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H Doughty, T O Apelseth, J Sivertsen, K Annaniasen, T Hervig
OBJECTIVES: To describe the change in massive transfusion (MT) practice in a single Norwegian centre throughout the period 2002-2015. BACKGROUND: MT support for traumatic haemorrhage has changed since the mid-2000s. However, life-threatening haemorrhage may occur in other clinical specialties. In 2007, Haukeland University Hospital (HUS) introduced a universal MT programme including education, Acute Transfusion Packages (ATPs) and thromboelastography. METHODS/MATERIALS: A retrospective review was performed of all MT episodes defined as ≥10 red cell concentrates (RCC) in 24 h...
April 23, 2018: Transfusion Medicine
Petra Jilma-Stohlawetz, Tim Wreford-Bush, Francesca Mills, Fiona Davidson, Friedrich W Kursten, Bernd Jilma, Janet Birchall
BACKGROUND: The transmission of pathogens, antibodies, and proteins is a possible consequence of blood product transfusion. A female patient had an unexpected positive serum β-human chorionic gonadotropin result, indicative of pregnancy, after she had received a transfusion with 1 unit of platelet concentrate, 4 units of red blood cells, and 4 units of pooled solvent/detergent-treated plasma (Octaplas). STUDY DESIGN AND METHODS: To investigate the possibility of passive transfusion of β-human chorionic gonadotropin from the plasma transfusion, one additional unit from the same batch was thawed and analyzed...
December 2017: Transfusion
Lynda Verghese, Efterpi Tingi, Jecko Thachil, Charles Hay, Louise Byrd
This is an article reviewing the management of pregnant women with factor XI (FXI) deficiency. Retrospective review of the electronic records of 67 pregnancies in 25 women with FXI deficiency over a ten-year period was undertaken. All women received care at St Mary's Tertiary Referral Obstetric/Haematology Clinic for some or all of their pregnancies. Outcome measures included antenatal complications, mode of delivery, anaesthesia provided and postpartum haemorrhage (PPH) and management required. A positive bleeding history was identified in 50% of women prior to pregnancy...
August 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Denis Kühnel, Sebastian Müller, Alexander Pichotta, Kai Uwe Radomski, Andreas Volk, Torben Schmidt
BACKGROUND: In 2016 the World Health Organization declared the mosquito-borne Zika virus (ZIKV) a "public health emergency of international concern." ZIKV is a blood-borne pathogen, which therefore causes concerns regarding the safety of human plasma-derived products due to potential contamination of the blood supply. This study investigated the effectiveness of viral inactivation steps used during the routine manufacturing of various plasma-derived products to reduce ZIKV infectivity...
March 2017: Transfusion
Chiara Vendramin, Siobhan McGuckin, Ferras Alwan, John-Paul Westwood, Mari Thomas, Marie Scully
BACKGROUND: Patients presenting with acute episodes of thrombotic microangiopathies (TMAs) require urgent access to plasma exchange (PEX). OctaplasLG, a solvent/detergent fresh-frozen plasma product that has undergone viral inactivation and prion reduction step, has been used in our institution since 2013, replacing Octaplas. STUDY DESIGN AND METHODS: We prospectively reviewed 981 PEX procedures where OctaplasLG was the replacement fluid in 90 patients admitted acutely with a TMA presentation within our institution from January 1, 2013, to December 31, 2015...
January 2017: Transfusion
Davinder Sidhu, Edward L Snyder, Christopher A Tormey
BACKGROUND: Thrombotic thrombocytopenic purpura (TTP) is a rare but serious disease caused by autoantibody-mediated deficiency in von Willebrand factor (VWF) cleaving protease, ADAMTS-13. The primary acute treatment is therapeutic plasma exchange (TPE). However, some patients can develop allergic/anaphylactic reactions to the replacement (i.e., donor) plasma over time. Two potential treatment strategies for patients with TTP who demonstrate severe allergic reactions to plasma used for exchange were examined...
June 2017: Journal of Clinical Apheresis
Melissa M Cushing, Lars Asmis, Carmencita Calabia, Jacob H Rand, Thorsten Haas
OBJECTIVES: Factor V (FV) plays an important role in coagulation. As no purified concentrate is available to restore critical FV levels, the main blood product used to replace FV is plasma. The aim of the present in vitro study was to compare the efficacy of the different available plasma products on the reversal of moderate and severe FV deficiency as assessed by ROTEM® and FV levels. METHODS: Five different plasma products (6 batches of each) were compared to determine their effectiveness in replacing FV in plasma moderately or severely deficient in FV...
August 2016: Transfusion and Apheresis Science
V Koljonen, J Tuimala, C Haglund, E Tukiainen, J Vuola, E Juvonen, J Lauronen, T Krusius
INTRODUCTION: Burn anemia represents a common complication following a burn injury. Burn anemia etiology carries distinct features occurring at each stage of the post-injury and treatment periods resulting from different causes. We aimed to analyze the use of blood components in Finnish burn victims and to identify patient- and injury-related factors influencing their use. METHODS: To study the use of blood products in burn patients, we used data collected from the Optimal Use of Blood registry, developed through co-operation between 10 major hospital districts and the Finnish Red Cross Blood Service...
September 2016: Scandinavian Journal of Surgery: SJS
Torunn O Apelseth, Venny L Kvalheim, Einar K Kristoffersen
BACKGROUND: Allergic transfusion reactions (ATRs) present with a broad range of symptoms probably caused by mediators released from mast cells and basophil granulocytes upon activation. Passive immunoglobulin (Ig)E sensitization may yield clinical symptoms and positive allergy tests. Unexpected findings of IgE antibodies in pooled solvent/detergent (S/D)-treated plasma (Octaplas, Octapharma) during routine analysis initiated an investigation of serum proteins. STUDY DESIGN AND METHODS: Consecutive batches of S/D-plasma transfused during September 2014 through March 2015 were investigated for IgE, IgG, IgA IgM, C3, C4, haptoglobin, anti-nuclear antibodies (ANAs), and red blood cell (RBC) antibodies...
May 2016: Transfusion
S Suuronen, A Kivivuori, J Tuimala, H Paajanen
BACKGROUND: Major bleeding is rare but among the most serious complications of laparoscopic surgery. Still very little is known on bleeding complications and related blood component use in laparoscopic cholecystectomy (LC). The aim of this study is to compare bleeding complications, transfusion rates and related costs between LC and open cholecystectomy (OC). METHODS: Data concerning LCs and OCs and related blood component use between 2002 and 2007 were collected from existing computerized medical records (Finnish Red Cross Register) of ten Finnish hospital districts...
August 13, 2015: BMC Surgery
Eeva-Maija Kinnunen, Tatu Juvonen, Fausto Biancari
OBJECTIVE: To examine the effect of blood products on the occurrence of stroke after coronary artery surgery. DESIGN: Institutional retrospective analysis. SETTING: University hospital. PARTICIPANTS: One thousand three hundred fourteen patients undergoing coronary artery surgery. INTERVENTIONS: Off-pump coronary artery bypass grafting (OPCAB). Epiaortic ultrasound was performed in all patients...
October 2015: Journal of Cardiothoracic and Vascular Anesthesia
Andrea Neisser-Svae, Jerard Seghatchian
In recent Coimbra' Conference, on the pre-launch of pathogen reduced-FFP for the local clinical use, the question was raised, by the moderator, on the efficacy of the current methodology used for prion removal processes and its influence on the overall quality and safety of the final product. This brief paper put together by speaker of this session and the moderator, as a consensus of opinions, which was largely discussed during Q&A session, to make it available to a large group of readers of transfusion apheresis science, who might be interested to this topic...
April 2015: Transfusion and Apheresis Science
Eline L Huisman, Shamika U de Silva, Maria A de Peuter
This study assessed the cost-effectiveness of Octaplas™ versus fresh frozen plasma (FFP) in patients receiving plasma transfusions in the United States (US). Acute and long-term complications of plasma transfusions were modelled in a decision tree followed by a Markov model, using a healthcare payer perspective. Over a lifetime time horizon, patients receiving Octaplas™ accumulate slightly more life years (0.00613 [95% uncertainty interval (95%UI): 0.00166-0.01561]) and quality-adjusted life years (QALY) (0...
August 2014: Transfusion and Apheresis Science
Håkon Haugaa, Eli Taraldsrud, Hans Christian Nyrerød, Tor Inge Tønnessen, Aksel Foss, Bjarte G Solheim
BACKGROUND: Liver transplantation regularly requires transfusion of red blood cells (RBCs), plasma, and platelets. Compared to fresh frozen plasma (FFP) from single blood donors, solvent/detergent-treated plasma (SD-plasma) pooled from several hundred blood donors has advantages with respect to pathogen reduction, standardized content of plasma proteins, and significantly reduced risk of transfusion related lung injury and allergic/immunologic adverse reactions. However, SD-plasma has been suspected to increase the incidence of hyperfibrinolysis and thromboembolic events...
September 2014: Clinical Medicine & Research
Ido J Bontekoe, Pieter F van der Meer, Dirk de Korte
BACKGROUND: Thromboelastography (TEG) is widely used in hospitals but less commonly in blood banks for evaluation of platelet (PLT) concentrates (PCs). A TEG-PC assay for testing fresh or stored PLTs must reflect the quality of the PLTs. The added value could be measurement of donor-dependent PLT quality. STUDY DESIGN AND METHODS: Whole blood (WB) normal values were generated from 100 donors, using standard tests. Nineteen single-donor PCs were evaluated with a TEG-PC assay, using Octaplas as microparticle-free diluent and kaolin or collagen as activator, stored up to 12 days, and also sampled for additional in vitro tests...
June 2014: Transfusion
R Mikkola, J Heikkinen, J Lahtinen, R Paone, T Juvonen, F Biancari
BACKGROUND: The aim of this study was to investigate the impact of transfusion of blood products on intermediate outcome after coronary artery bypass surgery. PATIENTS: Complete data on perioperative blood transfusion in patients undergoing coronary artery bypass surgery were available from 2001 patients who were operated at our institution. RESULTS: Transfusion of any blood product (relative risk = 1.678, 95% confidence interval = 1.087-2...
2013: Scandinavian Journal of Surgery: SJS
Christoph J Schlimp, Cristina Solomon, Gerald Hochleitner, Johannes Zipperle, Heinz Redl, Herbert Schöchl
BACKGROUND: Viscoelastic tests such as functional fibrinogen polymerization assays (FFPAs) in thrombelastography (TEG(®)) or thromboelastometry (ROTEM(®)) measure the elasticity of extrinsically activated clotting under conditions of platelet inhibition. There are no reports on whether components of the FFPAs have any effects on fibrin polymerization, aside from the effects of platelet inhibition. METHODS: Using various platelet-free plasma (PFP) preparations, we compared the extrinsically activated EXTEM thromboelastometric assay with 3 FFPAs: FIBTEM, FIBTEM PLUS, and the Functional Fibrinogen Test(®) (FFTEG)...
July 2013: Anesthesia and Analgesia
Andrea Heger, Hubert Brandstätter, Bettina Prager, Janja Brainovic, Rhoda Cortes, Jürgen Römisch
BACKGROUND: Pooling of plasma of different blood groups before large scale manufacturing of Uniplas(®) results in the formation of low levels of soluble immune complexes (CIC). The aim of this study was to investigate the level and removal of CIC during Uniplas(®) manufacturing. In addition, an in vitro hemolysis assay should be developed and investigate if Uniplas(®) does induce complement-mediated hemolysis of human red blood cells (RBC). MATERIALS AND METHODS: In-process samples from Uniplas(®) (universal plasma) and Octaplas(LG)(®) (blood group specific plasma) routine manufacturing batches were tested on CIC using commercially available ELISA test kits...
February 2015: Transfusion and Apheresis Science
Marvin M Goldenberg
Bedaquiline for multiresistant pulmonary tuberculosis; Flublok influenza vaccine; and Octaplas for coagulation factor deficiency.
March 2013: P & T: a Peer-reviewed Journal for Formulary Management
Petra Jilma-Stohlawetz, Friedrich W Kursten, Michaela Horvath, Gerda Leitner, Jana List, Jana Marcek, Peter Quehenberger, Michael Schwameis, Johann Bartko, Ulla Derhaschnig, Bernd Jilma
BACKGROUND: Octaplas LG is a prion-depleted version of a previous generation product called Octaplas S/D. We compared the recovery, safety, and tolerability of these two pharmaceutical-grade plasmas. STUDY DESIGN AND METHODS: In this comparative, block-randomized, open-label, active-controlled, crossover Phase I trial, 60 healthy adult volunteers received single transfusions of 1200 mL of parent product (in Period 1) and of the LG plasma product (in Period 2) or vice versa...
September 2013: Transfusion
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