons and NewYork-Presbyterian Hospital, New York, New York, USA
| | | | | | - Yelena Ginzburg
- Division of Hematology Oncology, Icahn School of Medicine at Mount Sinai Hospital, New York, New York, USA
| | - James C. Zimring
- Carter Immunology Center, University of Virginia School of Medicine, Charlottesville, Virginia, USA
| | - Steven L. Spitalnik
- Department of Pathology and Cell Biology, Columbia University Vagelos College of Physicians and Surgeons and NewYork-Presbyterian Hospital, New York, New York, USA
| | - Eldad A. Hod
- Department of Pathology and Cell Biology, Columbia University Vagelos College of Physicians and Surgeons and NewYork-Presbyterian Hospital, New York, New York, USA
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27
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Goel R, Josephson CD, Patel EU, Petersen MR, Makhani S, Frank SM, Ness PM, Bloch EM, Gehrie EA, Lokhandwala PM, Nellis MM, Karam O, Shaz BH, Patel RM, Tobian AA. Perioperative Transfusions and Venous Thromboembolism. Pediatrics 2020; 145:peds.2019-2351. [PMID: 32198293 PMCID: PMC7111487 DOI: 10.1542/peds.2019-2351] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/03/2019] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Annual incidence of venous thromboembolism (VTE) including postoperative VTE in hospitalized children is rising significantly. A growing body of evidence supports the role of red blood cells (RBCs) in pathologic thrombosis. In this study, we examined the association of perioperative RBC transfusion with postoperative VTE in pediatric patients. METHODS The pediatric databases of the American College of Surgeons' National Surgical Quality Improvement Project from 2012 to 2017 were used. Multivariable logistic regression was used to examine the association between perioperative RBC transfusion status and the development of new or progressive VTE within 30 days of surgery. The analyses were age stratified, as follows: neonates (≤28 days), infants (>28 days and <1 year), and children (≥1 year). RESULTS In this study, we included 20 492 neonates, 79 744 infants, and 382 862 children. Postoperative development of VTE was reported in 99 (0.48%) neonates, 147 (0.2%) infants, and 374 (0.1%) children. In all age groups, development of VTE was significantly more common among patients with a perioperative RBC transfusion than patients without a perioperative RBC transfusion (neonates: adjusted odds ratio [aOR] = 4.1, 95% confidence interval [CI] = 2.5-6.7; infants: aOR = 2.4, 95% CI = 1.7-3.6; children: aOR = 2.2, 95% CI = 1.7-2.9). Among children who received an intra- or postoperative transfusion, the weight-based volume of RBCs (mL/kg) transfused was associated with postoperative VTE in a dose-dependent manner: second tertile (odds ratio = 2.3, 95% CI = 1.3-4.1) and third tertile (odds ratio = 4.1, 95% CI = 2.3-7.4) versus first tertile. CONCLUSIONS Perioperative RBC transfusions are independently associated with development of new or progressive postoperative VTE in children, infants, and neonates. These findings need further validation in prospective studies and emphasize the need for evidence-based perioperative pediatric blood transfusion decisions.
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Affiliation(s)
- Ruchika Goel
- Division of Transfusion Medicine, Department of Pathology, Johns Hopkins University, Baltimore, Maryland;,Departments of Internal Medicine and Pediatrics, School of Medicine, Southern Illinois University and Mississippi Valley Regional Blood Center, Springfield, Illinois
| | - Cassandra D. Josephson
- Department of Pathology, School of Medicine, Emory University and,Department of Pediatrics, Children’s Healthcare of Atlanta and School of Medicine, Emory University, Atlanta, Georgia
| | - Eshan U. Patel
- Division of Transfusion Medicine, Department of Pathology, Johns Hopkins University, Baltimore, Maryland
| | - Molly R. Petersen
- Division of Transfusion Medicine, Department of Pathology, Johns Hopkins University, Baltimore, Maryland
| | - Sarah Makhani
- Herbert Wertheim College of Medicine, Florida International University, Miami, Florida
| | - Steven M. Frank
- Department of Anesthesiology, Johns Hopkins Hospital, Baltimore, Maryland
| | - Paul M. Ness
- Division of Transfusion Medicine, Department of Pathology, Johns Hopkins University, Baltimore, Maryland
| | - Evan M. Bloch
- Division of Transfusion Medicine, Department of Pathology, Johns Hopkins University, Baltimore, Maryland
| | - Eric A. Gehrie
- Division of Transfusion Medicine, Department of Pathology, Johns Hopkins University, Baltimore, Maryland
| | - Parvez M. Lokhandwala
- Division of Transfusion Medicine, Department of Pathology, Johns Hopkins University, Baltimore, Maryland
| | | | - Oliver Karam
- Department of Pediatrics, Children’s Hospital of Richmond at Virginia Commonwealth University, Richmond, Virginia; and
| | | | - Ravi M. Patel
- Department of Pediatrics, Children’s Healthcare of Atlanta and School of Medicine, Emory University, Atlanta, Georgia
| | - Aaron A.R. Tobian
- Division of Transfusion Medicine, Department of Pathology, Johns Hopkins University, Baltimore, Maryland
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28
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Shaz BH, Domen RE, France CR. Remunerating donors to ensure a safe and available blood supply. Transfusion 2019; 60 Suppl 3:S134-S137. [DOI: 10.1111/trf.15647] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 11/13/2019] [Accepted: 11/13/2019] [Indexed: 12/30/2022]
Affiliation(s)
| | - Ronald E. Domen
- Penn State College of Medicine and Hershey Medical Center Hershey Pennsylvania
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29
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Shih AW, Apelseth TO, Cardigan R, Marks DC, Bégué S, Greinacher A, de Korte D, Seltsam A, Shaz BH, Wikman A, Barty RL, Heddle NM, Acker JP. Not all red cell concentrate units are equivalent: international survey of processing and in vitro quality data. Vox Sang 2019; 114:783-794. [PMID: 31637738 DOI: 10.1111/vox.12836] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [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: 04/12/2019] [Revised: 07/03/2019] [Accepted: 07/15/2019] [Indexed: 01/08/2023]
Abstract
INTRODUCTION In vitro qualitative differences exist in red cell concentrates (RCCs) units processed from whole blood (WB) depending on the method of processing. Minimal literature exists on differences in processing and variability in quality data. Therefore, we collected information from blood manufacturers worldwide regarding (1) details of WB collection and processing used to produce RCCs and (2) quality parameters and testing as part of routine quality programmes. METHODS A secure web-based survey was developed, refined after pilot data collection and distributed to blood centres. Descriptive analyses were performed. RESULTS Data from ten blood centres in nine countries were collected. Six blood centres (60%) processed RCCs using the top-and-top (TAT) method which produces RCCs and plasma, and eight centres (80%) used the bottom-and-top (BAT) which additionally produces buffy coat platelets. Five of the centres used both processing methods; however, four favoured BAT processing. One centre utilized the Reveos automated system exclusively. All centres performed pre-storage leucoreduction. Other parameters demonstrated variability, including active cooling at collection, length of hold before processing, donor haemoglobin limits, acceptable collection weights, collection sets, time to leucoreduction, centrifugation speeds, extraction devices and maximum RCC shelf life. Quality marker testing also differed amongst blood centres. Trends towards higher RCC unit volume, haemolysis and residual leucoctyes were seen in the TAT compared with BAT processing across centres. CONCLUSION Methods and parameters of WB processing and quality testing of RCCs differ amongst surveyed blood manufacturers. Further studies are needed to assess variations and to potentially improve methods and product quality.
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Affiliation(s)
- Andrew W Shih
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
- Vancouver Coastal Health Authority, Vancouver, BC, Canada
| | - Torunn Oveland Apelseth
- Department of Immunology and Transfusion Medicine, Haukeland University Hospital, Bergen, Norway
| | - Rebecca Cardigan
- National Health Service Blood and Transplant, Cambridge, UK
- Department of Haematology, University of Cambridge, Cambridge, UK
| | - Denese C Marks
- Research and Development, Australian Red Cross Blood Service, Sydney, NSW, Australia
| | - Stéphane Bégué
- Établissement Français du Sang, La-Plaine-Saint-Denis, France
| | - Andreas Greinacher
- Department of Transfusion Medicine, University Medical Center Greifswald, Greifswald, Germany
| | | | | | - Beth H Shaz
- New York Blood Center, New York City, NY, USA
| | - Agneta Wikman
- Department of Clinical Immunology and Transfusion Medicine, Karolinska University Hospital and Karolinska Institute, Stockholm, Sweden
| | - Rebecca L Barty
- McMaster Centre for Transfusion Research, McMaster University, Hamilton, ON, Canada
| | - Nancy M Heddle
- McMaster Centre for Transfusion Research, McMaster University, Hamilton, ON, Canada
- Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Jason P Acker
- Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, AB, Canada
- Centre for Innovation, Canadian Blood Services, Edmonton, AB, Canada
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30
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Francis RO, Mahajan S, Rapido F, La Carpia F, Soffing M, Divgi C, Yeh R, Mintz A, Leslie L, Agrest I, Karafin MS, Ginzburg Y, Shaz BH, Spitalnik SL, Schwartz J, Thomas T, Fu X, Amireault P, Buffet P, Zimring JC, D'Alessandro A, Hod EA. Reexamination of the chromium-51-labeled posttransfusion red blood cell recovery method. Transfusion 2019; 59:2264-2275. [PMID: 31002399 DOI: 10.1111/trf.15310] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2019] [Revised: 03/06/2019] [Accepted: 03/10/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND The chromium-51-labeled posttransfusion recovery (PTR) study has been the gold-standard test for assessing red blood cell (RBC) quality. Despite guiding RBC storage development for decades, it has several potential sources for error. METHODS Four healthy adult volunteers each donated an autologous, leukoreduced RBC unit, aliquots were radiolabeled with technetium-99m after 1 and 6 weeks of storage, and then infused. Subjects were imaged by single-photon-emission computed tomography immediately and 4 hours after infusion. Additionally, from subjects described in a previously published study, adenosine triphosphate levels in transfusates infused into 52 healthy volunteers randomized to a single autologous, leukoreduced, RBC transfusion after 1, 2, 3, 4, 5, or 6 weeks of storage were correlated with PTR and laboratory parameters of hemolysis. RESULTS Evidence from one subject imaged after infusion of technetium-99m-labeled RBCs suggests that, in some individuals, RBCs may be temporarily sequestered in the liver and spleen immediately following transfusion and then subsequently released back into circulation; this could be one source of error leading to PTR results that may not accurately predict the true quantity of RBCs cleared by intra- and/or extravascular hemolysis. Indeed, adenosine triphosphate levels in the transfusates correlated more robustly with measures of extravascular hemolysis in vivo (e.g., serum iron, indirect bilirubin, non-transferrin-bound iron) than with PTR results or measures of intravascular hemolysis (e.g., plasma free hemoglobin). CONCLUSIONS Sources of measurement error are inherent in the chromium-51 PTR method. Transfusion of an entire unlabeled RBC unit, followed by quantifying extravascular hemolysis markers, may more accurately measure true posttransfusion RBC recovery.
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Affiliation(s)
- Richard O Francis
- Pathology and Cell Biology, Columbia University Irving Medical Center-New York Presbyterian Hospital, New York, New York
| | - Sonia Mahajan
- Nuclear Medicine, Columbia University Irving Medical Center-New York Presbyterian Hospital, New York, New York
| | - Francesca Rapido
- Pathology and Cell Biology, Columbia University Irving Medical Center-New York Presbyterian Hospital, New York, New York
- Pôle Neuroscience Tête et Cou, Département d'Anesthésie -Réanimation Hôpital Gui de Chauliac- Centre Hospitalier Universitaire, Montpellier, France
| | - Francesca La Carpia
- Pathology and Cell Biology, Columbia University Irving Medical Center-New York Presbyterian Hospital, New York, New York
| | - Mark Soffing
- Nuclear Medicine, Columbia University Irving Medical Center-New York Presbyterian Hospital, New York, New York
| | - Chaitanya Divgi
- Nuclear Medicine, Columbia University Irving Medical Center-New York Presbyterian Hospital, New York, New York
| | - Randy Yeh
- Nuclear Medicine, Columbia University Irving Medical Center-New York Presbyterian Hospital, New York, New York
| | - Akiva Mintz
- Nuclear Medicine, Columbia University Irving Medical Center-New York Presbyterian Hospital, New York, New York
| | - Lenhurst Leslie
- Nuclear Medicine, Columbia University Irving Medical Center-New York Presbyterian Hospital, New York, New York
| | - Irina Agrest
- Nuclear Medicine, Columbia University Irving Medical Center-New York Presbyterian Hospital, New York, New York
| | | | - Yelena Ginzburg
- Division of Hematology Oncology, Icahn School of Medicine at Mount Sinai, New York, New York
| | | | - Steven L Spitalnik
- Pathology and Cell Biology, Columbia University Irving Medical Center-New York Presbyterian Hospital, New York, New York
| | - Joseph Schwartz
- Pathology and Cell Biology, Columbia University Irving Medical Center-New York Presbyterian Hospital, New York, New York
| | - Tiffany Thomas
- Pathology and Cell Biology, Columbia University Irving Medical Center-New York Presbyterian Hospital, New York, New York
| | - Xiaoyun Fu
- BloodWorks Northwest, Seattle, Washington
| | - Pascal Amireault
- Biologie Intégrée du Globule Rouge UMR_S1134, INSERM, Univ. Paris Diderot, Sorbonne Paris Cité, Univ. de la Réunion, Univ. des Antilles, Institut National de la Transfusion Sanguine, Laboratory of Excellence GR-Ex, Paris, France
- Laboratory of Cellular and Molecular Mechanisms of Hematological Disorders and Therapeutic Implications U1163/CNRS ERL 8254, INSERM, CNRS, Univ Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Pierre Buffet
- Biologie Intégrée du Globule Rouge UMR_S1134, INSERM, Univ. Paris Diderot, Sorbonne Paris Cité, Univ. de la Réunion, Univ. des Antilles, Institut National de la Transfusion Sanguine, Laboratory of Excellence GR-Ex, Paris, France
- Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | | | | | - Eldad A Hod
- Pathology and Cell Biology, Columbia University Irving Medical Center-New York Presbyterian Hospital, New York, New York
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31
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Livitz IE, France CR, France JL, Fox KR, Ankawi B, Slepian PM, Kessler DA, Rebosa M, Shaz BH. An automated motivational interview promotes donation intention and self‐efficacy among experienced whole blood donors. Transfusion 2019; 59:2876-2884. [DOI: 10.1111/trf.15402] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 05/17/2019] [Accepted: 05/17/2019] [Indexed: 11/28/2022]
Affiliation(s)
| | | | | | | | - Brett Ankawi
- Department of PsychologyOhio University Athens Ohio
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32
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Vossoughi S, Gorlin J, Kessler DA, Hillyer CD, Van Buren NL, Jimenez A, Shaz BH. Ten years of TRALI mitigation: measuring our progress. Transfusion 2019; 59:2567-2574. [PMID: 31145481 DOI: 10.1111/trf.15387] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Revised: 05/06/2019] [Accepted: 05/07/2019] [Indexed: 12/15/2022]
Abstract
BACKGROUND Transfusion-related acute lung injury (TRALI) is a leading cause of transfusion-associated mortality for which multiple mitigation strategies have been implemented over the past decade. However, product-specific TRALI rates have not been reported longitudinally and may help refine additional mitigation strategies. STUDY DESIGN AND METHODS This retrospective multicenter study included analysis of TRALI rates from 2007 through 2017. Numerators included definite or probable TRALI reports from five blood centers serving nine states in the United States. Denominators were components distributed from participating centers. Rates were calculated as per 100,000 components distributed (p < 0.05 significant). RESULTS One hundred four TRALI cases were reported from 10,012,707 components distributed (TRALI rate of 1.04 per 100,000 components). The TRALI rate was 2.25 for female versus 1.08 for male donated components (p < .001). The TRALI rate declined from 2.88 in 2007 to 0.60 in 2017. From 2007 to 2013, there was a significantly higher TRALI rate associated with female versus male plasma (33.85 vs. 1.59; p < 0.001) and RBCs (1.97 vs. 1.15; p = 0.03). From 2014 through 2017, after implementation of mitigation strategies, a significantly higher TRALI rate only from female-donated plateletpheresis continued to be observed (2.98 vs. 0.75; p = 0.04). CONCLUSION Although the TRALI rates have substantially decreased secondary to multiple strategies over the past decade, a residual risk remains, particularly with female-donated plateletpheresis products. Additional tools that may further mitigate TRALI incidence include the use of buffy coat pooled platelets suspended in male donor plasma or platelet additive solution due to the lower amounts of residual plasma.
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Affiliation(s)
- Sarah Vossoughi
- New York Blood Center, New York, New York.,Department of Pathology and Cell Biology, Columbia University Irving Medical Center, New York, New York
| | - Jed Gorlin
- Innovative Blood Resources, St. Paul, Minnesota
| | | | | | | | | | - Beth H Shaz
- New York Blood Center, New York, New York.,Department of Pathology and Cell Biology, Columbia University Irving Medical Center, New York, New York
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Cohn CS, Allen ES, Cushing MM, Dunbar NM, Friedman DF, Goel R, Harm SK, Heddle N, Hopkins CK, Klapper E, Perumbeti A, Ramsey G, Raval JS, Schwartz J, Shaz BH, Spinella PC, Pagano MB. Critical developments of 2018: A review of the literature from selected topics in transfusion. A committee report from the AABB's Clinical Transfusion Medicine Committee. Transfusion 2019; 59:2733-2748. [PMID: 31148175 DOI: 10.1111/trf.15348] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Revised: 05/01/2019] [Accepted: 05/03/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND The AABB compiles an annual synopsis of the published literature covering important developments in the field of transfusion medicine. An abridged version of this work is being made available in TRANSFUSION, with the full-length report available as Appendix S1 (available as supporting information in the online version of this paper). STUDY DESIGN AND METHODS Papers published in late 2017 and 2018 are included, as well as earlier papers cited for background. Although this synopsis is comprehensive, it is not exhaustive, and some papers may have been excluded or missed. RESULTS The following topics are covered: "big data" and "omics" studies, emerging infections and testing, platelet transfusion and pathogen reduction, transfusion therapy and coagulation, transfusion approach to hemorrhagic shock and mass casualties, therapeutic apheresis, and chimeric antigen receptor T-cell therapy. CONCLUSION This synopsis may be a useful educational tool.
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Affiliation(s)
- Claudia S Cohn
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, Minnesota
| | - Elizabeth S Allen
- Department of Pathology, University of California, San Diego, California
| | - Melissa M Cushing
- Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, New York
| | - Nancy M Dunbar
- Department of Pathology and Laboratory Medicine, Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire
| | - David F Friedman
- Blood Bank and Transfusion Medicine Department, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Ruchika Goel
- Division of Transfusion Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland.,Division of Hematology/Oncology, Mississippi Valley Regional Blood Center, Springfield, Illinois
| | - Sarak K Harm
- University of Vermont Medical Center, Burlington, VT
| | - Nancy Heddle
- McMaster Center for Transfusion Research, McMaster University, Hamilton, Ontario, Canada
| | | | - Ellen Klapper
- Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, California
| | - Ajay Perumbeti
- Department of Pathology and Laboratory Medicine, Children's Hospital Los Angeles, Los Angeles, California
| | - Glenn Ramsey
- Department of Pathology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Jay S Raval
- Department of Pathology, University of New Mexico, Albuquerque, New Mexico
| | - Joseph Schwartz
- Department of Pathology and Cell Biology, Columbia University, and, New York, New York
| | | | - Philip C Spinella
- Department of Pediatrics, Division of Pediatric Critical Care, Washington University in St Louis School of Medicine, Saint Louis, Missouri
| | - Monica B Pagano
- Transfusion Medicine Division, Department of Laboratory Medicine, University of Washington, Seattle, Washington
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34
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Patel EU, White JL, Bloch EM, Grabowski MK, Gehrie EA, Lokhandwala PM, Brunker PAR, Goel R, Shaz BH, Ness PM, Tobian AAR. Association of blood donation with iron deficiency among adolescent and adult females in the United States: a nationally representative study. Transfusion 2019; 59:1723-1733. [PMID: 30779173 PMCID: PMC6791124 DOI: 10.1111/trf.15179] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [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: 11/29/2018] [Revised: 01/03/2019] [Accepted: 01/03/2019] [Indexed: 12/17/2022]
Abstract
BACKGROUND Blood donation results in a loss of iron stores, which is particularly concerning for young female blood donors. This study examines the association of blood donation and iron deficiency among adolescent and adult females in the United States. STUDY DESIGN AND METHODS A cross-sectional analysis was performed using data from the 1999-2010 National Health and Nutrition Examination Survey (NHANES). Females who reported their blood donation history in the preceding year and had serum ferritin (SF) measurements were included. Analyses were weighted and stratified by adolescents (16-19 years; n = 2419) and adults (20-49 years; n = 7228). Adjusted prevalence ratios (aPRs) were estimated by multivariable Poisson regression. Standard errors were estimated by Taylor series linearization. RESULTS Geometric mean SF levels (ng/mL) were lower in blood donors compared to nondonors among adolescents (21.2 vs. 31.4; p < 0.001) and among adults (26.2 vs. 43.7; p < 0.001). The prevalence of absent iron stores (SF < 12 ng/mL) was higher in blood donors compared to nondonors among adolescents (22.6% vs. 12.2%; aPR = 2.03 [95% confidence interval (CI) = 1.45-2.85]) and among adults (18.3% vs. 9.8%; aPR = 2.06 [95% CI = 1.48-2.88]). Additionally, the prevalence of iron deficiency anemia (SF < 26 ng/mL and hemoglobin < 12.0 g/dL) was also higher in blood donors compared to nondonors among adolescents (9.5% vs. 6.1%; aPR = 2.10 [95% CI = 1.13-3.90]) and among adults (7.9% vs. 6.1%; aPR = 1.74 [95% CI = 1.06-2.85]). Similar results were observed in a sensitivity analysis restricted to adolescents aged 16 to 18 years. CONCLUSIONS Blood donation is associated with iron deficiency among adolescent and adult females in the United States. These national data call for further development and implementation of blood donation practices aimed toward mitigating iron deficiency.
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Affiliation(s)
- Eshan U. Patel
- Division of Transfusion Medicine, Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Jodie L White
- Division of Transfusion Medicine, Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Evan M. Bloch
- Division of Transfusion Medicine, Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Mary K. Grabowski
- Division of Transfusion Medicine, Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Eric A. Gehrie
- Division of Transfusion Medicine, Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Parvez M. Lokhandwala
- Division of Transfusion Medicine, Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Patricia A. R Brunker
- Division of Transfusion Medicine, Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland
- Biomedical Services, Greater Chesapeake and Potomac Region, The American Red Cross, Baltimore, Maryland
| | - Ruchika Goel
- Division of Transfusion Medicine, Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland
- Division of Hematology/Oncology, Simmons Cancer Institute at SIU School of Medicine, Springfield, Illinois
| | | | - Paul M. Ness
- Division of Transfusion Medicine, Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Aaron A. R. Tobian
- Division of Transfusion Medicine, Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland
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35
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Goel R, Patel EU, White JL, Chappidi MR, Ness PM, Cushing MM, Takemoto CM, Shaz BH, Frank SM, Tobian AAR. Factors associated with red blood cell, platelet, and plasma transfusions among inpatient hospitalizations: a nationally representative study in the United States. Transfusion 2018; 59:500-507. [PMID: 30548491 DOI: 10.1111/trf.15088] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Revised: 10/19/2018] [Accepted: 10/22/2018] [Indexed: 01/28/2023]
Abstract
BACKGROUND Demographic and hospital-level factors associated with red blood cell (RBC), plasma, and platelet transfusions in hospitalized patients across the U.S. are not well characterized. METHODS We conducted a retrospective analysis of the National Inpatient Sample (2014). The unit of analysis was a hospitalization; sampling weights were applied to generate nationally-representative estimates. The primary outcome was having ≥ 1 RBC transfusion procedure; plasma and platelet transfusions were similarly assessed as secondary outcomes. For each component, factors associated with transfusion were measured using adjusted prevalence ratios (adjPR) and 95% confidence intervals (95% CI) estimated by multivariable Poisson regression. RESULTS The prevalence of RBC, plasma, and platelet transfusion was 5.8%, 0.9%, and 0.7%, respectively. RBC transfusions were associated with older age (≥ 65 vs. < 18 years; adjPR = 1.80; 95% CI = 1.66-1.96), female sex (adjPR = 1.13; 95% CI = 1.12-1.14), minority race/ethnic status, and hospitalizations in rural hospitals compared to urban teaching hospitals. Prevalence of RBC transfusion was lower among hospitalizations in the Midwest compared to the Northeast (adjPR = 0.73; 95% CI = 0.67-0.80). All components were more likely to be transfused in patients with a primary hematologic diagnosis, patients with a higher number of total diagnoses, patients who experienced a higher number of other procedures, and patients who eventually died in the hospital. In contrast to RBC transfusions, prevalence of platelet transfusion was greater in urban teaching hospitals (vs. rural; adjPR = 1.71; 95% CI = 1.49-1.98) and lower in blacks (vs. whites; adjPR = 0.80; 95% CI = 0.76-0.85). CONCLUSIONS Nationally, there is heterogeneity in factors associated with transfusion between each blood component, including by hospital type and location. This variability presents patient blood management programs with potential opportunities to reduce transfusions.
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Affiliation(s)
- Ruchika Goel
- Department of Pathology, Johns Hopkins University, Baltimore, MD, United States.,Division of Hematology/Oncology, Simmons Cancer Institute at SIU School of Medicine, Springfield, IL, United States
| | - Eshan U Patel
- Department of Pathology, Johns Hopkins University, Baltimore, MD, United States
| | - Jodie L White
- Department of Pathology, Johns Hopkins University, Baltimore, MD, United States
| | - Meera R Chappidi
- Department of Pathology, Johns Hopkins University, Baltimore, MD, United States
| | - Paul M Ness
- Department of Pathology, Johns Hopkins University, Baltimore, MD, United States
| | - Melissa M Cushing
- Department of Pathology, New York-Presbyterian Hospital, Weill Cornell Medical College, New York, NY, United States
| | - Clifford M Takemoto
- Department of Pediatrics, Johns Hopkins University, Baltimore, MD, United States
| | - Beth H Shaz
- New York Blood Center, New York, NY, United States
| | - Steven M Frank
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University, Baltimore, MD, United States
| | - Aaron A R Tobian
- Department of Pathology, Johns Hopkins University, Baltimore, MD, United States
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Harm SK, Yazer MH, Bub CB, Cohn CS, Jacob EK, Kutner JM, Mair DC, Raval JS, Shaz BH, Ziman A, Dunbar NM. Seasonal variability is not observed in the rates of high anti‐A and anti‐B titers in plasma, apheresis platelet, and whole blood units tested by different methods. Transfusion 2018; 59:762-767. [DOI: 10.1111/trf.15083] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Revised: 10/19/2018] [Accepted: 10/22/2018] [Indexed: 12/27/2022]
Affiliation(s)
- Sarah K. Harm
- Department of Pathology and Laboratory MedicineUniversity of Vermont Medical Center Burlington Vermont
| | - Mark H. Yazer
- Department of Pathology and Laboratory MedicineUniversity of Pittsburgh Pittsburgh Pennsylvania
| | - Carolina B. Bub
- Hemotherapy and Cell Therapy DepartmentHospital Israelita Albert Einstein Sao Paulo Brazil
| | - Claudia S. Cohn
- Department of Laboratory Medicine and PathologyUniversity of Minnesota Minneapolis Minnesota
| | - Eapen K. Jacob
- Department of Laboratory Medicine and PathologyMayo Clinic Rochester Minnesota
| | - Jose M. Kutner
- Hemotherapy and Cell Therapy DepartmentHospital Israelita Albert Einstein Sao Paulo Brazil
| | - David C. Mair
- Blood Services ‐ West DivisionAmerican Red Cross Minnesota
| | - Jay S. Raval
- Department of Pathology and Laboratory MedicineUniversity of North Carolina Chapel Hill North Carolina
| | | | - Alyssa Ziman
- Wing‐Kwai and Alice Lee‐Tsing Chung Transfusion Service, Department of Pathology and Laboratory MedicineDavid Geffen School of Medicine, University of California Los Angeles Los Angeles California
| | - Nancy M. Dunbar
- Department of Pathology and Laboratory MedicineDartmouth‐Hitchcock Medical Center Lebanon New Hampshire
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Goel R, Kessler D, Nandi V, Ortiz C, Hillyer CD, Shaz BH. Donor incentives improve cardiovascular disease risk profile and donation rates. Transfusion 2018; 59:250-258. [PMID: 30408199 DOI: 10.1111/trf.14989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2018] [Revised: 09/12/2018] [Accepted: 09/12/2018] [Indexed: 11/29/2022]
Abstract
BACKGROUND Blood centers may offer point-based reward systems or cardiovascular disease (CVD) screening to incentivize donors. However, combining these incentives to improve CVD risk and blood donation rates has not been studied. STUDY DESIGN AND METHODS Study was a three-arm prospective controlled trial: Group 1, control (routine points, no CVD screening); Group 2, CVD screening with routine points; and Group 3, CVD screening plus incentive double points. The primary objective was to determine if double versus routine incentive points led to improvement or maintenance of CVD risk profile assessed using self-reported changes in 1) reading food labels for calorie and fat content, 2) exercising daily, 3) reduced fat intake, and 4) increase in eating fruits and vegetables. Outcomes were compared at first and final (2-year) follow-up visits. As secondary outcome, median blood donation rates before enrollment and during study were compared. RESULTS A total of 570 donors (290 in Group 1, 134 in Group 2, 146 Group 3) were selected. At first follow-up visit, 71.4% in Group 3 versus 62.0% in Group 2 subjects reported at least one of four positive behavioral changes (p < 0.001). Increase in reading food labels for calorie and fat content was the most common change and higher in Group 3 (Group 3 from 60.9% to 79.1%; Group 2 from 67.6% to 77.5%; p < 0.001). Final evaluation showed significant increase in self-reported exercise in Group 3 only (from baseline 52.9% to 68.3%; p < 0.05). Group 3 reported higher increase in median number of donations/year during study enrollment (6.8 [IQR, 4.3-12] vs. baseline 4.6 [IQR, 3.2-7.1] donations/year) than Group 2 (5.6 [IQR, 4.2-10.5] vs. baseline 4.9 [IQR, 3.5-10.2]) and Group 1 (4.4 [IQR, 2.7-8.0] vs. baseline 4.4 [IQR, 2.5-6.0] donations/year; p < 0.001). CONCLUSION Positive donor reinforcement (double vs. routine points) resulted in better self-reported health maintenance behavior and increased donation rates.
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Affiliation(s)
- Ruchika Goel
- Division of Hematology/Oncology, Simmons Cancer Institute at SIU School of Medicine, Springfield, Illinois.,Division of Transfusion Medicine, Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland
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Shaz BH. Risk-based decision making: a good start to aiding US blood policy decisions? Transfusion 2018; 58:1827-1830. [DOI: 10.1111/trf.14927] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Accepted: 08/10/2018] [Indexed: 11/29/2022]
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Abstract
BACKGROUND Therapeutic apheresis is a term used to describe a group of treatments where blood components are separated in real time, and one component is removed, exchanged, and/or treated to remove pathogenic substances from the circulation. Plasma exchange, which removed all plasma components, and lipid apheresis which selectively removes lipoproteins from circulation, have both been used to treat atherosclerotic vascular diseases. METHODS To review the literature regarding the application of therapeutic apheresis for atherosclerotic vascular diseases. RESULTS Primarily lipid apheresis is used to treat atherosclerotic vascular diseases, particularly familial hypercholesterolemia, lipoprotein (a) hyperlipoproteinemia and peripheral vascular diseases. Lipid apheresis can be used as first line or second line treatment with a strong evidenced-based recommendation. Its use has decreased atherosclerotic events. CONCLUSION Lipid apheresis is an important therapy for the treatment of familial hypercholesterolemia, lipoprotein (a) hyperlipoproteinemia and peripheral vascular diseases. Lipid apheresis does more than remove low-density lipoproteins and other lipoproteins but also decreases inflammatory markers and improves blood flow.
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Affiliation(s)
| | - Beth H Shaz
- New York Blood Center, New York, New York, USA
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Frye V, Duffy L, France JL, Kessler DA, Rebosa M, Shaz BH, Carlson BW, France CR. The Development of a Social Networking-Based Relatedness Intervention Among Young, First-Time Blood Donors: Pilot Study. JMIR Public Health Surveill 2018; 4:e44. [PMID: 29699961 PMCID: PMC5945991 DOI: 10.2196/publichealth.8972] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Revised: 01/28/2018] [Accepted: 02/15/2018] [Indexed: 12/14/2022] Open
Abstract
Background Increasing repeat blood donation behavior is a critical public health goal. According to self-determination theory, the process of developing internal motivation to give blood and an associated self-identity as a blood donor may be promoted by feelings of “relatedness” or a connection to other donors, which may be enhanced through social relations and interactions. Objective The purpose of this report it to describe the development and pilot testing of a social networking-based (Facebook) intervention condition designed to increase feelings of relatedness via virtual social interaction and support. Methods To develop the intervention condition content, images, text, polls, and video content were assembled. Ohio University college students (N=127) rated the content (82 images/text) presented by computer in random order using a scale of one to five on various dimensions of relatedness. Mean ratings were calculated and analyses of variance were conducted to assess associations among the dimensions. Based on these results, the relatedness intervention was adapted and evaluated for feasibility, acceptability, and preliminary efficacy among 24 first-time donors, aged 18 to 24 years, in a 30-day pilot trial. Paired t-tests were conducted to examine change over time in relatedness and connectedness. Results The intervention condition that was developed was acceptable and feasible. Results of the uncontrolled, preintervention, and postintervention evaluation revealed that feelings of individual-level relatedness increased significantly after the intervention. Conclusions By promoting first-time blood donor relatedness, our goal is to enhance internal motivation for donating and the integration of the blood donor identity, thus increasing the likelihood of future repeat donation. Trial Registration ClinicalTrials.gov NCT02717338; https://clinicaltrials.gov/ct2/show/NCT02717338 (Archived by WebCite at http://www.webcitation.org/6ymHRBCwu)
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Affiliation(s)
- Victoria Frye
- City University of New York School of Medicine, Community Health and Social Medicine, City University of New York, New York, NY, United States.,New York Blood Center, New York, NY, United States
| | - Louisa Duffy
- New York Blood Center, New York, NY, United States
| | - Janis L France
- Ohio University, Department of Psychology, Athens, OH, United States
| | | | - Mark Rebosa
- New York Blood Center, New York, NY, United States
| | - Beth H Shaz
- New York Blood Center, New York, NY, United States
| | - Bruce W Carlson
- Ohio University, Department of Psychology, Athens, OH, United States
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41
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Cushing MM, Kelley J, Klapper E, Friedman DF, Goel R, Heddle NM, Hopkins CK, Karp JK, Pagano MB, Perumbeti A, Ramsey G, Roback JD, Schwartz J, Shaz BH, Spinella PC, Cohn CS, Cohn CS, Cushing MM, Kelley J, Klapper E. Critical developments of 2017: a review of the literature from selected topics in transfusion. A committee report from the AABB Clinical Transfusion Medicine Committee. Transfusion 2018. [PMID: 29520794 DOI: 10.1111/trf.14520] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND The AABB compiles an annual synopsis of the published literature covering important developments in the field of Transfusion Medicine. For the first time, an abridged version of this work is being made available in TRANSFUSION, with the full-length report available as an Appendix S1 (available as supporting information in the online version of this paper). STUDY DESIGN AND METHODS Papers published in 2016 and early 2017 are included, as well as earlier papers cited for background. Although this synopsis is comprehensive, it is not exhaustive, and some papers may have been excluded or missed. RESULTS The following topics are covered: duration of red blood cell storage and clinical outcomes, blood donor characteristics and patient outcomes, reversal of bleeding in hemophilia and for patients on direct oral anticoagulants, transfusion approach to hemorrhagic shock, pathogen inactivation, pediatric transfusion medicine, therapeutic apheresis, and extracorporeal support. CONCLUSION This synopsis may be a useful educational tool.
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Affiliation(s)
| | - James Kelley
- Department of Laboratory Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Ellen Klapper
- Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, California
| | - David F Friedman
- Blood Bank and Transfusion Medicine Department, Children's Hospital of Philadelphia and University of Pennsylvania, Philadelphia, Pennsylvania
| | - Ruchika Goel
- Department of Pathology, Weill Cornell Medicine, New York, New York
| | - Nancy M Heddle
- McMaster Center for Transfusion Research, McMaster University, Hamilton, Ontario, Canada
| | | | - Julie Katz Karp
- Department of Pathology, Anatomy, and Cell Biology, Thomas Jefferson University Hospitals, Philadelphia, Pennsylvania
| | - Monica B Pagano
- Transfusion Medicine Division, Department of Laboratory Medicine, University of Washington, Seattle, Washington
| | - Ajay Perumbeti
- Department of Pathology and Laboratory Medicine, Children's Hospital Los Angeles, Los Angeles, California
| | - Glenn Ramsey
- Department of Pathology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - John D Roback
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - Joseph Schwartz
- Department of Pathology and Cell Biology, Columbia University Medical Center and the New York-Presbyterian Hospital
| | | | - Philip C Spinella
- Department of Pediatrics, Division of Pediatric Critical Care, Washington University School of Medicine, St Louis, Missouri
| | - Claudia S Cohn
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, Minnesota
| | - Claudia S Cohn
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, Minnesota
| | | | - James Kelley
- Department of Laboratory Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Ellen Klapper
- Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, California
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42
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Weisberg SP, Shaz BH, Tumer G, Silliman CC, Kelher MR, Cohn CS. PAS-C platelets contain less plasma protein, lower anti-A and anti-B titers, and decreased HLA antibody specificities compared to plasma platelets. Transfusion 2018; 58:891-895. [DOI: 10.1111/trf.14523] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2017] [Revised: 11/24/2017] [Accepted: 11/24/2017] [Indexed: 11/30/2022]
Affiliation(s)
- Stuart P. Weisberg
- Department of Pathology and Cell Biology; Columbia University; New York New York
| | - Beth H. Shaz
- Department of Pathology and Cell Biology; Columbia University; New York New York
| | - Gizem Tumer
- Department of Laboratory Medicine and Pathology; University of Minnesota; Minneapolis Minnesota
| | - Chris C. Silliman
- Department of Surgery; Denver Health Medical Center; Denver Colorado
| | | | - Claudia S. Cohn
- Department of Laboratory Medicine and Pathology; University of Minnesota; Minneapolis Minnesota
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43
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Westhoff CM, Storry JR, Shaz BH. Human Blood Group Antigens and Antibodies. Hematology 2018. [DOI: 10.1016/b978-0-323-35762-3.00110-4] [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: 11/29/2022] Open
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44
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Abdel-Wahab O, Abrahm JL, Adams S, Adewoye AH, Allen C, Ambinder RF, Anasetti C, Anastasi J, Anderson JA, Antin JH, Antony AC, Araten DJ, Armand P, Armstrong G, Armstrong SA, Arnold DM, Artz AS, Awan FT, Baglin TP, Benson DM, Benz EJ, Berliner N, Bhagat G, Bhardwaj N, Bhatia R, Bhatia S, Bhatt MD, Bhatt VR, Bitan M, Blinderman CD, Bollard CM, Braun BS, Brenner MK, Brittenham GM, Brodsky RA, Brown M, Broxmeyer HE, Brummel-Ziedins K, Brunner AM, Buadi FK, Burkhardt B, Burns M, Byrd JC, Caimi PF, Caligiuri MA, Canavan M, Cantor AB, Carcao M, Carroll MC, Carty SA, Castillo JJ, Chan AK, Chapin J, Chiu A, Chute JP, Clark DB, Coates TD, Cogle CR, Connell NT, Cooke E, Cooley S, Corradini P, Creager MA, Creger RJ, Cromwell C, Crowther MA, Cushing MM, Cutler C, Dang CV, Danial NN, Dave SS, DeCaprio JA, Dinauer MC, Dinner S, Diz-Küçükkaya R, Dodd RY, Donato ML, Dorshkind K, Dotti G, Dror Y, Dunleavy K, Dvorak CC, Ebert BL, Eck MJ, Eikelboom JW, Epperla N, Ershler WB, Evans WE, Faderl S, Ferrara JL, Filipovich AH, Fischer M, Fredenburgh JC, Friedman KD, Fuchs E, Fuller SJ, Gailani D, Galipeau J, Gallagher PG, Ganapathi KA, Gardner LB, Gee AP, Gerson SL, Gertz MA, Giardina PJ, Gibson CJ, Golan K, Golub TR, Gonzales MJ, Gotlib J, Gottschalk S, Grant MA, Graubert TA, Gregg XT, Gribben JG, Gross DM, Gruber TA, Guitart J, Gurbuxani S, Gur-Cohen S, Gutierrez A, Hamadani M, Hari PN, Hartwig JH, Hayman SR, Hayward CP, Hebbel RP, Heslop HE, Hillis C, Hillyer CD, Ho K, Hockenbery DM, Hoffman R, Hogg KE, Holtan SG, Horny HP, Hsu YMS, Hunter ZR, Huntington JA, Iancu-Rubin C, Iqbal A, Isenman DE, Israels SJ, Italiano JE, Jaffe ES, Jaffer IH, Jagannath S, Jäger U, Jain N, James P, Jeha S, Jordan MB, Josephson CD, Jung M, Kager L, Kambayashi T, Kanakry JA, Kantarjian HM, Kaplan J, Karafin MS, Karsan A, Kaufman RJ, Kaufman RM, Keller FG, Kelly KM, Kessler CM, Key NS, Keyzner A, Khandoga AG, Khanna-Gupta A, Khatib-Massalha E, Klein HG, Knoechel B, Kollet O, Konkle BA, Kontoyiannis DP, Koreth J, Koretzky GA, Kotecha D, Kremyanskaya M, Kumari A, Kuzel TM, Küppers R, Lacy MQ, Ladas E, Landier W, Lapid K, Lapidot T, Larson PJ, Levi M, Lewis RE, Liebman HA, Lillicrap D, Lim W, Lin JC, Lindblad R, Lip GY, Little JA, Lohr JG, López JA, Luscinskas FW, Maciejewski JP, Majhail NS, Manches O, Mandle RJ, Mann KG, Manno CS, Marcogliese AN, Mariani G, Marincola FM, Mascarenhas J, Massberg S, McEver RP, McGrath E, McKinney MS, Mehta RS, Mentzer WC, Merlini G, Merryman R, Michel M, Migliaccio AR, Miller JS, Mims MP, Mondoro TH, Moorehead P, Muniz LR, Munshi NC, Najfeld V, Nayak L, Nazy I, Neff AT, Ness PM, Notarangelo LD, O'Brien SH, O'Connor OA, O'Donnell M, Olson A, Orkin SH, Pai M, Pai SY, Paidas M, Panch SR, Pande RL, Papayannopoulou T, Parikh R, Petersdorf EW, Peterson SE, Pittaluga S, Ponce DM, Popolo L, Prchal JT, Pui CH, Puigserver P, Rak J, Ramos CA, Rand JH, Rand ML, Rao DS, Ravandi F, Rawlings DJ, Reddy P, Reding MT, Reiter A, Rice L, Riese MJ, Ritchey AK, Roberts DJ, Roman E, Rooney CM, Rosen ST, Rosenthal DS, Rossmann MP, Rot A, Rowley SD, Rubnitz JE, Rydz N, Salama ME, Sauk S, Saunthararajah Y, Savage W, Scadden D, Schaefer KG, Schiffman F, Schneidewend R, Schrier SL, Schuchman EH, Scullion BF, Selvaggi KJ, Senoo K, Shaheen M, Shaz BH, Shelburne SA, Shpall EJ, Shurin SB, Siegal D, Silberstein LE, Silberstein L, Silverstein RL, Sloan SR, Smith FO, Smith JW, Smith K, Steensma DP, Steinberg MH, Stock W, Storry JR, Stramer SL, Strauss RG, Stroncek DF, Taylor J, Thota S, Treon SP, Tulpule A, Valdes RF, Valent P, Vedantham S, Vercellotti GM, Verneris MR, Vichinsky EP, von Andrian UH, Vose JM, Wagner AJ, Wang E, Wang JH, Warkentin TE, Wasserstein MP, Webster A, Weisdorf DJ, Weitz JI, Westhoff CM, Wheeler AP, Widick P, Wiley JS, William BM, Williams DA, Wilson WH, Wolfe J, Wolgast LR, Wood D, Wu J, Yahalom J, Yee DL, Younes A, Young NS, Zeller MP. Contributors. Hematology 2018. [DOI: 10.1016/b978-0-323-35762-3.00168-2] [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: 10/18/2022] Open
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45
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Yazer MH, Anani WQ, Denomme GA, Karafin MS, Sayers M, Shaz BH. Trends in antigen-negative red blood cell distributions by racial or ethnic groups in the United States. Transfusion 2017; 58:145-150. [DOI: 10.1111/trf.14376] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2017] [Revised: 08/22/2017] [Accepted: 08/22/2017] [Indexed: 01/28/2023]
Affiliation(s)
- Mark H. Yazer
- The Institute for Transfusion Medicine; Pittsburgh Pennsylvania
| | | | | | | | - Merlyn Sayers
- Carter BloodCare and the University of Texas Southwestern; Dallas Texas
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46
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Weisberg SP, Staley EM, Williams LA, Pham HP, Bachegowda LS, Cheng YH, Schwartz J, Shaz BH. Survey on Transfusion-Transmitted Cytomegalovirus and Cytomegalovirus Disease Mitigation. Arch Pathol Lab Med 2017; 141:1705-1711. [PMID: 28849943 DOI: 10.5858/arpa.2016-0461-oa] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
CONTEXT - Cytomegalovirus (CMV) can be transmitted by cellular blood products, leading to severe disease in immunosuppressed patients such as neonates and transplant recipients. To mitigate transfusion-transmitted CMV (TT-CMV), "CMV-safe" blood products (leukoreduced and/or CMV-seronegative) are transfused. Attempts to develop practice guidelines for TT-CMV mitigation have been limited by paucity of high-quality clinical trials. OBJECTIVE - To assess current TT-CMV mitigation strategies across medical institutions for specific at-risk populations. DESIGN - Supplemental questions regarding TT-CMV and CMV disease mitigation were added to a College of American Pathologists Transfusion Medicine (Comprehensive) Participant Survey in 2015, addressing whether a given institution provided CMV-safe products for 6 at-risk patient populations. RESULTS - Ninety percent (2712 of 3032) of institutions reported providing universally leukoreduced blood products. Among institutions without universal leukoreduction, 92% (295 of 320) provided leukoreduced products on the basis of clinical criteria. Eighty-three percent (2481 of 3004) of respondents reported having availability of CMV-seronegative products; however, wide variation in policies was reported governing CMV-seronegative product use. Among all respondents, less than 5% reported using CMV prophylaxis and monitoring in high-risk patient groups. Transplant centers reported higher rates of CMV prophylaxis (25% [97 of 394] solid organ) and monitoring (15% [59 of 394] solid organ) for CMV-negative transplant recipients. CONCLUSIONS - Universal leukoreduction is the primary strategy for mitigating TT-CMV. While most institutions have both CMV-seronegative and leukoreduced blood products available, consensus is lacking on which patients should receive these products. High-quality studies are needed to determine if CMV-seronegative and leukoreduced blood products are needed in high-risk patient populations.
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47
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Jimenez A, Shaz BH, Kessler D, Bloch EM. How do we manage blood donors and recipients after a positive Zika screening result? Transfusion 2017; 57:2077-2083. [PMID: 28734023 DOI: 10.1111/trf.14252] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Revised: 06/10/2017] [Accepted: 06/11/2017] [Indexed: 12/28/2022]
Abstract
Zika virus (ZIKV) is a mosquito-borne flavivirus that is the focus of an ongoing pandemic. ZIKV is notable for its severe neurologic sequelae in babies born to infected mothers. High rates of subclinical infection, as evidenced by the finding of ZIKV RNA in asymptomatic donors, raise concerns of risk to the blood supply. To date, a total of four suspected cases of transfusion-transmitted ZIKV have been reported (all in Brazil), none of which were associated with clinical infection in the transfusion recipients. In 2016, the US Food and Drug Administration issued a guidance mandating national blood donor screening for ZIKV in the United States. Five days after implementation of donor screening at our facility, we encountered a ZIKV-positive donor. We provide a practical approach to donor, recipient, and blood product management in the setting of a positive donor ZIKV result. Such has been informed by the challenges we faced in the workup of a ZIKV-reactive donation and recipient lookback.
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Affiliation(s)
| | - Beth H Shaz
- New York Blood Center, New York, New York.,Columbia University Medical Center, New York, New York
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48
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France CR, France JL, Carlson BW, Himawan LK, Kessler DA, Rebosa M, Shaz BH, Madden K, Carey PM, Slepian PM, Ankawi B, Livitz IE, Fox KR. A motivational interview promotes retention of blood donors with high internal motivation. Transfusion 2017; 57:2433-2439. [PMID: 28671277 DOI: 10.1111/trf.14203] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Revised: 05/12/2017] [Accepted: 05/12/2017] [Indexed: 11/28/2022]
Abstract
BACKGROUND Based on the hypothesis that self-determined motivation is associated with an increased likelihood of future behavior, the present study examined the ability of a motivational interview to promote internal motivation for giving blood and future donation attempts. STUDY DESIGN AND METHODS A sample of 484 recent whole-blood and double red blood cell donors (62.4% female; age = 30.2 ± 11.8 years) were randomly assigned to either a telephone-delivered motivational interview or a control call approximately 6 weeks after donating. Several weeks before the call and again 1 week after the call, participants completed the Blood Donor Identity Survey, a multidimensional measure of donor motivation, to derive indices of amotivation, external motivation, and internal motivation to give blood. Repeat donation attempts were tracked using blood center records. RESULTS Relative to controls, participants in the motivational interview group showed a shift toward more self-determined motivation, as indicated by significant decreases in amotivation (p = 0.01) and significant increases in external (p = 0.009) and internal (p = 0.002) motivation. Furthermore, those with initially high levels of autonomous motivation were more likely to make a donation attempt in the subsequent year if they completed the motivational interview (71.1%) versus the control call (55.1%). CONCLUSION Motivational interviewing is a potentially useful strategy to enhance retention of existing blood donors, particularly among those who express a greater sense of internal motivation for giving.
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Affiliation(s)
| | | | | | | | | | | | | | - Katrala Madden
- Hoxworth Blood Center, University of Cincinnati, Cincinnati, Ohio
| | - Patricia M Carey
- Hoxworth Blood Center, University of Cincinnati, Cincinnati, Ohio
| | | | - Brett Ankawi
- Department of Psychology, Ohio University, Athens, Ohio
| | | | - Kristen R Fox
- Department of Psychology, Ohio University, Athens, Ohio
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Bachegowda LS, Timm B, Dasgupta P, Hillyer CD, Kessler D, Rebosa M, France CR, Shaz BH. Impact of predictive scoring model and e-mail messages on African American blood donors. Transfusion 2017; 57:1515-1521. [DOI: 10.1111/trf.14113] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Revised: 02/04/2017] [Accepted: 02/04/2017] [Indexed: 11/28/2022]
Affiliation(s)
| | - Brad Timm
- Hindsait, Inc.; Hackensack New Jersey
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50
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Yazer MH, Vassallo R, Delaney M, Germain M, Karafin MS, Sayers M, van de Watering L, Shaz BH. Trends in age and red blood cell donation habits among several racial/ethnic minority groups in the United States. Transfusion 2017; 57:1644-1655. [DOI: 10.1111/trf.14108] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Revised: 02/06/2017] [Accepted: 02/06/2017] [Indexed: 11/26/2022]
Affiliation(s)
- Mark H. Yazer
- The Institute for Transfusion Medicine; Pittsburgh Pennsylvania
| | | | | | | | | | - Merlyn Sayers
- Carter BloodCare and the University of Texas Southwestern; Dallas Texas
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