Long-Term Persistence and Relevant Therapeutic Impact of High-Titer Viral-Neutralizing Antibody in a Convalescent COVID-19 Plasma Super-Donor: A Case Report

A convalescent, non-severe, patient with COVID-19 was enrolled as a hyper-immune plasma voluntary donor by the Immuno-Hematology and Transfusion Unit of the Regina Elena National Cancer Institute in Rome, under the TSUNAMI national study criteria. During a nearly 6-month period (May–October 2020), the patient was closely monitored and underwent four hyperimmune plasma collections. Serum SARS-CoV-2 (anti-S + anti-N) IgG and IgM, anti-S1 IgA, and neutralizing titers (NTs) were measured. Anti-SARS-CoV-2 antibody levels steadily decreased. No correlation was found between anti-S/anti-N IgG and IgM levels and viral NT, measured by either a microneutralization test or the surrogate RBD/ACE2-binding inhibition test. Conversely, NTs directly correlated with anti-S1 IgA levels. Hyperimmune donor plasma, administered to five SARS-CoV-2 patients with persistent, severe COVID-19 symptoms, induced short-term clinical and pathological improvement. Reported data suggest that high NTs can persist longer than expected, thus widening hyperimmune plasma source, availability, and potential use. In vitro RBD/ACE2-binding inhibition test is confirmed as a convenient surrogate index for neutralizing activity and patients’ follow-up, suitable for clinical settings where biosafety level 3 facilities are not available. IgA levels may correlate with serum neutralizing activity and represent a further independent index for patient evaluation.

Gambaran Hasil Pemeriksaan HIV pada Darah Donor

HIV cases in Jepara District in recent years have demanded the handling of several aspects simultaneously including the Blood Transfusion Unit (BTU). HIV can be transmitted through blood transfusion or other blood products. BTU of PMI Jepara Regency carries out recruitment of voluntary donor from Jepara society. The HIV examination as part of an IMLTD screening test is done for safety of donor blood. The HIV examination in all donor blood uses rapid and elisa method. Examination results are stated as reactive and non reactive. Research objective to find out the description of HIV examination results in donor blood at the BTU of PMI Kabupaten Jepara in 2019. Research method the research type was descriptive using records of donor data at BTU of PMI Kabupaten Jepara in 2019. The examination results of reactive HIV in 12 donor blood (0,08%). non-reactive blood donor of HIV in age groups 18 years, 18-24, 25-44, 45-59, and ≥ 60 years respectively 9,55%, 22,39%, 51,75%, 16,01% and 0,21%. Reactive HIV in age groups 18-24, 25-44, and 45-59 years were 0,034%, 0,034%, and 0,13%. Non-reactive HIV in men 68,22% and in women 31,70%. Reactive HIV in men 0,07%, and women 0,01%. Non-reactive HIV in voluntary donor blood was 99,779% and substitute donor was 0,127%. HIV of reactive voluntary donor blood was 0,074%, and substitute donor was 0,007%. HIV filter test is indispensable for blood safety because the age, gender and blood type of donors have the potential for reactive HIV.

Prevalence of hepatitis B infection among voluntary donor in Wuse District Hospital, Abuja

Blood transfusion is an important and lifesaving intervention of the healthcare system there by reducing mortality worldwide, resulting from high level of blood demanding health conditions. Screening and testing of the donated blood are necessary in order to prevent the risks and complications associated with blood transfusion. This study was carried out in retrospective, considering the six (6) month testing and screening of seven hundred and fifty (n= 750) samples from the relative donor of Wuse District Hospital, Abuja, this was done using the screening method with the use of a rapid test kit. The gender showed 689(91.9%) for male and female 61(8.1), result showed that 32(4.3%) were positive with 28(87.5%) male and 4(12.5%) female respectively, the percentage age group showed the highest to be (56.4%)of 29 -38 years. The study showed an overall seroprevalence of (4.3%) falling within (2 – 7%) intermediate risk group for hepatitis B virus infection as described by the WHO. Government should make available the vaccine against HBV, create more awareness for vaccination and make it free for all (without payment) as soon as possible

Prevalence and Haemolytic Significance of Red Cell Antibodies among Dangerous Universal Donors in a Tertiary Care Hospital in South India

Background and Aims: A subgroup of group O individuals called ‘dangerous universal donors’ have immune (IgG) anti A and anti B antibodies which are active at 37˚C and capable of reacting with the red cells and causing lysis. The aim of this study was to find the prevalence of dangerous O group among the voluntary donor population and to assess the relation between the degree of haemolysis and the antibody titre. Materials and Methods: Group O donors excepting those with history of transfusion or pregnancy were included in the study. The serum samples were tested for haemolysins as per standard procedure. The degree of haemolysis was graded and strongly haemolytic samples were further characterised for the type of immunoglobulin class after treatment with dithiothretiol. The results were coded and analysed using SPSS software. Results: The age of the donors in this study ranged from 18 to 56 years. Majority were males. The prevalence of dangerous O group in our study population was found to be 10.75%. Within the dangerous O group samples, the titre of anti B IgG antibody was found to be higher than anti A IgG antibody. Titres for both anti A and anti B IgG antibodies ranged from 1:2 to 1:64. Conclusions: A simple screening for donor haemolysins will help in identification of strongly haemolytic samples, which are likely to have high titres of IgG, particularly anti A antibody. This will prevent transfusion of blood containing high titres of immune anti A and anti B antibodies to non O group recipients.

Seroprevalence of HIV in blood donors at tertiary care center, M.Y.H. Indore, India

Background: Transfusion of blood has become an important mode of transmission of infections such as human immunodeficiency virus and hepatitis B to the recipients. Blood transfusion is a boon in medical era if properly screened. The aim of study was to determine the seroprevalence of HIV donors in blood bank at M.Y.H. Indore.Methods: The study was conducted in the blood bank, M.Y.H. Hospital, Indore. Total 115775 donors attending blood bank were included in the study. All the donor samples were screened for detection of antibodies for human immunodeficiency virus by microwell Enzyme Linked Immunosorption Assay (ELISA) method. The seroprevalence of HIV infection among the donors was determined over a period of five years since January 2013 to December 2017.Results: Total 115775 blood donors were recorded. Out of total 115775 blood donors included in the study, replacement donor were 10766 (9.29%) while voluntary donor were 105009 (90.70%). In the duration of five-year study period, total 80 cases (0.06%) were reactive to HIV. Out of total 115775 blood donors included in the study, maximum cases i.e. 22 (0.08%) cases were found to be positive for HIV infection in year 2017. Out of 10766 replacement donors included in the study, 64 cases (0.59%) were reactive to HIV infection. While out of 105009 voluntary donors, 16 cases (0.01%) were found to be reactive to HIV infection. Voluntary donors are more as compared to the replacement donors. Number of HIV positive patients were found to more in replacement donor as compared to the voluntary donors.Conclusions: The seroprevalence of HIV is low in this study and hence it is concluded that the more the number of voluntary donors, the less the number of HIV positive cases. Voluntary donors can be motivated by proper health education and high quality screening programs.

The gift

This chapter looks at the nature of the gift of blood. The gift of blood has certain unique attributes which distinguish it from other forms of gift. The gift of blood takes place in impersonal situations, sometimes with physically hurtful consequences to the donor. Moreover, the recipient is in almost all cases not personally known to the donor; there can, therefore, be no personal expressions of gratitude or of other sentiments. If the principle of anonymity were generally abandoned, the consequences could be disastrous for givers and receivers as well as for all blood transfusion services. The chapter then presents a classification of the different types of blood donors: the paid donor; the professional donor; the pain-induced voluntary donor; the responsibility fee donor; the family credit donor; the captive voluntary donor; the fringe benefit voluntary donor; and the voluntary community donor.

Gender based knowledge, attitude and practice study about blood donation among medical students in a sub-Himalayan state

Background: WHO is advocating a policy towards 100% voluntary non-remunerated blood donation by year 2020. The youth in general and medical students in particular constitute the core group for recruitment and retention of voluntary donor population in order to ensure safe and sustainable blood transfusion practices in India. The objective of the present study is to elucidate the knowledge, attitude and practices about voluntary blood donation among medical undergraduate students.Methods: A pretested, close ended questionnaire was administered to second and third year MBBS students of a tertiary care teaching hospital in Northwest India. Results were expressed in proportions and chi-square test was used as a test of significance (p<0.05).Results: More than 90% of the respondents knew the suitable age for blood donation and interval between two blood donations. Knowledge parameters like age for blood donation, minimum weight for blood donation and volume of blood collected for blood donation were found to be statistically significant (p<0.5) between boys and girls. More females than males had positive attitude for voluntary blood donation which was statistically significant (p<0.05). In the practice part, voluntary blood donation rate was 26.69%.Conclusions: Every opportunity should be availed to sensitise medical students about voluntary blood donation after their entry into medical colleges. It can greatly enhance the movement for voluntary non-remunerated blood donation and ensure safe and adequate quality of blood.

Incidence of immediate adverse reaction of blood donation

Transfusion of blood and blood components saved millions of lives each year. In most developing countries, however, preventable deaths still occur due to inadequate supply of safe blood and blood components which can be minimize by blood donation. In Bangladesh the annual demand for blood transfusion is estimated to be 2,00,000 to 2,50,000 unit per year. But due to lack of voluntary donor and consciousness among people this demand is hardly met. Because blood donors are altruistic volunteers, they should be protected as much as possible by the pre-donation counseling. This prospective observational study was carried out in the department of transfusion medicine in Bangabandhu Sheikh Mujib Medical University from February 2010 to january 2011 with the intention to see the immediate adverse reactions after blood donation. 1,500 patients were selected consecutively after considering inclusion and exclusion criteria. Adverse reaction were observed during and 30 minutes following blood donation. Among the total 1500 respondents, 394 cases experienced adverse effects of blood donation namely; vertigo (9.7%), sweating and warmness (5.0%), bruising (3.0%), nausea (6.3%) and fainting (2.3%). careful monitoring of all blood donors after donation and counseling of adverse effect before donation is important.Bangladesh Med J. 2016 May; 45 (2): 75-78