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Mindy Goldman

Publications and source records attributed to Mindy Goldman.

6 recordsLinked to original sources
PubMed2003

Clinical outcomes following institution of the Canadian universal leukoreduction program for red blood cell transfusions.

CONTEXT: A number of countries have implemented a policy of universal leukoreduction of their blood supply, but the potential role of leukoreduction in decreasing postoperative mortality and infection is unclear. OBJECTIVE: To evaluate clinical outcomes following adoption of a national universal prestorage leukoreduction program for blood transfusions. DESIGN, SETTING, AND POPULATION: Retrospective before-and-after cohort study conducted from August 1998 to August 2000 in 23 academic and community hospitals throughout Canada, enrolling 14 786 patients who received red blood cell transfusions following cardiac surgery or repair of hip fracture, or who required intensive care following a surgical intervention or multiple trauma. INTERVENTION: Universal prestorage leukoreduction program introduced by 2 Canadian blood agencies. A total of 6982 patients were enrolled during the control period and 7804 patients were enrolled following prestorage leukoreduction. MAIN OUTCOME MEASURES: All-cause in-hospital mortality and serious nosocomial infections (pneumonia, bacteremia, septic shock, all surgical site infections) occurring after first transfusion and at least 2 days after index procedure or intensive care unit admission. Secondary outcomes included rates of posttransfusion fever and antibiotic use. RESULTS: Unadjusted in-hospital mortality rates were significantly lower following the introduction of leukoreduction compared with the control period (6.19% vs 7.03%, respectively; P =.04). Compared with the control period, the adjusted odds of death following leukoreduction were reduced (odds ratio [OR], 0.87; 95% confidence interval [CI], 0.75-0.99), but serious nosocomial infections did not decrease (adjusted OR, 0.97; 95% CI, 0.87-1.09). The frequency of posttransfusion fevers decreased significantly following leukoreduction (adjusted OR, 0.86; 95% CI, 0.79-0.94), as did antibiotic use (adjusted OR, 0.90; 95% CI, 0.82-0.99). CONCLUSION: A national universal leukoreduction program is potentially associated with decreased mortality as well as decreased fever episodes and antibiotic use after red blood cell transfusion in high-risk patients.

Adult↗
PubMed2003

Proceedings of a consensus conference: blood-borne HIV and hepatitis-optimizing the donor selection process.

Over the past several years, concern for the safety of blood transfusion has evolved from a primary focus on bacterial infections such as syphilis to viral infections including hepatitis B, C, and human immunodeficiency virus (HIV), and most recently, the theoretical risk of variant Creutzfeldt-Jakob Disease (vCJD). As a result of these changes, blood bankers have found themselves faced with the dilemma of balancing the rights of transfusion recipients to receive safe blood products, with the rights of individuals wishing to donate blood as an altruistic contribution to society.

Acquired Immunodeficiency Syndrome↗
PubMed2002

Declining value of preoperative autologous donation.

BACKGROUND: Preoperative autologous blood donation (PABD) has been shown to decrease allogeneic blood transfusion requirements in major elective surgery. Changes in transfusion practice motivated an examination of blood use from 1993 to 2000 of patients participating in the Héma-Québec PABD program. STUDY DESIGN AND METHODS: Blood donation and transfusion, type of surgery, and demographic characteristics were prospectively entered into a computer database for patients participating in the Héma-Québec PABD program. RESULTS: Autologous donations represented from 0.8 to 2 percent of total blood collections and have declined by 26 percent after peaking in 1995. The mean number of units collected per patient declined, as did the number of units transfused per patient and the utilization rate. For radical prostatectomy, knee replacement surgery, hip replacement surgery, and scoliosis, utilization rates were 72, 60, 83, and 78 percent in 1993 compared with 50, 50, 58, and 58 percent in 2000, respectively. In 2000, 18 percent of patients were receiving a 1-unit autologous transfusion. Depending on the surgical procedure, 85 to 95 percent of patients avoided allogeneic transfusion; this did not change significantly from 1993 to 2000. CONCLUSION: Patients participating in the PABD program successfully avoided allogeneic transfusion in over 85 percent of cases. However, declining utilization rates and frequent 1-unit transfusions demonstrate the decreasing utility of PABD over time.

Adolescent↗
PubMedDate not supplied

Blood donor selection and screening: strategies to reduce recipient risk.

Various measures are taken to ensure the safety of the blood supply. Donor selection begins with education of the public about transfusion-transmissible diseases. Potential donors must answer a questionnaire designed to identify specific risk factors for these infections. The questionnaire is the only line of protection against certain infections for which no testing is performed, such as malaria, babesiosis, leishmaniasis, and Chagas disease. All donations are tested for the presence of antibodies to HIV-1 and -2, HCV, HTLV and syphilis, the hepatitis B surface antigen (HbsAg), the p24 antigen (HIV), and also for HIV and HCV nucleic acids. The introduction of new and improved screening tests for transfusion-transmissible diseases has led to remarkable improvement in the safety of the blood supply, with substantial shortening of the window period for HIV, HCV, and HBV infections. The current challenge of the industry is to reduce even further the small but significant risk of bacterial contamination of platelet components. Finally, some safety measures are purely precautionary, such as the deferral of donors who have traveled to certain countries affected by the bovine spongiform encephalopathy (BSE).

Antibodies, Viral↗