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INTRODUCTION: Since being designated as medicines by World Health Organization (WHO), blood components are subject to pharmacovigilance reporting. Using VigiBase, the WHO global database of individual case safety reports (ICSRs), we characterized reports of adverse reactions for all blood products. STUDY DESIGN AND METHODS: ICSRs involving blood products as the suspected medicine in VigiBase between 1968 and 2021 were extracted. MedDRA preferred terms and the International Society of Blood Transfusion haemovigilance definitions were used to stratify adverse reactions. Descriptive statistics were used to characterize ICSR demographics. RESULTS: A total of 111,033 ICSRs containing 577,577 suspected adverse reactions with 6152 MedDRA preferred terms were reported for 34 blood products. There were 12,153 (10.9%) reports for blood components, 98,135 (88.4%) reports for plasma-derived medicines, and 745 (0.7%) reports for recombinant products. The majority of reports (21.0% and 19.7%, respectively) were from patients aged 45-64 and over 65 years. The Americas contributed the most ICSRs (49.7%). Top reported suspected adverse reactions were for the following MedDRA preferred terms: headache (3.5%), pyrexia (2.8%), chills (2.8%), dyspnoea (1.8%), and nausea (1.8%). CONCLUSION: VigiBase already has a large number of reports on blood products. When compared to other existing haemovigilance databases, our study found reports from a broader range of countries and reporters. This may provide us with new perspectives, but for VigiBase to reach its full potential in haemovigilance some alterations in what is captured in reports are required.

Background: Postoperative bleeding requiring re-exploration in cardiac surgery has been associated with complications impacting short-term outcomes and perioperative survival. Many aspects of decision-making for re-exploration still remain controversial, especially in hemodynamically stable patients with significant but not acutely cumulating chest drain output. We investigated the impact of re-exploratory surgery on short-term outcomes in a “borderline population” of CABG patients who experienced significant non-acute bleeding, but that were not in critically hemodynamic unstable conditions. Methods: A prospectively collected database of 8287 patients undergoing primary isolated elective CABG was retrospectively interrogated. A population of hemodynamically stable patients experiencing significant non-acute or rapidly cumulating bleeding (>1000 mL of blood loss in 12 h

Background and aims:Wastage of all blood products is an important issue for health providers worldwide. Optimizing blood collection and processing would reduce the rate of wastage and improve the efficiency of the blood transfusion services. The aim of this study is to determine the rate of wastage of blood and blood components and identify its reasons at two hospitals in Riyadh. Method:A retrospective study was conducted on the data retrieved from the blood donation centers records on production and wastage of blood products during the period from November 2016 to October 2017 at two hospitals in Riyadh. The data were analyzed with MS Excel and SPSS 20. Results:A total of 3220 units of whole blood were collected in both hospitals during the study period. The most prepared blood component in both hospitals was packed red blood cells (PRBCs) 96.9%, followed by fresh frozen plasma (FFP) 58.66%, and platelets (PC) 52.67%. The wastage rates for safe blood components during the study period were 3.75% for PRBCs, 6.62% for FFP, and 75.8% for Platelets. The highest wastage rate of safe blood components was for Platelets (75.8%). The major reason for that high rate was delay in getting the results of transfusion transmitted infection (TTI) tests and some units were expired before released to the blood bank. The total cost for blood wastage was 262,828.3₤ (1,201,125.33 SAR. Conclusion:This study reported the highest wastage rate for all 3 blood components in comparison with other similar studies which urge the need to take an action to reduce these occurrences.

A 73-year-old, 104 kg female patient was hospitalised for debulking and low anterior colon resection operations. Anaphylactoid symptoms devel-oped when administering erythrocyte suspension and fresh frozen plasma. Through the immediate haematology department consultation, it was found that the patient might possibly have immunoglobulin A deficiency. Immunoglobulin A level was found to be very low in the patient’s blood sample, which was sent intraoperatively to verify the diagnosis. This case report discusses a sudden anaphylactic reaction that occurred as a result of a blood transfusion in a previously undiagnosed immunoglobulin A deficiency.

In the paper, a novel mathematical model for blood supply chain network and a variant of Genetic Algorithm for the problem are proposed. The proposed mathematical model is developed using Mixed-integer nonlinear programming. The model is designed as a location, allocation, and routing problem that includes determining locations of local blood centers, assigning transfusion and blood donation centers to predetermined local blood centers, and routing between them. Eventually, a case study is conducted in the Eastern Black Sea Region of Turkish Red Crescent to illustrate the practicality and validity of the proposed model. © 2023.

Mass-scale red blood cell genotyping of donors and transfusion recipients increases the availability of extended antigen matched red blood cell units. Therefore, a new mathematical framework is developed that can be applied for general blood groups (i.e., beyond the ABO, RhD blood groups). It determines which red blood cell units should be issued from inventory, such that requests from hospitals can be satisfied with antigen compatible red blood cell units, shortages for future requests are avoided, and outdating is prevented. The optimization model consists of two steps: a binary vector representation for general blood groups and the formulation of the inventory allocation problem as a minimum cost flow problem. The potential practical performance of the optimization model is evaluated by iterative simulations, based on historical data on supply and demand of red blood cell units in the Netherlands. When including the fourteen clinically most relevant antigens, more than 90% of all requests can be satisfied with antigen identical red blood cell units. Shortages and outdating can be kept restricted and could even be reduced to virtually zero, when only the ABO, RhD blood groups are considered.

Introduction: Coagulation disorders occur during the first 48 h after major burn injury, affecting mainly PT/INR and aPTT. Some authors consider them burn specific. The aim was to assess the magnitude of coagulation disorders during the first 10 days after severe burn injury and its eventual association with fluid intakes. Methods: Retrospective study of prospectively collected data including patients with burns ≥ 20%BSA (body surface area) who stayed ≥ 24 h at the burn-intensive care unit (ICU). Predetermined data for the analysis of fluid and blood products administration and laboratory values were extracted from the computerized information system. Descriptive statistics, data as median. Results: 167 patients included. The volumes of fluid resuscitation decreased over the first 10 days (median 6815 ml on day 1 decreasing to 4190 ml by day 10, p

Background: Recent data suggest that anesthesiologic interventions—e.g., the choice of the anesthetic regimen or the administration of blood products—might play a major role in determining outcome after tumor surgery. In contrast to adult patients, only limited data are available regarding the potential association of anesthesia and outcome in pediatric cancer patients. Methods: A retrospective multicenter study assessing data from pediatric patients (0–18 years of age) undergoing surgery for nephroblastoma between 2004 and 2018 was conducted at three academic centers in Europe. Overall and recurrence-free survival were the primary outcomes of the study and were evaluated for a potential impact of intraoperative administration of erythrocyte concentrates, the use of regional anesthesia and the choice of the anesthetic regimen. The length of stay on the intensive care unit, the time to hospital discharge after surgery and blood neutrophil-to-lymphocyte ratio were defined as secondary outcomes. Results: In total, data from 65 patients were analyzed. Intraoperative administration of erythrocyte concentrates was associated with a reduction in recurrence-free survival (hazard ratio (HR) 7.59, 95% confidence interval (CI) 1.36–42.2, p = 0.004), whereas overall survival (HR 5.37, 95% CI 0.42–68.4, p = 0.124) was not affected. The use of regional anesthesia and the choice of anesthetic used for maintenance of anesthesia did not demonstrate an effect on the primary outcomes. It was, however, associated with fewer ICU transfers, a shortened time to discharge and a decreased postoperative neutrophil-to-lymphocyte ratio. Conclusions: The current study provides the first evidence for a possible association between blood transfusion as well as anesthesiologic interventions and outcome after pediatric cancer surgery.

Background Some long-term non-progressors (LTNPs) have decreasing CD4+ T cell counts and progress to AIDS. Exploring which subsets of CD4+ T cell decreasing and the determinants associated with the decay in these patients will improve disease progression surveillance and provide further understanding of HIV pathogenesis. Methods Twenty-five LTNPs infected with HIV by blood products were classified as decreased (DG) if their CD4+ cell count dropped to + cell count was ≥400 cells/μL. Laboratory and clinical assessments were conducted at 6 consecutive visits to identify DG characteristics. Results The LTNPs were infected with HIV for 12 (IQR: 11.5–14) years, and 23 were classified as the B′ subtype. Six individuals lost LTNP status 14.5 (IQR: 12.5–17.5) years after infection (DG), and the CD4+ T cell count decreased to 237 (IQR: 213–320) cells/μL at the latest visit. The naïve CD4+ T cell count decrease was greater than that of memory CD4+ T cells [− 128 (IQR: − 196, − 107) vs − 64 (IQR: − 182, − 25) cells/μL)]. Nineteen individuals retained LTNP status (non-DG). At enrolment, the viral load (VL) level (p = 0.03) and CD8+CD38+ percentage (p = 0.03) were higher in DG than non-DG individuals. During follow-up, viral load and CD8+CD38+ percentage were significantly increased and negatively associated with CD4+ cell count [(r = − 0.529, p = 0.008), (r = − 0.476, p = 0.019), respectively]. However, the CD8+CD28+ percentage and B cell count dropped in DG and were positively correlated with CD4+ T cell count [(r = 0.448, p = 0.028), (r = 0.785, p Conclusion Immunological progression was mainly characterized by the decrease of naïve CD4+ T cell in LTNPs infected with HIV by blood products and it may be associated with high HIV RNA levels.

Objective: To review current literature evidence on outcomes of cardiac surgery in Jehovah’s Witness patients. Methods: A comprehensive electronic literature search was done from 2010 to 20th August 2020 identifying articles that discussed optimisation/outcomes of cardiac surgery in Jehovah’s Witness either as a solo cohort or as comparative to non-Jehovah’s Witnesses. No limit was placed on place of publication and the evidence has been summarised in a narrative manner within the manuscript. Results: The outcomes of cardiac surgery in Jehovah’s Witness patients has been described, and also compared, to non-Witness patients within a number of case reports, case series and comparative cohort studies. Many of these studies note no significant differences between outcomes of the two groups for a number of variables, including mortality. Pre-, intra and post-operative optimisation of the patients by a multidisciplinary team is important to achieve good outcomes. Conclusion: The use of a bloodless protocol for Jehovah’s Witnesses does not appear to significantly impact upon clinical outcomes when compared to non-Witness patients, and it has even been suggested that a bloodless approach could provide advantages to all patients undergoing cardiac surgery. Larger cohorts and research across multiple centres into the long term outcomes of these patients is required.

Hepatitis C is a relatively common blood-borne infectious disease. It has been estimated that 3% of the world���s population is infected. Hepatitis C accounts for about 20% of cases of acute hepatitis and 70% of cases of chronic hepatitis. Its importance is that it is a major cause of cirrhosis and hepatocellular cancer1. End-stage liver disease secondary to hepatitis C virus infection is main reason for liver transplantation. Following the discovery in February 1994 that anti-D immunoglobulin manufactured by the Irish Blood Transfusion Service Board was infected with hepatitis C, a number of screening programmes were put in place to identify those persons who had been infected, either directly or indirectly. It is estimated that about 1,600 persons have been infected with hepatitis C through the administration of blood and blood products in the Republic of Ireland. Acute hospital services for persons diagnosed positive for hepatitis C were put in place in 1994 in specialist hepatology (liver) units at six designated hospitals: Beaumont Hospital, the Mater Hospital, St Vincent���s Hospital, Elm Park, and St James���s Hospital in Dublin, Cork University Hospital, and University College Hospital in Galway. More recently, St Luke���s Hospital in Kilkenny has been included in the list of hospitals funded to provide specialist hepatology services. These services, provided under the Health Act (1970), are free of charge and include access to both in-patient and out-patient treatment as required. On 23 September 1996, the Health (Amendment) Act (1996) came into effect. This legislation provided statutory entitlement to a range of primary health care services, free of charge, to persons who have contracted hepatitis C from the receipt of a blood product or blood transfusion. The services provided include general practitioner services, medicines, home nursing services, home support services, dental, opthalmic, and aural services, as well as counselling services. At the request of the then Minister for Health, each health board appointed a liaison officer to ensure the efficient delivery of services under the Act, and to serve as a contact point for individuals and various interest groups whose members can avail of services under the Act. A Health Care Package for secondary services was also agreed between Positive Action and the Department of Health and Children in 1995. This covered entitlements to hospital treatments and sought to ensure sufficient funding, staffing, and facilities to provide high quality and appropriate secondary care services to those requiring them as a consequence of hepatitis C.

Background Terrorism-related incidents that are associated with mass casualties (mass-casualty terrorist incidents) are a medical and organisational challenge for every hospital because of the special injury patterns involved, the time of the incident, the development of the situation, the initial lack of information, the number of injured, and the number of uninjured survivors who self-refer to a hospital. Methods The Terror and Disaster Surgical Care (TDSC®) - Course was developed in order to address mass-casualty terrorist incidents and to provide surgeons with the specialist medical and surgical knowledge and skills required for these special situations. The focus of the TDSC® course is on how to provide surgical care and how to deploy scarce resources in a particular tactical situation in such a way that the number of survivors is maximised. Results The effective management of such a tactical situation must be based on priorities and first and foremost requires the standardised sorting and categorisation of the injured at the hospital. The aim of triage, or the sorting of the injured, is to immediately identify patients with life-threatening injuries in environments with strained resources. The medical management of mass-casualty terrorist incidents requires tactical abbreviated surgical care (TASC) teams that have the skills needed to perform a primary survey and to provide care for casualties who need immediate surgery (triage category 1—T1). Initial fluid therapy should be restrictive (permissive hypotension) unless contraindicated. Clotting products are replaced in a standardised manner on the basis of patient requirements, which are calculated using rapidly available surrogates (blood gas analysis). Blood products can be administered or kept available depending on risks and triage categories. The highest priority should be given to the identification and management of haemodynamically unstable patients who require immediate surgery for injuries associated with bleeding into body cavities (T1 + +). Conclusion The recommendations and approaches described here should be considered as proposals for hospitals to develop standards or modify well-established standards that enable them to prepare themselves successfully for situations (e.g. mass-casualty terrorist or shooter incidents) in which their resources are temporarily overwhelmed.

The effect of preparations from whole blood (dry plasma) on the animal organism was studied. In the course of our research, 2 groups of animals with 15 animals in each of 10 days of age were formed on the basis of analogues. The first group of animals was given dry plasma mixed with mixed feed (based on 5% of the feed weight), the second group was the control one and received no additives. Piglets of both groups were kept in the same sanitary and hygienic conditions, every day they evaluated the clinical status of animals, took into account morbidity, mortality, mortality, weighed, and blood was taken for morphological and biochemical blood tests. It was found that in the group of animals that used dry plasma, they gained weight more intensively during 1.5-2 months than the pigs of the control group, a low percentage of the incidence of pathologies from the gastrointestinal tract and respiratory system was established (2-4% whereas in the control group - 9-14%), higher weight gain (10-15%), mortality was not observed (whereas in the control group 2 pigs fell on the background escherichiosis and salmonellosis). Piglets of the experimental group were mobile, active, appetite expressed. In the control group, in addition to the above morbidity and mortality, low daily weight gain was observed (350 grams per day), some animals were inactive, lethargic, and a decrease in appetite was observed (50% of the animals of the group). The results of laboratory studies showed that the use of dry plasma in the diet of piglets contributes to the fastest restoration of blood counts to physiological norm. So already on the 15th day after giving dry plasma, the number of red blood cells was in the range 6.0 ± 0.42 x 1012 / l, platelets 180.5 ± 1.3 x 109 / l, the amount of hemoglobin in the range of 90.5 ± 0, 95 g / l, white blood cells 15.33 ± 0.62 x 109 / l, a decrease in ESR to 1.55 ± 0.07 mm / h was observed, the amount of total protein was in the range of 64.55 ± 2.12 g / l , the level of albumin is 18.89 ± 3.52 g / l, the activity of the enzymes AsAT, AlAT 0.55 ± 0.06 μkat / l and 0.66 ± 0.03 μkat / l, respectively, the activity of alkaline phosphatase was at level 1, 01 ± 0.12 μkat / l, bilirubin 7.51 ± 0.168 mmol / l, which indicates an improvement in metabolism, in the first The next step is protein metabolism. Feeding dry plasma increases the average daily growth (500 grams per day), positively affects the improvement of the overall metabolism (especially protein metabolism), which leads to an increase in the body's resistance and, as a result, a decrease in the incidence and mortality of animals. Key words: antibiotics, antibiotic resistance, piglets, prebiotics, probiotics, synbiotics, blood products, dry blood plasma.

Blood transfusions are vital components of modern medical treatment to which there is no viable alternative despite efforts to create artificial blood. Each year thousands of lives are saved by blood transfusions in every country of the world. However, blood and blood products can result in significant adverse events including immunologic reactions, infections, inefficacy, and others which can sometimes result in death and severe disability. Thus, the sustainability of safe blood systems and costs are considered to be at crisis level. In industrialized countries, the risk of transfusion-transmitted infections such as HIV, syphilis, hepatitis viruses B and C are very low [generally [

One of the most common manifestations in HIV infected patients are hematological. Few studies on these manifestations have been conducted in Romania and worldwide. Anemia and infections occur frequently among people living with HIV and reflect the immune suppression of the host. Besides, the etiology of anemia in HIV infection often remains unclear. Therefore, C Reactive Protein (CRP) and fibrinogen can be used as markers of the degree of immune suppression. It is noteworthy that anti-anemic therapies may accelerate the progression of HIV disease. Primary infection or reactivation of known or unknown pathogens is still a major concern associated with blood transfusions and possibly lead to a reduced prognosis. Existing data suggest that severe anemia is one of the main factors. Chronic inflammation and increased hemostasis in HIV-infected persons are thought to be a consequence of viral replication or persistence and it is associated with poor prognostic in HIV-infected patients. Whether low levels of viremia predispose to increased inflammation is unclear. We investigated the relationship between anemia, inflammatory markers, and blood transfusions. The present study is an effort to evaluate correlation as well as the association between inflammatory markers and blood products administration in HIV/AIDS patients.

The King Khalid University Hospital (KKUH) blood bank undertakes all the functions of blood transfusion service, from the recruitment of donors to the issue of blood products to patients. Currently, the blood bank depends on a mixture of replacement and voluntary donations. The blood bank had a previous experience of organizing a successful centralized King Saud University student donor drive which in the years 1885 to 1990 collected over 4000 blood units that almost covered KKUH blood needs. However, due to administrative difficulties, this drive did not continue. The main blood products consumed at the KKUH are packed red blood cell (PRBC), fresh frozen plasma (FFP), and platelet concentrate (PC). Long-term audits of their consumption showed that their consumption initially increased slowly with the total hospital admissions up to the year 1995 and then fell sharply to its lowest level in the year 2000: FFP dropped by 30.9%, PRBC by 27.8%, and PC by 48.6%. From 1995 onward, the total hospital patient admissions remained stable around 32,000 patients. The drop in consumption was taken to represent the magnitude of the inappropriate use of these products. This drop in consumption coincided with and was attributed to the widespread “HIV scare” that blood transfusion can transmit the infection, which made both patients and physicians reluctant to resort to blood therapy. There is a need to make sure that guidelines for the use of blood products are followed by all involved in the blood transfusion from blood collection to infusion into patients. These guidelines need to be supported by educational efforts targeting all those involved in hemotherapy, particularly physicians and nurses.

The disposal of blood bags, as well as their derivatives, follows the rules of Anvisa, which considers contamination, expiration dates, inadequate collections, among others. In Brazil, the serologic screening of transfusion materials is mandatory, and serology for Chagas, Hepatitis B, Hepatitis C, HIV, HTLV I, HTLV II and Syphilis is investigated in every donor, and if present, they make the candidate unsuitable for donation, either definitely or temporarily. Due to the emergence and re-emergence of such infectious and contagious diseases, it is even more important to assess the prevalence of these diseases in order to avoid further contamination, as well as to enable quantification and provide data for the realization of public health strategies aimed at reducing their emergency, thus reducing these diseases and optimizing the availability and quality of hemotherapeutic products and services, which are necessary for various situations, such as transfusions for patients with hypovolemic shock, sickle cell anemia or deficiencies in clotting factors (among other factors). This study evaluated the prevalence of inability of candidates for blood donation in a blood bank in Goiânia from 2017 to 2019, aiming to analyze the collected data and compare with national epidemiological data. La disposición de las bolsas de sangre, así como sus derivados, sigue las reglas de Anvisa, que considera contaminación, fechas de vencimiento, recogidas inadecuadas, entre otros. En Brasil, el cribado serológico de los materiales de transfusión es obligatorio, y la serología para Chagas, Hepatitis B, Hepatitis C, VIH, HTLV I, HTLV II y Sífilis se investiga en cada donante y, si está presente, hacen que el candidato no sea apto para la donación, ya sea definitiva o temporalmente. Debido a la aparición y reaparición de tales enfermedades infecciosas y contagiosas, es aún más importante evaluar la prevalencia de estas enfermedades para evitar una mayor contaminación, así como para permitir la cuantificación y proporcionar datos para la realización de estrategias de salud pública. orientadas a reducir sus enfermedades de emergencia y optimizar la disponibilidad y calidad de los productos y servicios hemoterapéuticos, que son necesarios para diversas situaciones, como transfusiones para pacientes con shock hipovolémico, anemia falciforme o deficiencias en factores de coagulación (entre otros factores). Este estudio evaluó la prevalencia de la incapacidad de los candidatos a la donación de sangre en un banco de sangre en Goiânia de 2017 a 2019, con el objetivo de analizar los datos recopilados y compararlos con los datos epidemiológicos nacionales. O descarte de bolsas de sangue, assim como seus derivados, segue conforme normas da Anvisa, que considera contaminações, prazos de validade, coletas inadequadas, entre outros. No Brasil, é obrigatória a triagem sorológica dos materiais de transfusão, sendo investigado em todo doador sorologias para Chagas, Hepatite B, Hepatite C, HIV, HTLV I, HTLV II e Sífilis, e caso presentes, tornam o candidato à doação inapto para tal fim, seja definitivamente ou temporariamente. Devido à emergência e reemergência de tais doenças infectocontagiosas, torna-se evidente a importância da avaliação das prevalências dessas doenças para fins de evitar maiores contaminações, assim como possibilitar quantificações e fornecer dados para realizações de estratégias de saúde pública com fins de reduzir a emergência dessas doenças e para otimizar a disposição e qualidade dos produtos e serviços hemoterápicos, que são necessários para diversas situações, como transfusões para pacientes com choque hipovolêmico, anemia falciforme ou deficiências nos fatores de coagulação (entre outros fatores). Este trabalho avaliou a prevalência de inaptidão dos candidatos à doação de sangue em um banco de sangue de Goiânia durante os anos de 2017 a 2019, visando analisar os dados coletados e comparar com dados epidemiológicos nacionais.

Hemorrhage in major trauma is life-threatening and the activation of the Massive Transfusion Protocol (MTP) was found to reduce the time to transfusion and mortality. The purpose was (i) to verify whether MTP activation identifies patients that require massive transfusions once admitted to the Emergency Department (ED), (ii) to establish whether pre-hospital MTP activation reduces the time to transfusion on arrival at the ED, (iii) to identify the variable that best predicts MTP activation.This is a retrospective, single-center study. The MTP was implemented at the end of 2012; it was activated for major trauma in pre-hospital setting on the basis on established criteria. Pre-hospital MTP activation aimed to make blood products available prior to the patients' arrival at the ED. The blood products are transfused when the patient arrives at the hospital.The MTP was activated in pre-hospital setting in 219 patients. On arrival at the hospital, the Trauma Team Leader confirmed MTP activation in 146 (66.7%) patients. Patients with MTP criteria received a higher amount of blood products than the patients without MTP criteria, median 7 (IQR 2-13) units versus 2 (0-6) units, respectively (P 0.001). At the same time, patients with a Shock Index ≥ 0.9 received more transfusions (5.5 [2-13] units) compared with patients characterized by a lower SI (2 [0-7.25] units, P = 0.009). 146 patients were transfused in the first hour of ED admission. Poisson's multiple regression shows that the SI is the variable that better predicted MTP activation compared to age, gender and the number of injured sites.Pre-hospital MTP activation is useful to identify patients that require an urgent blood transfusion on arrival at the ED. Further analysis should be considered to evaluate the implementation of the Shock Index as a criterion to activate MTP.

Blood transfusion is an essential component in modern healthcare. Blood being an irreplaceable resource needs to be appropriately utilized with preferably minimal or zero percent wastage. Only one third of required blood units are collected in a Northern Tanzania Hospital, demanding the need for zero rate of discard of blood and blood products. This study aimed to determine the rate and reasons for discarding blood and blood products at Northern Zone Blood Transfusion Centre in Tanzania. From the current study the discard rate of blood and blood component units was 2.48% and the main reason for discarding blood and blood components was Transfusion Transmitted infections, followed by plasma prepared after 24 hours of collection of blood. . Furthermore, the common discarded blood product was packed red blood cells in Northern Tanzania.

Background Gastrointestinal cancer demands a high frequency of transfusions, and the high availability of blood products. We aimed to determine the frequency of blood transfusions and the most used blood products according to the type of gastrointestinal cancer. Methods A cross-sectional study was conducted in a Peruvian Type I Hemotherapy and Blood Bank Service of a Private Oncological Clinic during 2016-2018. We included patients with gastrointestinal cancer using the International Code of Diseases. The donations were made in compliance with the requirements of the Programa Nacional de Hemoterapia y Banco de Sangre and in accordance with the Standardised Operational Procedure of the clinic. Results We analysed 3,022 patients, of which 163 (5.4%) had gastrointestinal cancer (67.1 ± 12 years). The 80 (49.1%) men did not show significant differences with the 83 (50.9%) women (p = 0.178). The most frequent neoplasia was the colon (41.7%) and pancreas (37.4%). Three hundred and four blood products were transfused (average 1.8 ± 2.5 units (range: 1-30 units/patient)), of which 81.3% (247 units) were red blood cells concentrated, 8.6% (26 units) were fresh-frozen-plasma (FFP) and 6.6% (20 units) were cryoprecipitate. The type of cancer that most blood products demanded was colon neoplasia (41.8%), followed by pancreatic cancer (26.3%) and liver cancer (10.9%). We determined that ~55% of patients were O Rh(D)+ and in five patients we were poly-transfused. Conclusion Our findings suggested that patients with gastrointestinal cancer require large numbers of transfusions of blood cell concentrate and FFP. Also, we showed that cancer of the colon, pancreas and liver demanded more than 75% of blood products.

International audience; PurposeManagement of NK can be difficult, involving a range of treatments with variable efficacy. We conducted a systematic review and meta-analysis to evaluate the efficacy of medical and surgical treatments for neurotrophic keratitis (NK).MethodPubMed, Cochrane Library, Embase, ClinicalTrial.gov, and ScienceDirect were searched for studies assessing efficacy of NK treatments. We computed random-effect meta-analyses on corneal healing, time to complete healing, and visual acuity changes between baselines and after treatment, stratified on treatment classes. We followed the PRISMA guidelines (registration number CRD42021225721).ResultsWe included 20 studies: 571 patients and 5 treatment classes (2 surgical and 3 non-surgical). The percentage of patients with complete corneal healing did not differ between specific treatments (nerve growth factor eyedrops (NGF), 75%, 95CI 46 to 104%; autologous serum (AS), 92%, 86 to 98%; neurotization, 99%, 95 to 103%; amniotic membrane transplantation (AMT), 86%, 78 to 94%). All specific treatments had better percentage of complete healing (p

Patients undergoing cardiac surgery are at high risk of postoperative bleeding, which is related to worse prognosis and survival. The use of ROTEM®, together with the implementation of a specific treatment algorithm, to reduce the risk of postoperative bleeding. An observational, comparative, cross-case study with historical controls. A total of 1772 consecutive patients admitted to intensive care unit after having undergone cardiac surgery, was divided into 3 groups: Group 1: Coagulation was only monitored by the classical coagulation test (control group). Group 2: Monitorization was done by ROTEM®, according to a protocol designed in our center. Group 3: VerifyNow® was added to ROTEM®, implementing a specific treatment algorithm. We observed a decreased of red blood cell transfusion (Group 1 55.5%, Group 2 52.7%, Group 3 46.6%, P < 0.01). Postoperative results include a significant reduction in complications with a marked improvement in overall survival in the ROTEM® - guided groups. Conclusions: Monitoring of hemostasis by POCT'S (ROTEM® and VerifyNow®) in patients undergoing cardiac surgery and cardiac transplantation was associated with a decreased incidence of blood transfusion, postoperative clinical complications, and mortality., This research was funded by the INSTITUTE OF CARLOS III, grant number: PI18/01197 . This study was co-financed by FEDER Funds.

Background: We aimed to explore the influencing factors of clinical adverse blood transfusion reactions, to provide theoretical basis and support for clinical safe blood transfusion, and to minimize the occurrence of adverse blood transfusion reactions. Methods: The method was to retrospectively analyze the report of adverse blood transfusion reports from 6 hospitals in Linyi area, Shandong, China to the blood station in Linyi City center from 2013 to 2020. We aimed to classify factors, analyze the occurrence of adverse transfusion reactions, and discuss the correlation between the occurrence of adverse transfusion reactions and the above factors. Results: Overall, 248 patients (77.98%) had a history of blood transfusion. The difference between this group and the group with no history was statistically significant (P

Osteoarthritis (OA) is hallmarked by a progressive degradation of articular cartilage. One major driver of OA is inflammation, in which cytokines such as IL-6, TNF-α and IL-1β are secreted by activated chondrocytes, as well as synovial cells—including macrophages. Intra-articular injection of blood products—such as citrate-anticoagulated plasma (CPRP), hyperacute serum (hypACT), and extracellular vesicles (EVs) isolated from blood products—is gaining increasing importance in regenerative medicine for the treatment of OA. A co-culture system of primary OA chondrocytes and activated M1 macrophages was developed to model an OA joint in order to observe the effects of EVs in modulating the inflammatory environment. Primary OA chondrocytes were obtained from patients undergoing total knee replacement. Primary monocytes obtained from voluntary healthy donors and the monocytic cell line THP-1 were differentiated and activated into proinflammatory M1 macrophages. EVs were isolated by ultracentrifugation and characterized by nanoparticle tracking analysis and Western blot. Gene expression analysis of chondrocytes by RT-qPCR revealed increased type II collagen expression, while cytokine profiling via ELISA showed lower TNF-α and IL-1β levels associated with EV treatment. In conclusion, the inflammation model provides an accessible tool to investigate the effects of blood products and EVs in the inflammatory context of OA.

The presence of viral nucleic material in the circulation poses a theoretical risk of transmission through transfusion. However, little is known about the possibility of the actual transmission through transfusion or transplantation of blood products. A PROSPERO registered systematic review pooled evidence from PubMed/MEDLINE, Google Scholar and CINAHL. The search included studies on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission through human blood products. In total 537 studies were extracted, and only eight articles (1.5%) were eligible for the final analysis. A total of 14 patients received blood products from coronavirus disease-2019 (COVID-19) virus-positive donors, and six (42.9%) tested negative for COVID-19 RT-PCR for up to 14 days post-transfusion/transplantation. There were no documented clinical details on the COVID-19 test for eight (57.1%) blood products recipients. Of the eight patients, none of them developed any COVID-19-related symptoms. In conclusion, there is limited evidence of transfusion transmission of SARS-CoV-2 via human blood products. Consolidation of further evidence, as it emerges, is warranted. ispartof: EJHaem vol:2 issue:3 pages:601-606 ispartof: location:United States status: Published online

In this paper, we report on the validation of an autonomous drone-based delivery system equipped with a smart capsule for the transportation of blood products in urban areas. The influence of some thermo-mechanical parameters, such as altitude, acceleration/deceleration, external temperature and humidity, on the specimens’ integrity were analyzed. The comparison of the results carried out by hemolytic tests, performed systematically on samples before and after each drone flight, clearly demonstrated that the integrity of blood is preserved and no adverse effects took place during the transport; these results can be addressed to the smart-capsule properties, which allows integrating real-time quality monitoring and control of the temperature experienced by blood products and mechanical vibrations. In addition, we demonstrated this transport system reduces the delivery time considerably. A risk analysis (i.e., HFMEA) was applied to all delivery processes to assess possible criticalities. To the best of our knowledge, this is the first time a drone-based delivery system of blood products in an urban area has been validated to be employed in a future clinical scenario.

Intra-articular injection of different types of blood-derived products is gaining popularity and clinical importance in the treatment of degenerative cartilage disorders such as osteoarthritis. The regenerative potential of two types of platelet-rich plasma (PRP), prepared in the presence of EDTA (EPRP) and citrate (CPRP) and an alternative blood product-hyperacute serum (hypACT) was evaluated using a 3D osteoarthritic chondrocyte pellet model by assessing the metabolic cell activity, cartilage-related gene expression and extracellular matrix deposition within the pellets. Chondrocyte viability was determined by XTT assay and it revealed no significant difference in metabolic activity of OA chondrocyte pellets after supplementation with different blood products. Nevertheless, the selection of blood products influenced the cartilage-related genes expression, ECM morphology and the tissue quality of pellets. Both PRP types had a different biological effect depending upon concentration and even though CPRP is widely used in clinics our assessment did not reveal good results in gene expression either tissue quality. HypACT supplementation resulted in superior cartilage-related genes expression together with tissue quality and seemed to be the most stable product since no remarkable changes were observed between the two different concentrations. All in all, for successful regenerative therapy, possible molecular mechanisms induced by blood-derived products should be always carefully investigated and adapted to the specific medical indications.

BackgroundEarly control of haemorrhage and optimisation of physiology are guiding principles of resuscitation after injury. Improved outcomes have been previously associated with single, timely interventions. The aim of this study was to assess the association between multiple timely life-saving interventions (LSIs) and outcomes of traumatic haemorrhagic shock patients.MethodsA retrospective cohort study was undertaken of injured patients with haemorrhagic shock who presented to Alfered Emergency & Trauma Centre between July 01, 2010 and July 31, 2014. LSIs studied included chest decompression, control of external haemorrhage, pelvic binder application, transfusion of red cells and coagulation products and surgical control of bleeding through angio-embolisation or operative intervention. The primary exposure variable was timely initiation of ≥ 50% of the indicated interventions. The association between the primary exposure variable and outcome of death at hospital discharge was adjusted for potential confounders using multivariable logistic regression analysis. The association between total pre-hospital times and pre-hospital care times (time from ambulance at scene to trauma centre), in-hospital mortality and timely initiation of ≥ 50% of the indicated interventions were assessed.ResultsOf the 168 patients, 54 (32.1%) patients had ≥ 50% of indicated LSI completed within the specified time period. Timely delivery of LSI was independently associated with improved survival to hospital discharge (adjusted odds ratio (OR) for in-hospital death 0.17; 95% confidence interval (CI) 0.03–0.83; p = 0.028). This association was independent of patient age, pre-hospital care time, injury severity score, initial serum lactate levels and coagulopathy. Among patients with pre-hospital time of ≥ 2 h, 2 (3.6%) received timely LSIs. Pre-hospital care times of ≥ 2 h were associated with delayed LSIs and with in-hospital death (unadjusted OR 4.3; 95% CI 1.4–13.0).ConclusionsTimely completion of LSI when indicated was completed in a small proportion of patients and reflects previous research demonstrating delayed processes and errors even in advanced trauma systems. Timely delivery of a high proportion of LSIs was associated with improved outcomes among patients presenting with haemorrhagic shock after injury. Provision of LSIs in the pre-hospital phase of trauma care has the potential to improve outcomes.

Currently, it is believed that TTV and HGV display multifaceted activities in developing diverse acute and chronic processes (disorders affecting the liver, respiratory tract, hematopoiesis oncology diseases etc.). Transfusion of contaminated blood and its components contribute in transmission of HGV and TTV infections. In connection with this, examining a role for HGV and TTV in etiological structure of pediatric liver damage in acute lymphoblastic leukemia (ALL) as well as their relation to developing toxic liver damage against during ongoing therapy is of special interest. Our study was aimed at assessing hospital-acquired HGV and TTV infection and its potential effect on the incidence rate and liver damage intensity in children with acute lymphoblastic leukemia. A rationale for the current study was previously verified hepatitis of unknown etiology excluding viral hepatitis B and C in such patients. In the study, there were examined 99 patients stayed at the Department of Hematology as well as 286 samples from diverse donor bloodderived products. The data obtained were examined by using epidemiological methods (retrospective and near real-time epidemiological analysis, prospective observation), microbiological monitoring, ELISA, PCR followed by analyzing with variation statistics methods. It was found that 51 children, mainly aged 24 years (47.1%), were diagnosed with new onset acute lymphoblastic leukemia during a six-year follow-up study. Treatment phase-specific dynamic investigation demonstrated a progressive increase in frequency of HGV-infected ALL patients from 9.8% (day 15 of therapy) up to 45.1% (maintenance therapy). Moreover, a therapeutic intervention was associated with TTV infection detected in 100% cases in baseline TTV DNA-negative patients 100%, and its rate was significantly increased. Thus, our study allowed to demonstrate that 48% and 77% ALL pediatric patients were infected HGV and TTV, respectively, at initial treatment phase (remission induction), that was paralleled with administering the maximum-dose parenteral therapy, including transfusion therapy. Finally, assessing blood donor-derived preparations allowed to detect HGV RNA and TTV DNA in 6.61.46% and 19.32.9% cases, respectively.

Objectives. To perform a comparative analysis of the efficacy of aminocaproic (EACA) and tranexamic acid (TX) for heart surgery with cardiopulmonary bypass (CPB). Material and methods. Three groups were formed: group 1 (n = 50) –EACA bolus was used (75 mg/kg) with titration of 30 mg/kg/h during CPB; group 2 (n = 30) – TX bolus was injected (12.5 mg/kg) with titration of 6.5 mg/ kg/h during the CPB and 1 mg/kg/h during the first 6 hours after surgery; group 3 (n = 60) – the controls. Results. The volume of perioperative blood loss in the first 42–48 hours in group 1 was 20.4 (16.4; 25.2) ml/kg, in group 2 – 19.3 (13.8; 22.4) ml/kg, in group 3 – 22.8 (19.0; 28.3) ml/kg. The frequency of transfusions was 8%, 3% and 28% respectively. Conclusion. The administration of EACA (10.1 (8.4; 11.5) g) or TX (2.5 (2.1; 3.0) g) effectively reduces perioperative blood loss and lowers the frequency of transfusions within 42-48 hours after CPB surgery, without increasing the number of complications and mortality.

Background Some long-term non-progressors (LTNPs) have decreasing CD4+ T cell counts and progress to AIDS. Exploring which subsets of CD4+ T cell decreasing and the determinants associated with the decay in these patients will improve disease progression surveillance and provide further understanding of HIV pathogenesis. Methods Twenty-five LTNPs infected with HIV by blood products were classified as decreased (DG) if their CD4+ cell count dropped to

La médecine transfusionnelle féline a connu une croissance exponentielle au cours des dix dernières années. La découverte du système de groupes sanguins AB et la meilleure compréhension des mécanismes d’incompatibilité donneur-receveur, ainsi que le développement de systèmes de collecte adaptés au chat et de techniques de typage sanguin au chevet du patient ont permis d’améliorer la sécurité des transfusions. Notre travail s’est intégré dans cette volonté d’optimiser la sécurité des transfusions sanguines chez le chat en se concentrant sur deux aspects différents : le prélèvement de sang et les antigènes érythrocytaires à l’origine d’incompatibilités donneur-receveur non expliquées par le système AB. Dans un premier temps, un système de collecte de sang adapté au chat a été fabriqué afin de permettre un prélèvement fermé et autoriser le stockage des produits sanguins. Ce système a été comparé à un système ouvert composé de seringues. Le système fermé apparaît adapté au prélèvement de sang car aucune différence significative n’a été enregistrée dans les paramètres vitaux des donneurs après le prélèvement, le succès du prélèvement, ou la qualité du produit sanguin en termes de contamination bactérienne et d’hémolyse, entre les deux systèmes. Le net avantage du système fermé est qu’il assure un temps de prélèvement plus rapide que le système ouvert. Dans un second temps, en réalisant des tests de compatibilité chez 258 chats de type A, nous avons montré que la probabilité de détecter des incompatibilités entre deux chats de groupe A sélectionnés aléatoirement était de 3.9 %, et que 7 % des chats de groupe A présentaient des allo-anticorps naturels extérieurs au système AB. Sept des 18 allo-anticorps naturels détectés ont été utilisés comme réactifs lors d’un typage sanguin extensif. Les analyses sur l’accord des résultats du typage obtenus avec les différents réactifs ont permis d’identifier cinq nouveaux antigènes érythrocytaires félins différents, nommés FEA 1 à FEA 5 (pour feline erythrocyte antigen), dont l’hérédité, la prévalence, la distribution géographique et par race, ainsi que l’immunogénicité restent encore à déterminer., Feline transfusion medicine has grown exponentially over the past decade. The discovery of the AB blood group system and the better understanding of the mechanisms of donor-receiver incompatibility, as well as the development of cat-friendly collection systems and bedside blood typing techniques have improved transfusion safety. Our work has been part of this effort to optimize the safety of blood transfusions in cats by focusing on two different aspects: blood collection and red blood cell antigens that cause donor-recipient incompatibilities unexplained by the AB system. First, a blood collection system adapted to the cat was manufactured to allow collection in a closed-system and storage of blood products. This system was compared to an open system consisting of syringes. The closed system appeared well-adapted for feline blood collection because no significant difference was found in the vital parameters of the donors after collection, the success of the collection, or the quality of the blood product in terms of bacterial contamination and hemolysis. The distinct advantage of the closed system was that it provided a shorter duration of collection than the open system. Secondly, based on the systematic crossmatches of 258 cats, we showed that the probability of detecting incompatibilities by randomly crossmatching two type A cats was 3.9 %, which resulted in at least 7 % of type A cats having naturally occurring alloantibodies outside the AB blood group system. Seven of the 18 detected naturally occurring alloantibodies were used as reagents in an extensive blood typing. Comparison of the results obtained from this extensive blood typing supports the existence of five, presumably different, new feline erythrocyte antigens, named FEA 1 to FEA 5, whose mode of inheritance, geographical and breed distribution, frequency and immunogenicity have yet to be determined.

BackgroundCOVID-19 Convalescent Plasma (CCP) is a promising treatment for COVID-19. Blood collectors have rapidly scaled up collection and distribution programs.MethodsWe developed a detailed simulation model of CCP donor recruitment, collection, production and distribution processes. Simulations based on epidemics in 11 U.S. states, in which key parameters were varied over wide ranges, allowed identification of the drivers of ability to calibrate collections capacity and ability to meet demand for CCP.ResultsChanges in collection capacity utilization lagged increases and decreases in COVID-19 hospital discharges, and never exceeded 75% in most simulations. Demand could be met for most of the simulation period in most simulations, but in states with early sharp increases in hospitalizations a substantial portion of demand went unmet during these early peaks. Modeled second wave demand could generally be met with stockpiles established during first epidemic peaks. Apheresis machine capacity (number of machines) and probability that COVID-19 recovered individuals are willing to donate were the most important supply-side drivers of ability to meet demand. Recruitment capacity was important in states with early peaks.ConclusionsEpidemic trajectory was the most important determinant of ability to meet demand for CCP, although our simulations revealed several contributing operational drivers of CCP program success.

Introduction: Coronavirus Disease 2019 (COVID-19) affected the usual number of blood donations as well as the component utilisation in routine use severely. Directions by government to maintain social distancing and avoidance of social gatherings resulted in lesser number of voluntary blood donation camps. This resulted in blood scarcity. Aim: To assess the impact on pattern of usage of blood components previously and during COVID-19 pandemic. Materials and Methods: This was a retrospective study, conducted in Department of Immunohaematology and Transfusion Medicine (Blood Centre) of a tertiary care hospital, Navi Mumbai, Maharashtra, India. The study was carried out for a period of two years i.e., from April 2019 to March 2021. The study was divided into two phases. Phase I- April 2019 to March 2020, Phase II- April 2020 to March 2021. Data was collected retrospectively from the donor registers and camp reports. Blood components utilisation data was collected from issue registers. Microsoft Excel and Microsoft Word were used to compile the data. Basic descriptive statistics and graphs were prepared using Statistical Package for the Social Sciences (SPSS). Independent t-test was applied to assess the difference in mean and Standard Deviation (SD) between two phases. The p-value p

La transfusión de hemoderivados es una práctica sanitaria muy extendida en la actualidad. Esta consiste en la transferencia de los distintos hemoderivados de un donante a un receptor. Es conocido que para que esta práctica sea segura es necesaria la realización de distintas pruebas de compatibilidad entre el donante y el paciente y unos correctos cuidados de enfermería durante todo el procedimiento. Un error durante el proceso puede llegar a dar lugar a una reacción transfusional que ponga en peligro la vida del receptor. Mediante una revisión bibliográfica de distintas bases de datos (Sirius, Teseo, Dialnet y Pubmed) se analizaron numerosas guías, protocolos y publicaciones de las principales instituciones nacionales e internacionales. Se ha visto que a lo largo de los años se han ido implementando distintas medidas que han hecho que cada vez haya menos eventos adversos transfusionales como la formación de comités transfusionales, realización de guías y protocolos estandarizados, implementación de nuevas tecnologías (bombas de infusión, lectores de códigos de barras…). Sin embargo, el error no ha desaparecido por completo por ello es necesario el continuo análisis de la situación y la actualización de las medidas de seguridad. En conclusión, en este trabajo se reconocen las distintas medidas de seguridad actuales, se detectan los principales efectos adversos y reacciones transfusionales, se analizan las debilidades y fortalezas del sistema transfusional y se plantea dos planes de mejora para la seguridad transfusional. The transfusion of blood products is a very widespread health practice nowadays. It consists of the transfer of different blood products from a donor to a recipient. It is well known that for this practice to be safe it is necessary to carry out various compatibility tests between the donor and the patient and to provide correct nursing care throughout the whole procedure. An error during the process can lead to a transfusion reaction that can endanger the life of the recipient. Through a (deep) bibliographic review of different databases (Sirius, Teseo, Dialnet and Pubmed), numerous guides, protocols and publications of the main national and international institutions were analyzed. It has been seen that, over the years, different measures have been implemented and that these have led to fewer and fewer adverse transfusion events, such as the formation of transfusion committees, standardized guidelines and protocols, the implementation of new technologies (infusion pumps, barcode readers, etc.). Nevertheless, the error has not completely disappeared; therefore, it is necessary to continuously analyze the situation and update safety measures. In conclusion, this paper recognizes the different current safety measures, detects the main adverse effects and transfusion reactions, analyzes the weaknesses and strengths of the transfusion system, and proposes two transfusion improvement plans. Graduado o Graduada en Enfermería por la Universidad Pública de Navarra Erizaintzan Graduatua Nafarroako Unibertsitate Publikoan

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Background Anemia is common in neurocritically ill patients. Considering the limited clinical evidence in this population, preclinical data may provide some understanding of the potential impact of anemia and of red blood cell transfusion in these patients. We aim to estimate the association between different transfusion strategies and neurobehavioral outcome in animal models. Methods We will conduct a systematic review of comparative studies of red blood cell transfusion strategies using animal models of traumatic brain injury, ischemic stroke or cerebral hemorrhage. We will search MEDLINE, EMBASE, and Web of Science databases for eligible studies from inception onwards. Two independent reviewers will perform study selection and data extraction. We will report our results in a descriptive synthesis focusing on characteristics of included studies, reported outcomes, risk of bias, and construct validity. Our primary outcome is the neurological function (neurobehavioral performance) and our secondary outcomes include mortality, infarct size, intracranial pressure, cerebral perfusion pressure, cerebral blood flow, and brain tissue oxygen tension. If appropriate, we will also perform a quantitative synthesis and pool results using random-effect models. Heterogeneity will be expressed with I2 statistics. Subgroup analyses are planned according to animal model characteristics, co-interventions, and risks of bias. Discussion Our study is aligned with the efforts to better understand the level of evidence on the impact of red blood cell transfusion strategies from preclinical studies in animal models of acute brain injury and the potential translation of information from the preclinical to the clinical research field. Systematic review registration PROSPERO CRD42018086662.

Aim: Tranexamic acid (TA) is an antifibrinolytic agent that prevents the dissolution of fibrin clot. We investigated the impact of the use of tranexamic acid (TA) on bleeding for patients under treatment of low molecular weight heparin during coronary artery bypass graft (CABG) operations. Methods: Among 82 patients, 60 patients undergoing CABG with cardiopulmonary bypass (CPB) were enrolled into a case-control study within a six month-period. On the first postoperative day, patients were divided into two groups depending on the intraoperative use of TA. TA was not administered to control group patients (n=30) while those in the study group (n=30) received TA intravenously at a dose of 10 mg/kg. Coagulation variables including complete blood cell count, D-Dimer, fibrinogen, prothrombin time (PT), activated partial thromboplastin time (aPTT) and international normalized ratio (INR) values were collected preoperatively and 24 hours after surgery. Estimated blood loss, loss by drainage, total amounts of packed red blood cell and fresh frozen plasma transfusions were recorded. P-value, Amaç: Traneksamik asit (TA), fibrin pıhtısının çözünmesini önleyen antifibrinolitik bir maddedir. Koroner arter bypass greft (KABG) operasyonları sırasında düşük moleküler ağırlıklı heparin tedavisi alan hastalarda TA kullanımının kanama üzerindeki etkisini araştırdık.Yöntemler: Toplam 82 hastadan, kardiyopulmoner bypass (CPB) ile KABG uygulanan 60 hasta, altı aylık bir dönemde vaka-kontrol bir çalışmaya alındı. Ameliyat sonrası birinci günde, intraoperatif TA kullanımına bağlı olarak hastalar iki gruba ayrıldı. Kontrol grubunda (n=30) TA verilmezken, çalışma grubunda Grup 2'de (n=30) TA intravenöz 10 mg/kg dozda uygulandı. Pıhtılaşma değişkenleri; tam kan hücresi sayımı, D-Dimer, fibrinojen, protrombin zamanı (PT), aktive parsiyel tromboplastin zamanı (aPTT) ve uluslararası normalleştirilmiş oran (INR) değerleri ameliyat öncesi ve ameliyattan 24 saat sonra toplandı. Tahmini kan kaybı, drenaj kaybı, toplam eritrosit süspansiyonu ve taze donmuş plazma hacimleri kaydedildi. P-değeri

RESUMEN Las cirugías de cabeza y cuello presentan un alto riesgo de sangrado que puede significar el uso de transfusiones sanguíneas. Existen casos en las que éstas son rechazadas, como sucede con los Testigos de Jehová. Se expone el caso de una paciente Testigo de Jehová con un tumor rinosinusal con alto riesgo de sangrado que consultó por epistaxis recurrente. Se evidencia un tumor ocluyendo la fosa nasal derecha de aspecto vascular a la rinoscopía y la tomografía computarizada. Múltiples aferencias de la arteria esfenopalatina y etmoidales se observaron en una angiografía cerebral. Previo a la resección, se embolizó la arteria maxilar. Durante la cirugía, se contó con un sistema de recuperación de sangre autóloga, hemodilución e infusión de ácido tranexámico. Se ligó la arteria etmoidal anterior derecha vía externa con apoyo endoscópico y luego se resecó el tumor vía endoscópica. La biopsia reveló un carcinoma sinonasal escamoso. Existen alternativas terapéuticas en pacientes que rechacen el uso de hemoderivados. Destacan medidas preoperatorias como la embolización endovascular, intraoperatorias como el uso de agentes hemostáticos, técnicas quirúrgicas y anestésicas. Es importante analizar todas las opciones disponibles de forma multidisciplinara y junto con el paciente, para determinar la conducta más adecuada a seguir. ABSTRACT Head and neck surgeries have a high risk of bleeding, and therefore could require the use of blood transfusions. There are cases for which blood transfusions are not an acceptable option, as is the case for Jehovah's Witnesses. We present the case of a Jehovah's Witness with a sinonasal tumor with a high risk of bleeding, who presented with recurrent epistaxis. Rhinoscopy and computed tomography revealed a vascular-like tumor occluding the right nasal cavity. Cerebral angiography showed afferents of the sphenopalatine and ethmoidal arteries leading to the tumor. Prior to the resection, the maxillary artery was embolized. During surgery, we relied on an autologous blood recovery system, hemodilution and tranexamic acid. Right anterior ethmoidal artery ligation was performed by an endoscopic assisted external approach. The tumor was resected endoscopically The biopsy revealed a squamous sinonasal carcinoma. There are therapeutic alternatives for patients who cannot receive blood products. There are preoperative measures such as endovascular embolization, intraoperative measures such as the use of hemostatic agents and specific surgical or anesthetic techniques. It's important to analyze all of the available options in a multidisciplinary team approach, and to take into consideration the patient's preferences, in order to determine the best surgical conduct.

Background and Aim: Whole blood is processed to derive a red cell concentrate, plasma, and buffy coat (BC) (from which platelets can be further extracted). Unused plasma and BCs are common in most blood establishments and considered a liability. The redirection of these products to xeno-free applications is not complicated or time-consuming and cannot only benefit the research recipients but also the blood establishment suppliers interested in research collaboration. The aim of this study is to describe a diverse yet by no means an exhaustive list of options for preparing blood products for research applications., Materials and Methods: Plasma and BCs from healthy donors were processed using basic laboratory techniques under aseptic conditions and tested for their ability to support the culture of mesenchymal stem cells in both 2D and 3D cultures using fibrin clots. The white blood cells (WBC) from the BCs were induced by phytohemagglutinin and CD marker expression was monitored using quantitative polymerase chain reaction., Results: All the methods tested for preparing blood products were successful but the applicability to different settings varied greatly with the most successful being the supplementation of Dulbecco’s Modified Eagle Medium: Nutrient Mixture F-12 with 20% cryodepleted plasma and 0.1 mg/mL platelet lysate, the formation of fibrin clots using a ratio of 3:1 (medium: plasma) and the culturing of WBCs with 5 µg/mL phytohemagglutinin., Conclusions: Using the wastes and by-products of blood establishments for xeno-free cell culturing of stem cells will reduce the reliance on commercially available, ready-made products, and increasing the potential for therapeutic stem cell research. Despite the benefits presented both in terms of cost and applications, further characterization and optimization of each blood product for reproducibility of results is required., Relevance for Patients: The availability of low-cost xeno-free reagents will speed up therapeutic stem cell research and allow patients to receive treatments of the expected high standards at lower costs., peer-reviewed

Поступила: 26.11.2020. Принята в печать: 28.12.2020. Идея написания этой статьи возникла на международной конференции IEEE International Conference on e-Health and Bioengineering (EHB 2019). Благодарим за содействие ООО «Лидкор», в лице генерального директора компании Улыбина Алексея Игоревича. Данная статья является частью работы, посвященной модернизации и разработке нового оборудования для трансфузионной терапии на базе продукции ООО «Лидкор». Received: 26.11.2020. Accepted: 28.12.2020. The idea of this article writing had originated in the conference shortly after the IEEE International Conference on e-Health and Bioengineering (EHB 2019). We are grateful for the assistance from the Leadcore LLC represented by Aleksey I. Ulybin General Manager of the company. This article is part of the work devoted to the modernization and development of new equipment for transfusion therapy based on Leadcore LLC production. В настоящее время одной из наиболее динамично развивающихся областей знаний является современная медицина. Во многом темпы развития медицины определяются технологическими возможностями. Служба крови относится к наиболее насыщенным техническими средствами отраслям медицины, так как от технологий обработки крови и ее компонентов зависит качество конечного продукта и в конечном итоге здоровье и жизнь пациента. Согласно техническому регламенту о требованиях безопасности крови, ее продуктов, кровезамещающих растворов и технических средств, используемых в трансфузионно-инфузионной терапии, утвержденному Правительством России 26.01.2010: «Компоненты донорской крови должны размораживаться и подогреваться до необходимой температуры с использованием специально предназначенного оборудования». Специально предназначенным оборудованием для размораживания и подогревания криоконсервированных продуктов крови являются размораживатели. Размораживатели криоконсервированных продуктов крови – это специализированные технические средства, используемые для измерения электрических, магнитных и электромагнитных величин, характеризующих температурные параметры объекта размораживания и подогревания. В области разморозки и подогревания криоконсервированных продуктов крови для трансфузионно-инфузионной терапии фундаментальной является задача разработки программного решения для моделирования систем размораживания, что может позволить определить оптимальные параметры систем размораживания на этапе предмакетного моделирования. Настоящая статья описывает экспериментальное исследование по оценке фазового перехода плазмы лед-жидкость при размораживании с использованием радиоизмерительного оборудования. Полученные данные будут использованы для создания математической модели процесса размораживания продуктов крови. В качестве нагревательного элемента конструкции размораживателя используется печатный нагреватель тонких листов полиэтилентерефталата (ПЭТ). One of the most dynamically developing areas of knowledge is modern medicine. In many ways, the pace of development of medicine is determined by technological capabilities. The blood service is one of the most technologically saturated branches of medicine since the quality of the final product and the patient’s health depend on the processing technology of the blood and its components. According to the technical regulations on the safety requirements of blood, its products, blood-substituting solutions and technical means used in transfusion-infusion therapy, approved by the Government of Russia on 01/26/2010: “The components of donated blood must be thawed and heated to the required temperature using specially designed equipment”. Defroster for cryopreserved blood products are specialized technical means used to measure electrical, magnetic and electromagnetic quantities characterizing the temperature parameters of the object to be thawed and heated. In the field of defrosting and heating cryopreserved blood products for transfusion-infusion, the fundamental task is to develop a software solution for simulating defrosting systems, which can make it possible to determine the optimal parameters of defrosting systems at the stage of pre-model modeling. This article describes an experimental study to evaluate the phase transition of an ice-liquid plasma during defrosting using radio measuring equipment. The obtained data will be used to create a mathematical model of the process of defrosting blood products. Исследование выполнено при финансовой поддержке РФФИ в рамках научного проекта № 20-37-90037. The reported study was funded by RFBR, project number № 20-37-90037.

Introduction: Blood transfusion (hemotherapy) is a therapeutic intervention used in treatment strategies of multiple diseases, thus, proper education is of utmost importance. Since currently there are no specified educational programs, undergraduate students were evaluated for the knowledge gained during university courses. Purpose: To evaluate and compare the level of knowledge of students of the faculty of Health Science, Department of Medicine (DM), and Department of Molecular Biology-Genetics (DMB&Gs) on issues related to the transfusion of blood products. Methods: A cross-sectional observational study was carried out with 123 students from the aforementioned departments of the Democritus University of Thrace, from the third year to the last year of study. A questionnaire was used, weighted, and was based on the European Commission's Guide to the Preparation, Use and Quality Assurance for Blood Components. Statistical tests such as chi-square (χ2), t-test, analysis of variance (ANOVA), and linear regression were used to investigate the factors that affect the overall score. Results: The mean score of the students was 42.55 while the standard deviation (SD) was 12.27. The difference in the scores between the students of the DM (M = 44.63, SD = 13.2) and those of the DMB&Gs (mean = 38.25, SD = 9.05) was statistically significant in the univariable analysis (t= 3.1, p = 0.0), but in the multivariable analysis, it was not statistically significant (β = -4.1, p = 0.1.). The results of the multiple regression model indicated that the year of study, the professional status of the father, and the grade in the hematology course were associated with the total score. Conclusions: The level of knowledge regarding blood product transfusion among students of the faculty of Health Science is insufficient.

Backgroud To assess the feasibility and efficacy of PuraStat®, a novel haemostatic agent, in achieving suture line haemostasis in a wide range of cardiac surgical procedures and surgery of the thoracic aorta. Methods A prospective, non-randomised study was conducted at our institution. Operative data on fifty consecutive patients undergoing cardiac surgery where PuraStat® was utilised in cases of intraoperative suture line bleeding was prospectively collected. Questionnaires encompassing multiple aspects of the ease of use and efficacy of PuraStat® were completed by ten surgeons (five consultants and five senior registrars) and analysed to gauge the performance of the product. Results No major adverse cardiac events were reported in this cohort. Complications such as atrial fibrillation, pacemaker requirement and pleural effusions were comparable to the national average. Mean blood product use of packed red cells, platelets, fresh-frozen plasma (FFP) and cryoprecipitate was below the national average. There was one incidence of re-exploration, however this was due to pericardial constriction rather than bleeding. Analysis of questionnaire responses revealed that surgeons consistently rated PuraStat® highly (between a score of 7 and 10 in the various subcategories). The transparent nature or PuraStat® allowed unobscured visualisation of suture sites and possessed excellent qualities in terms of adherence to site of application. The application of PuraStat® did not interfere with the use of other haemostatic agents or manipulation of the suture site by the surgeon. Conclusion PuraStat® is an easy-to-use and effective haemostatic agent in a wide range of cardiac and aortic surgical procedures.

Introduction: International guidance suggests that injury-associated haemorrhagic shock should be resuscitated using blood products. However, in low- and middle-income countries resuscitation emphasises the use of crystalloids – mainly due to poor access to blood products. This study aimed to estimate the amount of blood loss from serious injury in relation to available emergency blood products at a secondary-level, public Cape Town hospital. Methods: This retrospective, cross-sectional study included all injured patients cared for in the resuscitation area of Khayelitsha Hospital’s emergency centre over a fourteen-week period. Injuries were coded using the Abbreviated Injury Scale, which was then used to estimate blood loss for each patient using an algorithm from the Trauma Audit Research Network. Descriptive statistics were used to describe blood volume lost and blood units required to replace losses greater than 15% circulating blood volume. Four units of emergency blood are stored in a dedicated blood fridge in the emergency centre. Platelets and fresh plasma are not available. Results: A total of 389 injury events were enrolled of which 93 were excluded due to absent clinic data. The mean age was 29 (±10) years. We estimated a median of one unit of blood requirement per week or weekend, up to a maximum of eight or six units, respectively. Most patients (n = 275, 94%) did not have sufficient injury to warrant transfusion. Overall, one person would require a transfusion for every 15 persons with a moderate to serious injury. Conclusion: The volume of available emergency blood appears inadequate for injury care, and doesn’t consider the need for other causes of acute haemorrhage (e.g. gastric, gynaecological, etc.). Furthermore, lack of other blood components (i.e. plasma and platelets) presents a challenge in this low-resourced setting. Further research is required to determine the appropriate management of injury-associated haemorrhage from a resource and budget perspective. Keywords: Injury, Low resource, Blood products

The proper utilization of blood is only clear in the application of blood transfusion to treat cases that lead to mortality and cannot be effectively prevented or treated by other methods 1. Blood transfusion process faces cases such as storage time limitation and high preserving costs 2. This study was conducted with the aim to determine blood consumption indices in patients hospitalized in educational hospitals in Zahedan. This descriptive-analytic study was carried out in educational hospitals of Zahedan, Iran, 2014. All submitted orders from the hospitals sections to the blood bank were assessed. Two major indices of crossmatch-to-transfusion ratio (C/T ratio) and Transfusion probability (TI%) were calculated for all the patients and individual sections and compared with the standard value. In relation to the C/T ratio index: the anesthetic section had the highest value with a ratio of 2.7 and the hematologic section had the lowest value with a ratio of 1.04. Furthermore, pediatric, internal, ICU and hematology sections were in a good position in terms of the C/T index. In relation to the TI index: the internal section had the highest value of 2.8 and the pediatric section had the lowest value of 0.87. In general, the orders of blood products and consumption are in a proper situation in the educational hospitals in Zahedan. Despite this, comparisons between the different studies can reveal contradictions in the situation of blood orders and consumption in the country.

The article gives an account of certification performed for a new batch of a Reference standard to be used with the test system for determination of the fractional (antigenic) composition of human serum products by immunoelectrophoresis -industry reference standard (IRS) 42-28-77 - in accordance with existing requirements. A candidate reference standard was represented by a batch of normal human serum intended for diagnostic purposes (more than 500 donors) and a batch of immunoelectrophoresis serum against human serum proteins (antiserum against human serum proteins). In accordance with the certification programme, the fractional (antigenic) composition of the reference standard was determined by immunoelectrophoresis using «KliniTest-EF» buffer and 0.05 M borate buffer solution and the modes stipulated in the general monograph 1.8.2.0002.15 Agar gel immunoelectrophoresis. The reaction between the antiserum against human serum proteins and the normal human serum components of the reference standard produced at least 15 precipitation lines. The study demonstrated that the bromphenol blue dye could be used together with «KliniTest-EF» buffer to assess albumin migration, and the pyronin B dye could be used together with «KliniTest-EF» buffer and 0.05 M borate buffer solution to assess immunoglobulin migration. The study confirmed the applicability of the certified reference standard designed for the test system for determination of the fractional (antigenic) composition of human serum products by immunoelectrophoresis, and set the criteria for its use in the context of human serum products identification (species specificity) testing not only by immunoelectrophoresis, but also by agar-gel immunodiffusion.