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Background: Sparse data are published regarding the amounts and types of intraoperative blood/components required during lung transplantation. Methods: The medical records of 165 patients undergoing lung transplantation from 1986 to 2000 were reviewed. Two patients required re-transplantation. Heart-lung transplant patients were excluded. Results: RBCs were the most frequent component transfused average 3 units(u), median 1 (range 0-44) followed by platelets: average 2 u, median 0 (range 0-60), cryoprecipitate: average 1, median 0 (range 0-30) and FFP: average 1 u, median 0 (range 0-27). Aprotinin was not given to most patients. No patients died during surgery. Conclusion: Intraoperative blood requirements for single-lung (s) transplantation are minimal. Double-lung (D) recipients require much moro (7,300%) intraoperative transfusion support than single-lung recipients perhaps because it is a more extensive and lengthy procedure. Some of these patients require cardiopulmonary bypass, which is well known to increase blood requirements. [ABSTRACT FROM AUTHOR]

Background: Febrile reactions, a rise ³1 °C above normal/baseline temperature, in patients receiving transfusions are well known yet little studied. Some believe that removing white blood cells from all cellular components prevent these events and that febrile reactions are so deleterious to patients' health that they should be prevented regardless of the tremendous costs involved. Methods: The Indiana University Medical Center hospitals (1999) transfused about 50K RBCs and 50K platelets providing hemotherapy support for two level I trauma centers, 51 liver and 157 renal allografts, 228 marrow transplants, as well as a large full service pediatric hospital. Records of 2000, 1999, 1995, 1990, 1984 febrile reactions were reviewed to determine their occurrence in patients receiving nonleukoreduced and leukoreduced blood components. Results: 191 febrile reactions in 186 patients were reported and reviewed. 162 (∼85%) reactions were caused by RBCs, 25 (∼13%) by platelets, 2 (∼1%) by FFP. The vast major of these patients were on the Medicine service (Hematology/Oncology). Forty-eight patients (∼30%) experienced febrile reactions after receiving leukoreduced products, 33 from RBCs, 15 from platelets. Three patients experienced recurrent reactions, two receiving leukoreduced RBCs while another had 3 recurrent reactions, one to leukoreduced platelets, one to non leukoreduced platelets and one to non leukoreduced RBCs. Two patients experienced reactions after receiving FFP. All reactions were self limited and without serious morbidity. Two patients developed mild shaking chills. Conclusion: Leukoreduction did not prevent all febrile reactions. Most were caused by RBCs. Febrile reactions can rarely be caused by FFP. In our experience, febrile reactions do not pose a serious threat to patients' health. [ABSTRACT FROM AUTHOR]

Abstract: Hemophilia is an X-linked congenital bleeding disorder for which factor replacement is life-saving but complicated by the sequelae of chronic hepatitis C virus (HCV) infection acquired decades ago. Although antiviral therapy clears HCV and reduces end-stage liver disease (ESLD), it may not reverse cirrhosis or prevent hepatocellular cancer (HCC). This was a retrospective cohort study of 121 men with hemophilia and HCV infection cared for at the Hemophilia Center of Western Pennsylvania to determine the incidence and predictors of ESLD and HCC. ESLD and HCC predictors were analyzed using Fisher exact test, and HCV-associated outcomes by Kaplan-Meier time-to-event and Cox proportional hazards regression analyses. At a mean 54 years (36-80) duration of HCV, ESLD occurred in 24 (19.8%), 0.365 per 100 person-years (py); and HCC in 7 (5.8%), 0.106 per 100 py. All 46 (38.0%) alive when HCV antiviral therapy became available, received it. Overall, 31 (25.6%) were HIV+. The leading causes of death were ESLD in 11 (32.3%), bleeding in 9 (26.5%), and HCC in 6 (17.6%). Major risk factors for ESLD included platelets <100 × 103/μL (odds ratio [OR], 6.009; P = .012) and HIV infection (OR, 3.883; P = .001). The major predictors of HCC were ESLD (OR, 11.476; P = .003) and platelets <100 000/μL (OR, 6.159; P = .014). No antiviral-treated patient developed ESLD, P = .001. For men with hemophilia, the sequelae of chronic HCV infection were significant. The major risk factors for ESLD were platelets <100 000/μL and HIV infection. Despite antiviral therapy, ESLD is the most significant predictor of HCC, and ESLD is the leading cause of death., (© 2024 by The American Society of Hematology. Licensed under Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0), permitting only noncommercial, nonderivative use with attribution. All other rights reserved.)

Background: Depression is a common pregnancy complication yet is often under-detected and, subsequently, undertreated. Data collected through mobile health tools may be used to support the identification of depression symptoms in pregnancy., Methods: An observational cohort study of 2062 pregnancies collected self-reports of patient history, mood, pregnancy-specific symptoms, and written language using a prenatal support app. These app inputs were used to model depression risk in subsequent 30- and 60-day periods throughout pregnancy. A selective inference lasso modeling approach examined the individual and additive value of each type of patient-reported app input., Results: Depression models ranged in predictive power (AUC value of 0.64-0.83), depending on the type of inputs. The most predictive model included personal history, daily mood, and acute pregnancy-related symptoms (e.g., severe vomiting, cramping). Across models, daily mood was the strongest indicator of depression symptoms in the following month. Models that retained natural language inputs typically improved predictive accuracy and offered insight into the lived context associated with experiencing depression., Limitations: Our findings are not generalizable beyond a digitally literate patient population that is self-motivated to report data during pregnancy., Conclusions: Simple patient reported data, including sparse language, shared directly via digital tools may support earlier depression symptom identification and a more nuanced understanding of depression context., Competing Interests: Declaration of competing interest Drs. Krishnamurti and Simhan are co-founders of Naima Health LLC, which provided the data for this study. However, no financial or material compensation was provided by Naima Health LLC to fund this work. The remaining authors report no conflicts of interest. To manage any conflict of interest, the University of Pittsburgh instituted a conflict-of-interest management plan for this research, which included assigning an independent data steward to the project. Under this plan, the two authors with a conflict of interest did not access the raw data or code, although they were engaged in analyses planning and interpretation of the output., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)