Transfus Apher Sci
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There have been several retrospective studies reporting severe adverse events of mortality and morbidity associated with blood transfusions. Mortality and morbidity associated with posttransfusion infection, transfusion related acute lung injury (TRALI), and systemic inflammatory response syndrome (SIRS) have been reported in patients undergoing cardiac surgery, after massive transfusions for severe traumatic injuries, and after transfusions for elective and emergency indications. After 35 days of storage at 4 degrees C in additive solutions, RBC have 24-h posttransfusion survival values of 75% but do not function satisfactorily. ⋯ One of the easiest ways to prevent the severe adverse events that have been observed is to ensure that the transfused blood products survive and function at an optimum level and that the levels of antibodies to granulocytes and WBC HLA antigens and biologically active substances are eliminated or reduced. The best way to ensure this is to store liquid-preserved leukoreduced human red blood cells at 4 degrees C in additive solutions for no more than 2 weeks and leukoreduced platelets at room temperature for no more than 2 days. These liquid-preserved blood products can be used in conjunction with frozen RBC, platelets, and plasma stored in -80 degrees C mechanical freezers and will avoid the need for fresh whole blood and prevent the severe adverse events associated with the transfusion of blood products.
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The effects of blood donation on iron status in donors without iron supplementation were studied. Analysing interactions between donations and iron status markers may predict these effects. ⋯ Adjusting the donation intervals is a way to prevent iron deficiency in blood donors.
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In order to further improve blood safety, mini-pool (MP) nucleic acid testing (NAT) was implemented to screen samples negative for hepatitis B surface antigen (HBsAg), anti-hepatitis C virus (anti-HCV), anti-human immunodeficiency virus (anti-HIV), syphilis (anti-Treponemal antibody) and with normal ALT. ⋯ MP NAT identified two HBsAg negative donors with presumed occult infection but no HIV or HCV seronegative/NAT positive (yield) donors. The HBV yield rate of 1 in 20,650 (95%CI - 1 in 5663 to 1 in 75,303) is comparatively high, exceeds the predicted rate based on previous modeling for the population and demonstrates the incremental blood safety value of NAT in countries where HBV is highly epidemic. The low viral load of the two yield samples underscores the importance of optimizing the sensitivity of the HBV NAT assay selected for screening.
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Multicenter Study
Does the preoperative iron status predict transfusion requirement of orthopedic patients?
In patients scheduled for major orthopedic surgery, the presence of anemia before surgery can preclude the transfusion requirements. Iron deficiency anemia is believed to be a major cause of anemia, especially in the elderly. The importance of screening patients undergoing major orthopedic surgery in Norway for anemia and iron deficiency has not been investigated. The aim of the present study was to investigate if preoperative testing of iron status could predict transfusion requirement related to major elective orthopedic surgery. ⋯ There was no correlation between the iron status before surgery and the need for transfusion during and after surgery, although anemia before surgery was a predictor for the need for transfusion. Based in our limited study we could not recommend iron status screening before surgery. However further studies are needed to truly establish the incidence and the underlying etiology, in order to reduce the transfusion requirements.