Transfus Apher Sci
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The minimum Hb for blood donation varies from nation to nation. This study assessed the impact of blood donation on donors' iron stores based on different Hb levels. An estimation of drop in the blood collection was made with the new suggested Hb cut-off value. ⋯ A modification in the minimum Hb level for blood donation is necessary when Hb is used as the single criterion for screening donors. Increasing the minimum Hb level will lead to an increase in donor deferral; therefore a comprehensive donor retention program will be needed.
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Ammonia concentration increases in red cell units (RBCs) during storage. We measured absolute amounts of ammonia (AA) per unit serially in stored RBCs and before and after removal of the supernatant by volume reduction (VR) or washing. ⋯ VR decreased AA 3.7-fold, whereas washing decreased it 38-fold (p<0.0001). At least for certain patients, e.g., infants receiving large volume transfusions and patients in liver failure, it may be advisable to use RBCs as fresh as possible and to limit infusion (by VR or washing) of ammonia in the supernatant.
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Due to the high transplant related morbidity and mortality (TRM), relatively younger acute leukemia patients that have a good performance status and no comorbidity are eligible for myeloablative conditioning (MAC) followed by allogeneic hematopoietic stem cell transplantation (allo-HSCT). The outcomes of 84 consecutive adult patients with ALL (n=38) or AML (n=46) who underwent allo-HSCT from their HLA-identical siblings were evaluated retrospectively. The median age at transplantation was 34 (17-58 years) for the whole patient population. ⋯ Eleven of the RIC patients (18.3%) and 6 of the MAC patients (25%) developed acute graft-versus-host disease (GvHD). Seventeen of the RIC patients (33.3%) and 4 of the MAC patients (16.7%) developed chronic GvHD. In conclusion, RIC conditioning regimens may provide a longer OS and DFS, especially in patients with AML who are in first CR, not eligible for MAC conditioning.
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The 7/1/2007 bridge collapse into the Mississippi River was instructional from both a disaster response and a mass casualty transfusion response perspective. It is a well cited example of how community disaster response coordination can work well, especially following systematic preparation of an integrated response network. The blood center is and should be an integral part of this disaster response and should be included in drills where appropriate. We give personal perspectives on both the hospital and transfusion service response to this particularly dramatic event.
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Two decades of war in south-west Asia has demonstrated the essential role of primary resuscitation with blood products in the care of critically injured soldiers. This idea has been widely adopted and is being critically tested in civilian trauma centers. The need for red cells, plasma and platelets to be immediately available in remote locations creates a logistic burden that will best be eased by innovative new blood products such as longer-stored liquid RBCs, freeze-dried plasma, small-volume frozen platelets, and coagulation factor concentrates such as fibrinogen concentrates and prothrombin complex concentrates. ⋯ It also will allow treatment in other austere environments such as the hundreds of small hospitals in the US which serve as Levels 3 and 4 trauma centers but do not currently have thawed plasma or platelets available. Such small trauma centers currently care for half of all the trauma patients in the country. Proving the new generation of blood products work, will help assure their widest availability in emergencies.