scholarly journals Improving transfusion practice in transfusion dependent thalassaemia patients

2017 ◽  
Vol 7 (1) ◽  
Author(s):  
Chathupa Wickremaarachchi ◽  
Elizabeth McGill ◽  
Annmarie Bosco ◽  
Giselee Kidson-Gerber
Keyword(s):  
Blood Cells ◽  
Maximum Rate ◽  
Fluid Overload ◽  
Transfusion Practice ◽  
Red Cells ◽  
Transfusion Rate ◽  
Allergic Reactions ◽  
Medical Review ◽  
Transfusion Reaction ◽  
Change In Practice

The aim of this study was to improve current transfusion practice in transfusiondependent thalassaemia patients by determining whether safe transition from triplewashed red cells (TWRC) to leucodepleted red cells (LDRC), increasing transfusion rates, reducing the use of frusemide and creating uniform practice across patients is possible. In patients receiving regular transfusions (50), triple-washed red blood cells were changed to LDRC, transfusion rates were increased to 5 mL/kg/h (in line with the Cooley’s Foundation guidelines) to a maximum of 300 mL/h and frusemide was ceased. Medical review occurred at completion of the transfusion. Of the 20 patients on TWRC, 18 were transitioned to leucodepleted red cells (90%). Recurrent allergic reactions in 2 patients required re-institution of TWRC. 7 of the 8 patients on regular frusemide ceased this practice with no documented transfusion-related fluid overload. One patient refused. Of the eligible 50 patients, 20 patients (40%) were increased to the maximum transfusion rate of 300 mLs/h; 6 (12%) increased rate but refused to go to the maximum; 9 (18%) refused a change in practice and 15 (30%) were already at the maximum rate. There was only one documented transfusion reaction (palpitations) however this patient was able to tolerate a higher transfusion rate on subsequent transfusions. Thalassemia patients on TWRC were safely transitioned to LDRC. Transfusion rates were safely increased, with a calculated reduction in day-stay bed time of 17.45 h per month. This confirms a guideline of 5 mL/kg/h for transfusion-dependant thalassaemia patients with preserved cardiac function is well tolerated and may be translated to other centres worldwide. 本研究的目的是通过确定是否有可能进行从三洗红细胞（TWRC）到去白细胞红细胞（LDRC）的安全过渡，提高输血速率，减少速尿的使用，并在患者中实施统一规则，从而改进输血依赖型地中海贫血患者中现有的输血实践。在接受定期输血的患者（50例）中，将三洗红细胞改为 LDRC，输血速率提高至5 mL/kg/h（符合库利氏贫血基金会的指引），最高可达到300 mL/h，并停止使用速尿。输血完成后进行体检。在使用TWRC的20例患者中，18例转为去白细胞红细胞（90%）。2例患者产生的复发性过敏反应需要重新输以TWRC。8名定期使用速尿的患者中，7名中止了使用该药物，并且没有输血相关液体超负荷的相关记录。一名病人拒绝。在符合条件的50例患者中，20例（40%）增加至300 mL/h的最大输血速率；6例（12%）输血速率提高但拒绝增加至最大；9例（18%）拒绝做出改变，15例（30%）已经达到了最大速率。只产生一例有记录的输血反应（心悸），但是该患者在随后的输血中能够耐受更高的输血速率。使用TWRC的地中海贫血患者安全转用LDRC。输血速率安全地得到提高，计算出减少的白天卧床时间为每月17.45小时。这证实了5 mL/kg/h的指引在心功能得到保护的输血依赖型地中海贫血患者中有良好的耐受性，可以推广至全球其他中心。

scholarly journals A Study of Frequency and Pattern of Adverse Transfusion Reactions at a Blood Bank in a Tertiary Care Hospital: Towards Hemovigilance

2020 ◽  
Vol 7 (12) ◽  
pp. A576-581
Author(s):  
Suzaan Shajil ◽  
Deepa Sowkur Anandarama Adiga ◽  
Debarshi Saha ◽  
Shrijeet Chakraborty ◽  
Ranjitha Rao
Keyword(s):  
Tertiary Care ◽  
Transfusion Practice ◽  
Blood Bank ◽  
Common Symptom ◽  
Allergic Reactions ◽  
Care Hospital ◽  
Transfusion Reaction ◽  
Surgical Emergencies ◽  
Life Saving ◽  
Transfusion Reactions

Background: Adequate and safe transfusion facility of blood and its components is necessary as blood transfusions are a part of life saving measures in medical and surgical emergencies. However, transfusion practice could result in non-fatal to fatal adverse transfusion reactions (ATR). Therefore, it is important to identify various adverse reactions so that steps can be taken to minimize such reactions and ensure safer transfusion being carried out. Methods: All ATRs reported to the blood bank from January 2013 to December 2016 were reviewed and analysed. The frequency of ATRs and its association with various component types were assessed. Result: During the study period, a total of 199106 units of blood were issued from the blood bank out of which there was an incidence of 77 (0.12%) transfusion reactions. Chills/rigors was the most common symptom (27.3%) of the symptomatic cases followed by pruritis (23.4%) Majority of the transfusion reaction were non haemolytic, 76 (98.7%) cases. One case was of haemolytic transfusion reaction. Among the non-haemolytic transfusion reactions, febrile non haemolytic transfusion reaction (FNHTR) constituted 28 (36.4%) and allergic reactions constituted 41(53.2%). Other transfusion reactions including hypotensive transfusion reaction (HTR), 1 (1.3%) case and transfusion associated dyspnoea (TAD), 6 (7.8%) cases were also seen. The frequency of ATRs was highest with packed red cells (PC) being 75.3% and least with platelet concentrate (PLTC) being 11.7%. Conclusion: The frequency of ATRs in our blood bank was found to be on a lower scale when compared to that of most of the similar studies. Allergic reactions and FNHTR were the most common ATRs seen, introduction of leukoreduction filters would help reduce FNHTRs.

Receptor Mediated Binding of the Fibrinolytic Components, Plasminogen and Urokinase, to Peripheral Blood Cells

1987 ◽  
Vol 58 (03) ◽  
pp. 936-942 ◽  
Author(s):  
Lindsey A Miles ◽  
Edward F Plow
Keyword(s):  
T Cells ◽  
B Cell ◽  
Peripheral Blood ◽  
Binding Sites ◽  
Blood Cells ◽  
High Capacity ◽  
Red Cells ◽  
Peripheral Blood Cells ◽  
Cellular Functions ◽  
Fibrinolytic Proteins

SummaryGlu-plasminogen binds to platelets; the monocytoid line, U937, and the human fetal fibroblast line, GM1380 bind both plasminogen and its activator, urokinase. This study assesses the interaction of these fibrinolytic proteins with circulating human blood cells. Plasminogen bound minimally to red cells but bound saturably and reversibly to monocytes, granulocytes and lymphocytes with apparent Kd values of 0.9-1.4 μM. The interactions were of high capacity with 1.6 to 49 × 105 sites/cell and involved the lysine binding sites of plasminogen. Both T cells and non-rosetting lymphocytes and two B cell lines saturably bound plasminogen. Urokinase bound saturably to gianulocytes, monocytes, non-rosetting lymphocytes and a B cell line, but minimally to T cells, platelets and red cells. Therefore, plasminogen binding sites of high capacity, of similar affinities, and with common recognition specificities are expressed by many peripheral blood cells. Urokinase receptors are also widely distributed, but less so than plasminogen binding sites. The binding ol plasminogen and/ or urokinase to these cells may lead to generation of cell- associated proteolytic activity which contributes to a variety of cellular functions.

HEMOLYTIC DISEASE OF THE NEWBORN DUE TO ANTI-A AND ANTI-B

PEDIATRICS ◽  
1955 ◽  
Vol 15 (1) ◽  
pp. 54-62
Author(s):  
Clare N. Shumway ◽  
Gerald Miller ◽  
Lawrence E. Young
Keyword(s):  
B Cells ◽  
Red Blood Cells ◽  
Blood Group ◽  
Newborn Infant ◽  
Blood Cells ◽  
Osmotic Fragility ◽  
Red Cells ◽  
Hemolytic Disease ◽  
Abo Incompatibility

Ten infants with hemolytic disease of the newborn due to ABO incompatibility were studied. In every case the investigations were undertaken because of jaundice occurring in the first 24 hours of life. The clinical, hematologic and serologic observations in the infants and the serologic findings in the maternal sera are described. Evidence is presented to show that the diagnosis of the disorder rests largely upon the demonstration of spherocytosis, increased osmotic fragility of the red cells, reticulocytosis, and hyperbilirubinemia in a newborn infant whose red blood cells are incompatible with the maternal major blood group isoantibody and against whose cells no other maternal isoantibody is demonstrable. The anti-A or anti-B in each of the maternal sera tested in this series hemolyzed A or B cells in the presence of complement. Other serologic findings in the maternal sera were less consistently demonstrated.

A case study of a patient with anti-Yta alloantibodies against the high-prevalence antigen of red blood cells qualified for heart transplantation

2021 ◽  
Vol 56 (3) ◽  
pp. 1-7
Author(s):  
Monika Witoszek ◽  
Małgorzata Kalaga
Keyword(s):  
Red Blood Cells ◽  
Blood Cells ◽  
Blood Donation ◽  
Heart Diseases ◽  
Blood Group System ◽  
Transfusion Reaction ◽  
Indirect Antiglobulin Test ◽  
High Prevalence ◽  
Compatible Blood

The Yta antigen from the Cartwright blood group system is a high-prevalence antigen found in 99.8% of the population. The literature data shows that antibodies anti-Yta demonstrate the variable clinical significance and are rarely the cause of a hemolytic post-transfusion reaction. The study aims to present the difficulties related to the selection and sustainable supply of blood for transfusion for the patient of the Silesian Centre for Heart Diseases with anti-Yta alloantibodies, qualified for a heart transplant. If Yt(a-) blood is not available Institute of Hematology and Transfusion Medicine in Warsaw, referring to reports in the publications, allowed transfusion of the least incompatible red blood cells in indirect antiglobulin test. One hour after transfusion of leucocyte-depleted concentrate of red blood cells (RBCs), issued in accordance with the above recommendations by Regional Blood Donation Center in Katowice as the least incompatible, the patient was observed to experience symptoms of an adverse post-transfusion reaction. For subsequent transfusions, RBCs from Yt(a-) donors were selected, of which only eight were registered in Poland at that time. Medical decisions on RBCs transfusion in patients for whom no compatible blood can be selected is very difficult, and the benefits of incompatible transfusion should be weighed against the risk of possible complications. To avoid this, it should be remembered that the early identification of antibodies increases the chance of finding serologically compatible blood and in many cases allows to supply blood for a patient with autologous donations.

scholarly journals Sensing of red blood cells with decreased membrane deformability by the human spleen

2018 ◽  
Vol 2 (20) ◽  
pp. 2581-2587 ◽  
Author(s):  
Innocent Safeukui ◽  
Pierre A. Buffet ◽  
Guillaume Deplaine ◽  
Sylvie Perrot ◽  
Valentine Brousse ◽  
...  
Keyword(s):  
Red Blood Cells ◽  
Blood Cells ◽  
Ex Vivo ◽  
Volume Ratio ◽  
Red Cells ◽  
Human Spleen ◽  
Rbc Membrane ◽  
Membrane Rigidity ◽  
Cellular Deformability ◽  
Distinct Features

Abstract The current paradigm in the pathogenesis of several hemolytic red blood cell disorders is that reduced cellular deformability is a key determinant of splenic sequestration of affected red cells. Three distinct features regulate cellular deformability: membrane deformability, surface area-to-volume ratio (cell sphericity), and cytoplasmic viscosity. By perfusing normal human spleens ex vivo, we had previously showed that red cells with increased sphericity are rapidly sequestered by the spleen. Here, we assessed the retention kinetics of red cells with decreased membrane deformability but without marked shape changes. A controlled decrease in membrane deformability (increased membrane rigidity) was induced by treating normal red cells with increasing concentrations of diamide. Following perfusion, diamide-treated red blood cells (RBCs) were rapidly retained in the spleen with a mean clearance half-time of 5.9 minutes (range, 4.0-13.0). Splenic clearance correlated positively with increased membrane rigidity (r = 0.93; P < .0001). To determine to what extent this increased retention was related to mechanical blockade in the spleen, diamide-treated red cells were filtered through microsphere layers that mimic the mechanical sensing of red cells by the spleen. Diamide-treated red cells were retained in the microsphilters (median, 7.5%; range, 0%-38.6%), although to a lesser extent compared with the spleen (median, 44.1%; range, 7.3%-64.0%; P < .0001). Taken together, these results have implications for understanding the sensitivity of the human spleen to sequester red cells with altered cellular deformability due to various cellular alterations and for explaining clinical heterogeneity of RBC membrane disorders.

scholarly journals CELLS INVOLVED IN THE IMMUNE RESPONSE

1969 ◽  
Vol 129 (4) ◽  
pp. 757-774 ◽  
Author(s):  
Nabih I. Abdou ◽  
Maxwell Richter
Keyword(s):  
Bone Marrow ◽  
Immune Response ◽  
Red Blood Cells ◽  
Blood Cells ◽  
Bone Marrow Cells ◽  
Allogeneic Bone Marrow ◽  
Red Cells ◽  
Allogeneic Bone ◽  
Sheep Red Blood Cells ◽  
Sheep Red Cells

Irradiated rabbits given allogeneic bone marrow cells from normal adult donors responded to an injection of sheep red blood cells by forming circulating antibodies. Their spleen cells were also capable of forming many plaques using the hemolysis in gel technique, and were also capable of undergoing blastogenesis and mitosis and of incorporating tritiated thymidine upon exposure to the specific antigen in vitro. However, irradiated rabbits injected with allogeneic bone marrow obtained from rabbits injected with sheep red blood cells 24 hr prior to sacrifice (primed donors) were incapable of mounting an immune response after stimulation with sheep red cells. This loss of reactivity by the bone marrow from primed donors is specific for the antigen injected, since the immune response of the irradiated recipients to a non-cross-reacting antigen, the horse red blood cell, is unimpaired. Treatment of the bone marrow donors with high-titered specific antiserum to sheep red cells for 24 hr prior to sacrifice did not result in any diminished ability of their bone marrow cells to transfer antibody-forming capacity to sheep red blood cells. The significance of these results, with respect to the origin of the antigen-reactive and antibody-forming cells in the rabbit, is discussed.

scholarly journals Transfusion Requirements in Anemic Patients undergoing Cardiac Surgery

2017 ◽  
Vol 2 (1) ◽  
pp. 26-27
Author(s):  
Vaishali S Badge ◽  
Henry Skinner
Keyword(s):  
Cardiac Surgery ◽  
Morbidity And Mortality ◽  
Surgical Patients ◽  
Transfusion Rate ◽  
Allergic Reactions ◽  
Blood Products ◽  
Transfusion Requirements

ABSTRACT Cardiac surgery is one of the largest consumer of blood and blood products in medicine. The transfusion rate in cardiac surgery accounts to almost 40-90%. Although lifesaving, it still increases the risk of allergic reactions, risk of transmission of infection, increased morbidity and mortality. The aim of this study was to find out causes of anaemia and requirement of blood or blood products in cardiac surgical patients. How to cite this article Badge VS, Skinner H. Transfusion Requirements in Anemic Patients undergoing Cardiac Surgery. Res Inno in Anesth 2017;2(1):26-27.

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