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PubMed1988

Refractoriness to platelet transfusion after single-donor consecutive platelet transfusions and its relationship to platelet antibodies.

In thirty patients with acute leukemia and severe aplastic anemia receiving random single donor platelet transfusions, the development of refractoriness by consecutive platelet transfusions with cytapheresis and its relationship to the appearance of anti-platelet antibodies were investigated. The median number of platelet transfusions inducing refractoriness was 13 times, and 20% of the patients remained unrefractory despite of the repeated multiple platelet transfusions up to 20 to 25 times. The results of anti-platelet antibody tasts by the enzyme-linked immunosorbent assay(ELISA) and immunofluorescent techniques(IFT) showed no statistically significant relationship with the refractoriness (p greater than 0.1). Although there was significant correlation between the results of ELISA and IFT, both tests were insufficient to find out refractoriness even with the use of pooled platelets from multiple donors as target cells. This study shows that 13 single donor platelet transfusions result in refractoriness, that both ELISA and IFT are insufficient to detect refractoriness despite of their significant correlation, and that other methods than these are needed in order to detect alloimmunization.

Adolescent↗

PubMed2000

Transfusion-associated graft-versus-host disease with transfusion practice in cardiac surgery.

BACKGROUND: Transfusion-associated graft-versus-host disease (TA-GVHD) in immunocompetent patients has still been underdiagnosed and underreported. Risk of TA-GVHD caused by transfusion practice in cardiac surgery should be appropriately recognized. METHODS: The correlation of TA-GVHD with transfusion practice in cardiac surgery was analyzed from our 17-year clinical experience. We retrospectively reviewed 2,686 consecutive adult patients who underwent cardiac surgery between 1980 and 1996. Classified according to transfusion practice, 847 patients (32%) received nonirradiated fresh homologous whole blood (mean per patient, 5+/-2 units) with or without other blood components; 592 patients (22%) nonirradiated stored RBCs older than 7 days (4+/-2), and 551 patients (21%) received irradiated homologous blood including, fresh whole blood (2+/-1), RBCs (4+/-1), and PCs (8+/-3), respectively. The remaining 696 patients (25%), did not require homologous transfusion. RESULTS: Four of 847 patients who received nonirradiated fresh homologous whole blood (< or =48 hours after donation) developed TA-GVHD. TA-GVHD did not occur in other patients. CONCLUSIONS: Our local experience demonstrates the incidence of TA-GVHD in patients who received fresh homologous whole blood in cardiac surgery was much higher, compared with previous reports. This result suggests that the frequency of TA-GVHD is nearly similar to the value calculated from the proportion of HLA haplotypes in the population.

Adult↗

PubMed2002

[Successful treatment of a huge meningeal hemangiopericytoma using Preoperative Autologous Transfusion and Hemodilutional Autologous Transfusion: case report].

We report successful operations for a meningeal hemangiopericytoma using sufficient amounts of Preoperative Autologous Transfusion (PAT) and Hemodilutional Autologous Transfusion (HAT). A 23-year-old woman with amenorrhea and bilateral visual field disturbance was found to have a huge intracranial tumor. MRI showed a well-enhanced cystic mass in the left middle fossa, suprasellar, intrasellar, sphenoidal sinus, and cavernous sinus. Preoperatively, the tumor was thought to be a cystic pituitary tumor or meningioma. Surgical removal was planned in three steps. The first operation was carried out via the transsphenoidal approach. Total blood loss was 1348 ml and 2 MAP infusion were required to control bleeding. Histopathological diagnosis was hemangiopericytoma. After preparation of PAT 400 ml and HAT 800 ml, we carried out the second partial removal operation mainly via the interhemispheric approach. Total blood loss was 1829 ml and required autologous transfusion only. After preparation of PAT 1200 ml and HAT 400 ml, the last total removal operation was carried out mainly via the pterional and subtemporal approach. Total blood loss was 1813 ml and required autologous transfusion only. We needed 2 MAP infusion in the first operation, but were able to perform total removal successfully without homologous blood transfusion because a sufficient amount of PAT and HAT had been prepared preoperatively. Hemangiopericytoma required postoperative radiation therapy to avoid local recurrence. After successful removal of the tumor surgically, postoperative radiation therapy was able to be carried out efficiently.

Adult↗

PubMed2005

Transfusion-related acute lung injury: a life-threatening transfusion reaction.

BACKGROUND: We present the case of a 57-year-old woman who developed transfusion-related acute lung injury (TRALI) following a transfusion of packed red blood cells (pRBCs). CASE REPORT: A 56-year-old woman had undergone a low anterior resection in 2002 because of a Duke's stage D adenocarcinoma of the rectum. In June 2003 she was referred to our department, presenting symptoms and signs of ileus. Abdominal radiograph revealed multiple air-fluid levels, while a computed tomography scan showed disease dissemination. Colonoscopic control verified recurrent disease in the anastomotic area. At surgery, a palliative loop ostomy was generated. In the 4(th) postoperative day it was decided that one unit of pRBCs be transfused. pRBC administration complicated with a severe reaction, developing within 35 minutes of the transfusion episode. The diagnosis of TRALI syndrome was based on clinical signs and symptoms. Hemodynamic stabilization and resuscitation required low doses of epinephrine, diuretics, and a high concentration of inspired oxygen in combination with bronchodilators. Ventilatory assistance was not required. Clinical improvement occurred 12 hours later. Full recovery of the syndrome was observed in 6 days, while chest X-ray returned to normal findings within 4 days. CONCLUSIONS: TRALI syndrome is an immune-mediated transfusion reaction which can cause severe complications or even death. Early diagnosis and treatment improves survival and usually results in full recovery. TRALI remains a clinical diagnosis in an appropriate setting, supported by serologic studies if these are available.

Acute Disease↗

PubMed1989

[More effective blood transfusion policies in elective surgery by objective transfusion guidelines].

The blood ordering practice in a general hospital was evaluated for 22 types of frequently scheduled elective surgical procedures. The following parameters were used: the C/T ratio (crossmatched/transfused ratio) for appraising the tendency to over-order in terms of frequency, the BOQ (blood ordering quotient) to establish whether the appropriate amount is ordered, and the transfusion probability to establish whether the risk accompanying the procedure warrants crossmatching blood. Using the results a list was compiled grouping the procedures as follows: 1. transfusion probability greater than 30%: type & screen and crossmatching of blood before the surgical procedure; 2. transfusion probability less than 30%: type & screen; 3. transfusion probability = 0%: no type & screen (remaining procedures). The number of units crossmatched for surgical procedures in the first group is in accordance with actual expected needs. Owing to the use of this list of expected haemotherapy requirements the number of patients for whom blood is crossmatched preoperatively has diminished from 76.5% to 29.8%. Furthermore, the C/T ratio has decreased from 3.33 to 1.45 with a practically unchanged transfusion probability (the mean for 22 types of surgical procedures). The number of crossmatches for these procedures has shown a 56% decrease. The use of the list of expected requirements has led to an annual saving of Dfl. 20,000-on laboratory expenses.

Blood Banks↗

PubMed1979

Beneficial effect of blood transfusion. Role of the time interval between the last transfusion and transplantation.

We analyzed the effect of blood transfusion (BT) on kidney allograft survival in 163 recipients. Transfused recipients (121) had better graft outcome than those never transfused (42), the difference being statistically significant at 3, 6, 12, and 24 months; however, the transfused group had a longer period of hemodialysis (P = 0.01). HLA antigen distribution does not bias the data. The group who had received the last BT within 3 months before grafting had a significantly better graft outcome than the nontransfused group (P less than 0.05 at 3, 6, and 24 months). They also did better (but not significantly) than the group who had been transfused more than 6 months before grafting. The group receiving two to five BTs had the highest rate of graft survival (P less than 0.05, 0.001, and 0.05 at 6, 12, and 24 months) as compared to the nontransfused. Practical suggestions for systematic BTs during hemodialysis are made.

Adolescent↗

PubMed1996

[Autologous blood transfusion: results with routine use of autologous blood transfusion, normovolemic hemodilution and postoperative retransfusion of drainage blood salvaged with the Solcotrans system].

BACKGROUND: Although the medical advantages of autologous blood transfusion are undisputed today, it has been established only in a few hospitals. At our hospital we have employed infusion of previously stored autologous blood and normovolemic hemodilution routinely in all patients undergoing major orthopedic surgery since June 1, 1986. QUESTION: In this study the efficacy of additionally infusing salvaged drainage blood postoperatively in reducing the need for homologous blood transfusion was examined. METHOD: From June 1, 1990 through December 30, 1993 the effectiveness of autotransfusion techniques with the additional use of postoperative infusion of salvaged blood was studied in 318 patients. RESULTS: Preexisting anemia with hemoglobin value of less than 11 g/dl proved to be the only contra-indication for autologous blood transfusions and was found in 8 (2.5%) of our patients. These patients were not eligible for the autologous blood program. The 310 remaining patients were all given their previously stored autologous blood with hemodilution. In addition, 261 of these patients (84%) were also given salvaged drainage blood postoperatively using the solcotrans system or solcotrans-plus-orthopedic system. Of the total 310 patients, 218 (70.3%) did well without homologous blood. This was also true for 206 (78.9%) of the patients treated with all 3 autotransfusion procedures. No complications implicating the autotransfusion techniques were encountered. In addition, the method described and as employed in our hospital led to a cost reduction of about 40% compared to homologous transfusions. DISCUSSION AND CONCLUSION: The efficiency of autologous blood transfusions and hemodilution in reducing the need for homologous blood at our hospital, as previously described, could be increased by 22% using the solcotrans system. The advanced age of our patients (average 73 years) and the number of preexisting, in part considerable, medical problems permit the conclusion that these autotransfusion techniques are quite well tolerated. The contraindications could be reduced to a few exceptions. The logistics necessary to carry out these procedures are simple and can be achieved with a bit of will and effort in all hospitals including those of middle and small size.

Adolescent↗

PubMed1997

Red blood cell transfusions contaminated with Yersinia enterocolitica--United States, 1991-1996, and initiation of a national study to detect bacteria-associated transfusion reactions.

Although bacteremia and sepsis are infrequently reported complications of red blood cell (RBC) transfusion, receipt of transfused blood contaminated with bacterial pathogens may result in sepsis, disseminated intravascular coagulation, and death. Such pathogens have included Yersinia enterocolitica and Pseudomonas fluorescens. From November 1985 through February 1991, a total of 11 cases of sepsis associated with receipt of transfused Y. enterocolitica-contaminated RBCs were reported in the United States. This report describes an additional 10 cases of Y. enterocolitica sepsis reported to CDC during March 1991-November 1996 in patients who received transfusions with contaminated RBCs and describes the development of a study to detect bacteria-associated reactions to transfusion of RBCs and other blood components.

Erythrocytes↗

PubMed1997

[History of blood transfusion--development and future of blood transfusion in Japan].

Blood was mentioned as possible therapeutic measures throughout human history. However modern blood transfusion medicine has developed only during the 20th century. In Japan, blood transfusion was tried since 1919 by several surgeons who had experienced during World War I in Europe. In 1930, the Prime Minister, Osachi Hamaguchi, was shot and became shock for intra-abdominal bleeding. He was saved by the blood transfusion by his son. This affair made Japanese people know the value of blood transfusion. After World War II (1945), blood transfusion has come into wide use in Japan. But posttransfusion infections, for example, hepatitis virus and human immunodeficiency virus I infection have been big problems these 30 years. We must try to make this life-saving treatment safer whenever possible.

Blood Transfusion↗

PubMed1997

[Cytokines and chemokines as inducers of nonhemolytic transfusion reactions after thrombocyte transfusion].

Recently, the leukocyte-derived cytokines interleukin (IL)-1 beta, IL-6, IL-8, and tumor necrosis factor(TNF)-alpha were found in considerable concentrations in platelet concentrates (PC) involved in nonhemolytic transfusion reactions (NHTR). We investigated transfusion reactions in two study periods over the last 3 years. In the 1st period, PC were leukocyte-depleted by bedside filtration. In the 2nd period we performed prestorage leukocyte filtration of PC. Recipients who experienced a transfusion reaction were tested for total and specific IgE, and reactions were analyzed with regard to the main symptoms. In the supernatant of platelets involved, we analyzed concentrations of IL-1 beta, IL-6, IL-8, TNF-alpha, macrophage inflammatory protein(MIP)-1 alpha, and RANTES. The incidence for NHTR did not change with the kind of PC transfused (n = 44, 1.63% and n = 46, 1.56%; p = 0.84), but allergic reactions were reduced in the 2nd observation period (0.92% versus 0.51%; p = 0.02). IL-1 beta, IL-6, IL-8, TNF-alpha, and MIP-1 alpha were not detectable in the majority of all products. PC involved in allergic reactions contained significantly higher concentrations of RANTES. We found evidence that the proinflammatory chemokine RANTES, stored in the platelet alpha-granules, is involved in allergic transfusion reactions. In contrast, leukocyte-derived inflammatory cytokines were of minor relevance in the onset of NHTR.

Blood Group Incompatibility↗

PubMed2026

Precision Medicine in Transfusion-Dependent and Non-Transfusion-Dependent β-Thalassemia: Toward Personalized Diagnosis and Therapy.

β-thalassemia comprises a clinically heterogeneous group of disorders in which anemia severity, transfusion exposure, iron loading, and organ complications vary widely among individuals. This structured narrative review summarizes practical applications of precision medicine in transfusion-dependent thalassemia (TDT) and non-transfusion-dependent thalassemia (NTDT), with explicit attention to which strategies apply to each clinical category. Literature indexed in PubMed and Scopus from 2000 to 2025 was reviewed using terms related to thalassemia, precision medicine, magnetic resonance imaging (MRI), chelation tailoring, next-generation sequencing (NGS), fetal hemoglobin (HbF) modifiers, luspatercept, mitapivat, hepcidin, gene therapy, gene editing, and artificial intelligence (AI). Evidence was synthesized descriptively because interventions, outcomes, and populations were heterogeneous, and no pooled meta-analysis was performed. In TDT, precision care is centered on individualized transfusion planning, extended red-cell antigen matching, MRI-guided cardiac and hepatic iron monitoring, organ-directed chelation intensification, and selection of disease-modifying or curative approaches. In NTDT, precision care emphasizes accurate phenotype classification, MRI liver iron concentration, because serum ferritin may underestimate iron burden, selective chelation, surveillance for NTDT-specific complications, and individualized use of agents that improve anemia. Personalized chelation should include deferiprone, either alone or in combination, when cardiac iron is increased. Comprehensive molecular diagnosis should include HBB together with HBA1 and HBA2 assessment, while secondary and tertiary modifiers help explain phenotypic variability and complication risk. Hepcidin and growth differentiation factor 15 (GDF-15) are discussed as investigational biomarkers; transferrin saturation is not recommended for routine iron-overload assessment in thalassemia. AI currently has its strongest role in screening and diagnosis, whereas risk-stratification models remain exploratory. Equitable implementation requires standardized TDT/NTDT pathways, regional MRI and genomics access, longitudinal registries, and multidisciplinary interpretation.

Humans↗

PubMed1999

Vascular surgical society of great britain and ireland: autologous transfusion reduces blood transfusion requirements in aortic surgery

BACKGROUND: Elective aortic surgery is associated with a blood loss that warrants a routine blood crossmatch of 4-6 units. Autologous transfusion strategies to reduce blood requirements were evaluated in a pilot study involving six hospitals in the North West. METHODS: Eighty patients undergoing elective aortic surgery were randomized to either autologous (a combination of acute normovolaemic haemodilution and intraoperative cell salvage) or homologous transfusion. The transfusion trigger, in the absence of pressing clinical need, was 8 g dl-1 haemoglobin for both groups. RESULTS: Randomization achieved two groups well matched for age, aneurysm or occlusive surgery, aspirin intake, estimated blood volume, preoperative haemoglobin and aneurysm size. In the 'best' hospitals (n = 49) mean(s.d.) blood loss (630(49) ml) was significantly lower (P < 0.01) than that in the 'worst' hospitals (1077(110) ml, n = 31) and fewer patients required transfusion (nine of 42 versus 15 of 30; P < 0.05). No significant differences were found between homologous and autologous groups for all variables measured in the 'best' hospitals. In the 'worst' hospitals blood requirements were significantly higher (P < 0.05) for the homologous group (800(112) ml) compared with the autologous group (489(65) ml), although blood loss was similar (1239(195) versus 915(92) ml respectively). CONCLUSION: Autologous transfusion techniques significantly reduced homologous blood requirements in aortic surgery where blood loss exceeded 800 ml.

Journal Article↗

PubMed2006

Exchange blood transfusion compared with simple transfusion for first overt stroke is associated with a lower risk of subsequent stroke: a retrospective cohort study of 137 children with sickle cell anemia.

A retrospective cohort study of children with sickle cell anemia (SCA) and strokes was used to test the hypothesis that exchange transfusion at the time of stroke presentation more effectively prevents second strokes than does simple transfusion. Children receiving simple transfusion had a 5-fold greater relative risk (95% confidence interval = 1.3 to 18.6) of second stroke than those receiving exchange transfusion.

Adolescent↗

PubMed2006

Transfusion support to Dengue patients in a hospital based blood transfusion service in north India.

We evaluated transfusion requirements in a retrospective study of 245 patients with various categories of Dengue infection. The majority (155/245) of our patients were of the Dengue fever (DF) category. There was no correlation between clinical bleed and platelet count as 81 non-bleeding patients were having counts < 20 x 10(3)/microL. Coagulopathy was observed in 37% of the patients with Dengue hemorrhagic fever or Dengue shock syndrome. A rapid response to platelet and fresh frozen plasma (FFP) transfusion was observed in all cases. However, inappropriate transfusion was a major concern as transfusion of 21.5% platelet concentrates was considered inappropriate.

Adolescent↗

PubMed2004

Combined use of autologous transfusion techniques to avoid allogeneic transfusion in spinal fusion surgery with instrumentation.

This study conducted a retrospective review of the medical records of 321 patients to delineate the efficacy of the combined use of autologous transfusion (AT) techniques. Transfusion profiles between an AT and homologous transfusion (HT) group were compared. A much lower proportion of patients were exposed to allogeneic blood in the AT group (13%) than in the HT group (98%, p<0.001). In the AT group, a significantly smaller proportion of patients were exposed to allogeneic blood in patients transfused with three or four AT techniques (8%) than those with one or two techniques (29%, p<0.05). A febrile reaction (11% of patients) after a reinfusion of post-operatively shed blood was the only side effect associated with an AT. In conclusion, an AT is effective for preventing the exposure of allogeneic blood in spinal fusion surgery. The combined use of multiple AT techniques may further improve its efficacy.

Adult↗

PubMed1995

The therapeutic value of HPA-1a-negative platelet transfusion in post-transfusion purpura complicated by life-threatening haemorrhage.

Post-transfusion purpura (PTP) was diagnosed in a female patient 1 week after transfusion for hysterectomy. Despite treatment with oral steroids and intravenous immunoglobulin, platelet counts remained low, and the patient developed profuse rectal bleeding. Random platelet transfusion is reported to be ineffective in PTP. We report a case in which the transfusion of HPA-la negative platelets provided good increment and clinical haemostasis before intravenous immunoglobulin could have had an effect.

Antigens, Human Platelet↗

PubMed1998

The transfusion medicine consultant and hospital transfusion committee.

AIM: The evolution of blood banking into the broad, multi-disciplinary specialty of transfusion medicine has created the need for a new type of physician-the transfusion medicine consultant. Both laboratorian and clinician, the transfusion medicine consultant offers a wide range of skills and support to both medical and surgical disciplines. This individual can be based in either the hospital or regional blood center. He is a crucial member of the hospital transfusion committee. The latter can play an activist role in patient care.

Acquired Immunodeficiency Syndrome↗

PubMed2005

Placental umbilical cord blood transfusion in transfusion-dependent beta thalassemic patients: a preliminary communication.

The term blood substitute is actually a misnomer because only a part of the total functions of the blood is replaced by any available so-called substitute, i.e., oxygen delivery and volume expansion only. Therefore, a more accurate term should be red cell substitute. Cord blood, because of its rich mix of fetal and adult hemoglobin, high platelet and WBC counts, and a plasma filled with cytokine and growth factors, as well as its hypoantigenic nature and altered metabolic profile, has all the potential of a real and safe alternative to adult blood during emergencies due to any etiology of blood loss and anemia. Our experience of 92 units of cord blood transfusion in patients with beta thalassemia with severe anemia (hemoglobin concentration varying from 3.5 to 5.9 g/dl with mean hemoglobin 4.6 g/dl) proved to be extremely effective in 14 patients as an emergency substitute of adult conc RBC transfusion (male: female ratio 1:1, age varying from 6 months to 38 years). In the present series, the collection of the blood varied from 57 ml-136 ml mean 84 ml +/- 7.2 ml SD, median 87 ml, mean packed cell volume 45 +/- 3.1 SD, mean hemoglobin concentration 16.4 g/dl +/- 1.6 g/dl SD. After collection the blood was immediately preserved in the refrigerator and transfused within 72 hours of collection from the consenting mother undergoing lower uterine cesarean section. We did not encounter a single case of immunological or non immunological reaction. We suggest that the medical fraternity use this precious gift of nature, which is free from infection, hypoantigenic with an altered metabolic profile, filled with growth factor and cytokine filled plasma with potential higher oxygen carrying capacity than for adult blood, as an emergency source of blood for the management of transfusion-dependent beta thalassemics.

Adolescent↗