The Immunohematologic and Clinical Evaluation of Increased Risk for Red Blood Cell Alloimmunization among Multi-Transfused Pediatric Patients in a Tertiary Medical Institution in Central Luzon, Philippines

2021 ◽  
Vol 156 (Supplement_1) ◽  
pp. S158-S159
Author(s):  
C C Ebreo ◽  
R M Castillo ◽  
M D Dizon ◽  
A D Domasian ◽  
G P Floresta ◽  
...  
Keyword(s):  
Blood Transfusion ◽  
Blood Cell ◽  
Red Blood Cell ◽  
Pediatric Patients ◽  
Sufficient Evidence ◽  
Age Group ◽  
Hematologic Disorders ◽  
Packed Red Blood Cells ◽  
Increased Risk ◽  
Transfusion Reactions

Abstract Introduction/Objective Multiple blood transfusion is a therapeutic treatment for patients with hematologic disorders. However, patients who undergo repeated blood transfusions are at higher risk of developing red blood cell alloimmunization. This may further delay the availability of compatible blood and pose a higher risk for hemolytic transfusion reactions. Methods/Case Report A total of 55 patients, with an age range of 2-19 years, were included in the study. All patients had hematologic disorders and underwent chronic blood transfusion. In this retrospective study, Student’s t-test and Fisher’s exact tests were used to compare the means and percentages, respectively, under 5% level of significance. R ver 4.0.3 was utilized in the analyses. Results (if a Case Study enter NA) Out of the 55 pediatric patients, 10 (18.2%; CI95%: 9.1 to 30.9%) were found to be alloimmunized. Two patients had multiple antibodies whereas the others had one specificity, having a total of 12 detected alloantibodies. The most prevalent alloantibody was anti-E (60%), followed by anti-Jka (20%), anti-Mia (20%), anti-S (10%), and anti-K (10%). All obtained alloantibodies showed no correlation (p>0.05) with the age group of the patients. Subsequently, it was not evident that average blood transfusion (p=0.949) and packed red blood cells transfused per year (p=0.782) significantly differ between alloimmunized and non-alloimmunized patients. Similarly, there was no sufficient evidence that the age group (p=0.723), sex (p=1.000), blood group (p=1.000) and hematologic disorder (p=0.949) were associated with their alloimmunization status. Conclusion The alloimmunization incidence rate of 18.2% in this study was higher compared to related literatures, and most of the detected alloantibodies were of IgG type which are commonly clinically significant. The study showed no significant correlation between the specific risk factors and the development of alloimmunization. For patient care, it is imperative to include precautions such as extended RBC phenotyping and provision of antigen matched RBCs to prevent unnecessary transfusion reactions caused by alloimmunization.

scholarly journals Red blood cell transfusion induces abnormal HIF-1α response to cytokine storm after adult cardiac surgery

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Emma Viikinkoski ◽  
Juho Jalkanen ◽  
Jarmo Gunn ◽  
Tuija Vasankari ◽  
Joonas Lehto ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Blood Transfusion ◽  
Blood Cell ◽  
Red Blood Cell ◽  
Adverse Outcomes ◽  
Red Blood Cell Transfusion ◽  
Clinical Trial Registration ◽  
Packed Red Blood Cells ◽  
The Impact ◽  
Adult Cardiac Surgery

AbstractPatients undergoing cardiac surgery develop a marked postoperative systemic inflammatory response. Blood transfusion may contribute to disruption of homeostasis in these patients. We sought to evaluate the impact of blood transfusion on serum interleukin-6 (IL-6), hypoxia induced factor-1 alpha (HIF-1α) levels as well as adverse outcomes in patients undergoing adult cardiac surgery. We prospectively enrolled 282 patients undergoing adult cardiac surgery. Serum IL-6 and HIF-1α levels were measured preoperatively and on the first postoperative day. Packed red blood cells were transfused in 26.3% of patients (mean 2.93 ± 3.05 units) by the time of postoperative sampling. Postoperative IL-6 levels increased over 30-fold and were similar in both groups (p = 0.115), whilst HIF-1α levels (0.377 pg/mL vs. 0.784 pg/mL, p = 0.002) decreased significantly in patients who received red blood cell transfusion. Moreover, greater decrease in HIF-1α levels predicted worse in-hospital and 3mo adverse outcome. Red blood cell transfusion was associated with higher risk of major adverse outcomes (stroke, pneumonia, all-cause mortality) during the index hospitalization. Red blood cell transfusion induces blunting of postoperative HIF-1 α response and is associated with higher risk of adverse thrombotic and pulmonary adverse events after cardiac surgery. Clinical Trial Registration ClinicalTrials.gov Identifier: NCT03444259.

scholarly journals Results of clinical application of pathogen-reduced red blood cell suspension in children with oncological and hematological diseases

2019 ◽  
Vol 17 (4) ◽  
pp. 43-50
Author(s):  
I. B. Kumukova ◽  
P. I. Trakhtman ◽  
N. N. Starostin ◽  
L. J. Kadaeva ◽  
O. A. Chaykina
Keyword(s):  
Blood Cell ◽  
Clinical Efficacy ◽  
Red Blood Cell ◽  
Pediatric Patients ◽  
Hemoglobin Concentration ◽  
Hematological Diseases ◽  
Wide Range ◽  
Efficacy Parameters ◽  
Gamma Irradiated ◽  
Transfusion Reactions

The problem of blood-borne infections remains relevant in transfusion medicine. Pathogen reduction technologies (PRT) provide a preventive approach to a wide range of transfusion-transmitted infectious diseases. To date, PRT widely used for a number of blood components, however, the use of these technologies for the treatment of erythrocyte-containing components has not been studied. Objective: to conduct a comparative analysis of the clinical efficacy of transfusions of pathogen-reduced and gamma-irradiated erythrocyte suspension in pediatric patients with various oncological and hematological diseases. Seventy transfusions of red blood cell suspensions (RBC-S) (35 transfusions of pathogen-reduced RBC-S and 35 transfusions of gammairradiated RBC-S) in pediatric patients with oncological and hematological diseases were analized. Clinical efficacy parameters such as the hemoglobin and the hematocrit increment after transfusion, the interval between transfusions, the frequency and severity of transfusion reactions were estimated. We also evaluated the correlation between the hemoglobin and the hematocrit increment with age, patient’s body weight, the hemoglobin concentration and patient's hematocrit before transfusion, the volume of transfusion, the hemoglobin dose and the adjusted hemoglobin dose received for transfusion. We found that the clinical efficacy and safety of RBC-Ss of the compared groups did not differ: the hematocrit and the hemoglobin increment, the frequency and severity of transfusion reactions, and the interval between transfusions were comparable between groups. There was no evidence of immune elimination and allo-sensibilization caused by pathogen-reduced RBC-S. In the group of patients receiving pathogen-reduced RBC-S, a correlation was found between the increase in the hemoglobin and hematocrit values with some of the EV indices. According to our data, the spectrum of efficiency and safety indicators of pathogen-reduced RBC-S is no worse than that of gamma-irradiated RBC-S, provided that RBC-S is used for 14 days of storage.

scholarly journals The effect of thyroid hormone deficiency on erythropoiesis in dogs

2019 ◽  
Vol 88 (3) ◽  
pp. 257-264 ◽  
Author(s):  
Olga Aniołek
Keyword(s):  
Thyroid Hormone ◽  
Blood Cell ◽  
Red Blood Cell ◽  
Clinical Symptoms ◽  
Cell System ◽  
Hormone Deficiency ◽  
Control Group ◽  
Average Mass ◽  
Packed Red Blood Cells ◽  
Experimental Group

This research aimed to evaluate the effect of thyroid hormone deficiency on the erythrocytic system in dogs. Dogs with clinical symptoms of hypothyreosis such as obesity, hyperpigmentation, and lethargy were selected. The dogs demonstrating breed predisposition to hypothyreosis were incorporated in the analysis: Dachshunds, Retrievers, and mixed-breed dogs. A detailed history was taken and clinical, hormonal, biochemical and haematological blood tests were performed. Peripheral blood samples were taken from 53 dogs. Finally, the dogs with the initial T4 (thyroxine) concentration < 1.3 µg/dl and animals demonstrating clinical improvement after a 2-month therapy with levothyroxine at a dose of 10 µg/kg administeredper ostwo times a day were qualified. The animals between 10 months to 13 years of age were divided into two groups: clinically healthy (control group, n = 35) and dogs presenting clinical symptoms of hypothyreosis (experimental group, n = 18). In this research, the broadly described normocytic normochromic non-regenerative anaemia was not diagnosed in dogs with hypothyreosis. However, a positive correlation between T4 and red blood cell indices such as the average mass of haemoglobin per red blood cell, concentration of haemoglobin in a given volume of packed red blood cells as well as a negative correlation with haematocrit value was discovered in the experimental group after the 2-month therapy with levothyroxine. These results point to the influence of thyroid hormones on erythropoiesis. This observation is partially consistent with other studies, which noted the casual link between the changes in red blood cell system and the function of thyroid in dogs and humans.

scholarly journals BLOOD TRANSFUSION IN CARDIAC SURGERY- NEED TO FOLLOW BASICS!

2020 ◽  
Vol 7 (3) ◽  
Keyword(s):  
Cardiac Surgery ◽  
Blood Transfusion ◽  
Blood Cell ◽  
Red Blood Cell ◽  
Red Blood Cell Transfusion ◽  
Transfusion Strategy ◽  
Transfusion Threshold ◽  
Restrictive Transfusion ◽  
Conflicting Evidence ◽  
American Society

More and more data is coming in recent times about hazards of blood transfusion. In a landmark TRICC1 trial Euvolemic patients in the intensive care unit (ICU) with Hb<9 g/dl were randomized to a restrictive transfusion strategy for transfusion of PRBCs (transfused if Hb<7 g/dl to maintain Hb between 7 and 9 g/dl) or a liberal strategy (transfused if Hb<10 g/dl to maintain Hb 10-12 g/dl). Mortality was similar in both groups, indicating that liberal transfusions were not beneficial. An Updated Report by the American Society of AnaesthesiologistsTask Force on Perioperative Blood Management tells us restrictive red blood cell transfusion strategy may be safely used to reduce transfusion administration. It further states that The determination of whether hemoglobin concentrations between 6 and 10 g/dl justify or require red blood cell transfusion should be based on potential or actual on going bleeding (rate and magnitude), intravascular volume status, signs of organ ischemia, and adequacy of cardiopulmonary reserve. Should we extrapolate these guidelines in Cardiac surgery? TRACS2 trial concluded that among patients undergoing cardiac surgery, the use of a restrictive perioperative transfusion strategy compared with a more liberal strategy resulted in noninferior rates of the combined outcome of 30-day all-cause mortality and severe morbidity.They advocated use of restrictive strategy, but 5 years later, the authors 3concluded that A restrictive transfusion threshold after cardiac surgery was not superior to a liberal threshold with respect to morbidity or health care costs. With this conflicting evidence, by which way anaesthesiologist to go?

scholarly journals A SARS-CoV-2-pandémia hatása a vérkészítmény-felhasználásra a Pécsi Tudományegyetemen

2021 ◽  
Vol 162 (43) ◽  
pp. 1717-1723
Author(s):  
Sándor Pál ◽  
Barbara Réger ◽  
Tamás Kiss ◽  
Hussain Alizadeh ◽  
András Vereczkei ◽  
...  
Keyword(s):  
Blood Transfusion ◽  
Blood Cell ◽  
Red Blood Cell ◽  
Blood Product ◽  
Patient Blood Management ◽  
Blood Products ◽  
Blood Management ◽  
Number Of Patients ◽  
Willingness To Donate ◽  
The Impact

Összefoglaló. Bevezetés: A COVID–19-világjárvány betegellátásra gyakorolt hatása hazánkban is jelentős. A vérellátást nehezítette a járványügyi intézkedések következményeként a véradási események elmaradása, a csökkent véradási hajlandóság, továbbá a nehezen megítélhető vérkészítményigény . A „Patient Blood Management” irányelveinek az orvosi gyakorlatban történő egyre szélesebb körű alkalmazása elősegíti az optimális vérkészítmény-felhasználást a transzfúziók lehetőség szerinti elkerülésével. Célkitűzés és módszer: Vizsgálatunk célja a Pécsi Tudományegyetem Klinikai Központjának Janus Pannonius Klinikai Tömbjében a vérkészítmény-felhasználás változásainak felmérése volt a 2020. év első öt hónapjában. Eredmények: A járványügyi intézkedéseket követő időszakban szignifikánsan csökkent a hospitalizált betegeknek (34,08%), a transzfúziót igénylő betegeknek (39,69%) és a felhasznált vörösvérsejt-készítményeknek (46,41%) a száma, valamint az egy betegre jutó felhasznált vörösvérsejt-koncentrátum átlaga (2,61-ről 1,97-re) is. Közel 30%-os arányban csökkent a felhasznált friss fagyasztott plazma egységeinek és a thrombocytakoncentrátumoknak a száma is. Következtetés: A szigorú korlátozások életbe léptetését követően a nehézségek ellenére sikerült elegendő mennyiségű vérkészítményt biztosítani a betegeknek. Az Országos Vérellátó Szolgálat Pécsi Regionális Vérellátó Központja munkatársainak és a klinikusok erőfeszítéseinek köszönhetően a vérkészítményigény és -kínálat között új egyensúly alakult ki, mely megfelelő ellátást biztosított a feltétlenül szükséges transzfúziók kivitelezéséhez. Orv Hetil. 2021; 162(43): 1717–1723. Summary. Introduction: The impact of COVID–19 pandemic on patient care is pronounced also in Hungary. Blood supply was hindered by the reduction of public blood donation events, the reduced willingness to donate, and the difficult predictability of blood product demand as a result of the epidemiological regulations. The wider application of Patient Blood Management guidelines in the medical practice will promote optimal blood product utilization by avoiding transfusions where possible. Objective and method: The aim of our study was to assess the changes in the usage of blood products in the first five months of 2020 at the Clinical Center of the University of Pécs, Janus Pannonius Clinical Building. Results: In the period following the epidemiological measures, we found reduction in the number of hospitalized patients (34.08%), in the number of patients requiring transfusion (39.69%) and in the number of red blood cell products used (46.41%). The number of transfused red blood cell concentrates per patient was also significantly reduced (from 2.61 to 1.97) in this period. The number of transfused fresh frozen plasma units and platelet concentrates also decreased by approximately 30%. Conclusion: After the implementation of the strict restrictions, despite the difficulties, it was possible to provide patients with sufficient blood products. Due to the efforts of both the Regional Blood Transfusion Center of Pécs of the Hungarian National Blood Transfusion Service and of the clinicians, a new balance was established between the demand and the supply of blood products, which provided adequate care for the necessary transfusions. Orv Hetil. 2021; 162(43): 1717–1723.

scholarly journals Сосудистая проницаемость и микрогемореология при системной склеродермии: возможности метода конъюнктивальной микроскопии

2020 ◽  
pp. 23-28
Keyword(s):  
Systemic Sclerosis ◽  
Blood Cell ◽  
Key Words ◽  
Vascular Permeability ◽  
Red Blood Cell ◽  
Cell Aggregation ◽  
Control Group ◽  
Age Group ◽  
Red Blood Cell Aggregation ◽  
Blood Cell Aggregation

In this article, the authors draw attention of readers to the capabilities of the conjunctival microscopy (CM) the method for studying the processes of vascular permeability and microhemorheology in patients with systemic sclerosis (SS). An original simultaneous examination of 48 patients with SS (mean age 51±1,7 years) and a comparable age group (4,74±2,3 years) of the control group of people without any diseases that might affect microcirculation (MC) by the CM-method was performed. The results demonstrated high informativeness of the CM-method in the diagnostics and assessment of vascular permeability and intravascular red blood cell aggregation (RBCA) in SS. The main changes in MC during SS revealed by the CM-method are the increase in vascular permeability and enhancement of RBCA in all types of microvessels. Key words: vascular permeability, intravascular red blood cell aggregation, conjunctival microscopy, systemic sclerosis.

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