P-BN63 Requirement of preoperative group and save testing prior to cholecystectomy: A systematic review

Background Group and save (G&S) testing is usually performed prior to cholecystectomy. However, there are no standard national or international guidelines regarding the routine use of preoperative G&S testing for patients undergoing emergency laparoscopy. Methods We evaluated the available literature on the necessity of G&S prior to cholecystectomy to determine whether this was required preoperatively. Studies from January 1980 to May 2021 assessing the requirement of G&S were retrieved from MEDLINE and EMBASE databases. Number of patients, co-morbidities, operation performed, number of patients that underwent preoperative G&S testing, perioperative transfusion rates and financial costs were extracted. Results We initially screened 194 studies of which 11 retrospective studies reported on cholecystectomy. A total of 177,692/474,485 (37.4%) patients underwent preoperative G&S testing with a perioperative transfusion rate of 2.07% (9803/474,485 patients, range 0.0% to 1.6%). The main preoperative risk factors, where recorded, associated with perioperative blood transfusion identified include cardiovascular co-morbidity (16/45, 35%), coagulopathy (13/45 patients, 28%), anaemia (9/45 patients, 20%) and haematological malignancy (6/45, 13%). All 11 studies concluded that routine G&S is not warranted. Conclusions The current evidence, though limited, suggests that G&S is not necessarily required for all patients undergoing cholecystectomy. Preoperative testing should be performed in selected cases, for example in septic coagulopathy, anaemia and haematological malignancy. There is no evidence to suggest that routine G&S screening benefits patient outcomes. Having a targeted G&S approach would reduce delays in elective and emergency lists, reduce the burden on the blood transfusion service and have financial implications.

Incompatible Results on Matched Cross Test Examination

Compatibility testing before blood transfusion is very crucial. This procedure to prevent transfusion reactions due to blood group incompatibility or irregular antibodies. Cross-matching to ensure that the blood safe for the recipient. There are two results in the cross-matching, namely compatible and incompatible. This study aims to determine the inappropriate results of cross-matching at Blood Transfusion Service of the Indonesian Red Cross, Kulon Progo Regency. This study used a quantitative descriptive research design with a retrospective approach. The samples used in this study were 78 incompatible samples in Blood Transfusion Service of the Indonesian Red Cross, Kulon Progo Regency. The sampling technique used was the total population. Methods of data analysis using descriptive analysis. The results show incompatibilities of most compatible cross tests found in minor and auto control (96.1%) with male gender frequency (35.9%) and women (64.1%). The most blood type that has incompatibilities is blood type O (43.3%). The most Diagnosis is anemia (76.9%), and the most components are PRC (88.4%). The most incompatible types are minor and auto control and the most commonly encountered in women, O blood type, anemia, and components of PRC.

Results of the Study of Morphological Features and Serotonin Accumulative Function of Platelets in Blood Donors

Blood transfusion service and its social component – donorship must be the priority areas of the state policy because the results of its work are of paramount importance. The main task of the blood transfusion service is supply of high quality components for blood transfusion therapy. Quality of blood components is compliance of properties and specifications of the blood component supplied to the recipient with the set standards. Strict order of conformance with the approved regulations and procedures is important at all technological states and is a cornerstone of blood transfusion service products quality. All actions, planned and implemented, starting with planning donorship and ending with the finished product manufacturing and storage conditions, are important for ensuring the quality as the final result. The purpose of the study was to determine the content of total, platelet and free serotonin in the plasma of primary and active blood donors for further use of the studied parameters to assess the quality of platelet concentrate. Materials and methods. 160 blood donors (118 men and 42 women) were examined, including 110 active donors (85 men and 25 women) who donated blood regularly at least 3 times a year and 50 primary reserve donors (32 men and 18 women), who donated blood for the first time. Primary reserve donors formed a control group. For the convenience of systematization and reproduction of scientific research results, objectification in comparing research data, all examined active donors, depending on the duration of donor experience and, accordingly, increasing the probability of occurrence of hidden platelet metabolism disorder, were divided into three subgroups: subgroup I – 51 donors (39 men and 12 women), whose donor experience lasted from 2 to 5 years; subgroup II – 31 donors (24 men and 7 women), duration of donor experience which ranged from 6 to 9 years; subgroup III – 28 donors (22 men and 6 women), whose donor experience lasted 10 years or more. The method of fractional determination of biological amines – serotonin – is presented in preliminarily dried biostrate specimens. The method described includes some extraction procedures with optimal controlled pH values necessary for isolating serotonin, producing fluorophors in accordance with orthophtaldialdehide and ninhydrin, the subsequent fluorimetric estimation of their levels being performed on the native fluorometer «БИАН». Results and discussion. It was found that active donors compared to control, have a level of free serotonin in peripheral blood platelets which was significantly higher. Biochemical shifts were revealed in the background of certain morphological changes of platelets. Possible pathophysiological mechanisms of the detected changes are discussed in the article. Conclusion. Active blood donation is accompanied by significant changes in the morphological parameters of platelets and the content of free serotonin in peripheral blood platelets. Further study of platelet hematopoiesis of active blood donors is required

Distribusi Komponen Darah Thrombocyte Contentrate (TC)

Blood transfusions become an important component in the management of patients with injuries to cases of accidents, surgical conditions, violence, pregnancy complications, anemia, hemodialysis, and other medical conditions. The blood transferred can be complete blood and blood components such as Packed Red Cells (PRC), Thrombocyte Concentrate (TC), Anti hemophilia Factor (AHF)/Cryoprecipitate, Fresh Frozen Plasma (FFP), Buffy Coat (BC), Liquid Plasma (LP). This research aims to determine the distribution of blood component Thrombocyte Concentrate (TC) in Indonesian Red Cross Blood Transfusion Service Pontianak City. The design of this research is a quantitative study with a descriptive design, the approach of time used is retrospective by collecting and processing all the distribution data of blood component Thrombocyte Concentrate (TC) in Indonesian Red Cross Blood Transfusion Service Pontianak City in 2019. Processing and analyzing data in this study using the Statistical Product and Service Solutions (SPSS) application. Data analysis results of the number of Thrombocyte Concentrate requests 5,427 bags in 12 months, with an average (Mean) of 452.25 and a data spread (Std. Deviation) of 224.620 is greater than the dosage amount and the distribution of Thrombocyte Concentrate 3,444 bags in 12 months, with an average (Mean) 287 and a data spread (Std. Deviation) 79.681. The most demand and distribution is Dr. Soedarso country general hospital, while the fewest are the Nabasa maternity hospital. The distribution of Thrombocyte Concentrate blood components in Indonesian Red Cross Blood Transfusion Service Pontianak City still needs improvement for both inventory and distribution to be fulfilled the number of Thrombocyte Concentrate requests.

Prevalence of SARS-CoV-2 Antibodies from a one-year National Serosurveillance of Kenyan Blood Transfusion Donors

In tropical Africa, SARS-CoV-2 epidemiology is poorly described because of lack of access to testing and weak surveillance systems. Since April 2020, we followed SARS-CoV-2 seroprevalence in plasma samples across the Kenya National Blood Transfusion Service. We developed an IgG ELISA against full length spike protein. Validated in locally-observed, PCR-positive COVID-19 cases and in pre-pandemic sera, sensitivity was 92.7% and sensitivity was 99.0%. Using sera from 9,922 donors, we estimated national seroprevalence of SARS-CoV-2 antibodies at 4.3% in April-June 2020 and 9.1% in August-September 2020. The second COVID-19 wave peaked in November 2020. Here we estimate national seroprevalence in early 2021. Between January 3 and March 15, 2021, we collected 3,062 samples from donors aged 16-64 years. Among 3,018 samples that met our study criteria 1,333 were seropositive (crude seroprevalence 44.2%, 95% CI 42.4-46.0%). After Bayesian test-performance adjustment and population weighting to represent the national population distribution, the national estimate of seroprevalence was 48.5% (95% CI 45.2-52.1%). Seroprevalence varied little by age or sex but was higher in Nairobi, the capital city, and lower in two rural regions. Almost half of Kenyan adult donors had evidence of past SARS-CoV-2 infection by March 2021. Although high, the estimate is corroborated by other population-specific estimates in country. Between March and June, 2% of the population were vaccinated against COVID-19 and the country experienced a third epidemic wave. Natural infection is outpacing vaccine delivery substantially in Africa, and this reality needs to be considered as objectives of the vaccine programme are set.

PREVALENCE OF SEROPOSITIVITY IN BLOOD DONORS AT A TERTIARY CARE HOSPITAL

Objectives: Blood transfusion service is one of the key components of health care system. However, the life of transfusion recipients is at risk due to development of Transfusion-transmissible infections (TTI) such as HIV, HBV and HCV. This study was conducted to determine seroprevalence of TTIs among blood donors. Methods: Aretrospective cross-sectional study was conducted at the blood bank of tertiary care hospital. Data was collected from records of blood bank from January 2016 to December 2020. Blood units were screened by ELISAfor HIV, HBVand HCV. Results: A total of 7108 donors were screened out of which majority were males 6928(97.48%). Total 1670(23.49%) were voluntary donors and 5438 (76.50%) were replacement donors. Seroprevalence of HIV, HBVand HCVwas 0.08%, 1.125%, and 1.80% respectively. Conclusion: Proper selection and testing of donor's blood by using standard methods should be done to ensure safety of recipients

Blood Donation Tested by Coronavirus Pandemy 2019 (Covid-19) in Cote d’Ivoire

The 2019 coronavirus pandemic (covid-19), which spread rapidly around the world, has disrupted all organizations and led to a decline in their productivity. Their reorganization was therefore essential. The purpose of this study was to analyze the resilience strategies adopted by the National Blood Transfusion Service (NBTS) to reverse the trend of population participation. Thus, based on the qualitative approach centered on free interviews conducted with 30 people including 27 managers of Blood Transfusion Establishments (Blood Transfusion Center (BTC), Blood Transfusion Antenna (BTA) and Sampling Site (SS)), 2 heads of department (Communication and Coordination of services), the chairman of the scientific advisory council and a direct observation, of the theory of resilience and the systemic method, the analysis of the data indicates that the resilience strategies adopted by the NBTS are four: the dynamic communication on blood donation, rational blood using, the reorganization of blood collections in fixed site (Sundays and extension of the collection time) and the reorganization of mobile collections (fragmentation of mobile collection activities on site).

Fourth-Generation ELISA Screening of Blood Donors: A Reliable Alternative to Nucleic Acid Testing

The gold standard for HIV screening of blood donors is individual nucleic acid amplification testing (NAT). However, individual NAT testing is cost-prohibitive, especially in a resource-limited setting. The fourth-generation ELISA that detects both p24 antigen and antibody to HIV-1 and 2 has been recommended as the minimum test for HIV to enhance blood transfusion safety and can be an alternative to NAT testing in resource-limited settings. The aim was to assess the performance of a fourth-generation ELISA in use at a regional blood transfusion service using nucleic acid amplification testing on units of screened blood negative to HIV. The study was a cross-sectional study conducted at the National Blood Transfusion Service center and the Plateau State Virology Research Centre, both in Jos, Nigeria. Between August and October 2016, one thousand and eighteen voluntary blood donors were recruited consecutively and had their samples tested using fourth-generation ELISA. One thousand p24 antigen-negative samples were pooled for NAT in an aliquot of 50 samples. All the pools of fifty samples of 1,000 HIV p24 antigen-antibody negative donor blood screened by the fourth-generation ELISA tested negative for HIV RNA on nucleic acid amplification. The yield of pooled NAT for HIV after a fourth-generation ELISA screening of blood donors was found to be zero in this study, thus establishing the fourth-generation ELISA's reliability. Therefore, we recommend adopting the fourth-generation ELISA test as a minimum requirement for blood donor screening.

Low risk of SARS-CoV-2 in blood transfusion

Background The novel coronavirus disease (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), continues to remain a global challenge. There is emerging evidence of SARS-CoV-2 virus found in the blood of patients from China and some developed countries. However, there is inadequate data reported in Ghana and other parts of Africa, where blood transfusion service heavily relies on voluntary and replacement blood donors. This study aimed to investigate whether plasma of infected individuals could pose significant transfusion transmitted risk of COVID-19 in Ghanaian populations. Methods This cross-sectional retrospective study was conducted at the Kumasi Centre for Collaborative Research into Tropical Medicine (KCCR), KNUST, Ghana. Study subjects comprised contacts of COVID-19 individuals, those with classical symptoms of COVID-19 and individuals who had recovered based on the new Ghana discharge criteria. Whole blood, sputum or deep coughed saliva samples were collected and transported to KCCR for SARS-CoV-2 testing. Viral nucleic acid was extracted from sputum/nasopharyngeal samples using Da An Gene column based kit and from plasma using LBP nucleic acid extraction kit. Real-Time PCR was performed specifically targeting the ORF1ab and Nucleocapsid (N) genomic regions of the virus. Results A total of 97 individuals were recruited into the study, with more than half being males (58; 59.7%). The mean age of all subjects was 33 years (SD = 7.7) with minimum being 22 years and maximum 56 years. Majority (76; 78.4%) of all the subjects were asymptomatic, and among the few symptomatic subjects, cough (10; 10.3%) was the most predominant symptom. Of the 97 sputum samples tested, 79 (81.4%) were positive for SARS-CoV-2. We identified SARS-CoV-2 viral RNA in the plasma of 1 (1.03%) subject who had clinically recovered. Conclusion This study reports the identification of SARS-CoV-2 viral RNA in a convalescent individual in Ghana. Due to the low prevalence observed and the marginal cycling thresholds associated, the risk of transfusion transmission of SARS-CoV-2 is negligible. Well-powered studies and advanced diagnostics to determine infectious viremia is recommended to further evaluate the potential risk of hematogenous transmission among recovered patients.