Self ‐sufficiency in plasma supply – achievable and desirable?
Debate concerning the principle of self‐sufficiency in plasma based on voluntary non‐remunerated donation has been going on for over 40 years. During this period the dependency on the commercial plasma industry has increased considerably. The debate has two main themes. The first focusses on the ethical principles underpinning World Health Assembly resolutions on voluntary non‐remunerated donation and questions relating to donor compensation and the use of incentives in the voluntary sector. The second theme concerns barriers to achieving the goal of self‐sufficiency. The needs of patients and the most effective w...
Source: ISBT Science Series - September 27, 2017 Category: Hematology Authors: P. Flanagan Tags: Congress Review Source Type: research
Emergency planning and business continuity: why blood services must plan for both. How the EBA working group (WG) is assisting blood services
BackgroundIn 2016, the Executive of the European Blood Alliance (EBA) decided to explore whether there was sufficient interest amongst member countries on whether they saw value in the re‐establishment of a Working Group on contingency planning. A survey of members was carried out and as there was sufficient interest a Working Group (WG) was established. The question then was how could the work of the WG add value to member countries in their contingency planning process? We set out to establish this.
MethodMembers of the WG decided that there were three areas where the WG should concentrate on and these were as follows:...
Source: ISBT Science Series - September 27, 2017 Category: Hematology Authors: R. Rackham, A. Kelly Tags: Congress Review Source Type: research
Making transfusion decisions in critical care
Transfusion triggers and parameters to consider in the decision to transfuse depend on the setting. In cases of massive bleeding, transfusion decision is made on haemodynamic parameters, vital signs and when possible on bleeding volume estimation. In anaemic haemodynamically stable patients, haemoglobin remains the primary trigger for transfusion. In the less severe or in the youngest critically ill patients, transfusion for a haemoglobin threshold of 7 g/dl has been shown to be associated with higher survival in comparison with a haemoglobin threshold of 10 g/dl. This lower threshold of 7 g/dl appears to be also safe i...
Source: ISBT Science Series - September 27, 2017 Category: Hematology Authors: C. Aubron Tags: Congress Review Source Type: research
Value of retaining HBsAg donor screening where HBV NAT and anti ‐HBc donor screening apply
Hepatitis B virus (HBV) is a transfusion‐transmissible human DNA virus with a global distribution. Since the early 1970s, hepatitis B surface antigen (HBsAg) detection has been the mainstay to identify donors infected with HBV. The implementation of donor HBsAg screening substantially reduced but did not eliminate the risk of transfusion‐transmitted HBV (TT‐HBV). In the late 1970s, it was recognized that TT‐HBV occurred more commonly from HBsAg‐negative donations containing detectable antibodies to the viral core (anti‐HBc) leading to some countries subsequently implementing universal anti‐HBc screening in ad...
Source: ISBT Science Series - September 27, 2017 Category: Hematology Authors: C. R. Seed Tags: Congress Review Source Type: research
Flow cytometry in transfusion medicine: an overview
ConclusionFlow cytometry has the advantages of a higher sensitivity for some antigens than in traditional serology and the ability to easily distinguish between two or more populations of cells, which makes it a useful tool in many clinical settings, for example in defining chimeras and in detection of fetomaternal bleeding. The combination of molecular testing and the detection of surface antigens by flow cytometry are found useful. When resolving clinically relevant ABO discrepancies we have found the combination of genetic testing and semiquantification of ABO antigens by flow cytometry very helpful. Taken together flow...
Source: ISBT Science Series - September 27, 2017 Category: Hematology Authors: A. K. Hult Tags: Congress Review Source Type: research
How do blood donors interpret the Swedish donor history questionnaire?
ConclusionOverall, the blood donors were satisfied with the readability of the questions. However, some questions turned out to be more difficult to interpret, and may need to be reworded. The study demonstrates the need for easy access to blood safety information. (Source: ISBT Science Series)
Source: ISBT Science Series - September 27, 2017 Category: Hematology Authors: C. Öhrner, M. Kvist Tags: Original Paper Source Type: research
The deferred donor
Donor selection criteria are an important step in ensuring both the safety of blood products and the well‐being of donors. In the absence of adequate testing for HIV and HCV in the 1980s, donor selection criteria were implemented to increase the safety of blood products. Donor selection criteria continue to have the advantage of rapid implementation in case of emerging infectious diseases. With the development of sensitive screening tests for HIV, HBV and HCV and with changes in the level of certain risks over time, a revision of some of the donor selection criteria may be necessary. Recent studies revealed that deferred...
Source: ISBT Science Series - September 27, 2017 Category: Hematology Authors: V. Compernolle Tags: Congress Review Source Type: research
Patient Blood Management – from local initiatives to European collaborations
Patient blood management (PBM), as defined by the WHO, is a patient‐focused, evidence‐based and systematic approach to optimize the management of patient and transfusion of blood products for quality and effective patient care. It is designed to improve patient outcomes through the safe and rational use of blood and blood products and by minimizing unnecessary exposure to blood products. Important elements of PBM are optimizing haemoglobin concentrations without blood transfusion, minimizing blood loss and managing anaemia, especially by use of evidence‐based transfusion guidelines and pharmacological agents. Local P...
Source: ISBT Science Series - September 27, 2017 Category: Hematology Authors: M. T. Bruun, J. Georgsen, K. Titlestad, M. Yazer, M. F. Murphy Tags: Congress Review Source Type: research
The challenge of growing enough reticulocytes for transfusion
There is considerable research interest in manufacturing blood products for patients using a variety of different cellular sources, including stem cells (embryonic, cord and adult), induced pluripotent stem cells and erythroid cell lines. Red blood cells (RBC) represent a particularly attractive regenerative medicine blood product due to the absence of the nucleus in the final cellular product meaning that they pose a minimal risk in terms of potential for transformation in the recipient, and allogeneic red cell transplants have been given for many years. The number of RBC required in a standard adult therapeutic dose (2 ...
Source: ISBT Science Series - September 27, 2017 Category: Hematology Authors: C. E. Severn, A. M. Toye Tags: Congress Review Source Type: research
Do we need cryoprecipitate in the era of fibrinogen concentrate and other specific factor replacement options?
Cryoprecipitate was first used in the 1960s as a source of factor VIII (FVIII) for the treatment of bleeding in haemophilia A. Although still used in some countries for this purpose, its main use now is as a concentrated source of fibrinogen, commonly administered as part of major haemorrhage therapy for patients with uncontrolled bleeding. Fibrinogen is recognized as the first clotting protein to fall to clinically significant low levels during major haemorrhage, and there has been a recent explosion of interest around the potential importance of fibrinogen replacement therapy in this setting. This has led many to questio...
Source: ISBT Science Series - September 27, 2017 Category: Hematology Authors: H. Wong, N. Curry Tags: Congress Review Source Type: research
Teenage blood donation: demographic trends, adverse reactions and iron balance
ConclusionTeenage donors continue to contribute substantially and disproportionately to the blood supply despite their higher risk of adverse reactions and possible adverse consequences of iron depletion after blood donation. Further measures could protect adolescent blood donors from donation‐related reactions, injuries and iron depletion. (Source: ISBT Science Series)
Source: ISBT Science Series - September 27, 2017 Category: Hematology Authors: A. F. Eder, L. A. Crowder, W. R. Steele Tags: Congress Review Source Type: research
Lessons for blood services following the Brussels terrorist attacks in March 2016
On 22 March 2016, Brussels was confronted with terrorist attacks using explosive devices. Two nail bombs exploded at the airport and one nail bomb exploded in the subway. Thirty‐five people were killed, and approximately 340 got injured. Stock levels were excellent for all blood products and all blood groups. The amount of blood distributed on March 22 was at the high end but in line with the amount of blood products distributed on regular Tuesdays. The total order of blood group O Rhesus D (RhD)‐negative red cell units was nonetheless approximately twice as high as normal. For three University hospitals, we investigat...
Source: ISBT Science Series - September 27, 2017 Category: Hematology Authors: V. Compernolle, T. Najdovski, I. De Bouyalski, P. Vandekerckhove Tags: Congress Review Source Type: research
Blood transfusion: one unit too much or one unit too few – which strategy poses the smallest risk to the patient?
ISBT Science Series,Volume 13, Issue 1, Page 101-104, February 2018. (Source: ISBT Science Series)
Source: ISBT Science Series - September 26, 2017 Category: Hematology Source Type: research
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ISBT Science Series,Volume 13, Issue 1, Page 101-104, February 2018. (Source: ISBT Science Series)
Source: ISBT Science Series - September 26, 2017 Category: Hematology Source Type: research
Blood transfusion: one unit too much or one unit too few – which strategy poses the smallest risk to the patient?
The last decades saw numerous prospective clinical trials using different haemoglobin levels as transfusion triggers for packed red blood cell transfusion. In most studies, a restrictive strategy with a lower haemoglobin value as transfusion trigger and a lower haemoglobin target range was compared to a more liberal strategy with higher patient haemoglobin values already triggering transfusion. While such studies answered some important clinical questions in well‐defined study patient populations, many more questions in this field are still open. Studies in patients suffering from acute or chronic neurological disorders,...
Source: ISBT Science Series - September 26, 2017 Category: Hematology Authors: E. Seifried, M. M. Mueller Tags: Congress Review Source Type: research
