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Background: The DEL phenotype is the D variant expressing the least amounts of D antigen per red cell. Asian‐type DEL (RHD:c:1227G > A) is the most prevalent DEL in East Asia without any anti‐D alloimmunization reported before. We investigated the first observation of an anti‐D in any DEL phenotype, reported in the Japanese language at a 1987 conference, only 3 years after the discovery of DEL. Methods: We contacted the proband 35 years after the initial report. Standard hemagglutination, adsorption/elution, and flow cytometry tests were performed, as was nucleotide sequencing for the RHD, RHCE, and HLA class I and class II genes. Results: The healthy multiparous Japanese woman, a regular blood donor, still had the anti‐D of titer 8 representing an alloantibody by standard serologic methods. Unexpectedly, she carried an Asian‐type DEL without any additional RHD gene variation. All 12 HLA alleles identified were known in the Japanese population. Interestingly, one of her HLA‐DRB1 and a variant of her HLA‐DQB1 alleles had previously been associated with anti‐D immunization. Conclusion: We described an allo‐anti‐D, maintained for more than three decades, in an Asian‐type DEL. The combination of two implicated HLA alleles were rare and could have contributed to the anti‐D immunization. Continued monitoring of anti‐D immunization events in patients with DEL is warranted, and we discuss possible mechanisms for further study. As only this single observation has been recognized in the last 35 years, the current recommendation is affirmed: Individuals with Asian‐type DEL should be treated as Rh D‐positive for transfusion and Rh immune prophylaxis purposes. [ABSTRACT FROM AUTHOR]

Background: Breast milk, nature's optimum source of nutrition for infants, can contain undesirable microorganisms that cause severe morbidity. After an outbreak of multidrug‐resistant Escherichia coli among neonates receiving breast milk donated by another mother in our neonatal intensive care unit (NICU), we were motivated to develop a high‐grade breast milk pasteurizer (BMP) designed to thaw and pasteurize breast milk at 63°C for 30 min in a sealed bag without having to open the bag or immerse it in water. Methods: Pre‐existing bacteria and spiked cytomegalovirus (CMV) were measured pre‐ and post‐pasteurization in frozen breast milk donated by mothers of children admitted to the NICU. Results: Among 48 breast milk samples (mean ± standard deviation [SD]), pre‐existing bacterial counts of 5.1±1.1 × 104 colony forming units (cfu)/mL decreased to less than 10 cfu/mL (below detection level) in 45 samples after pasteurization for 30 min. In three samples, 10–110 cfu/mL persisted. As no CMV was detected in any of the 48 samples, CMV at ≥5 × 104 pfu/mL was spiked into 11 breast milk samples. After just 10 min of pasteurization, infectious CMV was not detected (threshold <50 pfu/mL) in any sample. Conclusion: A new BMP was shown to pasteurize milk effectively with more than a 3‐log reduction of microorganisms. Compared to conventional pasteurizers, this device reduces the effort involved in pasteurizing breast milk, avoids various contamination risks, and may reduce the risk of infectious disease transmission via breast milk. [ABSTRACT FROM AUTHOR]

Background: Anti‐M is frequently observed as a naturally occurring antibody of little clinical significance. Naturally occurring anti‐M is often found in children although the specific triggers of production, persistence, and evanescence of anti‐M have yet to be elucidated. Methods: In a retrospective, multicenter, nationwide cohort survey conducted from 2001 to 2015, alloantibody screening was performed before and after transfusion in 18,944 recipients younger than 20 years. Recipients were categorized into six cohorts based on their age at transfusion; within and among these cohorts, allo‐anti‐M was analyzed in regard to its production, persistence, and evanescence. Results: In 44 patients, anti‐M detected before and/or after transfusion was an age‐related phenomenon, with a median age of 2 years and an interquartile range of 1–3 years; anti‐M was most frequently detected in a cohort of children 1 to <5 years (0.77%, 31 of 4035). At least five patients were presumed to have concurrent infections. Among 1575 adolescents/young adults (15 to <20 years), no anti‐M was detected. Of 29 patients with anti‐M prior to transfusion, the antibody fell to undetectable levels in 17 recipients (89.5%, of whom at least 13 received only M‐negative red cells) after anywhere from 5 days to 5.8 years; anti‐M persisted in 2, and was not tested in 10. Only 15 recipients (0.08%) produced new anti‐M after transfusion. Conclusion: Naturally occurring anti‐M is a phenomenon of younger ages, predominantly between 1 and 3 years. After transfusion, it often falls to undetectable levels. [ABSTRACT FROM AUTHOR]

Background: During storage, the potassium level of red blood cell (RBC) components increases, especially after irradiation. Neonates are prone to hyperkalemia, for example, non‐oliguric hyperkalemia, so using potassium adsorption filters during transfusion may be helpful. To overcome dilution of RBC components caused by saline priming of existing potassium adsorption filters, a downsized potassium adsorption filter for neonates (PAF‐n, Kawasumi Laboratories Inc., Tokyo, Japan) was developed. Study Design and Methods: To assess the performance of PAF‐n, its adsorption efficiency and RBC recovery rate were evaluated by testing pre‐filtration and serial post‐filtration (0‐30 mL, 30‐60 mL, 60‐90 mL, and 90‐120 mL) samples from 8 RBC components. Results: The average potassium adsorption rate of the PAF‐n was 90.5% ± 0.78%, and never less than 89.0% in any of 8 RBC components. RBC recovery rates were 99.3% ± 1.12%. Conclusion: The PAF‐n showed an effective potassium ability with negligible RBC dilution. [ABSTRACT FROM AUTHOR]

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Background and objective: Human T‐cell lymphotropic viruses (HTLV) 1 and 2 are endemic in sub‐Saharan Africa (SSA), transfusion‐transmissible and causally linked to various severe diseases. However, even in SSA countries with moderate to high endemicity, routine blood donor screening for HTLV is rarely, if ever, performed. Information on seroprevalence is limited. The aim of this review is to establish the prevalence of HTLV‐1 and HTLV‐1/2 among blood donors in sub‐Saharan Africa. Materials and Methods: We systematically reviewed databases including EMBASE, MEDLINE and the Cochrane database library from their inception to June 2018. Studies presenting data on HTLV prevalence among blood donors in sub‐Saharan Africa were included. A random‐effect meta‐analysis was conducted on all eligible studies. Results: A total of 25 studies were included, representing 74 119 blood donors, of whom over 80% (61 002) were only tested for HTLV‐1. The evidence base was high and moderate in quality. The pooled prevalence of the 17 studies that screened only for HTLV‐1 and the nine studies that screened for HTLV‐1/2 was 0·68 (95% CI: 0·29–1·60) and 1·11 (95% CI: 0·47–2·59) per 100 blood donors, respectively. Conclusion: The prevalence of HTLV‐1 infection among blood donors is relatively low. The current review is intended to inform debates and decisions about best practices to prevent transfusion‐transmitted HTLV in sub‐Saharan Africa. Further work is required to determine the risk of infections by transfusion and the cost‐effectiveness of any new measures such as routine screening. [ABSTRACT FROM AUTHOR]

Background: Autoimmune hemolytic anemia (AIHA) is caused by autoantibodies to red blood cells (RBCs), which can be panreactive and/or specific to Rh/other blood group antigens. We report a severe case of AIHA after bone marrow transplantation (BMT) due to autoanti-D triggered by reactivation of Epstein-Barr virus (EBV) infection. A combined strategy of D- RBC transfusion and administration of anti-CD20 monoclonal antibody (MoAb) resolved the hemolysis.Case Report: A 33-year-old male underwent allogeneic BMT from an ABO-identical and HLA-matched unrelated male donor. Five months later, while having mild chronic graft-versus-host disease, he manifested AIHA, with a hemoglobin (Hb) level of 5.1 g/dL on AIHA Day 2 (Posttransplant Day 156) and was refractory to D+ RBCs, with a Hb level of 2.4 g/dL on AIHA Day 6. Anti-D-like autoantibodies (titer 1280, subclass immunoglobulin G1 , monocyte monolayer assay 28.7%) and panreactive (titer 40) were identified. Changing the RBC transfusion strategy to D- increased his Hb level to 6.7 g/dL on Day 10. Administration of anti-CD20 MoAb mitigated EBV-related B-cell proliferation and reduced anti-D autoantibody titer to 320 by Day 16 with normalized Hb concentration after 6 months.Conclusion: In severe AIHA, when standard treatment and regular RBC transfusions are ineffective, transfusion of RBCs lacking the target antigen(s) of autoantibodies and administration of anti-CD20 MoAb should be considered. [ABSTRACT FROM AUTHOR]

Background Recent evidence from alcohol and trauma studies suggests that disasters are associated with increases in the consumption of alcohol. The Great East Japan Earthquake and the associated nuclear disaster have continued to affect the mental health of evacuees from Fukushima. This study aimed to extend these findings by examining the relationship between drinking behaviors and the risk of mental illness after the compound disaster. Methods We conducted the Mental Health and Lifestyle Survey with 56,543 evacuees. Kessler's K6 was used to assess the risk of mental illness, and logistic regression models were applied to analyze how drinking behavior patterns influence the risk of serious mental illness after adjustment for confounding variables. Results Logistic regression analysis evidenced that beginning heavy and light drinkers had the highest and a higher risk of serious mental illness, respectively. Individuals who were nondrinkers pre- and postdisaster had the lowest proportional risk of mental illness. Abstainers also had some risk to their mental health after the compound disaster. Conclusions The results of this study highlight that beginning drinkers have a high risk of serious mental illness. Thus, mental health professionals should pay attention to the drinking behaviors of evacuees, which might predict increased risk of serious mental illness and consequently indicate a need for psychological intervention. [ABSTRACT FROM AUTHOR]

Background In the Spectra apheresis instrument ( Terumo BCT), both manual ( Spectra- MNC) and automated ( Spectra- Auto) programs have been widely used to collect peripheral blood progenitor cells ( PBPCs). However, direct comparison of these programs remains extremely limited. Study Design and Methods We investigated 188 collections and products from autologous (patient) and allogeneic (donor) subjects and analyzed a subset of 89 allogeneic collections and products. Twenty-nine subjects who received apheresis for 2 consecutive days using both programs were also evaluated with a paired crossover comparison. Results The two programs processed similar volumes, but run time was longer with Spectra- Auto. Yield and efficiency of CD34+ cell collection were similar between these programs in the whole cohort, although white blood cell ( WBC) and mononuclear cell ( MNC) yields were higher with Spectra- MNC. In the allogeneic cohort, yield and efficiency of WBC collection were greater in Spectra- MNC. However, collected WBCs, MNCs, and CD34+ cells were similar between these programs in paired comparison. Regardless of program, preapheresis peripheral WBC, MNC, and CD34+ cell counts correlated with the number of cells collected. In contrast, preapheresis WBC counts in the whole cohort were negatively correlated with collection efficiencies of CD34+ cells in Spectra- MNC but not Spectra- Auto. The products collected using Spectra- MNC contained more contaminating platelets ( PLTs) than Spectra- Auto, with a corresponding reduction in postdonation circulating PLTs. Conclusion Spectra- MNC and Spectra- Auto showed distinct features that should be considered on a case-by-case basis. Similar investigations should be undertaken as new collection platforms are introduced. [ABSTRACT FROM AUTHOR]

Background Microparticles in blood components might contribute to transfusion-related immunomodulation or other side effects. To elucidate the role of leukofiltration, we compared three commercially available filters for their effect on platelet (PLT)-derived ( PDMP), leukocyte-derived ( LDMP), and red blood cell-derived ( RDMP) microparticle formation in apheresis PLTs. Study Design and Methods Apheresis PLTs from pairs of ABO-identical male donors were pooled and divided into four volumes. One volume was stored without filtration, whereas the other three were filtered with different devices. PDMPs, LDMPs, and RDMPs were measured by flow cytometry during 2 weeks of controlled-temperature (22°C) agitated storage. Results On average, PDMPs doubled over 5 days of storage, followed by a much steeper increase by which PDMPs on Day 14 were nearly 20 times higher than on Day 0. LDMP and RDMP counts were relatively stable over 14 days. Significant differences among filtered and nonfiltered products did not emerge. Conclusion Although the conditions of this study showed no favorable or unfavorable effects of three different filters on microparticle formation, surveillance and investigation of unanticipated outcomes in other experimental and clinical circumstances should continue. [ABSTRACT FROM AUTHOR]

BACKGROUND: Screening blood donors for hepatitis C virus (HCV) antibody has effectively mitigated transfusion transmission of HCV. We conducted a post hoc analysis to clarify the impact of donor screening on a general population of reproductive-age females and their offspring. STUDY DESIGN AND METHODS: Anti-HCV screening in Japan started in late-1989. In a cohort studied between May 1990 and November 2004, a total of 22,664 consecutive serum samples from pregnant women were screened for anti-HCV. Reactive samples were further tested for HCV RNA. Linear structural regression was applied to identify causal relationships. RESULTS: Anti-HCV–reactive rates declined significantly by two measures. First, among women known to have been transfused, rates fell from 14.8% to 3.1% with the implementation of anti-HCV screening (p < 0.01). Nevertheless, this is 10 times higher than the 0.3% reactive rate seen in a similar cohort of nontransfused women. Second, rates fell from 1.8% among women born in 1955 or before to 0.3% for women born in 1966 or later (p < 0.01). Among 103 anti-HCV–reactive women, 31 (30%) had been transfused and another 17 (17%) had other identifiable risk factors. The remaining 55 (53%) had no clear risk factor. Blood transfusion accounted for 19% of anti-HCV acquisition, by path analysis. Only one infant in this cohort was vertically infected with HCV. CONCLUSION: Anti-HCV screening of donated blood and hygienic improvements have markedly decreased HCV infection of pregnant women with a transfusion history; however, 70% of anti-HCV–reactive women were deemed to be infected via routes other than transfusion. [ABSTRACT FROM AUTHOR]

Examines the transfusion-associated graft versus host disease (TA-GVHD). Description of the single case form a cohort of patients; Variation of TA-GVHD among different populations; Correlation between socioeconomics and historical incidence of TA-GVHD.

Background and Objectives Materials and Methods Results Conclusion Restless legs syndrome (RLS), with adverse health outcomes, has been linked to blood donation, but evidence published thus far has not been rigorously analysed. This systematic review aggregates existing evidence on RLS among blood donors and identifies associated factors worthy of further investigation.MEDLINE and EMBASE were searched for articles published through 16 December 2023. Eleven studies from eight countries were selected from 142 publications. The pooled prevalence of RLS was calculated using a random‐effects model, with heterogeneity assessed by the Cochran Q and I2 statistics. Meta‐regression and sensitivity analyses explored sources of heterogeneity and the robustness of findings.Eleven studies, involving 20,255 blood donors, were included. The pooled prevalence of RLS among blood donors was 10.30% (95% confidence interval [CI]: 5.54%–16.30%), which was significantly higher than in the general adult population (3.0%, 95% CI: 1.4%–3.8%). Meta‐regression identified the year of study and geographical region as significant sources of heterogeneity. From the five studies that used logistic regression analyses, female sex and older age stand out as associated factors. No publication bias was detected, and sensitivity analysis confirmed the robustness of results.Our findings suggest a high burden of RLS among blood donors, underscoring the need for further research with standardized criteria, appropriate design and analytical methodologies to better understand the impact of RLS on individual donors and the global blood supply. [ABSTRACT FROM AUTHOR]