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Vox Sanguinis

M P Janssen, M van Hulst, B Custer
BACKGROUND AND OBJECTIVES: The cost-utility of safety interventions is becoming increasingly important as a driver of implementation decisions. The aim of this study was to compare the cost-utility of different blood screening strategies in various settings, and to analyse the extent and cause of differences in health economic results. MATERIALS AND METHODS: For eight Western countries (Australia, Canada, Denmark, Finland, France, The Netherlands, UK and the United States of America), data were collected on donor and recipient populations, blood products, screening tests, and on patient treatment practices and costs...
June 22, 2017: Vox Sanguinis
E N Opheim, T O Apelseth, S J Stanworth, G E Eide, T Hervig
BACKGROUND AND OBJECTIVES: Platelet count is used as a prophylactic platelet transfusion trigger, although evidence suggests that it is a poor predictor of bleeding. Thus, alternative tests are required. The primary objective of this study was to compare thromboelastography (TEG) parameters on days with and without bleeding symptoms. The secondary objectives were to investigate the relationship between TEG parameters and haematological variables, fever, C-reactive protein (CRP) and platelet transfusion...
June 22, 2017: Vox Sanguinis
J Gorlin, S Kinney, M K Fung, A Tinmouth
For emergent warfarin reversal, four-factor prothrombin complex concentrates (4FPCCs) are recommended by many international guidelines. We surveyed international clinical sites including members of the Biomedical Excellence for Safer Transfusion (BEST) Collaborative. Most sites have emergent warfarin reversal protocols (53% use PCC, 25% use PCC+ plasma and 2% use plasma alone); however, variation between adjusted dosing and fixed dosing was observed.
June 21, 2017: Vox Sanguinis
J-S David, E-J Voiglio, E Cesareo, O Vassal, E Decullier, P-Y Gueugniaud, S Peyrefitte, K Tazarourte
BACKGROUND: This study aimed to evaluate the accuracy of prehospital parameters, including vital signs and resuscitation (fluids, vasopressor), to predict trauma-induced coagulopathy (TIC, fibrinogen <1·5 g/l or PTratio > 1·5 or platelet count <100 × 10(9) /l), and a massive transfusion (MT, ≥10 RBC units within the first 24 h). METHODS: From a trauma registry (2011-2015), in which patients are prospectively included, we retrospectively retrieved the heart rate (HR), systolic blood pressure (SBP), volume of prehospital fluids and administration of noradrenaline...
June 14, 2017: Vox Sanguinis
F M A van Hout, I J Bontekoe, L A E de Laleijne, J-L Kerkhoffs, D de Korte, J Eikenboom, J G van der Bom, P F van der Meer
BACKGROUND AND OBJECTIVES: There are concerns about the haemostatic function of platelets stored in platelet additive solution (PAS). Aim of this study was to compare the haemostatic function of PAS-C-platelets to plasma-platelets in reconstituted whole blood. MATERIALS AND METHODS: In our experiment, whole blood was reconstituted with red blood cells, solvent-detergent (SD) plasma and either PAS-C-platelets or plasma-platelets (n = 7) in a physiological ratio. On storage days 2, 5, 8 and 13, the agonist-induced aggregation (multiple electrode aggregometry), clot formation (thromboelastography) and agonist-induced CD62P responsiveness (flow cytometry) were measured...
June 9, 2017: Vox Sanguinis
P Natarajan, M Santhanakrishnan, C A Tormey, J E Hendrickson
Emerging data in animal models and humans suggest that pathogen-associated and damage-associated molecular patterns variably impact RBC alloantibody formation. In this study, we tested the hypothesis that vaccinations may enhance immune responses to transfused RBCs. The Pneumovax23 vaccine decreased the magnitude of anti-KEL alloimmunization in a murine model, whereas the hepB vaccine did not impact the response; RBC transfusion did not alter immune responses to either vaccine. These data highlight the complexities of the intersection of innate and adaptive immunity and suggest that future studies investigating the pathways through which inflammation impacts alloimmunization are warranted...
June 8, 2017: Vox Sanguinis
B Custer, M P Janssen, G Hubben, M Vermeulen, M van Hulst
BACKGROUND AND OBJECTIVES: Most countries test donations for HIV, HCV and HBV using serology with or without nucleic acid testing (NAT). Cost-utility analyses provide information on the relative value of different screening options. The aim of this project was to develop an open access risk assessment and cost-utility analysis web-tool for assessing HIV, HCV and HBV screening options ( An analysis for six countries (Brazil, Ghana, the Netherlands, South Africa, Thailand and USA) was conducted...
June 8, 2017: Vox Sanguinis
R A Sikorski, N A Rizkalla, W W Yang, S M Frank
Almost 150 years after the first autologous blood transfusion was reported, intraoperative blood salvage has become an important method of blood conservation. The primary goal of autologous transfusion is to reduce or avoid allogeneic red blood cell transfusion and the associated risks and costs. Autologous salvaged blood does not result in immunological challenge and its consequences, provides a higher quality red blood cell that has not been subjected to the adverse effects of blood storage, and can be more cost-effective than allogeneic blood when used for carefully selected surgical patients...
June 5, 2017: Vox Sanguinis
T Gremmel, S Panzer
Patients on antiplatelet therapy, be it aspirin only, or aspirin in combination with oral adenosine diphosphate (ADP) receptor inhibitors like clopidogrel, prasugrel and ticagrelor, or the protease-activated receptor-1 inhibitor vorapaxar, may develop bleeding or need transient reversal of platelet blockade for acute interventions. In this review, we summarize reports on patients with antiplatelet therapy receiving platelet concentrates due to bleeding, and in vitro experiments estimating the feasibility to restore platelet function by spiking blood from healthy individuals or patients on antiplatelet treatment with noninhibited platelets...
May 30, 2017: Vox Sanguinis
M H Yazer, L van de Watering, M Lozano, S Sirdesai, K Rushford, E M Wood, A P Yokoyama, J M Kutner, Y Lin, J Callum, C Cserti-Gazdewich, L Lieberman, J Pendergrast, K Pendry, M F Murphy, K Selleng, A Greinacher, N Marwaha, R Sharma, A Jain, Y Orlin, V Yahalom, P Perseghin, A Incontri, N Masera, H Okazaki, T Ikeda, Y Nagura, J J Zwaginga, R Pogłod, A Rosiek, M Letowska, J Yuen, J Cid, S K Harm, P Adhikari
No abstract text is available yet for this article.
May 19, 2017: Vox Sanguinis
M H Yazer, L van de Watering, M Lozano, S Sirdesai, K Rushford, E M Wood, A P Yokoyama, J M Kutner, Y Lin, J Callum, C Cserti-Gazdewich, L Lieberman, J Pendergrast, K Pendry, M F Murphy, K Selleng, A Greinacher, N Marwaha, R Sharma, A Jain, Y Orlin, V Yahalom, P Perseghin, A Incontri, N Masera, H Okazaki, T Ikeda, Y Nagura, J J Zwaginga, R Pogłod, A Rosiek, M Letowska, J Yuen, J Cid, S K Harm, P Adhikari
No abstract text is available yet for this article.
May 19, 2017: Vox Sanguinis
Ø Wendelbo, E Netland Opheim, T H Felli Lunde, Ø Bruserud, T Hervig, H Reikvam
The effects of fever on red cell transfusions are not well documented. In this pilot study, we have compared the outcome of red-blood-cell transfusions in haematologic patients with and without fever. The results indicate that haemoglobin increment per unit is significantly lower in febrile patients receiving red cell transfusions than in patients without fever. These findings are in line with earlier findings in preclinical studies. Larger studies are necessary to confirm our results, and laboratory studies should be conducted to investigate the underlying mechanisms...
May 18, 2017: Vox Sanguinis
J D Treviño-Báez, E Briones-Lara, J Alamillo-Velázquez, M I Martínez-Moreno
BACKGROUND AND OBJECTIVES: To estimate the risk of iron overload in very low birthweight (VLBW) infants who receive more than two red blood cell (RBC) transfusions, in comparison with those who receive two or less during their hospital stay. MATERIALS AND METHODS: Prospective open cohort study in VLBW infants with >2 (exposed) and ≤2 (non-exposed) RBC transfusions. Ferritin, alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were measured at birth and after each RBC transfusion...
May 18, 2017: Vox Sanguinis
S A Esper, I J Welsby, K Subramaniam, W John Wallisch, J H Levy, J H Waters, D J Triulzi, J W A Hayanga, G J Schears
BACKGROUND AND OBJECTIVES: Extracorporeal membrane oxygenation (ECMO) is a method of life support for either isolated cardiac failure or respiratory failure, with or without cardiac failure. When used for hemodynamic support, the ECMO circuit presents a non-endothelialized, artificial surface to blood inciting an inflammatory response which activates haemostatic pathways. Anticoagulation may complicate a pre-existing coagulopathy and/or inadequate surgical hemostasis of varying severity...
May 3, 2017: Vox Sanguinis
M Loza-Correa, M Kalab, Q-L Yi, L J Eltringham-Smith, W P Sheffield, S Ramirez-Arcos
BACKGROUND AND OBJECTIVES: Canadian Blood Services produces apheresis and buffy coat pooled platelet concentrates (PCs) stored in bags produced by two different manufacturers (A and B, respectively), both made of polyvinyl chloride-butyryl trihexyl citrate. This study was aimed at comparing Staphylococcus epidermidis adhesion to the inner surface of both bag types in the presence or absence of plasma factors. MATERIALS AND METHODS: Sets (N = 2-6) of bags type A and B were left non-coated (control) or preconditioned with platelet-rich, platelet-poor or defibrinated plasma (PRP, PPP and DefibPPP, respectively)...
May 3, 2017: Vox Sanguinis
J Nilsson, I Granrot, J Mattsson, B Omazic, M Uhlin, S Thunberg
BACKGROUND AND OBJECTIVES: Allogeneic hematopoietic stem cell transplantation (HSCT) is a routine clinical procedure performed to treat patients with haematological malignancies, primary immune deficiencies or metabolic disorders. Infections during lymphopenia after allogeneic HSCT are associated with high mortality and morbidity. Typical infectious agents are Epstein-Barr virus, cytomegalovirus, herpes simplex virus, varicella-zoster virus and fungi. The study aim was to evaluate whether measurement of the responses of antigen-specific T-cells, recognizing infectious pathogens would correlate to protective functions in the stem cell recipient post-transplant...
May 2, 2017: Vox Sanguinis
K Kramer, M F Verweij, H L Zaaijer
BACKGROUND AND OBJECTIVES: Concern with the costs of blood safety is growing, which raises the question whether safety measures that reduce risk only marginally should be discontinued. Withdrawing such safety measures would allow reallocating resources to more efficient health care interventions, but it might raise moral objections. MATERIALS AND METHODS: This study evaluates two ethical arguments why discontinuing blood safety measures would be more objectionable than not implementing them...
May 2, 2017: Vox Sanguinis
S S Lee, E K H Cheung, J N S Leung, C K Lee
BACKGROUND AND OBJECTIVES: Donor screening alone cannot eliminate the risk of transfusion-transmitted HIV infection. Donor deferral according to established criteria is a supplemental strategy, which has focused largely on men who have sex with men (MSM). A study was conducted to determine the compliance of non-MSM donors with such criteria and examine its implications on blood safety. MATERIALS AND METHODS: Chinese donors who have just donated blood at blood donor centres in Hong Kong were recruited...
April 11, 2017: Vox Sanguinis
S Ramirez-Arcos, C Jenkins, W P Sheffield
Although key coagulation factor activities are maintained in thawed cryoprecipitate stored for up to 24 h at ambient temperature, several jurisdictions limit such storage to 4-6 h. Here, we separately spiked thawed cryoprecipitate units with four bacterial strains: Staphylococcus epidermidis, Serratia liquefaciens, Pseudomonas putida and Pseudomonas aeruginosa. No strains grew in the first 4 h of storage, but by 24 h, three of four exhibited up to 1000-fold proliferation. Pathogen inactivation technologies could be explored to mitigate the safety risk posed by extending storage of thawed cryoprecipitate at room temperature...
April 6, 2017: Vox Sanguinis
S M Qadri, D Chen, P Schubert, D V Devine, W P Sheffield
γ-Irradiation of red blood cell (RBC) concentrates prevents transfusion-associated graft-versus-host disease but may diminish RBC quality. Herein, we show that early γ-irradiation (25 Gy) of RBC units and their subsequent storage in SAG-M additive solution altered membrane microvesiculation, supernatant haemoglobin and cytosolic ATP. γ-Irradiation did not influence phosphatidylserine externalization, a marker of erythrocyte apoptotic cell death (eryptosis), in RBC stored for 42 days. However, shorter periods (4-21 days) of storage accentuated eryptosis in γ-irradiated RBC versus untreated RBCs following energy depletion, suggesting that γ-irradiated RBC is primed for stress-induced eryptosis during storage...
April 5, 2017: Vox Sanguinis
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