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Biomedical subjects

S Gerald Sandler

Publications and source records attributed to S Gerald Sandler.

7 recordsLinked to original sources
PubMed2003

Use of sentinel sites for daily monitoring of the US blood supply.

BACKGROUND: This report describes the first year of a government-sponsored program that uses daily reports from 29 sentinel sites to monitor the capacity of the US blood supply to meet demand. STUDY DESIGN AND METHODS: From August 15, 2001, to August 14, 2002, 29 sentinel sites provided daily reports of the number of units of RBCs in inventory, transfused, exported, and outdated by ABO and Rh, and platelets by random or apheresis donor. Days supply of each component category was calculated as the number of units in inventory reported on a day divided by the sum of units transfused, exported, and outdated on that day. Sites also provided daily responses to questions about threatened or actual shortages. RESULTS: The median of the days supply of RBCs at the 26 hospital transfusion services was 7.2 days. However, median days supply varied substantially by site and by day of the week. A+, O+, and O- units accounted for 30, 35, and 12 percent of total inventory and were maintained at a median supply of 7.4, 6.4, and 9.5 days, respectively. Reports of threatened RBC shortages peaked in early January 2002 and again in early July 2002. The July 2002 peak was about twice the January 2002 peak. Inventories at community-based centers were similar to those at hospital transfusion services. Hospitals maintained only a 1-day supply of platelets. Eight percent of random and 4 percent of apheresis platelets were outdated. There were 20 reports that surgery had to be postponed or canceled because platelets were unavailable. CONCLUSIONS: Inventories of RBCs maintained at the participating sites were sufficient, with only one brief exception, to meet local demand during the first year of this monitoring program. The weekly rate of threatened shortage reports was more sensitive than days inventory as a predictor of actual shortages of RBCs. Unlike RBCs, platelet days supply, reports of threatened or actual platelet shortages, and platelet outdate rates did not vary seasonally.

Blood Banks↗
PubMed2002

Predicting the effect of transfusing only phenotype-matched RBCs to patients with sickle cell disease: theoretical and practical implications.

BACKGROUND: Transfusing only phenotype-matched RBCs has been recommended to reduce the incidence of alloimmunization to blood group antigens in patients with sickle cell disease (SCD). STUDY DESIGN AND METHODS: The expected benefit of phenotype matching was determined by identifying which of the existing blood group alloantibodies in patients with SCD who received conventional transfusions would not have been formed if they had received only phenotype-matched RBCs. By use of each patient's alloantibodies as a baseline, it was possible to identify specific alloantibodies that would not have been formed if each of five different phenotype-matching protocols had been used. RESULTS: During a 12-year period, 351 patients received transfusions with 8939 units of ABO- and D-matched RBCs. Of these, 102 patients (29.1%) formed at least one blood group alloantibody. An additional 35 patients with SCD with alloantibodies were identified by reviewing clinical records, yielding a total of 137 alloimmunized patients for inclusion in this study. If all transfusions had been selected by limited phenotype matching (C, c, E, e, and K, as well as for ABO and D), all alloantibodies would have been prevented for more than half (53.3%) of the 137 alloimmunized patients. If all transfusions had been matched for C, c, E, e, K, S, Fya, and Jkb, all antibodies would have been prevented for 70.8 percent of the 137 alloimmunized patients. Approximately 13.6 percent of random white blood donors would be expected to match a limited phenotype-matching protocol, whereas only 0.6 percent would match an extended phenotype-matching protocol. CONCLUSION: Limited phenotype matching would have prevented all alloantibodies in 53.3 percent of the patients who formed alloantibodies. This protocol requires RBCs that are readily available. Extended phenotype matching would have prevented alloimmunization in 70.8 percent of patients who formed alloantibodies. However, this would require phenotypes that are 22.7 times less prevalent among random blood donors and is therefore impractical for a long-term strategy.

ABO Blood-Group System↗