Complete RH and Kell matching related to low alloimmunisation risk in sickle cell disease: prevalence and risk factors of alloimmunisation in a Spanish Tertiary Care National Reference Centre.
nsalvo S, Falero C, Díez-Martín JL, Anguita J Abstract BACKGROUND: Red blood cell (RBC) transfusion remains an essential part of sickle cell disease (SCD) management but it can lead to alloimmunisation, with an increased incidence in this population. Prevention is based on RBC antigen phenotype matching, with complete RH and Kell matching being a standard of care. MATERIALS AND METHODS: We performed a retrospective, single-centre study analysing alloimmunisation prevalence and risk factors in a cohort of transfused SCD patients. RESULTS: Eighty-seven patients (96.5% of paediatric age) recei...
Source: Blood Transfusion - October 14, 2020 Category: Hematology Authors: Regalado-Artamendi I, Pérez-Corral AM, García-Morín M, Cela E, Beléndez C, Bardón-Cancho EJ, Pérez-Rus G, Pérez-Sánchez I, Pascual C, Monsalvo S, Falero C, Díez-Martín JL, Anguita J Tags: Blood Transfus Source Type: research
Platelet transfusion for patients with platelet dysfunction: effectiveness, mechanisms, and unanswered questions
Purpose of review In this review, we discuss current clinical guidelines and potential underlying mechanisms regarding platelet transfusion therapy in patients at risk of bleeding, comparing management of patients with thrombocytopenia versus those with qualitative platelet disorders. Recent findings Platelet transfusion therapy is highly effective in managing bleeding in patients with hypoproliferative thrombocytopenia. Clinical trials have demonstrated that platelet transfusion can be used at a lower trigger threshold and reduced platelet doses, and may be used therapeutically rather than prophylactically in some si...
Source: Current Opinion in Hematology - October 3, 2020 Category: Hematology Tags: TRANSFUSION MEDICINE AND IMMUNOHEMATOLOGY: Edited by Karina Yazdanbakhsh Source Type: research
Molecular evolution pattern of Merkel cell polyomavirus identified by viral metagenomics in plasma of high-risk blood donors from the Brazilian Amazon.
In conclusion, this study brings information for the genetic relationships of MCPyV isolated from blood donors from the Brazilian Amazon and demonstrates the possible phylogeographic behavior of our strain in relation to the other findings. We also demonstrated a strong evidence of viremic MCPyV phase in blood donations, however, more studies are necessary in order to understand the MCPyV impact on transfusion therapy. PMID: 32971251 [PubMed - as supplied by publisher] (Source: Infection, Genetics and Evolution)
Source: Infection, Genetics and Evolution - September 20, 2020 Category: Genetics & Stem Cells Authors: Dos Santos Bezerra R, Bitencourt HT, Covas DT, Kashima S, Slavov SN Tags: Infect Genet Evol Source Type: research
Immunohematologic Aspects of Alloimmunization and Alloantibody Detection: A Focus on Pregnancy and Hemolytic Disease of the Fetus and Newborn
Alloimmunization to non-ABO, red blood cell (RBC) antigens remains one of the most clinically-relevant complexities faced by blood banking practitioners. In the setting of transfusion therapy, these antibodies raise risks for incompatibilities, while for pregnant patients they can mediate deadly forms of hemolytic disease of the fetus and newborn. As such, a thorough understanding of pathways that lead to alloimmunization, as well as the tools used by blood banks to detect alloantibodies, is critical to transfusion practice. (Source: Transfusion and Apheresis Science)
Source: Transfusion and Apheresis Science - September 14, 2020 Category: Hematology Authors: Gaurav K. Gupta, Raisa Balbuena-Merle, Jeanne E. Hendrickso, Christopher A. Tormey Source Type: research
Blood Transfusion Frequency and Indications in Yemeni Children with Sickle Cell Disease.
Conclusion: Intermittent blood transfusion remains a common practice for the management of children with acute SCD complications. Main indications were acute anemic crises, severe pain crises, ACS, and stroke. In limited resource settings, such as Yemen, conservative transfusion policy appears to be appropriate. PMID: 32908695 [PubMed] (Source: Anemia)
Source: Anemia - September 13, 2020 Category: Hematology Tags: Anemia Source Type: research
Acute-on-Chronic Liver Failure in Pregnant Patients with Chronic Hepatitis B: A Retrospective Observational Case Series Study.
Conclusion: Asthenia, anorexia, and jaundice during mid-late pregnancy should be immediately investigated. Before and during the pregnancy, hepatologists or obstetricians should actively screen pregnant women with CHB for HBV DNA status and alanine aminotransferase levels. Reactivation of HBV replication in pregnant women with CHB may lead to ACLF, especially in multiparous women. Once ACLF is diagnosed, antiviral therapy should be considered as soon as possible to protect maternal and fetal health. PMID: 32849869 [PubMed] (Source: Gastroenterology Research and Practice)
Source: Gastroenterology Research and Practice - August 28, 2020 Category: Gastroenterology Tags: Gastroenterol Res Pract Source Type: research
Automated exchange compared to manual and simple blood transfusion attenuates rise in ferritin level after 1 year of regular blood transfusion therapy in chronically transfused children with sickle cell disease.
Abstract BACKGROUND: Optimal strategies for regular blood transfusion therapy are not well defined in sickle cell disease (SCD). This analysis tested the hypothesis that in the first of year of regular transfusions, when chelation therapy use is minimal, automated exchange transfusion would be the superior method for attenuating the rise in ferritin levels compared to simple and manual exchange transfusions. STUDY DESIGN AND METHODS: The Silent Cerebral Infarct Multi-Center Clinical Trial randomly allocated children with SCD and silent cerebral infarcts to receive standard care or regular transfusions with a ...
Source: Transfusion - August 18, 2020 Category: Hematology Authors: Kelly S, Rodeghier M, DeBaun MR Tags: Transfusion Source Type: research
Effectiveness of Deferasirox in Pediatric Thalassemia Patients: Experience from a Tertiary Care Hospital of Odisha
CONCLUSIONS: Deferasirox is an effective iron chelator when started at an optimum time and with optimum dose. At least 1 year of deferasirox therapy is needed for a significant lowering of serum ferritin levels of pediatric thalassemia patients on multiple blood transfusions. (Source: Indian Journal of Pharmacology)
Source: Indian Journal of Pharmacology - August 3, 2020 Category: Drugs & Pharmacology Authors: Mousumee Panigrahi Trupti Rekha Swain Rabindra Kumar Jena Ashutosh Panigrahi Nishant Debta Source Type: research
Vaso-occlusive crisis in a sickle cell patient after transfusion-transmitted dengue infection.
CONCLUSION: This is the first description of TT-DENV in a SCD patient. A presumed high viral load in the transfused RBC unit probably determined the early clinical manifestation. In endemic regions dengue fever should be considered as differential diagnosis in SCD patients with fever and acute pain crisis, mainly during DENV outbreaks. PMID: 32735379 [PubMed - as supplied by publisher] (Source: Transfusion)
Source: Transfusion - July 30, 2020 Category: Hematology Authors: Santos FLS, Slavov SN, Bezerra RS, Santos EV, Silva-Pinto AC, Morais ALL, Sá MB, Ubiali EMA, De Santis GC, Covas DT, Kashima S Tags: Transfusion Source Type: research
Refractory gram-negative septic shock complicated by extended purpura fulminans and multiple organ failure in 23-year-old puerpera: A case report.
Conclusions: Septic shock is a significant and yet not completely understood life-threatening condition which can be associated with purpura fulminans, multiple organ dysfunction, disseminated intravascular coagulation and massive tissue necrosis. PMID: 32689761 [PubMed - as supplied by publisher] (Source: Korean Journal of Anesthesiology)
Source: Korean Journal of Anesthesiology - July 23, 2020 Category: Anesthesiology Tags: Korean J Anesthesiol Source Type: research
Red cell exchange for patients with sickle cell disease: an international survey of current practices.
CONCLUSIONS: This survey solicited the current practice variations in RCE from a diverse range of practice sites. Many sites reported similar practice patterns and challenges but some variations emerged. To our knowledge, this survey represents the largest and most in-depth investigation of the use of RCE for patients with SCD, and could inform future studies in the field. PMID: 32583456 [PubMed - as supplied by publisher] (Source: Transfusion)
Source: Transfusion - June 23, 2020 Category: Hematology Authors: Karafin MS, Hendrickson JE, Kim HC, Kuliya-Gwarzo A, Pagano MB, Perumbeti A, Shi PA, Tanhehco YC, Webb J, Wong E, Eichbaum Q Tags: Transfusion Source Type: research
Blood utilization and characteristics of patients treated with chronic transfusion therapy in a large cohort of Brazilian patients with sickle cell disease.
CONCLUSION: Red blood cell transfusion was common in Brazilian SCD patients, with utilization driven by CTT. Transfusion reactions were not common; however, alloimmunization and iron overload were frequent among those on CTT, highlighting the need for novel clinical strategies to mitigate these risks. PMID: 32579245 [PubMed - as supplied by publisher] (Source: Transfusion)
Source: Transfusion - June 23, 2020 Category: Hematology Authors: Kelly S, Belisário AR, Werneck Rodrigues DO, Carneiro-Proietti ABF, Gonçalez TT, Loureiro P, Flor-Park MV, Maximo C, Mota RA, Dinardo C, Brambilla D, Preiss L, Sabino E, Custer B, NHLBI Recipient Epidemiology Donor Evaluation Study (REDS-III) Internatio Tags: Transfusion Source Type: research
The impact of blood product ratio and procoagulant therapy on the development of thromboembolic events in severely injured hemorrhaging trauma patients.
Abstract INTRODUCTION: Transfusion therapy in hemorrhaging trauma patients is associated with the development of thromboembolic events. It is unknown whether current resuscitation strategies, including large volumes of plasma and early administration of procoagulant therapy, increases this risk. METHODS: A systematic search was conducted in MEDLINE, PubMed, and Embase. Studies were screened by two independent reviewers and included if they reported on thromboembolic events in patients with severe trauma (injury severity score ≥16) who received transfusion of at least 1 unit of red blood cells. The ratio by...
Source: Transfusion - June 23, 2020 Category: Hematology Authors: Wirtz MR, Schalkers DV, Goslings JC, Juffermans NP Tags: Transfusion Source Type: research
Performance characteristics of thromboelastometry assays using incompletely filled and prolonged stored samples.
CONCLUSION: Completely and half-filled samples, and completely filled samples after prolonged cold storage, produced normal ROTEM results. Tubes that are less than half-filled should not be used for ROTEM testing. PMID: 32478884 [PubMed - as supplied by publisher] (Source: Transfusion)
Source: Transfusion - May 31, 2020 Category: Hematology Authors: Paarup HM, Rasmussen MH, Yazer MH, Sprogøe U Tags: Transfusion Source Type: research
Blood transfusion preparedness for mass casualty incidents: Are we truly ready?
Authors: Stubbs JR, Jenkins DH Abstract Mass casualty incidents (MCI) are high profile contributors to the number of annual trauma-related deaths in the United States. A critical aspect of MCI care is the ability to provide blood components in sufficient types and quantities to prevent deaths due to hemorrhage. For transfusions to play an optimal role in the prevention of trauma-related hemorrhagic death, including MCI, there appears to be a very tight time window after injury to initiate transfusion therapy. In order to meet this tight window, blood components of appropriate numbers and quantities must be immediat...
Source: American Journal of Disaster Medicine - May 19, 2020 Category: International Medicine & Public Health Tags: Am J Disaster Med Source Type: research
Radioligand Therapy with 177Lu-PSMA-617 in Patients with Diffuse Bone Marrow Involvement: Safety and Efficacy Results
This study aims to assess safety and efficacy of RLT in a patient cohort presenting with diffuse bone marrow involvement. Methods: Twenty-nine patients with progressive metastatic prostate cancer and diffuse marrow involvement (dmi based on the PROMISE miTNM classification) were treated with RLT. A mean activity of 6.6± 1.1 GBq 177Lu-PSMA-617 was administered in a median of 4 treatment cycles (IQR 2 to 6) at standard intervals of 6-8 weeks. Mean cumulative activity was 29.7± 3.7 GBq. Hematological and renal parameters were measured at baseline, prior to each treatment course, 2-4 weeks thereafter and througho...
Source: Journal of Nuclear Medicine - May 14, 2020 Category: Nuclear Medicine Authors: Groner, D., Nguyen Ngoc, C., Davis, K., Happel, C., Baumgarten, J., Banek, S., Mandel, P., Gruenwald, F., Sabet, A. Tags: GU - Radioligand Therapy (Poster Session) Source Type: research
Systematic Review of Viscoelastic Testing (TEG/ROTEM) in Obstetrics and Recommendations from the Women's SSC of the ISTH.
Abstract Thromboelastography (TEG®) and rotational thromboelastometry (ROTEM®) are point-of-care viscoelastic devices that use whole blood samples to assess coagulation and fibrinolysis. These devices have been studied extensively in cardiac surgery, but there is limited robust evidence supporting its use in obstetrics. The hesitancy toward its routine use in obstetrics may be due to the current lack of randomized controlled trials and large observational studies. The study aims to systematically review studies that investigated TEG/ROTEM use in pregnancy or peripartum, and to provide recommendations for f...
Source: Thrombosis and Haemostasis - April 30, 2020 Category: Hematology Authors: Amgalan A, Allen T, Othman M, Ahmadzia HK Tags: J Thromb Haemost Source Type: research
Immunohematological Study of the First Pediatric Patient with the Bombay Phenotype in Medell ín, Colombia
We present a case of a pediatric patient with the Bombay phenotype who was carried to the emergency department of the Hospital Universitario San Vicente Fundaci ón in Medellín, Colombia. The patient presented gastrointestinal hemorrhage and required transfusion therapy. Pretransfusion and molecular immunohematological analyses identified the Bombay phenotype. (Source: Transfusion and Apheresis Science)
Source: Transfusion and Apheresis Science - April 24, 2020 Category: Hematology Authors: Catalina G ómez Piedrahita, Leidy Alejandra Toro Espinosa, Daniel Téllez Paz, Ana Claudia Perón, María Angélica Patiño Perez, Carlos Arturo Vallejo Rios Tags: Case Report Source Type: research
Patient and family experience with chronic transfusion therapy for sickle cell disease: A qualitative study
There is a limited understanding of the patient and family experience of Chronic Transfusion Therapy (CTT) for prevention of complications of Sickle Cell Disease (SCD). We sought to understand patient and fami... (Source: BMC Pediatrics)
Source: BMC Pediatrics - April 18, 2020 Category: Pediatrics Authors: Lauren M. Hawkins, Cynthia B. Sinha, Diana Ross, Marianne E. M. Yee, Maa-Ohui Quarmyne, Lakshmanan Krishnamurti and Nitya Bakshi Tags: Research article Source Type: research
Gender differences in blood transfusion strategy for patients with hip fractures - a retrospective analysis.
Conclusion: Over the course of five years, a restrictive transfusion strategy was implemented within clinical practice in patients undergoing surgery for hip fractures. In parallel, a significant reduction in the hospital LOS and an increased ICU LOS was noted. Whether there is an association between increased ICU LOS and decreasing hospital LOS and whether there is a gender effect on transfusion requirements in patients with surgery for hip fractures should be subject to further research. PMID: 32210711 [PubMed - in process] (Source: International Journal of Medical Sciences)
Source: International Journal of Medical Sciences - March 28, 2020 Category: Biomedical Science Tags: Int J Med Sci Source Type: research
Effects of repleting organic phosphates in banked erythrocytes on plasma metabolites and vasoactive mediators after red cell exchange transfusion in sickle cell disease.
DISCUSSION: In summary, treatment of RBCs with PIPA prior to RCE elicited favourable or neutral changes in key metabolic and vascular biomarkers. Further study of its efficacy and safety is recommended and could ultimately serve to improve outcomes in chronically transfused SCD patients. PMID: 32203007 [PubMed - as supplied by publisher] (Source: Blood Transfusion)
Source: Blood Transfusion - March 16, 2020 Category: Hematology Authors: Lopez Domowicz DA, Welsby I, Esther CR, Zhu H, Marek RD, Lee G, Shah N, Poisson JL, McMahon TJ Tags: Blood Transfus Source Type: research
Successful prevention of severe allergic transfusion reactions with omalizumab.
CONCLUSION: This case suggests that omalizumab is a promising new alternative treatment for the prevention of severe ATRs. PMID: 32134497 [PubMed - as supplied by publisher] (Source: Transfusion)
Source: Transfusion - March 4, 2020 Category: Hematology Authors: Shi S, Han J, Yao Y, Xu Y, Wu D, Wang Y Tags: Transfusion Source Type: research
Do Recent Randomized Trial Results Influence which Patients with Myelodysplastic Syndromes Receive Iron Chelation?
Abstract Iron overload (IOL) in patients with myelodysplastic syndromes (MDS) is mainly attributable to chronic transfusion therapy. The importance of iron chelation therapy (ICT) in MDS has been a matter of debate. The Telesto study, the only randomized, placebo-controlled trial of ICT with deferasirox in MDS, showed improved event-free survival with ICT in patients with lower-risk MDS. Although Telesto was not powered to detect differences between deferasirox and placebo for single-event categories of the composite primary endpoint for event-free survival, results are consistent with the view that iron-related c...
Source: The Medical Clinics of North America - February 26, 2020 Category: General Medicine Authors: Gattermann N Tags: Hematol Oncol Clin North Am Source Type: research
Evaluation and monitoring of response to platelet transfusion therapy: experience from a tertiary care center
. (Source: Acta Clinica Belgica)
Source: Acta Clinica Belgica - February 21, 2020 Category: General Medicine Authors: Deepika Chenna Shamee Shastry Poornima Baliga Source Type: research
Do Recent Randomized Trial Results Influence which Patients with Myelodysplastic Syndromes Receive Iron Chelation?
Iron overload (IOL) in patients with myelodysplastic syndromes (MDS) is mainly attributable to chronic transfusion therapy. The importance of iron chelation therapy (ICT) in MDS has been a matter of debate. The Telesto study, the only randomized, placebo-controlled trial of ICT with deferasirox in MDS, showed improved event-free survival with ICT in patients with lower-risk MDS. Although Telesto was not powered to detect differences between deferasirox and placebo for single-event categories of the composite primary endpoint for event-free survival, results are consistent with the view that iron-related cardiac dysfunction...
Source: Hematology/Oncology Clinics of North America - January 20, 2020 Category: Cancer & Oncology Authors: Norbert Gattermann Source Type: research
Low dose Iloprost effect on platelet aggregation in comatose out-of-hospital cardiac arrest patients: A predefined sub-study of the ENDO-RCA randomized -phase 2- trial
Publication date: Available online 30 December 2019Source: Journal of Critical CareAuthor(s): A.S.P. Meyer, S.R. Ostrowski, J. Kjærgaard, M. Frydland, J.H. Thomsen, P.I. Johansson, C. HassagerAbstractPurposeThis is a predefined sub-study of the Endothelial Dysfunction in Resuscitated Cardiac Arrest (ENDO-RCA) trial. We aim to investigate Iloprost, a prostacyclin analogue, safety by evaluating change in whole blood platelet aggregometry (Multiplate) in out of hospital cardiac arrest (OHCA) patients from baseline to 96-h post randomization.MethodsA randomized, placebo controlled double-blinded trial in 46 OHCA patients...
Source: Journal of Critical Care - December 31, 2019 Category: Gastroenterology Source Type: research
Complications in pregnant women with sickle cell disease.
Authors: Smith-Whitley K Abstract Pregnancy in women with sickle cell disease (SCD) is associated with increased maternal and fetal morbidity and mortality. Outcomes vary widely owing to methodological limitations of clinical studies, but overall, hypertensive disorders of pregnancy, venothromboembolism, poor fetal growth, and maternal and perinatal mortality are increased globally. Few therapeutic interventions have been explored other than prophylactic and selective transfusion therapy. Unfortunately, existing data are limited, and it remains unclear whether prophylactic use of chronic transfusions will improve p...
Source: Hematology ASH Education Program - December 7, 2019 Category: Hematology Tags: Hematology Am Soc Hematol Educ Program Source Type: research
Clinical decision support and improved blood use in patient blood management.
We describe our own institutional experience using a targeted CDS to promote restrictive blood transfusion practice and to improve RBC use. A 42% reduction in RBC transfusions was demonstrated at our institution from a baseline in 2008 through 2015, and the rate remained stable through 2018. Although the data cannot be used to infer causality, this decreased RBC use was accompanied by improved clinical outcomes. PMID: 31808902 [PubMed - in process] (Source: Hematology ASH Education Program)
Source: Hematology ASH Education Program - December 7, 2019 Category: Hematology Tags: Hematology Am Soc Hematol Educ Program Source Type: research
How do I incorporate red cell genotyping to improve chronic transfusion therapy?
CONCLUSION: We demonstrate how a CTTP can be developed in a community hospital through collaboration with the blood supplier, hospital, and clinical care team. A model of incorporating RBC genotyping informs risk for alloimmunization and allows consideration of transfusion strategy for providing prophylactic antigen matched blood. PMID: 31758587 [PubMed - as supplied by publisher] (Source: Transfusion)
Source: Transfusion - November 22, 2019 Category: Hematology Authors: Van Buren NL, Gorlin JB, Corby SM, Cassidy S, FritchLilla S, Nelson SC, Westhoff CM Tags: Transfusion Source Type: research
Indications for RBC Exchange Transfusion in Patients with Sickle Cell Disease: Revisited.
DISCUSSION: In the 1980s and 1990s we used the Haemonetics Corporation's V-50 machine to perform intermittent whole blood (WB) exchange to treat severe complications of sickle cell disease (SCD.) The results were excellent, as previously described . PMID: 31882437 [PubMed - in process] (Source: Annals of Clinical and Laboratory Science)
Source: Annals of Clinical and Laboratory Science - October 31, 2019 Category: Laboratory Medicine Authors: Ballas SK Tags: Ann Clin Lab Sci Source Type: research
Catastrophic Delayed Hemolytic Transfusion Reaction in a Patient With Sickle Cell Disease Without Alloantibodies: Case Report and Review of Literature
While packed red blood cell (PRBC) transfusion therapy is a mainstay in the treatment of certain patients with sickle cell disease (SCD) and the standard of care for preoperative management, there are associated risks. Delayed hemolytic transfusion reaction (DHTR) is a risk of PRBC transfusion occurring 2 to 20 days from transfusion and typically presents with severe pain characteristic of vaso-occlusive crisis, fever, and hemolytic anemia. DHTRs are uncommon, occurring in only 4% to 11% of transfused patients with SCD, but may be catastrophic in nature with progression to multiorgan failure within hours. Here, we describe...
Source: Journal of Pediatric Hematology Oncology - October 23, 2019 Category: Hematology Tags: Clinical and Laboratory Observations Source Type: research
Effect of Sickle Cell Anemia Therapies on the Natural History of Growth and Puberty Patterns
As pediatric patients with sickle cell anemia (SCA) have impaired growth and puberty patterns, we studied the effect of disease-modifying therapies on growth and puberty patterns for patients with SCA receiving hydroxyurea (HU), transfusions, or no therapy. We performed a retrospective study of children with SCA in whom anthropometric measurements and therapy type were recorded. Penalized smoothing splines were fitted to estimate growth curves and growth velocity, and linear mixed models were used to examine differences across treatment groups. Across group analyses were divided into early childhood (4.0 to 7.9 y) a...
Source: Journal of Pediatric Hematology Oncology - October 23, 2019 Category: Hematology Tags: Original Articles Source Type: research
Cost Analysis of Transfusion Therapy in Coronary Artery Surgery.
Abstract BACKGROUND: In patients undergoing coronary artery bypass grafting (CABG), wide variability in transfusion rate (7.8% to 92.8%) raises the question of the amount of unnecessary transfusions. The aim of the study was (1) to identify CABG patients at low risk of bleeding to whom transfusion treatment should be avoided and (2) to calculate the amount of possible cost savings that would be achieved by avoiding transfusion in low bleeding risk patients. METHODS: This retrospective observational study enrolled patients undergoing isolated elective CABG from January 2010 to January 2018. Patient...
Source: The Thoracic and Cardiovascular Surgeon - October 10, 2019 Category: Cardiovascular & Thoracic Surgery Authors: Petricevic M, Petricevic M, Pasalic M, Cepulic BG, Raos M, Dujmic D, Kalamar V, Mestrovic V, Gasparovic H, Vasicek V, Goerlinger K, Biocina B Tags: Thorac Cardiovasc Surg Source Type: research
Cost Analysis of Transfusion Therapy in Coronary Artery Surgery
Thorac cardiovasc Surg DOI: 10.1055/s-0039-1697600 Background In patients undergoing coronary artery bypass grafting (CABG), wide variability in transfusion rate (7.8% to 92.8%) raises the question of the amount of unnecessary transfusions. The aim of the study was (1) to identify CABG patients at low risk of bleeding to whom transfusion treatment should be avoided and (2) to calculate the amount of possible cost savings that would be achieved by avoiding transfusion in low bleeding risk patients. Methods This retrospective observational study enrolled patients undergoing isolated elective CABG from January...
Source: The Thoracic and Cardiovascular Surgeon - October 10, 2019 Category: Cardiovascular & Thoracic Surgery Authors: Petricevic, Mirna Petricevic, Mate Pasalic, Marijan Cepulic, Branka Golubic Raos, Mirela Dujmic, Dora Kalamar, Viktor Mestrovic, Vice Gasparovic, Hrvoje Vasicek, Vesna Goerlinger, Klaus Biocina, Bojan Tags: Original Cardiovascular Source Type: research
Allogeneic red cell transfusion and its influence on relevant humoral and cellular immunological parameters: A prospective observational trial
CONCLUSION Our data indicate that red cell transfusion alone does not create an immunological response in otherwise healthy surgical patients. Our findings do not generally contradict the transfusion-related immunomodulation phenomenon, which has, however, primarily been observed in patients with an already weakened or procedure-deteriorated immune system, such as from malignant disease, significant comorbidity, extensive abdominal/thoracic surgery and cardiopulmonary bypass. TRIAL REGISTRATION The study was registered on 15 May 2014, before enrolment of the first patient, at www.ClinicalTrials.gov, NCT02140216. (Sour...
Source: European Journal of Anaesthesiology - October 7, 2019 Category: Anesthesiology Tags: Coagulation Source Type: research
Mechanisms of alloimmunization in sickle cell disease
Purpose of review Red blood cell (RBC) transfusion is an important treatment for some complications of sickle cell disease (SCD). On the contrary, transfusion may lead to alloimmunization to RBC antigens, with such alloantibodies putting patients at risk for acute or delayed hemolysis, and increasing the difficulty of finding compatible RBCs. Patients with SCD are more susceptible to developing RBC alloantibodies than other multiply transfused patient populations, for reasons that are not completely understood. In this review, we summarize the available data about risk factors and underlying mechanisms associated with RB...
Source: Current Opinion in Hematology - October 4, 2019 Category: Hematology Tags: TRANSFUSION MEDICINE AND IMMUNOHEMATOLOGY: Edited by Steven L. Spitalnik Source Type: research
Echocardiographic Screening of Cardiovascular Status in Pediatric Sickle Cell Disease
In conclusion, mild RV pressure elevation and LV dilation in children with SCD is associated with abnormal laboratory markers of disease severity, but not with ventricular dysfunction over the 3-year study period. (Source: Pediatric Cardiology)
Source: Pediatric Cardiology - September 20, 2019 Category: Cardiology Source Type: research
Splenectomy for people with thalassaemia major or intermedia.
CONCLUSIONS: The review was unable to find good quality evidence, in the form of randomised controlled studies, regarding the efficacy of splenectomy for treating thalassaemia major or intermedia. The single included study provided little information about the efficacy of splenectomy, and compared open surgery and laparoscopic methods. Further studies need to evaluate the long-term effectiveness of splenectomy and the comparative advantages of surgical methods. Due to a lack of high quality evidence from randomised controlled studies, well-conducted observational studies may be used to answer this question. PMID: 3152...
Source: Cochrane Database of Systematic Reviews - September 16, 2019 Category: General Medicine Authors: Sharma A, Easow Mathew M, Puri L Tags: Cochrane Database Syst Rev Source Type: research
Transfusion as a Palliative Strategy
AbstractPurpose of ReviewThe palliative care population is a complex and heterogeneous one. While transfusion therapy is a readily available intervention for many patients, inadequate knowledge for accurately identifying which patient subsets at end-of-life will benefit from a transfusion, along with an unclear understanding of the magnitude of attendant risks of transfusion in those receiving palliative care, complicates the risk-benefit assessment of this therapy. In this brief review, the current literature surrounding transfusion of red cells and platelets in the palliative care patient population will be reviewed and ...
Source: Current Oncology Reports - August 29, 2019 Category: Cancer & Oncology Source Type: research
Perioperative Anemia Management as Part of PBM in Cardiac Surgery – A Narrative Updated Review
Anemia is common in patients with cardiac disease. Iron deficiency is the cause of anemia in about 80% of all cases. Preoperative anemia is associated with an increased morbidity and mortality in patients undergoing cardiac surgery. The risk of receiving red blood cell transfusions, which are potentially associated with severe side effects, is very high in these patients. Patient Blood Management (PBM) is a multidisciplinary approach to manage anemia, minimize unnecessary blood loss, and optimize transfusion therapy. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - August 5, 2019 Category: Anesthesiology Authors: Patrick Meybohm, Sabine Westphal, Hanne Berg Ravn, Marco Ranucci, Seema Agarwal, Suma Choorapoikayil, Donat R. Spahn, Aamer B. Ahmed, Bernd Froessler, Kai Zacharowski Tags: Review Article Source Type: research
Bleeding with negative coagulation screening test as initial presentation of chronic myelogenous leukemia managed by fresh frozen plasma: A case report
Introduction: Chronic myelogenous leukemia (CML), a clonal disorder of pluripotent stem cell, rarely presents with bleeding in chronic phase due to the function preservation of the platelets. Factor (F) XIII deficiency, an extremely rare hemorrhagic disease, can cause fatal bleeding, which has been previously described in autoimmune disorders and leukemias. Patient concerns: A 38-year-old woman with a 20-day history of spontaneous subcutaneous hemorrhage visited our hospital, who presented with intracranial hemorrhage, hematuria, and delayed hematoma after a bone marrow puncture. Initial management included cytogeneti...
Source: Medicine - August 1, 2019 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
Patient Blood Management: transfusion appropriateness in the post-operative period.
This study aimed to evaluate the appropriateness of RBC transfusion therapy in the post-operative period, before and after starting a multifactorial PBM policy. MATERIALS AND METHODS: A 2-phase observational study was conducted on patients who underwent major surgery. The study was designed as follows: 3 months of preliminary audit, followed by multifactorial PBM policy, and a final audit. The policy comprised seminars, teaching lessons, periodic consultations and the insertion of Points of Care. RBC transfusion appropriateness was evaluated in both audits. RESULTS: The preliminary audit, performed on 168 patient...
Source: Blood Transfusion - July 9, 2019 Category: Hematology Authors: Di Bartolomeo E, Merolle L, Marraccini C, Canovi L, Berni P, Guberti M, Mazzi A, Bonini A, Romano N, Magnani A, Pertinhez TA, Baricchi R Tags: Blood Transfus Source Type: research
Comparison of efficacy of low and high dose prophylactic platelet transfusion therapy in thrombocytopenic haemato-oncology patients
(Source: Transfusion and Apheresis Science)
Source: Transfusion and Apheresis Science - July 9, 2019 Category: Hematology Authors: Yashaswi Dhiman, Rekha Hans, Ratti Ram Sharma, Pankaj Malhotra, Neelam Marwaha Source Type: research
Chronic pain persists in adults with sickle cell disease despite regular red cell transfusions
Pain affects over 50% of adults with sickle cell disease (SCD), and this pain is largely managed outside of the hospital. While chronic transfusion therapy is used to decrease the rate of acute pain events in patients with SCD, less is known about its impact on the day-to-day experience of pain. To address this knowledge gap, we provided pain diaries to patients with SCD receiving chronic transfusion. (Source: Transfusion and Apheresis Science)
Source: Transfusion and Apheresis Science - July 8, 2019 Category: Hematology Authors: Matthew S. Karafin, Danielle E. Mullins, Susan T. Johnson, Debora Nischik, Mingen Feng, Pippa Simpson, Joshua J. Field Source Type: research
Invasive Yersiniosis in a Pediatric Patient With β-Thalassemia Major: Acute Decompensation After Rapid Blood Transfusion
Yersinia enterocolitica infection, or yersiniosis, is a common cause of gastroenteritis in developing nations, but the disease is less common in the developed world. Yersiniosis typically presents as a self-limited gastroenteritis in an immunocompetent patient and rarely progresses to the more fulminant disseminated form. Certain patient populations are at greater risk of disseminated disease, and providers caring for these patients should have heightened suspicion for invasive disease. Patients dependent on serial transfusion therapy, such as those with inherited hemoglobinopathies, often have chronically elevated serum i...
Source: Pediatric Emergency Care - July 1, 2019 Category: Emergency Medicine Tags: Illustrative Cases Source Type: research
Guest editorial of the theme section: Patient blood management
The balance between life-saving transfusion and avoidable transfusion is the real state-of-the art of transfusion medicine. This theme section includes current knowledge of an interdisciplinary group of experts in the field of patient blood management (PBM). Surgeons, anesthesiologists, hematologists, pediatrics, internists and transfusion medicine specialists met a couple of years ago and founded a network for advancement of transfusion alternatives (NATA). The aim of the network was to optimize transfusion therapy thereby improving safety of transfusion. (Source: Transfusion and Apheresis Science)
Source: Transfusion and Apheresis Science - June 24, 2019 Category: Hematology Authors: Rainer Moog Tags: Editorial Source Type: research
Extracellular Ubiquitin is the Causal Link between Stored Blood Transfusion Therapy and Tumor Progression in a Melanoma Mouse Model
Conclusions: The present findings provide novel insights into the role of ubiquitin in immune regulation in a melanoma mouse model, and suggest ubiquitin as the causal link between allogeneic blood transfusion therapy and poor cancer prognosis. (Source: Journal of Cancer)
Source: Journal of Cancer - June 13, 2019 Category: Cancer & Oncology Authors: Jingjun Zhang, Shuying Chen, Yuzhong Yan, Xinfang Zhu, Qi Qi, Yang Zhang, Qi Zhang, Rong Xia Tags: Research Paper Source Type: research
Hydroxyurea reduces cerebral metabolic stress in patients with sickle cell anemia
Chronic transfusion therapy (CTT) prevents stroke in selected patients with sickle cell anemia (SCA). We have shown that CTT mitigates signatures of cerebral metabolic stress, reflected by elevated oxygen extraction fraction (OEF), which likely drives stroke risk reduction. The region of highest OEF falls within the border zone, where cerebral blood flow (CBF) nadirs; OEF in this region was reduced after CTT. The neuroprotective efficacy of hydroxyurea (HU) remains unclear. To test our hypothesis that patients receiving HU therapy have lower cerebral metabolic stress compared with patients not receiving disease-modifying t...
Source: Blood - May 29, 2019 Category: Hematology Authors: Fields, M. E., Guilliams, K. P., Ragan, D., Binkley, M. M., Mirro, A., Fellah, S., Hulbert, M. L., Blinder, M., Eldeniz, C., Vo, K., Shimony, J. S., Chen, Y., McKinstry, R. C., An, H., Lee, J.-M., Ford, A. L. Tags: Sickle Cell Disease, Red Cells, Iron, and Erythropoiesis Source Type: research
Critical developments of 2018: A review of the literature from selected topics in transfusion. A committee report from the AABB's Clinical Transfusion Medicine Committee.
CONCLUSION: This synopsis may be a useful educational tool. PMID: 31148175 [PubMed - as supplied by publisher] (Source: Transfusion)
Source: Transfusion - May 29, 2019 Category: Hematology Authors: Cohn CS, Allen ES, Cushing MM, Dunbar NM, Friedman DF, Goel R, Heddle N, Hopkins CK, Klapper E, Perumbeti A, Ramsey G, Raval JS, Schwartz J, Shaz BH, Spinella PC, Pagano MB Tags: Transfusion Source Type: research