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Background: Anti‐K is an alloantibody stimulated in response to the KEL1 antigen and may cause hemolytic disease of the fetus and newborn (HDFN). Provision of KEL1 negative blood to females of child‐bearing potential was not our practice. We assessed the impact of our policy and assessed feasibility of a KEL1 negative transfusion policy. Study design and methods: This is a cohort study spanning Jan 1, 2007–Jun 30, 2017 in Hamilton, Canada. Data were obtained via our institution's transfusion database. Chart reviews of females age ≤45 with anti‐K were performed; data on RBC KEL1 phenotype were obtained from the blood supplier when needed to ascertain the cause of alloimmunization. Descriptive analysis of hospital KEL1 negative inventory demand and supply was performed. Results: From Jan 2007‐Jun 2017, 8.6% of all RBC units transfused were provided to females age ≤45. There were 111 females with detectable anti‐K. Median age at time of antibody detection was 34 years (interquartile range 27–40) and 28 of 111 (25.2%) patients may have been alloimmunized by transfusion. Of 49 pregnancies, seven had complications due to anti‐K. We estimated that our existing RBC inventory (with 16% units known to be KEL1 negative in 2017) is sufficient to meet demand and support a KEL1 negative transfusion policy for females age ≤45. Conclusion: Transfusion was responsible for alloimmunization in 25% of females with anti‐K over 10 years. Analysis of supply and demand can be used to inform feasibility of a KEL1 negative transfusion policy. [ABSTRACT FROM AUTHOR]

Limitations in platelet inventory necessitate the use of ABO-incompatible (ABOi) platelets for transfusion with possible risk of an acute hemolytic transfusion reaction due to the presence of high titre (HT) isohemagglutinins (ISO). Pooled platelets psoralen-treated (PPPT) are manufactured following the division of 7 donor buffy coats in a platelet additive solution (PAS). The PAS:plasma ratio of 60:40 provides a dilutional effect on ISO levels. The purpose of this study is to compare the proportion of PPPT that test ISO HT positive versus untreated 4 donor platelet pools without PAS (UPP). Component-based ISO titration was performed on 1001 UPP (November 8 2022-February 8 2023) and 1019 PPPT (June 1 2023-August 31 2023) followed by testing of 834 additional group O PPPT (September 1 2023-January 19 2024) to refine the HT rate estimate. All testing was performed at a single laboratory by a manual immediate spin tube method using an aliquot of platelet supernatant diluted 1:50 with saline tested separately against A1 and B cells. Agglutination with either/both A1 and B cell(s) constituted a positive HT result. The proportion of components with HT results were compared for PPPT vs UPP. Statistical analysis was performed using SAS with P -values calculated using the chi-square method. Of 1019 PPPT in PAS, 3 (0.29%) tested HT positive and all were group O. By comparison, 64/1001 (6.4%) UPP were HT positive (P -value <.0001). The rate of HT positivity by ABO blood group for PPPT vs UPP: Group O 3/559 (0.54%) vs 53/496 (10.6%) (P -value <.0001); Group A 0/439 (0%) vs 9/468 (1.9%); Group B 0/21 (0%) vs 2/37 (5.4%). For group A and B platelets, the relatively low rate of HT positive events in both UPP and PPPT precluded meaningful statistical comparison. Testing of 834 additional group O PPPT yielded 6 HT positive components for a total of 9/1393 (0.65%) HT positive group O PPPT (99% CI 0.23-1.43%). Greater than 99% of pathogen reduced pooled platelets in PAS have low isohemagglutinin titres using a common component-based testing assay. For PPPT, none of the group A or B tested HT positive with 0.65% positivity in group O. The significant reduction in HT positive pooled platelet components with this new manufacturing method confers a greater safety profile when ABO incompatible platelet transfusion cannot be avoided. These findings may impact hospital decisions around inventory management, platelet selection and titre testing. [ABSTRACT FROM AUTHOR]

Background Methods and Discussion Conclusion Health data comprise data from different aspects of healthcare including administrative, digital health, and research‐oriented data. Together, health data contribute to and inform healthcare operations, patient care, and research. Integrating artificial intelligence (AI) into healthcare requires understanding these data infrastructures and addressing challenges such as data availability, privacy, and governance. Federated learning (FL), a decentralized AI training approach, addresses these challenges by allowing models to learn from diverse datasets without data leaving its source, thus ensuring privacy and security are maintained. This report introduces FL and discusses its potential in transfusion medicine and blood supply chain management.FL can offer significant benefits in transfusion medicine by enhancing predictive analytics, personalized medicine, and operational efficiency. Predictive models trained on diverse datasets by FL can improve accuracy in forecasting blood transfusion demands. Personalized treatment plans can be refined by aggregating patient data from multiple institutions using FL, reducing adverse reactions and improving outcomes. Operational efficiency can also be achieved through precise demand forecasting and optimized logistics. Despite its advantages, FL faces challenges such as data standardization, governance, and bias. Harmonizing diverse data sources and ensuring fair, unbiased models require advanced analytical solutions. Robust IT infrastructure and specialized expertise are needed for successful FL implementation.FL represents a transformative approach to AI development in healthcare, particularly in transfusion medicine. By leveraging diverse datasets while maintaining data privacy, FL has the potential to enhance predictions, support personalized treatments, and optimize resource management, ultimately improving patient care and healthcare efficiency. [ABSTRACT FROM AUTHOR]

We report a case of a 56‐year‐old woman with a history of idiopathic thrombocytopenic purpura (ITP) following splenectomy on mycophenolate mofetil (MMF), who developed moderate bleeding after stopping MMF. Her laboratory testing suggested the presence of an abnormal circulating heparin‐like anticoagulant with demonstrable anti‐Xa activity. She was initially treated with antifibrinolytic therapy and was subsequently started on MMF alongside intravenous immunoglobulin, which significantly improved her bleeding symptoms. The presence of abnormal circulating heparin‐like anticoagulants is a rare cause of coagulopathy. Few cases exist in the literature, with nearly all occurring in the setting of hematologic or solid‐organ malignancy. The mechanism by which these endogenous anticoagulants develop is unclear. Clinical manifestations range from mild bleeding and bruising to life‐threatening hemorrhage refractory to conventional therapy. Diagnosis of a heparin‐like anticoagulant is based on coagulation testing as well as exclusion of other exogenous anticoagulants, acquired inhibitors, and/or factor deficiencies. [ABSTRACT FROM AUTHOR]

An author index for the October, 2012 issue of the periodical is presented.