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PubMedDate not supplied

Characteristics and natural history of alloimmunization following HLA-matched leukocyte transfusion in Hunter's syndrome.

The characteristics and natural history of alloimmunization to HLA were studied in five patients with Hunter's syndrome receiving long term transfusions of leukocytes collected from human leukocyte antigen (HLA) matched donors. Patients were not given any other blood component transfusions. All patients became alloimmunized at an average interval of eight months following an average of 15 transfusions. All patients developed HLA alloantibodies to transfused cross-reactive HLA antigens. Antibodies to transfused incompatible HLA antigens also developed in all patients. Multispecific HLA antibodies in which specificity determination could not be made were also seen in four patients. In a small number of patients in this study, despite matching for the private HLA specificities, HLA alloimmunization was not prevented. In fact, broad alloimmunization was seen uniformly in our patients.

Adult↗
PubMed1993

[Quality criteria in preoperative autologous blood donation from the viewpoint of the transfusion physician].

To maintain the advantages of autologous blood transfusion, the overall risk has to be lower than that in homologous transfusion practice. Therefore, autologous blood should be collected and prepared according to the rules applied to homologous blood products. Guidelines for quality control in autologous hemotherapy are discussed from the point of view of a transfusion practitioner.

Aged↗
PubMed1998

Transfusion of white-cell containing allogeneic blood components and postoperative wound infection: effect of confounding factors.

Randomized controlled trials (RCTs) of the relationship between allogeneic transfusion and post-operative bacterial infection at any site have generated discordant results, but have suggested an association of transfusion with wound infection. To examine the specific association of perioperative transfusion with wound infection, we reviewed the records of 964 consecutive patients undergoing elective colorectal cancer resection at our hospital. Diagnoses of wound infection were made retrospectively by the Centers for Disease Control criteria, and transfusion was defined as number of units of white-cell containing allogeneic blood components received. The probability of wound infection in association with the transfusion was calculated following adjustment for the effects of 12 confounders that had not been previously considered in combination. These factors related to severity of illness, difficulty of operation and risk of wound infection. Wound infection developed in 39 (11.4%) transfused patients, as compared to 24 (3.9%) untransfused subjects (P < 0.0001). In the multivariate analysis, there was a trend suggesting an adverse transfusion effect, which amounted to a 7% increase in the risk of wound infection per unit of red cells or platelets transfused (relative risk [RR] = 1.07; 95% confidence interval for RR = 0.98-1.16; P = 0.1241). This marginally significant effect was related to post-operative (P = 0.1274), rather than perioperative (P = 0.3061), transfusion. We conclude that allogeneic transfusion may perhaps be associated with a small increase in the risk of post-operative wound infection, but this small effect can be established only by RCTs enrolling several thousand patients. The modest magnitude of the effect may have been responsible for the disagreements among the published RCTs.

Aged↗
PubMed1996

Monitoring for undertransfusion.

BACKGROUND: Most published reviews and audits of blood and blood component transfusion have focused on the issue of overtransfusion and on the inappropriate use of red cell components. There is growing concern that efforts to curb unnecessary transfusions may result in a trend toward undertransfusion of patients. There is little published information that addresses this issue or the magnitude of this practice. STUDY DESIGN AND METHODS: Undertransfusion was evaluated by examining the transfusion records from a 3-month period for 55 patients who met the study criteria of having either a hemoglobin level < 7 g per dL or a platelet count of < 10 x 10(9) per L. If the identified patient did not receive a transfusion within 24 hours of the reported hemoglobin level or platelet count, the medical record was reviewed by a resident physician. RESULTS: A total of 213 individual hemoglobin levels and platelet counts, representing the 55 patients, met our transfusion criteria. All except 8 of the identified patients received red cells and/or platelet transfusions. Reasons for not transfusing red cells included the patient's response to nutritional support and iron supplementation, refusal of blood, and noncompliance. Reasons for not transfusing platelets included falsely low platelet count because of platelet clumping in vitro, contraindication based on clinical diagnosis (e.g., immune thrombocytopenic purpura), and the patient's death before transfusion. CONCLUSION: Red cell and platelet transfusions were appropriately ordered for all patients who met the transfusion criteria. Undertransfusion is not a problem at this institution according to the criteria established. It is recommended that other institutions expand their blood utilization audits to include investigation for evidence of undertransfusion. Further research regarding the issue of undertransfusion is warranted and could be expanded to include other components.

Alcoholism↗
PubMed2000

[Quality indicators and dashboards: the experience of a collection department].

Production of labile blood products and pharmaceutical products derived from blood must meet quality and safety requirements set and controlled by regulatory provisions (Guidelines for Transfusion Practices, Characteristics of Labile Blood Products). With its activities exerted at the start of the transfusional chain, collection departments have to meet internal requirements (self-sufficiency, procurement regulation, compliance of blood products as raw materials) as well as external ones (donor and recipient safety). To fit in a dynamics of on-going quality improvement, the quality approach of a department must implement a system to monitor and control its activities. The subject of this work is to report an experience of the implementation of quality indicators and specific dash boards for whole blood collection and related activities in a blood transfusion center.

Blood Banks↗
PubMed1998

[Safety of blood transfusions; need for 'hemo-vigilance'].

Blood transfusion in the Netherlands depends wholly on voluntary donations of blood. Very soon the measures to ensure the safety, the quality and clinical appropriateness of the application of blood products will be re-evaluated. Currently it is not so much viral but bacterial contamination that causes worry, in addition to immunological transfusion reactions. Safety not only depends on freedom from viral or bacterial contamination, but also on the appropriate clinical use of blood products. Physicians will need to document the individual indications for the use of blood products and the patient's reactions at follow-up. European legal harmonisation emphasises look-back procedures and haemovigilance as a means of ensuring sound clinical practice regarding blood transfusion.

Blood↗
PubMed2001

Detection of enterovirus viraemia in blood donors.

BACKGROUND AND OBJECTIVES: The infrastructure established for screening blood donations for hepatitis C virus has enabled large-scale population testing for other viruses which are potentially transmissible by transfusion of blood components and plasma-derived blood products. We have measured the frequency of viraemia of enteroviruses and parechoviruses in 83 600 Scottish blood donors to allow an initial assessment of their risk to blood safety. MATERIALS AND METHODS: Plasma samples collected from blood donors over 7 calendar months were tested anonymously in mini-pools of 95 donations, by polymerase chain reaction (PCR) for human enterovirus and parechovirus sequences. RESULTS: A total of 19 mini-pools, from the 880 that were tested, were PCR-positive for enterovirus RNA, predicting a donor prevalence of 0.023%. Enterovirus sequences were not detected in factor VIII or IX clotting factor concentrates. None of the 230 mini-pools or concentrates contained detectable parechovirus RNA. CONCLUSIONS: The prevalence of enterovirus viraemia detected in this study predicts that at least 1000 enterovirus-contaminated blood components are transfused per year in the UK. The frequency of transmission and clinical outcome after exposure to enterovirus-contaminated blood components in recipients is unknown.

Base Sequence↗
PubMed2005

A case of axillary kaposiform hemangioendothelioma resembles a soft tissue sarcoma.

Kaposiform hemangioendothelioma is a rare, aggressive vascular proliferation in children that is clinically and histologically distinct from hemangioma of infancy. It is often complicated with Kasabach-Merritt syndrome. The authors describe a 2-month-old girl who developed a rapidly enlarging deep subcutaneous solid tumor in the left axilla. The tumor size was about 10x7 cm and there was no skin change over the mass. The results of laboratory tests were significant for a moderate anemia (7.0 g/dL) and a profound thrombocytopenia (3x10/L). The preoperative radiologic findings were suspicious for a soft tissue sarcoma with scapular erosion. Anemia and thrombocytopenia were corrected by preoperative corticosteroid therapy and blood component transfusion. The tumor was excised totally and the pathologic findings were consistent with Kaposiform hemangioendothelioma. Serial blood examinations showed that the hemoglobin and platelet count returned to the normal range after surgery.

Axilla↗
PubMed2002

[Transfusions of blood and blood products and virus infections].

Transfusions of blood and blood products are commonly used in medicine, but being biological materials they carry a risk of transmitting infections--viral, bacterial, parasitic, as well as prions. Laboratory tests used for screening of donated blood for viral infections at present cannot detect all infectious units. Criteria for selection of blood donors therefore must be very strict, while methods of inactivation of viruses and laboratory assays for detection of their presence must be improved. Indications for blood transfusion should be restricted.

Blood Component Transfusion↗