scholarly journals A day in the life of a biomedical scientist

2020 ◽  
Vol 42 (4) ◽  
pp. 64-65
Keyword(s):  
Blood Transfusion ◽  
University Hospital ◽  
Transfusion Reaction ◽  
Blood Components ◽  
Cell Disease ◽  
Vast Array ◽  
Monitoring And Diagnosis ◽  
Biomedical Scientist ◽  
Clinically Significant ◽  
Compatible Blood

Andrew Paluszkiewicz is a biomedical scientist at Nottingham University Hospital Trust (NUH) working in the haematology and blood transfusion departments, which provides a 24/7 service to patients. The two departments perform a vast array of routine and specialized tests to aid the monitoring and diagnosis of conditions such as anaemia, leukaemia, sickle cell disease, haemophilia and other bleeding and clotting conditions, while also providing compatible blood components and products. This is achieved by identifying patients’ blood groups and detecting and identifying clinically significant antibodies that could cause a transfusion reaction, and potentially death, if incompatible units are transfused.

scholarly journals EFFECTS OF IDENTIFYING TRANSFUSIONAL INCIDENTS BY ACTIVE SEARCHING AT A TERTIARY HOSPITAL

2020 ◽  
Vol 11 (1) ◽  
pp. 10-22
Author(s):  
Henrique de Paula Bedaque ◽  
Rodolfo Daniel de Almeida Soares ◽  
Carolina Lemos de Brito ◽  
Gabriela Lia de Aquino Revoredo
Keyword(s):  
Blood Transfusion ◽  
Average Rate ◽  
Tertiary Hospital ◽  
University Hospital ◽  
Blood Transfusions ◽  
Blood Components ◽  
Blood Products ◽  
Chi Square ◽  
Sentinel Network ◽  
Active Searching

Objective: The present study aims to analyze implementation consequences on active search for incidents related to blood transfusion at Onofre Lopes University Hospital (HUOL) and establish a blood transfusion profile in this facility. Methods: Blood transfusion and TIs registered on Hemotherapy Core at HUOL were counted through SPSS 20, comparing IT/1000 blood transfusion averages between 2012 and 2014. T Test of Student was used to compare data and chi-square (X²) and relative risk calculation to associate the use of blood components and risk to develop TI. Results: An increase of TI numbers at HUOL was shown by active searching and its equivalence to reference French and Brazilian services, liked to ANVISA sentinel network. Thus, there was a change in the average rate from 1.86 TI/1000 blood transfusions in 2012 to 5.36 TI/1000 blood transfusions in 2013 and 5.86 TI/1000 in 2014 (p = 0.001). It was also observed that the red blood cell concentrate is the fraction with the highest risk of occurrence of TIs (p = 0.003) and the greatest chance of causing any type of TI in relation to the other blood products, RR = 1.848 (95% CI; 1.042 - 3.266). It was also seen that the infusion of platelet concentrate is related to the allergic reaction (p <0.01), and greater risk compared to other blood components, RR = 2.746 (95% CI; 1.477 - 5.107). Conclusion: This study demonstrates active Hemovigilance importance on Tis subnotifications decrease.

Blood Group Genotyping to Prevent Alloimmunization in Children with Sickle Cell Disease

Blood ◽  
2016 ◽  
Vol 128 (22) ◽  
pp. 2486-2486
Author(s):  
Nancy Robitaille ◽  
Yves D. Pastore ◽  
Anne-Julie Landry ◽  
Catherine Latour ◽  
Josée Lavoie ◽  
...  
Keyword(s):  
Blood Transfusion ◽  
Blood Group ◽  
Blood Donors ◽  
Conflicts Of Interest ◽  
African Descent ◽  
African Ancestry ◽  
Adult Life ◽  
Blood Groups ◽  
Cell Disease ◽  
Compatible Blood

Abstract Introduction:Sickle cell disease (SCD) patients can suffer from devastating complications of their disease as a result of chronic hemolysis and vasculopathy. Chronic blood transfusion can effectively prevent some of the most severe organ damage such as cerebral vasculopathy. However, alloimmunization remains a major concern for chronically transfused patients, even if prophylactic antigen matching is performed for C, E and Kell antigens. Variants in the Rh blood group have been well described in people of African descent and must be considered when transfusing patients with SCD. The main objectives of this study were to determine the frequency of variants in the Rh and Duffy blood groups and to identify compatible blood donors presenting similar Rh variants Methods: Extended erythrocyte phenotypes were routinely done at diagnosis for every SCD patient followed at the SCD clinic of CHU Sainte-Justine. Serologic testing was performed by standard methods. Upon informed consent, genotyping for Rh and Fy blood groups was also proposed to all SCD patients. DNA analyses were used to predict D phenotype (including RHD pseudogene), C, c, E, e antigen profile, FY phenotype with GATA-1 status, and to confirm critical position in the RHD (DAU cluster, zygosity) and RHCEgenes (position 48, 254, 733, 1006). The study was approved by the local Research Ethics Board (REB). Results: 203 SCD patients were evaluated: HbSS 64.3%, HbSC 29.6%, HbSb0 3.1%, HbSb+ 2.5% and HbSDIran 0.5%. ABO blood groups followed published prevalence: Group O 48.7%, A 26.2%, B 20.4%and AB 4.7%. 90.2% of patients had either a normal RHD*01 or RHD*10.00 gene which would predict a normal D+ phenotype. Twenty patients would require D− units (9.8%) to reduce their alloimmunization risk (D−, weak partial D and partial D). The RHCE genotyping results were as followed: normal c allele 61.2%, normal e allele 39.3%, partial e allele 34.1% and weak e allele 17.6%. Most RHCE alleles present in the cohort reflected variants previously reported in individuals of African descent. Most patients were compound heterozygotes. 45.8% of RHCE alleles were considered normal: RHCE*ce, RHCE*Ce and RHCE*cE. Fy(a-b-) phenotype was found in 91.6% of patients (186/203). The list of RHCE variant alleles observed in the cohort was compared to Héma-Québec's (blood supplier for the province of Quebec) African descent blood donor database. For partial e, weak partial e and rare hrB− phenotypes, only D+ donors are available whereas some of the patients are D−. The same is true for one Sec− (RH46, high-prevalence antigen) patient for which no donor is available. As for CEAG− recipients (partial ce-phenotype), two compatible blood donors were identified by screening O− units from donors of African descent. Overall, five patients (2.4%) may not have suitable donors in our blood bank based upon genotype compatibility. Twenty other patients could be added to this calculation because of a variant e allele in trans to a normal E allele. Conclusions: The RH and FY results indicate that very few patients require rare blood units. More than 90% present a normal D antigen and are Fy(a−b−), similar to most blood donors of African ancestry. However, RHCE variants could be more problematic in terms of finding compatible units. This study showed a large array of RH variants, although most are present in heterozygous form accompanied by a normal allele. This could explain the low alloimmunization rate of 3% for Rh antigens observed in this cohort (overall alloimmunization rate of 18.9%). However, as all patients were younger than 18 years old, they will probably be exposed to more blood transfusion during their adult life. Having their RH and FY genotype readily available should make the blood donors' selection easier. Further prospective studies are needed to evaluate if such an approach will lower the alloimmunization rate. Disclosures No relevant conflicts of interest to declare.

scholarly journals Transfusion reaction and hemovigilance: An imperative discussion in Brazilian hemotherapy services

10.3823/2526 ◽  
2017 ◽  
Vol 10 ◽  
Author(s):  
João Paulo dos Santos ◽  
Angela Alzamora ◽  
Mariana Dutra Teles ◽  
Veruska Lucena ◽  
Tatiana Almeida Omura de Paula ◽  
...  
Keyword(s):  
Blood Transfusion ◽  
Transfusion Reaction ◽  
Blood Components ◽  
Important Data ◽  
History Of ◽  
Transfusion Reactions

Transfusion of blood components is considered safer, but it took years to reach this level. One of the most effective ways to make blood transfusion a safer practice is hemovigilance, which provides important data, including the history of feared transfusion reactions. In recent years in Brazil, there has been an improvement in the reporting of transfusion reactions, however due to the great diversity of hematology services, there are still transfusion reactions. The aims of this study were described the main types of transfusion reactions, as well as to evaluate the underreporting importance of transfusion occurrences of hemotherapy services in Brazil.

scholarly journals Importance of haemovigilance and reports on transfusion reaction in blood component therapy

2012 ◽  
Vol 65 (1-2) ◽  
pp. 50-53 ◽  
Author(s):  
Jasmina Grujic ◽  
Zdravko Gulan ◽  
Zorana Budakov
Keyword(s):  
Blood Transfusion ◽  
Fresh Frozen Plasma ◽  
Blood Component ◽  
Safe Procedure ◽  
Transfusion Reaction ◽  
Blood Components ◽  
Blood Component Therapy ◽  
Fresh Frozen ◽  
Novi Sad ◽  
Transfusion Reactions

Introduction. Application of blood and blood components throughout decades is very successful and mostly safe procedure in patients? therapy. However, it may lead to unfavourable effects, such as transfusion reactions. Material and Methods. In the period from 2000 to 2009, 180 transfusion reactions were reported at the Department of Clinical Transfusion of the Service for Blood Transfusion of Vojvodina in Novi Sad. The aetiology of transfusion reactions was determined by examining pretransfusion and post-transfusion sample of patient?s blood and by examining the unit of blood component that induced reaction. Results. Out of 180 reported transfusion reactions, 98 (54.4%) were febrile non-haemolytic transfusion reactions, 69 (38.3%) allergic reactions and 2 (1.11%) haemolytic reactions. Blood components that caused most of transfusion reactions were erythrocytes (62.4%), fresh frozen plasma (11.2%) and platelets (14.4%). All patients underwent multiple transfusions. Discussion. The fact that only 0.13% transfusion reactions were reported, compared with data from literature (2-15%), points to the lack of regular reporting of transfusion reactions, as well as the fact that there is only one report of delayed transfusion reaction. Conclusions. To improve and make blood transfusion safer it is necessary to respect all pre-transfusion procedures, constant follow up of blood transfusion must be done and patients with diagnosed non-haemolytic transfusion reaction should be given leukocyte reduced blood components.

scholarly journals The safety of kidd-incompatible blood transfusion in a restricted setting: a case report

2019 ◽  
Vol 10 (2) ◽  
pp. 137-139
Author(s):  
Elida Marpaung
Keyword(s):  
Blood Transfusion ◽  
Hydatidiform Mole ◽  
Transfusion Practice ◽  
Health Science ◽  
Transfusion Reaction ◽  
Science Journal ◽  
Hemolytic Disease ◽  
Hemolytic Transfusion Reaction ◽  
Compatible Blood ◽  
Level 2

Latar belakang: Protein Kidd merupakan transporter urea pada sel darah merah. Walaupun jarang, adanya antibodi terhadap antigen ini dapat menyebabkan reaksi transfusi dan hemolytic disease of the newborn. Keberadaan anti-Jka dan anti-Jkb cukup jarang ditemukan pada pemeriksaan identifikasi antibodi pasien. Studi ini melaporkan kasus pasien dengan keberadaan anti-Jka and anti-Jkb, yang mendapat darah dengan kadar aglutinasi terendah pada kondisi dimana darah kompatibel sulit didapat sementara tindakan transfusi sangat dibutuhkan segera. Penyajian Kasus: Wanita, 36 tahun, G4P3A0, datang dengan perdarahan vaginam sejak sebulan terakhir. Dari hasil pemeriksaan USG, didapatkan adanya mola hidatidosa. Pasien memerlukan terapi kuret segera setelah anemia terkoreksi (Hb 8.3 g/dL). Pada uji kecocokan pre-transfusi dengan prosedur skrining antibodi yang dilanjutkan dengan identifikasi antibodi, ditemukan anti-Jka dan anti-Jkb. Dari setidaknya 50 darah donor yang dilakukan uji kecocokan, tidak ditemukan darah yang kompatibel, sehingga pasien diputuskan untuk mendapat transfusi menggunakan darah inkompatibel dengan derajat aglutinasi terendah (level 2) dari 5 level, disertai dengan pemantauan ketat terhadap potensi terjadinya reaksi transfusi. Demam dan pruritus dilaporkan dalam 24 jam setelah transfusi, dan membaik setelah pemberian injeksi difenhidramin, deksametason, dan parasetamol. Kesimpulan: Transfusi dengan darah yang inkompatibel merupakan pilihan terakhir bila tidak ditemukan darah donor yang kompatibel. Reaksi transfusi merupakan efek yang sulit dihindari, tetapi dapat dilakukan pemantuan ketat. Pemilihan darah dengan level aglutinansi terendah adalah keputusan terbaik, mengingat tindakan medis diperlukan segera untuk menyelamatkan nyawa. Pada kasus ini, pasien mendapat tatalaksana optimal dari aspek tindakan operasi dan respon transfusi, yang ditunjukkan melalui kenaikan nilai Hb yang bermakna. Sementara itu, efek samping reaksi transfusi yang muncul hanya ringan dan dapat ditanggulangi dengan pemberian obatobatan. (Health Science Journal of Indonesia 2019;10(2):137-9) Kata kunci: reaksi transfusi, inkompatibilitas, kelompok darah Kidd   Abstract Background: Kidd protein is red blood cell’s (RBC) major urea transporter. Albeit rare, the presence of antibodies against Kidd antigen may cause significant hemolytic transfusion reaction and hemolytic disease of the newborn. Yet, anti-Jka and anti-Jkb are rare to be discovered during antibody identification. This paper reported “bestmatched” transfusion practice in a patient with anti-Jka and anti-Jkb, where compatible PRC cannot be found, but transfusion is urgently needed. Case Presentation: A 36 years old, G4P3A0 female, came with continuous vaginal bleeding for the past one month before admission. USG revealed hydatidiform mole. She needed immediate curettage following correction of her anemia (Hb 8.3g/dL). After antibody screening procedure followed by antibody identification, we found a positive anti-Jka and anti-Jkb in her blood sample. At least 50 blood donors were tested for compatibility and none was a match. She was then transfused with the lowest agglutination blood available (level 2 of 5 levels), with a closed monitoring to anticipate the possibility of transfusion reaction development. Fever and pruritus transpired within 24 hours post transfusion and it resolved following diphenhydramine, dexamethasone, and paracetamol injection. Conclusion: Incompatible blood transfusion is the last option when compatible blood cannot be found. The development of transfusion reaction is inevitable, but it can be anticipated by closed monitoring. In restricted setting, blood transfusion with the lowest level of agglutination is acceptable when transfusion is imperative. In this case, the patient got optimal treatment in term of the medical surgery and transfusion response, which was shown by the significant increase of Hb level. Meanwhile, the adverse transfusion reaction was only mild, and could be treated with medicine. (Health Science Journal of Indonesia 2019;10(2):137-9) Keywords: Transfusion reaction, incompatibility, Kidd blood group

scholarly journals Transfusion management of patients with alloanti-Gerbich antibodies: Case report

2011 ◽  
Vol 139 (7-8) ◽  
pp. 518-522
Author(s):  
Radmila Jovanovic ◽  
Nevenka Bujandric ◽  
Slobodanka Lisulov ◽  
Sanja Bogdanovic
Keyword(s):  
Blood Transfusion ◽  
Blood Group ◽  
High Frequency ◽  
Time Frame ◽  
Medical Intervention ◽  
Blood Group Antigens ◽  
Specific Patient ◽  
Clinically Significant ◽  
Compatible Blood ◽  
Cross Match

Introduction. Transfusion management of patients who are alloimmunized against high-prevalence erythrocyte antigens is often problematic. Strategy management depends, not only on the specific clinical circumstances of the patient, but also on the acceptable time frame. In patients without clinically significant antibody incompatible transfusion it may be less harmful than delaying medical intervention. Case Outline. We report a 57-year-old female from Libya, blood group O, RhD-positive, who was treated at the Institute of Cardiovascular Diseases of Vojvodina. At the Blood Transfusion Institute of Vojvodina, during pretransfusion testing an IgG alloantibody of unknown specificity was determined. A total of 200 blood units (O, RhD-positive) were crossmatched, but positive reactions indicating that the donor units were incompatible for that specific patient. By testing the patient?s family members in Tripoli, six compatible blood units were found and applied during and after surgery. Due to the deterioration of the patient?s condition a rapid transfusion was required; however cross-match compatible blood was not available. After a biological crossmatch to predict the clinical significance of this antibody, 12 units of erythrocytes with the lowest positive cross-match reactions, were transfused to the patient without any adverse effects. Good tolerance of the units suggested that the present antibodies were not clinically significant. Later on, a rare alloantibody directed to the high frequency Gerbich blood group antigens was identified by the Foundation Central Laboratory, Blood Transfusion Service in Bern, Switzerland. Conclusion. In cases of emergency patients with alloantibodies against high frequency Gerbich, when autologous or compatible alogenous transfusion is unavailable, blood with the lowest positive cross-match reaction could be transfused if the biological cross-match is negative. Formation of a national register of donors with rare blood groups and their connection with international registers is of crucial significance in the management of patients requiring antigen negative blood otherwise unavailable from routine blood banks.

Sign in / Sign up

Export Citation Format

Share Document