The application of multiparameter reference intervals for pre-donation capillary blood counts: the experience of a single institution

OBJECTIVES

To evaluate a set of reference counts applied to multiparameter pre-counts in blood donors.

AIM

Analyse the impact of pre-donation counts and specific reference intervals on donors' management.

BACKGROUND

Multiparameter blood counts allow an improved enrollment process of blood donors due to a prompt identification of abnormalities involving haemoglobin (Hb), white blood cells (WBC) and platelets (PLT).

METHODS/MATERIALS

Multiple pre-donation capillary counts were applied in the enrollment process of 13,347 consecutive donors. The rate of specific alterations of permanent exclusion and donor readmittance to donations for temporary exclusion had been evaluated, applying a set of multiparameter reference intervals.

RESULTS

Alterations involved Hb in 72.55% of cases, mean corpuscular volume (MCV) in 20.99%, total WBC in 9.39%, lymphocytes in 7.55% and PLT in 6.07%. Among donors with initial alterations (543; 4.06%), 12.70% were readmitted to donations within 15 days, 14.36% had permanent exclusion, 36.83% underwent prompt supplementation treatment and 36.09% were lost at follow-up or refused treatments.

DISCUSSION

The systematic use of blood count reference intervals and pre-donation multiparameter blood counts allowed prompt identification of WBC, PLT and MCV alterations, readmittance within 15 days of 12.70% of initially excluded donors and contributed to prompt management of supplement deficiency.

[Autologous transfusion technique application table]

The authors make a survey on the reasons leading to the application of different methods of autologous transfusion. They underline, incidentally, the important role played by the issues encountered in dealing with Jehovah's Witnesses as well as the discovery and spread of new transfusion transmitted diseases like AIDS and hepatitis C. They explain their experience, from which they have produced a Best Autologous Transfusion Technique Application Table (Scheda di Applicazione Ottimale delle Metodiche di Autotrasfusione, SAOMA), specific for every type, of operation, through the analysis of many parameters (surgeon, anaesthetist, transfusionist, general conditions of the patients, type of surgical operation). Moreover the authors evaluate advantages and disadvantages of the different autologous transfusion methods, including their cost efficiency aspects, and how they can be combined depending on the type of surgical operation. As a conclusion they attribute great importance to SAOMA to minimize homologous blood transfusion risks, even though at times the clinical aspect is made to prevail over the economic one.

[Critical evaluation of 245 cases of lymph node biopsy]

We examined 245 lymph node biopsies of subjects possibly suffering from systemic lymphopathy, in which non-invasive means did not allow a certain diagnosis. The parameters considered are: histological finding, age of patients at the time of diagnosis, presence of general symptoms, location of the superficial lymph nodes concerned, collateral tests usually performed, familiarity. The significance of differences between the main disease groups has been checked by the usual statistical methods. Our data are generally consistent with the diagnostic criteria commonly accepted in the literature, except for some details: e. g. in Hodgkin's disease the distribution of patient ages at the time of first diagnosis shows a single peak (unimodal), instead of two, as described in other countries. The involvement of supraclavicular nodes in chronic aspecific lymphopathies is less frequent than in systemic lymphomas. Our experience has widely confirmed the indications and usefulness of lymph node biopsy for hematological diagnosis.