Search results for “transfusion”

Bridging Gaps in Blood Transfusion Services through Collaborative Healthcare Systems in Cameroon: The Cornerstone University Blood Management System version 1.0

The rising need for structured and efficient blood transfusion services in low-resource settings has driven the adoption of collaborative blood transfusion management systems (CBTMS). This study explores the functionality and impact of the Cornerstone University Blood Management System version 1.0 (CUBMS vs 1.0) in Cameroon. This study was an exploratory research design which used a system interface analysis, comparative case reviews from four countries, and literature synthesis, to reveal that CUBMS improves accessibility, data management, inventory control, emergency responsiveness, and community engagement. Despite infrastructural challenges in rural regions, the system can enhance efficiency, transparency, and safety in blood services. The success of CBTMS in Cameroon is linked to digital infrastructure, training, and culturally relevant community engagement. The Ministry of Public Health of Cameroon should prioritize the nationwide implementation of CBTMS, ensuring consistency in digital health tools.

RETRACTED: Assessment of the Risk of Hemochromatosis in Polytransfused Sickle Cell Patients at the Abidjan Transfusion Therapy Unit

This article has been retracted on 29 January 2021. VIEW THE RETRACTION NOTICE (https://doi.org/10.14302/issn.2372-6601.jhor-25-5854) In Côte d'Ivoire, sickle cell disease affects 14% of the population. It is responsible for significant morbidity and mortality. Transfusion is a significant element in the management of major sickle cell anemia, which exposes them to post-transfusion hemochromatosis. The biological diagnosis is based on the determination of serum iron and the transferrin saturation coefficient (CST). As the determination of the CST was not available in our exercise context in Côte d'Ivoire, we determined only the ferritinemia. The interest of this work lies in the therapeutic implication linked to the identification of patients at risk of hemochromatosis because chelators are difficult to access for most patients. This was a prospective, descriptive and analytical study, on polytransfused sickle cell patients, followed at the transfusion therapy unit (UTT) of the CNTS of Abidjan, from 2010 to 2018. We included 78 sickle cell patients, all ages and genders who have received at least ten transfusions. The ferritinemia assay was carried out by ELISA. Transfusion exchange, with 59% of cases, was the most used mode of transfusion. The mean ferritinemia was 1719.19 ng / ml. Hyperferritinemia was found in 63% of patients. Most of the patients were on a long-term transfusion program with an average of 27.5 bags of red blood cell concentrates. Thirty-two patients had received at least 20 bags of red blood cell concentrates. We noted 21 patients treated, including 3 with deferoxamine and 18 treated with oral deferasirox. We have identified 33 sickle cell anemia patients at risk for hemochromatosis. The determinants of the risk of hemochromatosis were the high number of blood bags and the method of transfusion.

Retraction Note: Assessment of the Risk of Hemochromatosis in Polytransfused Sickle Cell Patients at the Abidjan Transfusion Therapy Unit

Exploring the Correlation between Glucose and Apoptosis Levels in Stored Platelets

Background and Objectives Platelets are small, anucleate blood cells produced in the bone marrow, primarily involved in blood coagulation. Platelet concentrate is a vital blood product with extensive applications. However, its short lifespan and limited donor availability pose global challenges. This study aimed to follow the trend of platelets 5 during days of storage. Material and Methods We studied on 40 platelet bags and analyzed glucose levels, lactate dehydrogenase (LDH), bacterial culture, and apoptosis using flow cytometry with Annexin V-PI over three consecutive days (first, third, and fifth) post-blood collection. Data were analyzed using SPSS. Results No significant correlations were found between age, blood group, or gender and the variables studied. No bacterial growth was detected. Glucose levels decreased significantly from day 1 (382 mg/dl) to day 5 (298 mg/dl). The average platelet apoptosis increased significantly from 3.65% on day 1 to 9.06% on day 5. Significant correlations were observed between glucose levels and apoptosis on days 3 (p<0.05) and 5 (p<0.01). No correlation found between LDH and apoptosis or necrosis, although a significant relationship between necrosis and apoptosis was noted on day 5 (p=0.003). Conclusion These findings suggest that while demographic factors do not influence the studied variables, the significant decrease in glucose levels correlates with increased platelet apoptosis over time, highlighting potential metabolic interactions that warrant further investigation.   Highlights 1. The study revealed subtle variations in metabolic markers related to donor demographics, particularly gender and age. Understanding these differences can inform targeted donor selection strategies to optimize platelet quality. 2. A significant negative correlation was found between glucose levels and apoptosis rates, indicating that as glucose decreases, platelet viability declines. This relationship highlights the need for careful monitoring of glucose levels during storage to maintain platelet function. 3. Fluctuations in lactate dehydrogenase (LDH) levels were correlated with increasing rates of apoptosis, suggesting that LDH could serve as a valuable biomarker for assessing platelet quality throughout the storage period. This finding could lead to improved storage protocols and enhanced transfusion safety.

ANH in Complex Cardiac Surgery: A Prospective Randomized Study

Objectives Blood transfusions in cardiac surgery are associated with increased morbidity and mortality. The purpose of this study is to identify potential benefits of ANH in high-risk cardiac surgery. Design This was a prospective, randomized, controlled study. Setting The study was performed at a tertiary care university hospital. Participants 61 patients who underwent complex cardiac surgery with cardiopulmonary bypass (CPB) were enrolled in the study. Measurements and Main Results After randomization, 32 patients were assigned to the ANH arm, and 29 patients were assigned to the control group. ANH was associated with a lower incidence of total perioperative pRBC transfusion (0.6 ± 1.2 units vs 2.7 ± 6.8 units; p = 0.030/0.049). Total perioperative transfusion of all other fractionated blood products, including platelets (0.8 ± units vs 1.9 ± 2.4 units; p=0.010), cryoprecipitate (0.5 ± 0.7 vs 1.3 ± 2.0; p=0.016) and FFP (0.5 ± 1.0 vs 2.3 ± 6.2 units; p=0.013), was significantly lower in the ANH group compared to controls. Participants in the ANH group received significantly fewer intraoperative transfusions of pRBC (0.4 ± 1.2 vs 2.6± 7.0 units; p=0.037), platelets (0.8 ± 1.2 units vs 1.9 ± 2.4 units; p=0.013, logtrans), FFP (0.4 ± 0.9 vs 2.5 ± 6.4 units; p=0.003) and cryoprecipitate (0.5 ± 0.7 vs 1.3 ± 2.1 units; p=0.012, logtrans). With respect to secondary clinical outcomes, ANH participants had statistically shorter ICU (3.7 ± 1.9 vs 5.4 ± 3.6 days; p=0.020) and hospital (6.7 ± 2.1 vs 9.5 ± 7.7 days; p = 0.048) length of stays Conclusions ANH in complex cardiac surgical patients is safe and may be effective in reducing the allogenic blood product transfusion of PRBCs, FFP, platelets and cryoprecipitate in the perioperative period.

Duffy Red Cell Antigen Phenotype among Indigenous Pregnant Women attending Antenatal Clinic at Federal Teaching Hospital Gombe, Gombe State, North Eastern Nigeria

Background and Objectives Duffy (FY) blood group system is implicated in transfusion incompatibilities and haemolytic disease of the foetus and newborn (HDFN). The primary objective was to determine the Duffy phenotype among indigenous pregnant women in Gombe, Gombe State, Nigeria. Materials and Methods This was a Cross sectional study where simple random sampling was employed on consented participants. Two hundred and fifty nine pregnant women attending antenatal clinic at Federal Teaching Hospital Gombe were randomly recruited into the study. About 3mls of blood was taken, and Duffy antigen typed by standard tube technique (LORNE LABORATORY UK). Results Among the Indigenous tribe, the percentage of Fy(a+b+) was seen in 2.2% of Fulani and 3.4% of Tangale, Fy(a+b-) phenotype was seen in 4.3% of Tangale, 6.8% of Fulani,9.5% of Tera, 10.3% of Hausa and 10.5% of Waja. Fy(a-b+) phenotype was seen in 5.3% of Waja, 7.6% of Fulani,8.7% of Tangale, 9.5% of Tera and 12.5% of Bolawa. Fy(a-b-) phenotype was seen in 2.4% of Tula,6.4% of Bolawa,7.3% of Waja, 7.8% of Tera, 17.8% of Tangale, 11.8% of Hausa and 46.5% of Fulani. About 84.6% of the study population had the null Duffy phenotype. Conclusion The research showed the phenotypic distribution of Duffy blood group among the study participants with relatively high percentage of null Duffy phenotype hence possible risk of alloimmunisation.

Prolonged survival of Diamond-Blackfan anemia and RPS19 mutation: an observation in Togo

Objective Drawing up a balance sheet of 16 years follow-up of the sole case of Diamond-Blackfan anemia diagnosed in Togo with arguments of molecular biology. Observation T.S a boy, born on 5th september 2006 has been followed up since he was three months, for Diamond-Blackfan anemia (DBA) in whom there has been found the mutation of ribosomial protein RPS19 in july 2010. It was the first observation in Subsaharian Africa. The treatment by transfusions from december 2006 to december 2022 has been associated with iron chelation through deferoxamin and promptly with corticotherapy at the dosage of 2mg/kg/day. The corticotherapy has been reduced as a consequence of corticoresistance from the fourth week, then definitely interrupted after four months. The evolution is marked by a clinical improvement with a staturo-balanced curve, and during the last control of 28th december 2022, the child was 53 kg heavy and 160 cm tall. The monthly physical tests did not reveal any signs of eventual overloading and the echocardiography of 26th december 2022 was normal. On the biological plan, the rate of the haemoglobin had been stable around 50g/l as a resultant of a transfusion each 4 to 6 weeks of red blood cell pellet. The chelation of iron had been done through deferoxamin with a monthly control of serum ferritin. That serum ferritin was 738,39ng/mg at diagnosis before the beginning of transfusions and during the follow-up, we noticed an average of 2977,3ng/ml (range 1817,1ng/ml and 4448,5ng/ml) Conclusion Thanks to the regular transfusions derived from the survey of the parameters of iron and the use of deferoxamin, we have succeded in keeping alive during sixteen years a patient who caught a disease whose evolution is unpredictable.

Rosenthal's Disease (Hemophilia C or factor XI Deficiency) Revealed by Chronic Epistaxis: The First Observation in Sub-Saharan Africa.

Objective Rosenthal's disease (RD) is a rare constitutional hemorrhagic disorder defined by factor XI deficiency. It is clinically characterized by the presence of minimal haemorrhage. We report the first observation of RD in Togo. Observation Mrs. G. A., 45 years old with no particular pathological antecedents, was referred for anemia in a context of chronic epistaxis. It was a spontaneous anterior exteriorization epistaxis often of great abundance, rocking and which evolved episodically. The patient received several transfusions for anemia. The ear-nose-throat examination was normal and a sinus CT scan found only an inflammatory process of the right maxillary sinus. The blood count showed microcytic severe anemia (2,2g/dl). Hemostasis tests showed a prolonged aPTT (57,9 seconds). Clinical examination documented an anemic syndrome with dry skin. Iron deficiency was found. The hemostasis balance confirmed aPTT elongation. Coagulation factors activity showed normal VIII and IX level, but moderate decrease of factor XI (32%). The family survey was not possible (orphan patient). It is recommended the setting under fresh frozen plasma (FFP) in case of a new episode. Follow-up is in progress. Conclusion In the event of any hemorrhagic syndrome, the isolated elongation of the aPTT must lead to a systematic analysis of intrinsic pathway factors

Lenalidomide-Induced High Grade Fever in a Patient with Multiple Myeloma: A Case Report

Lenalidomide is a second generation immunomodulatory agent and a potent analogue of thalidomide that is FDA approved mainly for the treatment of multiple myeloma (MM) and transfusion-dependent anemia due to low or intermediate-1- risk myelodysplastic syndromes (MDS) associated with 5q deletion among other indications. Through its action on the immune system, lenalidomide alters the production of different cytokines ultimately resulting in immune activation against tumors. This immune activation may lead to collateral immune toxicities like fever, angioedema, Stevens-Johnson syndrome, tumor flare and others. Here we report a case of lenalidomide-induced high grade fever in a patient with MM and we summarize the literature about the physiology of such reaction and how to mitigate this adverse event.

Evaluation of Blood Ordering Practice for Packed Red Blood Cells in A Tertiary Care Hospital

Introduction: Blood is a valuable resource and blood transfusion is life saving in many situations. However blood transfusions carry the risk of transfusion transmitted infections, allergic reactions, hemolytic reactions and introduction of foreign antigens. So monitoring of blood transfusion practice is necessary for the rationale use of blood components. The aim of this study was to evaluate the appropriateness of blood ordering practice for Packed Red Blood Cells (PRBC) as per National Blood Transfusion Guidelines. Materials & Methods: The study was conducted in a tertiary care hospital in Tamilnadu. A total of 4236 blood request forms were analyzed over a period of 12 months. Number of units requested were noted and the appropriateness of the requested transfusion was assessed according to the National guidelines on transfusion 3. Request forms of neonates and children up to 18 years of age (in whom Transfusion guidelines are different) were excluded from the study. Cross match to Transfusion ratio (CT ratio) was also calculated. Results: A total of 4236 blood request forms were analyzed out of which 76.6 % (n=3246) were for PRBC, and hemoglobin values were mentioned in 68.8% (n=2235) and not mentioned in 31.2% (n=1011) of request forms. Anemia, surgery and bleeding were the most common indications for which transfusions were requested. There were 3246 PRBC requests out of which 53.5% (n=1736) requests were considered appropriate, 38.6% (n=1254) were considered inappropriate and 7.9% (n=256) requests could not be assessed due to inadequate details on Hemoglobin and clinical relevance. CT ratio was 1.5. Conclusion: In this study, it was noted that significant percentage (38.6%) of inappropriate PRBC transfusions were given and 7.9% forms could not be assessed due to inadequate investigation details. Regular audits and CMEs should be conducted in this hospital to rationalize the use of blood components.

Application of Nanotechnology for the Preservation of Red Blood Cells

This study was devoted to the learning of the use of nanotechnology to correct the functional activity of red blood cells (RBCs) at the storage stages at a positive temperature. It was established that saline NaCl, which had previously been processed by magnetite nanoparticles (ICNB) had a marked membrane-stabilizing effect, inhibits hemolysis and increasing the sedimentation stability of preserved RBCs. The complex analysis of the obtained data allowed to determine the primary mechanisms effect of the saline NaCl, which had previously been processed by ICNB on the preserved RBCs. The proposed method of additive modernization of preserved RBCs was adapted to the production process. The optimization results were obtained in creating a simple and practical method of additive modernization of preservation solutions that does not violate the compliance requirements, improves the quality, efficiency and safety transfusion of RBCs.

Identification of Eyes At Risk for Severe Retinopathy of Prematurity (ROP) by Third Year Ophthalmology Residents in a Tertiary Hospital

Objective: The aim of the present study is to determine the efficiency of third year ophthalmology residents from a tertiary hospital in performing preliminary retinal examination to identify eyes at risk retinopathy of prematurity on the basis of retinal fundus findings up to International Classification of Retinopathy of Prematurity (ICROP) Zone II. Methods: This is a single-center, cross-sectional, prospective comparative research conducted from June to October 2015 at a tertiary training hospital in the Philippines. All infants referred for retinopathy of prematurity screening within the study period where included. The presence of retinal vessel dilatation and tortuosity were identified by third year ophthalmology residents using indirect funduscopy. The residents’ fundus findings were then compared to that of a retina consultant who is proficient in the diagnosis and management of retinopathy of prematurity (ROP). The Kappa index was used to rate inter-observer agreement. The correlation between ROP risk factors and the presence of abnormal retinal vessels were assessed using odd ratio computations. Fisher’s exact test was used to determine the correlation between retinopathy of prematurity and the presence of retinal dilatation and tortuosity. The McNemar’s test was also applied to determine significant differences in the retinal findings of the consultant and ophthalmology residents. Results: A total of 82 eyes of 41 premature infants were evaluated to determine if retinal findings observed by ophthalmology residents were comparable to that of a retina consultant. Odds ratios show that age of gestation, birth weight, and history of blood transfusion are significantly associated with the presence of retinopathy of prematurity. Retinal vessel tortuosity and dilatation are also more common among infants diagnosed with retinopathy of prematurity. There was no significant difference between the retinal vascular findings of the retina consultant and the third year ophthalmology resident in terms of identifying retinal vessel dilatation and tortuosity (P < 0.05). Conclusion: After sufficient and in-depth ophthalmology training, third year ophthalmologists, who will be general ophthalmologists in the future, can reliably identify eyes at risk for severe retinopathy of prematurity on the basis of retinal vascular dilatation and/or tortuosity.  

Blood Donation and Misconceptions- A Nationwide Survey in Dental Hospitals of Pakistan

Background Blood donation is a common practice in many countries of the world and it benefits many of the people suffering from conditions which require blood transfusions. The blood donated should be appropriately screened for certain infectious diseases such as HIV/AIDS, Hepatitis B, Syphilis and Gonorrhea through serological tests. Materials and Methods This cross sectional study was conducted from January 2014 to August 2014, Data was collected from eight dental hospitals in four provinces of Pakistan. Attendants of the patients admitted in the surgical ward with age more than 16 years were included. Knowledge and practices of the participants were evaluated through a self-administered questionnaire. Ethical consent was obtained from the ethical committee or concerned authority of all eight hospitals. Results Response rate was 84 %. In total 55% male and 45 % female participated with 15.5% of the total sample population was under the age of 20 years. The age group with the maximum number of participant was between 20 to 39 years of age. 26% and 22.5% of the males and female participants respectively had knowledge. About blood donation, lesser percentage of attendants, 7.2% of the males and 4.6% declared that they had donated blood in the past. Based on education levels, it was highest among graduates (3.5%) and less in primary educated (2.2%) and uneducated respondents was 0.7%. 18% of the males and 17% females asserted that they hold some kind of fear of blood donation. Conclusion The population is not adequately knowledgeable regarding blood donation. There is a need for proper campaign to educate masses at national level within Pakistan to promote more people to become regular volunteers.

Compound Heterozygous Hemoglobin SD Disease Presenting as Sickle Cell Crisis in Pregnancy

A case report of compound heterozygous hemoglobin SD disease presenting as sickle crisis during pregnancy. The discussion covers transfusion, pain control, and peripartum care.

Reduced Physical Activity Patterns in Patients with Thalassemia Compared to Healthy Controls

Background: Patients with Thal (Thalassemia) are presumed to be inactive for many of the same reasons as healthy adults, though there are limited published data to support this claim. The primary aim of this study was to compare physical activity patterns in subjects with Thal to healthy controls as well as to explore the effects of transfusion therapy on physical activity in transfusion dependent patients with Thal. Methods: 37 Thal (23 Thal major, 14 Thal intermedia, 21 Female, 27.3±10.1 years) and 30 healthy controls (17 Female, 28.0 ± 13.7 years) wore an ActiGraph accelerometer for one to two weeks. Results: Thal subjects recorded a significantly fewer total number of steps per day and lower total energy expenditure compared to healthy controls (p=0.001). None of the adult Thal subjects met the recommended 10,000 steps/day as opposed to 27% of healthy adult controls (p=0.004). Thal spent significantly less time in moderate (p=0.03) to vigorous (p=0.005) activities and more time in sedentary activity (p=0.006). Conclusion: It is now clear that Thal spend significantly less time in physically demanding activities than age-matched healthy controls, a result that has long been assumed though not previously documented. Further research is needed to define an appropriate physical activity regimen best suited for patients with Thal while examining its effect on mental and physical health.

Haematological Disturbances in Dengue Haemorrhagic Fever - its Pathogenesis and Management Perspectives

Haemorrhage is common to both dengue fever (DF) and dengue haemorrhagic fever (DHF). Thrombocytopaenia is exceedingly common, while prolonged partial thromboplastin time and reduced fibrinogen concentration are the other abnormal haemostatic indices evident from early in the disease course. These haematological abnormalities correlate better with the timing and severity of plasma leakage rather than the clinical haemorrhagic manifestations. Blood products including prophylactic platelet transfusions are hardly required in the management of DHF. Judicious fluid therapy is the most effective intervention to prevent complications and bleeding in DHF. Concealed haemorrhage is an important complication requiring early recognition and blood transfusions to improve outcomes. Understanding the pathogenesis of coagulopathy and the significance of altered haemostatic indices, and its co-relation to disease severity and phase of DHF, is essential for appropriate interventions particularly when DHF co-exists in patients on mandatory anticoagulation for prosthetic heart valves and atrial fibrillation.