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Jens Kjeldsen-Kragh
No abstract text is available yet for this article.
September 21, 2018: Transfusion
Femke Noorman, John R Hess
BACKGROUND: Thromboelastography (TEG) is widely advocated as a rapid method for obtaining critical blood coagulation data to guide resuscitation, but the method suffers well-known limits in sensitivity, repeatability, and interpretability. STUDY DESIGN AND METHODS: Mixtures of fresh human blood components were prepared that represent the range of blood element concentrations seen in health and disease and after injury. These mixtures were tested in a TEG device after kaolin, tissue factor and phospholipid, or tissue factor and phospholipid with abciximab activation...
September 20, 2018: Transfusion
Debra Berry, Margaret DiGuardo, Yunchuan Delores Mo, Gay Wehrli
BACKGROUND: The blood bank and transfusion medicine services (BBTMS) engages with electronic health records (EHRs), clinicians, and outside hospitals (OHs) to obtain comprehensive patient history to optimize care. Detection of anti-D in a pregnant patient underscores this work. Differentiating passive anti-D due to RhIG administration versus alloanti-D affects clinical decision making. The objectives of this study were to identify the required steps, barriers, and outcomes of anti-D investigations in obstetric patients...
September 19, 2018: Transfusion
Dora García, Ana Aguilera, Francisco Antolín, José-Luis Arroyo, Miguel Lozano, Pedro Sanroma, Iñigo Romón
BACKGROUND: Hospital at Home (HH) provides specialized care at the patients' homes. Keeping patients in familial surroundings can result in better outcomes reducing readmission to hospital, mortality, and costs of care. Home transfusion (HT) can be a key element in HH management but is scarcely deployed due to concerns about safety and cost. We have reviewed our HT practice to assess its feasibility and safety. STUDY DESIGN AND METHODS: We prospectively reviewed data collected from 1985 to 2015, focusing specially on feasibility and procedural safety, looking for adverse events of transfusion...
September 19, 2018: Transfusion
Debora Bertaggia Calderara, David Crettaz, Alessandro Aliotta, Stefano Barelli, Jean-Daniel Tissot, Michel Prudent, Lorenzo Alberio
BACKGROUND: Collagen- and thrombin-activated (COAT) platelets (PLTs), generated by dual-agonist stimulation with collagen and thrombin (THR), enhance THR generation at the site of vessel wall injury. There is evidence that higher amounts of procoagulant COAT PLTs are associated with stroke, while a decreased ability to generate them is associated with bleeding diathesis. Our aim was to study PLT functions, particularly the ability to generate COAT PLTs, in PLT concentrates (PCs) from buffy coat...
September 19, 2018: Transfusion
Anno Saris, Aukje L Kreuger, Anja Ten Brinke, Jean Louis H Kerkhoffs, Rutger A Middelburg, Jaap Jan Zwaginga, Pieter F van der Meer
BACKGROUND: Storage of platelet concentrates (PCs) results in reduced recovery and survival of transfused platelets (PLTs). Upon storage PLTs develop storage lesion that can be monitored by several laboratory tests. However, correlation of these descriptive tests with corrected count increments (CCIs), a marker frequently used to establish the effectiveness of PLT transfusions, is limited or unknown. This study investigated to what extent a functional test or a combined in vitro rating score improves the correlation of laboratory tests with 1-hour CCI...
September 18, 2018: Transfusion
Christopher R France, Janis L France
BACKGROUND: Although the risk of fainting and prefaint reactions (e.g., dizziness, lightheadedness) is low during blood donation, there is evidence that this risk remains a concern for many donors. This study sought to measure perceived risk for such reactions within the general population and to relate perceived risk to individual reports of fear of having blood drawn. STUDY DESIGN AND METHODS: A sample of 1019 men and women (52.2% male; mean ± SD age, 37.2 ± 12...
September 17, 2018: Transfusion
Khoan Vu, Andrew D Leavitt
BACKGROUND: Posttransfusion purpura (PTP) is a rare condition characterized by severe thrombocytopenia following receipt of blood products. Most reported PTP cases involve alloantibodies directed against human platelet antigen (HPA)-1a. We present a case of PTP-mediated severe thrombocytopenia associated with alloantibodies directed against HPA-4a in the setting of combination checkpoint inhibitor therapy. CASE REPORT: A 62-year-old woman with rectal melanoma that progressed on combination checkpoint inhibitors (ipilimumab and nivolumab) was admitted for abdominoperineal resection...
September 17, 2018: Transfusion
Nicole S Fraser, Christine M Knauth, Elizna M Schoeman, Assia Moussa, Andrew C Perkins, Terry Walsh, Glenda M Millard, Melinda M Dean, Catherine A Hyland, Robert L Flower
INTRODUCTION: KLF1 is an essential transcriptional activator that drives erythropoiesis. KLF1 variants can result in the Inhibitor of Lutheran, or In(Lu), phenotype where red blood cells (RBCs) have reduced BCAM (LU) and CD44 (IN). Other RBC surface molecules also have changed expression; however, there is controversy in the literature regarding which are truly impacted. We aimed to investigate KLF1 variants in the Australian population. STUDY DESIGN AND METHODS: In(Lu) samples were sourced through screening and through the RBC reference laboratory...
September 17, 2018: Transfusion
Elona Turley, Eunike C McGowan, Catherine A Hyland, Elizna M Schoeman, Robert L Flower, Amanda Skoll, Marie-France Delisle, Tanya Nelson, Gwen Clarke, Nicholas Au
BACKGROUND: RhD DEL variants may show complete or partial expression of RhD epitopes. There have been only rare reports of anti-D causing hemolytic disease of the fetus and newborn (HDFN) in this context. We report a case of severe HDFN associated with a recently described DEL variant. CASE REPORT: A multiparous woman presented with an allo-anti-D and showed incongruent phenotyping and genotyping results on initial study. Further investigations identified the RHD mutation, defined as RHD*148+1T and named RHD*01EL...
September 17, 2018: Transfusion
Amanda Thijsen, Carley N Gemelli, Tanya E Davison, Justine O'Donovan, Barbara Bell, Barbara Masser
BACKGROUND: Vasovagal reactions (VVRs) have a negative impact on donor safety and return. Applied muscle tension (AMT) increases blood pressure temporarily and has been suggested as a way to reduce donors' risk of VVRs. This study evaluated whether using AMT at three different time points during the donation procedure reduces the VVR symptoms reported by donors and the VVR reactions recorded by phlebotomists. STUDY DESIGN AND METHODS: A three-arm, multicenter, open-label randomized controlled trial was used to compare VVR symptoms and reaction rates between those practicing AMT during the entire donation (n = 244) to practicing AMT at VVR high-risk time points (n = 250) to a standard blood donation control group (n = 240)...
September 17, 2018: Transfusion
Kornelia Hummel, Michaela Sachse, Johannes J M L Hoffmann, Ludi P J M van Dun
BACKGROUND: Decisions on prophylactic platelet (PLT) transfusions are generally based on the recipient's PLT count, but few clinicians are aware of precision and accuracy of the PLT counting methods used by the clinical laboratory. Each PLT counting technology has its specific inaccuracy, especially in thrombocytopenic samples and therefore may impact decisions on PLT transfusions. STUDY DESIGN AND METHODS: Five routine PLT counting methods available in two hematology analyzers (Sysmex XN-2000 and Abbott CELL-DYN Sapphire) were investigated (impedance and optical on both analyzers and fluorescent on XN-2000), using the CD61 immunologic PLT method as a reference...
September 17, 2018: Transfusion
Xiaojun Yang, Haihua Xie, Liangyuan Chen, Haibin Lin, Fawen Chen
No abstract text is available yet for this article.
September 17, 2018: Transfusion
Nori J L Smeets, Rob Fijnheer, Silvie Sebastian, Quirijn De Mast
BACKGROUND: The Gram-negative bacillus Capnocytophaga canimorsus may cause a severe illness resembling thrombotic thrombocytopenic purpura (TTP). The pathogenesis and optimal therapy of this secondary thrombotic microangiopathy (TMA) remain uncertain. CASE REPORT: A 63-year-old Caucasian man was admitted with suspicion for TTP, but blood cultures grew C. canimorsus. Initial investigations revealed severe thrombocytopenia, a disintegrin and metalloproteinase with a thrombospondin type 1 motif, member 13 (ADAMTS13) activity level of less than 1%, and strongly elevated D-dimer and lactate dehydrogenase levels...
September 17, 2018: Transfusion
Marta Ferro, Hada C Macher, Gema Fornés, Jesús Martín-Sánchez, Pilar Jimenez-Arriscado, Patrocinio Molinero, José A Pérez-Simón, Juan M Guerrero, Amalia Rubio
BACKGROUND: The development of new noninvasive approaches for the diagnosis of human platelet antigen (HPA)-1 fetomaternal incompatibility has become of great interest. These approaches allow determination of whether the fetus is incompatible or not with the mother and a decision on antenatal therapy to avoid fetal or neonatal alloimmune thrombocytopenia (FNAIT). The objective of this work was to perform rapid, noninvasive prenatal test for HPA-1ab fetal antigen detection after the detection of an HPA-1-homozygous mother by using plasma cell-free DNA (cfDNA)...
September 17, 2018: Transfusion
Vincent M DeMario, Robert A Sikorski, David T Efron, Mara A Serbanescu, Rica M Buchanan, Eric J Wang, Mereze Visagie, Eric A Gehrie, Mariuxi C Manukyan, Kathy Noll, K H Ken Lee, Paul M Ness, Steven M Frank
BACKGROUND: Blood transfusion can be lifesaving for patients with hemorrhage; however, transfusion requirements for victims of gun violence are poorly understood. STUDY DESIGN AND METHODS: In an urban, Level 1 trauma center, 23,422 trauma patients were analyzed in a retrospective cohort study. Patients with gunshot wounds (GSWs) (n = 2,672; 11.4% of trauma patients) were compared to those with non-GSW traumatic injuries from 2005 to 2017, to assess blood utilization...
September 12, 2018: Transfusion
Banseok Kim, Yongjung Park, Young Ah Kim, Minjin Kang, Sinyoung Kim, Hyun Ok Kim
BACKGROUND: Red blood cell (RBC) transfusion is a lifesaving process for patients with perioperative bleeding, but transfusion can cause adverse events. Effective utilization and management of blood products as a limited resource is essential when considering cost-efficiency and patient safety. STUDY DESIGN AND METHODS: We analyzed the number of RBC units used during the hospitalization of patients who had undergone surgical procedures from 2002 to 2013 using National Health Insurance Service-National Sample Cohort data, which include a total of 487,238 cases for 206 selected operations...
September 12, 2018: Transfusion
William E Plautz, Jay S Raval, Mitchell R Dyer, Marian A Rollins-Raval, Brian S Zuckerbraun, Matthew D Neal
ADAMTS13 is an enzyme that acts by cleaving prothrombotic von Willebrand factor (VWF) multimers from the vasculature in a highly regulated manner. In pathologic states such as thrombotic thrombocytopenic purpura (TTP) and other thrombotic microangiopathies (TMAs), VWF can bind to the endothelium and form large multimers. As the anchored VWF chains grow, they provide a greater surface area to bind circulating platelets (PLTs), generating unique thrombi that characterize TTP. This results in microvasculature thrombosis, obstruction of blood flow, and ultimately end-organ damage...
September 12, 2018: Transfusion
Xiaofei Li, Aijun Li, Xiaoye Xia, Deqing Wang, Faming Zhu
No abstract text is available yet for this article.
September 11, 2018: Transfusion
Robert A DeSimone, David A Berlin, Scott T Avecilla, Cheryl A Goss
BACKGROUND: Jehovah's Witnesses pose a clinical challenge in the setting of critical anemia. Most do not accept transfusions, but some accept hemoglobin-based oxygen carriers on a compassionate-use basis. PEGylated carboxyhemoglobin bovine (PCHB) is an acellular dual-action carbon monoxide (CO)-releasing and oxygen transfer agent currently being investigated in Phase II clinical trials. CASE REPORT: We present the case of a 42-year-old Jehovah's Witness with an acute upper gastrointestinal bleed and hemorrhagic shock who required emergent PCHB for stabilization during lifesaving interventions...
September 11, 2018: Transfusion
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