Transfusion
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In 2005, the South African National Blood Service introduced individual-donation (ID) nucleic acid test (NAT) screening for human immunodeficiency virus (HIV) RNA, hepatitis C virus (HCV) RNA, and hepatitis B virus (HBV) DNA. At the same time the use of ethnic origin to prioritize the transfusion of blood according to a hierarchy of residual risk was discontinued. ⋯ One-year ID-NAT screening of 732,250 donations interdicted 16 HIV, 20 HBV, and 1 HCV window phase donations and 42 anti-hepatitis B core antigen-reactive infections during an early recovery or a later stage of occult HBV infection.
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Thousands of patients with chronic renal failure die yearly without a kidney transplant due to the severe shortage of donors. Therapeutic plasma exchange (TPE) is performed to permit ABO-incompatible (ABO-I) kidney transplants, but little is known about how well TPE reduces ABO antibodies or complications related to TPE in this clinical setting. ⋯ With current infectious disease blood screening protocols, TPE has minimal complications and can reduce ABO antibody titers to permit ABO-I renal transplantation.
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Comparative Study
The clinical utility of an index of global oxygenation for guiding red blood cell transfusion in cardiac surgery.
This observational study explored the potential utility of oxygen extraction ratio (O2ER) as an adjunct to the hemoglobin (Hb) concentration for guiding red blood cell (RBC) transfusion decisions after cardiac surgery with cardiopulmonary bypass (CPB). ⋯ If a normal O2ER in anemic patients with no evidence of organ dysfunction indicates adequate tissue oxygen delivery, then our findings suggest that incorporating O2ER into the transfusion decision will substantially reduce post-cardiac surgery RBC transfusions by allowing us to safely avoid transfusing this group of patients. Future studies are needed to assess the validity of this conclusion.
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In August 2005, the Canadian Blood Services decreased the deferral period for tattooing and ear or body piercing from 12 to 6 months. This study assessed the impact of this change on blood safety and availability. ⋯ There was no measurable adverse effect on safety and a positive but less than expected effect on blood availability after shortening the deferral period for tattoo and piercing. The length of other temporary deferrals should be reassessed, since their current contribution to blood safety may be negligible.
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In 2002, the US National Heart, Lung, and Blood Institute (NHLBI) conducted a workshop to determine needs of the cell therapy community. A consensus emerged that improved access to cGMP facilities, regulatory assistance, and training would foster the advancement of cellular therapy. ⋯ PACT is an active and successful cell therapy manufacturing resource in the United States, addressing research and training while forging relationships among academia, industry, and participating institutions.