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MedWorm: Transfusion Therapy



MedWorm.com provides a medical RSS filtering service. Over 7000 RSS medical sources are combined and output via different filters. This feed contains the latest news and research in the Transfusion Therapy category.



Last Build Date: Tue, 29 Mar 2016 16:20:06 +0100

 



Pulmonary hypertension associated with thalassemia syndromes

Tue, 22 Mar 2016 23:00:00 +0100

Chronic hemolytic anemia has increasingly been identified as an important risk factor for the development of pulmonary hypertension (PH). Within the thalassemia syndromes, there are multiple mechanisms, both distinct and overlapping, by which PH develops and that differ among β‐thalassemia major or intermedia patients. PH in β‐thalassemia major correlates with the severity of hemolysis, yet in patients whose disease is well treated with chronic transfusion therapy, the development of PH can be related to cardiac dysfunction and the subsequent toxic effects of iron overload rather than hemolysis. β‐Thalassemia intermedia, on the other hand, has a higher incidence of PH owing to the low level of hemolysis that exists over years without the requirement for frequent transfusions, whil...

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Management of iron overload before, during, and after hematopoietic stem cell transplantation for thalassemia major

Mon, 21 Mar 2016 00:00:00 +0100

Solid evidence has established the negative impact of high iron burden and related tissue damage on the outcome of hemopoietic stem cell transplantation for thalassemia major. Recent improvements in our knowledge of iron metabolism have been focused on elevated non‐transferrin‐bound iron and labile plasma iron levels in the peritransplantation period as potential contributors to tissue toxicity and subsequent adverse transplant outcome. As mouse models have shown, iron overload can injure bone marrow hematopoiesis by increasing reactive oxygen species. The Pesaro experience, conducted in the deferoxamine‐only era, clearly defined three iron‐related factors (liver fibrosis, hepatomegaly, and quality of lifelong chelation) as significantly affecting transplant outcome. The detrime...



Effectiveness of red blood cell exchange, partial manual exchange, and simple transfusion concurrently with iron chelation therapy in reducing iron overload in chronically transfused sickle cell anemia patients.

Sat, 19 Mar 2016 23:00:00 +0100

CONCLUSION: We recommend RCE plus chelation as an effective method for reducing iron overload, while maintaining HbS at 30% to 35%. PMID: 26997031 [PubMed - as supplied by publisher] (Source: Transfusion)



Estimation of iron overloads using oral exfoliative cytology in beta-thalassemia major patients

Fri, 18 Mar 2016 00:00:00 +0100

Conclusion: The use of exfoliative buccal mucosal cells for the evaluation of iron overloads in the body provides us with a diagnostic medium that is noninvasive, easy to collect, store, and transport, cost effective, and above all reliable. (Source: CytoJournal)



Transfusion therapy evidence-based recommendations for the pediatric cancer patient

Wed, 16 Mar 2016 00:00:00 +0100

Conclusions This paper is an evidence-base approach on the recommendations for transfusion therapy in children with cancer. (Source: Colombian Journal of Anesthesiology)



Transfusion Considerations in Pediatric Hematology and Oncology Patients

Sun, 13 Mar 2016 00:00:00 +0100

Publication date: Available online 12 March 2016 Source:Hematology/Oncology Clinics of North America Author(s): Rachel S. Bercovitz, Cassandra D. JosephsonTeaser Pediatric patients with malignancies or benign hematologic diseases are a heterogeneous group with complicated underlying pathophysiologies leading to their requirements for transfusion therapy. Common practice among pediatric hematologists, oncologists, and transplant physicians is to transfuse stable patients red cells to maintain a hemoglobin greater than 7 or 8 g/dL and transfuse platelets to maintain a count greater than 10,000 or 20,000 platelets/μL. This review compiles data from myriad studies performed in pediatric patients to give readers the knowledge needed to make an informed choice when considering different ma...

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Coagulation management in trauma-associated coagulopathy: allogenic blood products versus coagulation factor concentrates in trauma care

Fri, 04 Mar 2016 21:07:21 +0100

Purpose of review: Coagulation management by transfusion of allogenic blood products and coagulation factors are competing concepts in current trauma care. Recent findings: Rapid and adequate therapy of trauma-associated coagulopathy is crucial to survival of severely injured patients. Standard coagulation tests such as prothrombin time and activated partial thromboplastin time are commonly used, but these tests are inappropriate for monitoring and guiding therapy in trauma patients. Coagulation factor-based treatment showed promising results, but randomized trials have not yet been performed. In addition, viscoelastic tests are needed to guide therapy, although there is in fact limited evidence for these in tests in trauma care. Regarding transfusion therapy with allogenic blood products...






Blood Transfusion Strategies for Hemostatic Resuscitation in Massive Trauma

Fri, 19 Feb 2016 13:22:31 +0100

Massive transfusion practices were transformed during the 1970s without solid evidence supporting the use of component therapy. A manual literature search was performed for all references to the lethal triad, acute or early coagulopathy of trauma, fresh whole blood, and component transfusion therapy in massive trauma, and damage control resuscitation. Data from recent wars suggest traditional component therapy causes a nonhemostatic resuscitation worsening the propagation of the lethal triad hastening death. These same studies also indicate the advantage of fresh whole blood over component therapy even when administered in a 1:1:1 replacement ratio. (Source: Nursing Clinics of North America)



Central nervous system complications and management in sickle cell disease

Thu, 18 Feb 2016 00:00:00 +0100

With advances in brain imaging and completion of randomized clinical trials (RCTs) for primary and secondary stroke prevention, the natural history of central nervous system (CNS) complications in sickle cell disease (SCD) is evolving. In order of current prevalence, the primary CNS complications include silent cerebral infarcts (39% by 18 years), headache (both acute and chronic: 36% in children with sickle cell anemia [SCA]), ischemic stroke (as low as 1% in children with SCA with effective screening and prophylaxis, but ~11% in children with SCA without screening), and hemorrhagic stroke in children and adults with SCA (3% and 10%, respectively). In high-income countries, RCTs (Stroke Prevention in Sickle Cell Anemia [STOP], STOP II) have demonstrated that regular blood transfusion ther...

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Coagulopathy and transfusion therapy in pediatric liver transplantation.

Sun, 14 Feb 2016 00:00:00 +0100

In conclusion, data from the adult world can be translated with difficulty into the pediatric field as indication for transplantation, baseline pathologies and levels of pro- and anticoagulation factors are not comparable between the two populations. PMID: 26877606 [PubMed - in process] (Source: World Journal of Gastroenterology : WJG)



CRISPR/Cas9-mediated conversion of human platelet alloantigen allotypes

Thu, 11 Feb 2016 00:00:00 +0100

Human platelet alloantigens (HPAs) reside on functionally important platelet membrane glycoproteins and are caused by single nucleotide polymorphisms in the genes that encode them. Antibodies that form against HPAs are responsible for several clinically important alloimmune bleeding disorders, including fetal and neonatal alloimmune thrombocytopenia and posttransfusion purpura. The HPA-1a/HPA-1b alloantigen system, also known as the PlA1/PlA2 polymorphism, is the most frequently implicated HPA among whites, and a single Leu33Pro amino acid polymorphism within the integrin β3 subunit is responsible for generating the HPA-1a/HPA-1b alloantigenic epitopes. HPA-1b/b platelets, like those bearing other low-frequency platelet-specific alloantigens, are relatively rare in the population and ...



Transfusion therapy for sickle cell disease

Fri, 29 Jan 2016 00:00:00 +0100

The clinical presentations of sickle cell disease include acute pain, acute chest syndrome, stroke and acute anaemia and blood transfusion therapy can be used effectively in the emergency setting for the treatment of many of these complications. Long‐term blood transfusion therapy is also used for the prevention of disease complications with most evidence for its use in primary stroke prevention. Transfusion can be given as a simple or top‐up transfusion or as an exchange transfusion and donor red cells should be haemoglobin S negative and as a minimum matched for ABO, full Rh and Kell type. Repeated transfusions lead to iron overload and appropriate monitoring and treatment should be provided. Alloimmunization is also a common complication of transfusion and can lead to haemolytic tra...



Supernatant protein biomarkers of red blood cell storage hemolysis as determined through an absolute quantification proteomics technology.

Tue, 26 Jan 2016 00:00:00 +0100

CONCLUSION: A targeted proteomics technology revealed novel biomarkers of the RBC storage lesion and promises to become a key analytical readout for the development and testing of alternative cell processing strategies. PMID: 26813021 [PubMed - as supplied by publisher] (Source: Transfusion)



EPO or PlacEPO? Science versus practical experience: panel discussion on efficacy of erythropoetin in improving performance.

Thu, 21 Jan 2016 03:56:02 +0100

Authors: Hardeman M, Alexy T, Brouwer B, Connes P, Jung F, Kuipers H, Baskurt OK Abstract Recombinant human erythropoietin (rHuEPO) is an agent commonly used by athletes with the aim to improve performance in endurance sports. However, the scientific community continues to debate the risks, benefits and its mechanism of action when used as a doping agent. This paper provides a brief overview on the pros and cons of rHuEPO use, as discussed by a group of scientist with diverse background, at the 17th Conference of the European Society for Clinical Hemorheology and Microcirculation in Pecs, Hungary. Among multiple topics, panel members challenged the common belief that the increased circulating hemoglobin concentration is the simple key to the improved sporting performance. Rather, h...

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The long-term and extensive efficacy of low dose thalidomide in a case of an untransfusable patient with Non-Transfusion-Dependent Thalassemia.

Sat, 16 Jan 2016 00:00:00 +0100

We report the case of a patient who experienced improvement of hemoglobin levels and of a part of NTDT related complications, following 36months of continuous therapy with low doses of thalidomide. PMID: 26810455 [PubMed - as supplied by publisher] (Source: Blood Cells, Molecules and Diseases)



The long-term and extensive efficacy of low dose thalidomide in a case of an untransfusable patient with Non-Transfusion-Dependent Thalassemia

Sat, 16 Jan 2016 00:00:00 +0100

We report the case of a patient who experienced improvement of hemoglobin levels and of a part of NTDT related complications, following 36months of continuous therapy with low doses of thalidomide. (Source: Blood Cells, Molecules, and Diseases)



Treatment–donation-stockpile dynamics in ebola convalescent blood transfusion therapy

Tue, 12 Jan 2016 00:00:00 +0100

Publication date: 7 March 2016 Source:Journal of Theoretical Biology, Volume 392 Author(s): Xi Huo, Xiaodan Sun, Kunquan Lan, Jianhong Wu The interim guidance issued by the World Health Organization during the West Africa 2014 Ebola outbreak provides guidelines on the use of convalescent blood from Ebola survivors for transfusion therapy. Here we develop a novel mathematical model, based on the interim guidance, to examine the nonlinear transmission–treatment–donation–stockpile dynamics during an Ebola outbreak and with a large scale use of the transfusion therapy in the population. We estimate the reduction of case fatality ratio by introducing convalescent blood transfusion as a therapy, and inform optimal treatment–donation–stockpile strategies to balance the treatment n...



Hemoglobin F Only Syndrome at Birth: A Case of Maternal HbA2’ Complicating the Diagnosis of β-Thalassemia

Fri, 01 Jan 2016 06:00:00 +0100

An asymptomatic infant of Ghanaian descent had hemoglobin F only detected on newborn screening. β-globin gene sequencing identified the intervening sequence (IVS)-II-849 (A→G) mutation with no normal β-globin gene. β-globin/δ-globin gene sequencing showed that both parents were heterozygous for the IVS-II-849 (A→G) mutation. The mother was heterozygous for the HbA2’ δ-globin mutation (δ16 (A13) Gly→Arg), thus β-thalassemia trait was unrecognized due to coinheritance of HbA2’. The infant developed anemia, splenomegaly, and began transfusion therapy by the age 6 of months. This is the first report of β-thalassemia major with homozygous IVS-II-849 (A→G) mutations. This case highlights the importance of δ-globin gene mutations in prenatal testing. (Source: Journal of Pedia...



The Contribution of Pin End-Cup Interactions to Clot Strength Assessed with Thrombelastography.

Sun, 20 Dec 2015 16:54:09 +0100

In conclusion, these data demonstrate that clot strength is not determined by a simple ratio of surface area of pin and cup to volume of sample, but rather strength is importantly influenced by the viscoelastic resistance of the fluid assessed. PMID: 26678469 [PubMed - in process] (Source: Anesthesia and Analgesia)

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Increased Incidence of Red Blood Cell Alloantibodies in Myelodysplastic Syndrome.

Sat, 19 Dec 2015 06:44:03 +0100

CONCLUSIONS: Patients with MDS are at increased risk to develop RBC alloantibodies, partly because these patients receive multiple RBC transfusions. Whether matching for RH and KEL would lead to lower rates of RBC alloantibodies remains to be determined. PMID: 26665317 [PubMed - in process] (Source: The Israel Medical Association Journal)



Management of Sickle Cell Disease: Recommendations from the 2014 Expert Panel Report.

Tue, 15 Dec 2015 00:00:00 +0100

Authors: Yawn BP, John-Sowah J Abstract Family physicians are the primary and sometimes only health care resource for families affected by sickle cell disease. Recently published guidelines provide important recommendations for health maintenance, acute care, and monitoring of disease-modifying therapy in persons with this condition. This overview highlights some of the most important clinical activities that can and should be carried out in the community care setting. Children with sickle cell anemia should receive prophylactic penicillin from birth through at least five years of age, and all persons with sickle cell disease require vaccination to prevent invasive pneumococcal disease. Annual screening with transcranial Doppler ultrasonography is recommended for all children with ...



Class I and II HLA antibodies in pediatric patients with thalassemia major.

Tue, 15 Dec 2015 00:00:00 +0100

CONCLUSION: HLA antibodies have a high prevalence in TM patients and may be associated with nonleukoreduced transfusions and older age. For such patients, antibody identification will be useful if subsequent organ or stem cell transplantation is needed. PMID: 26666394 [PubMed - as supplied by publisher] (Source: Transfusion)



Platelet transfusion goals in oncology patients.

Thu, 10 Dec 2015 03:26:04 +0100

Authors: Fasano RM, Josephson CD Abstract Despite the advances in platelet component preparation and transfusion support over the years, platelet products remain a limited resource due to their short (5 day) shelf life, and therefore their optimal use in the non-bleeding thrombocytopenic patient continue to draw much attention. There have been a number of national and international guidelines for platelet transfusion therapy in patients with hematologic diseases, some within the last 1-2 years that have incorporated key randomized controlled trials (RCTs) which address issues, such as the optimal platelet dose, the most appropriate threshold for prophylactic platelet transfusions, and whether prophylactic platelet transfusions are superior to therapeutic-only platelet transfusion p...



Comparison of different platelet count thresholds to guide administration of prophylactic platelet transfusion for preventing bleeding in people with haematological disorders after myelosuppressive chemotherapy or stem cell transplantation.

Wed, 18 Nov 2015 00:00:00 +0100

CONCLUSIONS: In people with haematological disorders who are thrombocytopenic due to myelosuppressive chemotherapy or HSCT, we found low-quality evidence that a standard trigger level (10 x 10(9)/L) is associated with no increase in the risk of bleeding when compared to a higher trigger level (20 x 10(9)/L or 30 x 10(9)/L). There was low-quality evidence that a standard trigger level is associated with a decreased number of transfusion episodes when compared to a higher trigger level (20 x 10(9)/L or 30 x 10(9)/L).Findings from this review were based on three studies and 499 participants. Without further evidence, it is reasonable to continue with the current practice of administering prophylactic platelet transfusions using the standard trigger level (10 x 10(9)/L) in the absence of other...

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Sickle cell disease in the ICU

Sat, 07 Nov 2015 19:23:00 +0100

Purpose of review: The review focuses on severe acute vaso-occlusive manifestations of sickle cell disease leading adult patients to the ICU. Recent findings: Careful consideration should be paid to look for pulmonary vascular dysfunction and acute kidney injury, because of their prognostic role during acute vaso-occlusive manifestations. Alloimmunization and delayed haemolytic transfusion reactions are emerging complications that should be thought to be diagnosed, as they may imply a conservative management. The life-threatening complication raises the question about the indications of blood transfusion therapy for acute sickle cell disease complications, no randomized controlled trials being available to assess the role of blood transfusion in the acute setting. Summary: Acute vaso-occlu...



Organ iron accumulation in chronically transfused children with sickle cell anaemia: baseline results from the TWiTCH trial

Mon, 02 Nov 2015 00:00:00 +0100

We report the baseline findings of abdominal organ iron burden in 121 participants. At enrollment, patients were young (9·8 ± 2·9 years), predominantly female (60:40), and previously treated with transfusions (4·1 ± 2·4 years) and iron chelation (3·1 ± 2·1 years). Liver iron concentration (LIC; 9·0 ± 6·6 mg/g dry weight) and serum ferritin were moderately elevated (2696 ± 1678 μg/l), but transferrin was incompletely saturated (47·2 ± 23·6%). Spleen R2* was 509 ± 399 Hz (splenic iron ~13·9 mg/g) and correlated with LIC (r2 = 0·14, P = 0·0008). Pancreas R2* was increased in 38·3% of patients but not to levels associated with endocrine toxicity. Kidney R2* was increased in 80·7% of patients; renal iron correlated with markers of intravascular ha...



Efficacy of transfusion with granulocytes from G-CSF/dexamethasone-treated donors in neutropenic patients with infection

Thu, 29 Oct 2015 00:00:00 +0100

In conclusion, there was no overall effect of granulocyte transfusion on the primary outcome, but because enrollment was half that planned, power to detect a true beneficial effect was low. RING was registered at www.clinicaltrials.gov as #NCT00627393. (Source: Blood)



Different doses of prophylactic platelet transfusion for preventing bleeding in people with haematological disorders after myelosuppressive chemotherapy or stem cell transplantation.

Tue, 27 Oct 2015 00:00:00 +0100

CONCLUSIONS: In haematology patients who are thrombocytopenic due to myelosuppressive chemotherapy or HSCT, we found no evidence to suggest that a low-dose platelet transfusion policy is associated with an increased bleeding risk compared to a standard-dose or high-dose policy, or that a high-dose platelet transfusion policy is associated with a decreased risk of bleeding when compared to a standard-dose policy.A low-dose platelet transfusion strategy leads to an increased number of transfusion episodes compared to a standard-dose strategy. A high-dose platelet transfusion strategy does not decrease the number of transfusion episodes per participant compared to a standard-dose regimen, and it may increase the number of transfusion-related adverse events.Findings from this review would sugg...



A therapeutic-only versus prophylactic platelet transfusion strategy for preventing bleeding in patients with haematological disorders after myelosuppressive chemotherapy or stem cell transplantation.

Wed, 30 Sep 2015 00:00:00 +0100

CONCLUSIONS: We found low- to moderate-grade evidence that a therapeutic-only platelet transfusion policy is associated with increased risk of bleeding when compared with a prophylactic platelet transfusion policy in haematology patients who are thrombocytopenic due to myelosuppressive chemotherapy or HSCT. There is insufficient evidence to determine any difference in mortality rates and no evidence of any difference in adverse events between a therapeutic-only platelet transfusion policy and a prophylactic platelet transfusion policy. A therapeutic-only platelet transfusion policy is associated with a clear reduction in the number of platelet components administered. PMID: 26422767 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)

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Hemoglobin thresholds for transfusion in pediatric patients at a large academic health center.

Tue, 29 Sep 2015 00:00:00 +0100

CONCLUSIONS: Red blood cell (RBC) transfusion therapy varies significantly in hospitalized children with mean Hb triggers above a restrictive threshold for most services. Our findings suggest that transfusions may be overused and that implementing a restrictive transfusion strategy could decrease the use of RBC transfusions, thereby reducing the associated risks and costs. PMID: 26415860 [PubMed - as supplied by publisher] (Source: Transfusion)



Validation of viscoelastic coagulation tests during cardiopulmonary bypass: reply.

Sat, 26 Sep 2015 00:00:00 +0100

This article is protected by copyright. All rights reserved. PMID: 26407643 [PubMed - as supplied by publisher] (Source: Thrombosis and Haemostasis)



Unexpected Anemia and Reticulocytopenia in an Adolescent With Sickle Cell Anemia Receiving Chronic Transfusion Therapy

Fri, 18 Sep 2015 20:04:50 +0100

In a patient with sickle cell disease receiving chronic transfusion, exacerbation of anemia with reticulocytopenia must prompt consideration of a delayed hemolytic transfusion reaction with hyperhemolysis, as further transfusion may worsen this condition; definitive diagnosis is sometimes difficult. Anemia evolving during parvovirus B19-induced erythroid hypoplasia (transient aplastic crisis) should be attenuated in chronic transfusion patients due to superior survival of transfused over endogenous red blood cells. A 16-year-old with sickle cell disease receiving chronic transfusion of modified intensity (goal to maintain hemoglobin S (Source: Journal of Pediatric Hematology Oncology)



Thromboelastography and Rotational Thromboelastometry Use in Trauma

Thu, 17 Sep 2015 00:00:00 +0100

The appropriate resuscitation of patients in hemorrhagic shock is critical to improving survival. Current strategies for massive transfusions utilize fixed ratio protocols to rapidly deliver plasma and platelets to the patient. However, there is some concern that these larger volumes of transfusions can lead to untoward effects. Efforts now exist on methods to provide patient specific transfusion therapy in order to avoid excess transfusions. Viscoelastic testing via thromboelastography (TEG) or Rotational Thromboelastometry (ROTEM) are two viscoelastic analyzers capable of providing such therapy. (Source: International Journal of Surgery)



Is there a “magic” hemoglobin number? Clinical decision support promoting restrictive blood transfusion practices

Thu, 10 Sep 2015 00:00:00 +0100

Blood transfusion has been identified as one of the most frequently performed therapeutic procedures, with a significant percentage of transfusions identified to be inappropriate. Recent key clinical trials in adults have provided Level 1 evidence to support restrictive red blood cell (RBC) transfusion practices. However, some advocates have attempted to identify a “correct” Hb threshold for RBC transfusion; whereas others assert that management of anemia, including transfusion decisions, must take into account clinical patient variables, rather than simply one diagnostic laboratory test. The heterogeneity of guidelines for blood transfusion by a number of medical societies reflects this controversy. Clinical decision support (CDS) uses a Hb threshold number in a smart Best Practices A...

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Immunophenotypic Parameters and RBC Alloimmunization in Children with Sickle Cell Disease on Chronic Transfusion

Tue, 01 Sep 2015 00:00:00 +0100

This article is protected by copyright. All rights reserved. (Source: American Journal of Hematology)



Validation of viscoelastic coagulation tests during cardiopulmonary bypass: reply

Tue, 01 Sep 2015 00:00:00 +0100

This article is protected by copyright. All rights reserved. (Source: Journal of Thrombosis and Haemostasis)



An analysis of transfusion support in haematopoietic stem cell transplantation – report from a centre in India

Tue, 18 Aug 2015 00:00:00 +0100

Transfusion support in haematopoietic stem cell transplantation (HSCT) can be very demanding and challenging. The conditioning regimen, stem cell dose, donor type, presence of GvHD, infection all influence transfusion therapy in haematopoietic stem cell transplantation (HSCT). We retrospectively analysed the first 100 days transfusion requirements among HSCT recipients with haematological as well as non-haematological malignancies in our centre. (Source: Transfusion and Apheresis Science)



An analysis of transfusion support in haematopoietic stem cell transplantation - report from a center in India

Tue, 18 Aug 2015 00:00:00 +0100

Transfusion support in haematopoietic stem cell transplantation (HSCT) can be very demanding and challenging. The conditioning regimen, stem cell dose, donor type, presence of GvHD, infection all influence transfusion therapy in haematopoietic stem cell transplantation (HSCT).We retrospectively analysed the first 100 days transfusion requirements among HSCT recipients with haematological as well as non- haematological malignancies in our center. (Source: Transfusion and Apheresis Science)



Chronic transfusion therapy improves but does not normalize systemic and pulmonary vasculopathy in sickle cell disease

Thu, 06 Aug 2015 00:00:00 +0100

Tricuspid regurgitant (TR) jet velocity and its relationship to pulmonary hypertension has been controversial in sickle cell disease (SCD). Plasma free hemoglobin is elevated in SCD patients and acutely impairs systemic vascular reactivity. We postulated that plasma free hemoglobin would be negatively associated with both systemic and pulmonary endothelial function, assessed by flow-mediated dilation (FMD) of the brachial artery and TR jet velocity, respectively. Whole blood viscosity, plasma free hemoglobin, TR jet, and FMD were measured in chronically transfused SCD pre- and posttransfusion (N = 25), in nontransfused SCD (N = 26), and in ethnicity-matched control subjects (N = 10). We found increased TR jet velocity and decreased FMD in nontransfused SCD patients compared with the other ...

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[In Process Citation].

Sat, 01 Aug 2015 00:00:00 +0100

CONCLUSIONS: The authors conclude that the identified problems can be resolved by improving professional responsibility of nurses, increasing supervision by nursing leaders and appropriate transfusiology training and regular retrainings. Orv. Hetil., 2015, 156(34), 1383-1392. PMID: 26278483 [PubMed - in process] (Source: Orvosi Hetilap)



Extramedullary hematopoiesis is associated with lower cardiac iron loading in chronically transfused thalassemia patients

Thu, 30 Jul 2015 00:00:00 +0100

In conclusion, in regularly transfused thalassemia patients, EMH was common and was associated with a thalassemia intermedia‐like pattern of cardiac iron deposition despite regular transfusion therapy. This article is protected by copyright. All rights reserved. (Source: American Journal of Hematology)



Restrictive versus liberal transfusion strategy for red blood cell transfusion in critically ill patients and in patients with acute coronary syndrome: a systematic review, meta-analysis and trial sequential analysis.

Sun, 26 Jul 2015 01:40:03 +0100

CONCLUSIONS: Restrictive strategy is at least as effective to liberal strategy in critically ill patients. Nevertheless, there is insufficient evidence to recommend a restrictive strategy for patients with acute coronary syndrome. PMID: 26198765 [PubMed - as supplied by publisher] (Source: Minerva Anestesiologica)



Bench Test for the Detection of Bacterial Contamination in Platelet Concentrates Using Rapid and Cultural Detection Methods with a Standardized Proficiency Panel

Fri, 17 Jul 2015 08:45:39 +0100

Conclusion: This proficiency panel facilitates the verification of the analytical sensitivity of rapid and cultural bacterial detection systems under controlled routine conditions. The concept of samples provided in this EQAP has three main advantages: i) samples can be examined by both rapid and culture methods, ii) the provided material is matrix-equivalent, and iii) the sample material is ready-to-use.Transfus Med Hemother (Source: Transfusion Medicine and Hemotherapy)



Autonomic responses to cold face stimulation in sickle cell disease: a time‐varying model analysis

Tue, 14 Jul 2015 00:00:00 +0100

This study investigated the effect of cold face stimulation (CFS) on autonomic function in subjects with sickle cell disease (SCD), chronically transfused SCD subjects, and healthy controls. Using a time‐varying computational model, we found that cardiac baroreflex sensitivity was impaired in nontransfused SCD subjects, but partially restored toward healthy control levels in SCD subjects undergoing transfusion therapy. As well, CFS reduced vascular resistance baroreflex sensitivity in the nontransfused SCD subjects but not in the other groups. (Source: Physiological Reports)

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TyG index and insulin resistance in beta-thalassemia

Tue, 30 Jun 2015 00:00:00 +0100

In this study, the TyG index were studied for IR monitoring in beta-thalassemia major (βTM) patients. The participants were 90 βTM patients on chronic regular transfusion therapy. The TyG index was computed based on fasting plasma glucose (FPG) and triglyceride (TG). The time gap between the first and the second TyG index survey (TyG.1 and TyG.2) was 2 years. The agreement between TyG and HOMA-IR were studied with the extension of limit of agreement (LOA). We included 90 patients 53.3 % men (n = 48). Among them, 14.4 % (14.6 % male, 14.3 % female) had impaired fasting glucose level (e.g., 100–125 mg/dl) at first test. It rose to 37.8 % (27.1 % male, 50 % female) during 2 years. Based on TyG.1, the 34.4 % of patients was detected as IR cases. After 2 years, the percent o...



Early cryoprecipitate for major haemorrhage in trauma: a randomised controlled feasibility trial

Thu, 18 Jun 2015 00:00:00 +0100

Conclusions Early Fg supplementation using cryoprecipitate is feasible in trauma patients. This study supports the need for a definitive RCT to determine the effect of early Fg supplementation on mortality and other clinical outcomes. Trial registry number ISRCTN55509212. (Source: British Journal of Anaesthesia)



A paradigm shift in platelet transfusion therapy

Thu, 04 Jun 2015 00:00:00 +0100

(Source: Blood)



Hyperbaric oxygen therapy for refractory radiation‐induced hemorrhagic cystitis

Mon, 01 Jun 2015 00:00:00 +0100

ConclusionsRefractory radiation‐induced hemorrhagic cystitis can be successfully and safely treated with hyperbaric oxygen. Treatment effectiveness seems to be correlated with the need for transfusion therapy and the number of sessions performed. (Source: International Journal of Urology)



Bmi-1 Regulates Extensive Erythroid Self-Renewal

Fri, 29 May 2015 00:00:00 +0100

Publication date: Available online 28 May 2015 Source:Stem Cell Reports Author(s): Ah Ram Kim , Jayme L. Olsen , Samantha J. England , Yu-Shan Huang , Katherine H. Fegan , Luis F. Delgadillo , Kathleen E. McGrath , Paul D. Kingsley , Richard E. Waugh , James Palis Red blood cells (RBCs), responsible for oxygen delivery and carbon dioxide exchange, are essential for our well-being. Alternative RBC sources are needed to meet the increased demand for RBC transfusions projected to occur as our population ages. We previously have discovered that erythroblasts derived from the early mouse embryo can self-renew extensively ex vivo for many months. To better understand the mechanisms regulating extensive erythroid self-renewal, global gene expression data sets from self-renewing and dif...

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How I treat and manage strokes in sickle cell disease

Thu, 28 May 2015 00:00:00 +0100

Neurologic complications are a major cause of morbidity and mortality in sickle cell disease (SCD). In children with sickle cell anemia, routine use of transcranial Doppler screening, coupled with regular blood transfusion therapy, has decreased the prevalence of overt stroke from ~11% to 1%. Limited evidence is available to guide acute and chronic management of individuals with SCD and strokes. Current management strategies are based primarily on single arm clinical trials and observational studies, coupled with principles of neurology and hematology. Initial management of a focal neurologic deficit includes evaluation by a multidisciplinary team (a hematologist, neurologist, neuroradiologist, and transfusion medicine specialist); prompt neuro-imaging and an initial blood transfusion (sim...



Restrictive and liberal red cell transfusion strategies in adult patients: reconciling clinical data with best practice

Tue, 05 May 2015 00:00:00 +0100

Red blood cell (RBC) transfusion guidelines correctly promote a general restrictive transfusion approach for anemic hospitalized patients. Such recommendations have been derived from evaluation of specific patient populations, and it is important to recognize that engaging a strict guideline approach has the potential to incur harm if the clinician fails to provide a comprehensive review of the patient’s physiological status in determining the benefit and risks of transfusion. We reviewed the data in support of a restrictive or a more liberal RBC transfusion practice, and examined the quality of the datasets and manner of their interpretation to provide better context by which a physician can make a sound decision regarding RBC transfusion therapy. Reviewed studies included PubMed-cited ...



Transfusion and coagulation management in major obstetric hemorrhage

Fri, 01 May 2015 18:59:03 +0100

Purpose of review: Major obstetric hemorrhage is a leading cause of maternal morbidity and mortality. We will review transfusion strategies and the value of monitoring the maternal coagulation profile during severe obstetric hemorrhage. Recent findings: Epidemiologic studies indicate that rates of severe postpartum hemorrhage (PPH) in well resourced countries are increasing. Despite these increases, rates of transfusion in obstetrics are low (0.9–2.3%), and investigators have questioned whether a predelivery ‘type and screen’ is cost-effective for all obstetric patients. Instead, blood ordering protocols specific to obstetric patients can reduce unnecessary antibody testing. When severe PPH occurs, a massive transfusion protocol has attracted interest as a key therapeutic resource by...



How we treat delayed haemolytic transfusion reactions in patients with sickle cell disease

Fri, 01 May 2015 00:00:00 +0100

Summary Transfusion therapy is effective in the prevention and treatment of many complications of sickle cell disease (SCD). However, its benefits must be balanced against its risks, including delayed haemolytic transfusion reactions (DHTR). Not only is the relative rate of alloimmunization higher in patients with SCD than in other patient populations, but attendant risks associated with DHTR are even greater in SCD. Clinicians' awareness of DHTR events is poor because symptoms of DHTR mimic acute vaso‐occlusive pain and immunohaematology findings are often negative. Transfusions delivered in the acute rather than elective setting appear to confer a higher risk of DHTR. Management of DHTR in SCD depends on the clinical severity, ranging from supportive care to immunosuppression, and opti...



Hydroxyurea use in prevention of stroke recurrence in children with sickle cell disease in a developing country: A cost effectiveness analysis

Thu, 30 Apr 2015 00:00:00 +0100

We undertook a cost effectiveness analysis (CEA) of hydroxyurea (HU) in preventing stroke recurrence and/or death. We followed 43 children with sickle cell disease from 2000 to 2009 after having a first clinical stroke, of whom 10 opted for HU therapy. HU use led to decreased stroke recurrence and death without significantly increasing the annual cost of care per patient (J$83,250 vs. J$76,901, P = 0.491). The incremental cost effectiveness ratio (ICER) for prevention of stroke recurrence amounted to J$169,238 (US$1,900), while that for death prevention equalled J$635,843 (US$7,140). HU may be recommended when safe and affordable transfusion therapy is not feasible. Pediatr Blood Cancer © 2015 Wiley Periodicals, Inc (Source: Pediatric Blood and Cancer)

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213 Comparative Effectiveness of Radiofrequency Ablation and Argon Plasma Coagulation for Treatment of Gastric Antral Vascular Ectasia: a Systematic Review and Meta-Analysis

Tue, 28 Apr 2015 11:05:03 +0100

Gastric antral vascular ectasia (GAVE), while a less common cause of gastrointestinal bleeding, may result in iron deficiency anemia and a requirement for frequent transfusion therapy. The current standard endoscopic treatment for GAVE is argon plasma coagulation (APC), though studies have shown mixed results to date. Recently, radiofrequency ablation (RFA) has emerged as an attractive alternative for the treatment of GAVE; however, data comparing the efficacy and tolerability of these 2 endoscopic modalities is lacking. (Source: Gastrointestinal Endoscopy)



Early and current days of transfusion medicine help to understand longevity and particularities of transfusion therapy in the elderly

Wed, 08 Apr 2015 00:00:00 +0100

Transfusion triggers for prescription of cellular blood products have many faces based on patient biometrics, polymorbidity degrees, pre-and intraoperative laboratory values, international or local guidelines, and last but not least, availability of blood products. (Source: Transfusion and Apheresis Science)



Prevalence and specificity of RBC alloantibodies in the general hospitalised population in Guangxi

Wed, 01 Apr 2015 00:00:00 +0100

ConclusionsThe frequency and specificities of erythrocyte alloantibodies among hospitalised patients in Guangxi were different from those in other Chinese populations and Caucasians, although the alloantibodies against the antigens of the Rh system are still common. Anti‐E and anti‐Mia/Mur were more common in Guangxi patients, but anti‐K and anti‐D, which are prone to develop in Caucasians, were less likely to develop in our patients. (Source: Transfusion Medicine)



Large-scale Convalescent Blood and Plasma Transfusion Therapy for Ebola Virus Disease

Tue, 24 Mar 2015 00:00:00 +0100

(Source: The Journal of Infectious Diseases)



Evaluating Large-scale Blood Transfusion Therapy for the Current Ebola Epidemic in Liberia

Tue, 24 Mar 2015 00:00:00 +0100

Conclusions. Transfusion therapy for EVD is a low-cost measure that can potentially save many lives in West Africa but will not measurably influence the prevalence. Under all scenarios considered, CP transfusions are predicted to achieve greater reductions in mortality than CWB. (Source: The Journal of Infectious Diseases)

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Guidelines for the Standard Monitoring of Patients With Thalassemia: Report of the Thalassemia Longitudinal Cohort

Mon, 23 Mar 2015 12:18:14 +0100

Chronic transfusion therapy has played a central role in extending life expectancy for patients with hemoglobinopathies such as thalassemia. However, this life-saving therapy is associated with numerous complications that now comprise the bulk of management considerations for patients with thalassemia. This review reports on the experience of the Thalassemia Longitudinal Cohort and reviews available literature to establish guidelines for the management of patients with thalassemia. (Source: Journal of Pediatric Hematology Oncology)



L-carnitine effectively improves the metabolism and quality of platelet concentrates during storage

Thu, 05 Mar 2015 15:40:25 +0100

Abstract Human platelets undergo structural and biochemical alternations during storage which are collectively called platelet storage lesion (PSL). PSL is characterized as metabolic and functionally changes. It causes decrease in platelet recovery and survival. Here, we evaluated the effect of L-carnitine (LC) on the metabolism, function, and mitochondrial metabolic activity of platelet during storage. Platelet-rich plasma was used to prepare platelet concentrate (PC) in Iranian Blood Transfusion Organization. For this purpose, ten PC bags from healthy donors were stored at 22 °C with gentle agitation in the presence or absence of LC. The effects of LC (15 mM) on the platelet quality were assessed by analyzing the levels of glucose, lactate, ATP, and lactate dehydrogenase (LD...



Hemostatic resuscitation in postpartum hemorrhage – a supplement to surgery

Thu, 05 Mar 2015 00:00:00 +0100

ConclusionDespite the lack of conclusive evidence for optimal hemostatic resuscitation in postpartum hemorrhage, the use of viscoelastic hemostatic assays, fibrinogen, tranexamic acid and balanced transfusion therapy may prove to be potentially pivotal in the treatment of postpartum hemorrhage. (Source: Acta Obstetricia et Gynecologica Scandinavica)



Immune parameter analysis of children with sickle cell disease on hydroxycarbamide or chronic transfusion therapy

Thu, 05 Mar 2015 00:00:00 +0100

This study provides additional support for HC treatment in SCD, as it appears that HC decreases the abnormally elevated immune cell counts in patients with SCD. (Source: British Journal of Haematology)



[Professional knowledge and practice mapping among nurses regarding transfusion therapy. A pilot study on reliability and validity testing].

Thu, 26 Feb 2015 21:42:04 +0100

CONCLUSIONS: The authors propose a better supervision by leaders in nursing aspects of transfusion therapy, and an increased professional responsibility. Orv. Hetil., 2015, 156(9), 366-378. PMID: 25702257 [PubMed - in process] (Source: Orvosi Hetilap)

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Guidelines for quantifying iron overload.

Fri, 20 Feb 2015 14:20:03 +0100

Authors: Wood JC Abstract Both primary and secondary iron overload are increasingly prevalent in the United States because of immigration from the Far East, increasing transfusion therapy in sickle cell disease, and improved survivorship of hematologic malignancies. This chapter describes the use of historical data, serological measures, and MRI to estimate somatic iron burden. Before chelation therapy, transfusional volume is an accurate method for estimating liver iron burden, whereas transferrin saturation reflects the risk of extrahepatic iron deposition. In chronically transfused patients, trends in serum ferritin are helpful, inexpensive guides to relative changes in somatic iron stores. However, intersubject variability is quite high and ferritin values may change disparatel...



A rapid paper‐based test for quantifying sickle hemoglobin in blood samples from patients with sickle cell disease

Mon, 16 Feb 2015 00:00:00 +0100

This study demonstrates the feasibility of the paper‐based %HbS assay. The paper‐based test could improve clinical care for SCD, particularly in resource‐limited settings, by enabling more rapid and less expensive %HbS monitoring. This article is protected by copyright. All rights reserved. (Source: American Journal of Hematology)



Transfusion therapy in paediatric trauma patients: a review of the literature

Sun, 15 Feb 2015 00:00:00 +0100

Haemorrhage is a leading cause of death in paediatric trauma patients. Predefined massive transfusion protocols (MTP) have the potential to significantly reduce mortality by treating haemorrhagic shock and coagulopathy, in adhering to the principles of haemostatic resuscitation with rapid administration of balanced ratios of packed red blood cells (RBC), fresh frozen plasma (FFP) and platelets (PLT).Because of their substantial physiological reserve, initial vital signs may not be good predictors of early haemorrhage in paediatric patients. Determining the triggers for MTP activation in paediatric trauma patients is challenging, and the optimal blood product ratio that will increase survival in massively bleeding paediatric trauma patients has yet to be determined. To date, only a few smal...



Prevalence of risk factors for platelet transfusion refractoriness in multitransfused hemato-oncological patients at tertiary care center in North India

Fri, 06 Feb 2015 00:00:00 +0100

Conclusion: Platelet refractoriness should be suspected in multitransfused patients not showing expected increment in platelet counts and thoroughly investigated to frame further guidelines in order to ensure proper management of these kind of patients. (Source: Asian Journal of Transfusion Science)



Hemostatic resuscitation in postpartum hemorrhage ‐ a supplement to surgery

Sun, 01 Feb 2015 00:00:00 +0100

ConclusionDespite the lack of conclusive evidence for optimal hemostatic resuscitation in postpartum hemorrhage, the use of viscoelastic hemostatic assays, fibrinogen, tranexamic acid and balanced transfusion therapy may prove to be potentially pivotal in the treatment of postpartum hemorrhage.This article is protected by copyright. All rights reserved. (Source: Acta Obstetricia et Gynecologica Scandinavica)

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Granulocyte Transfusion Therapy

Fri, 09 Jan 2015 00:00:00 +0100

Bacterial and fungal infections continue to be a major cause of morbidity and mortality in severely neutropenic patients undergoing aggressive chemotherapy regimens or hematopoietic stem cell transplantation. Traditional granulocyte transfusion therapy, a logical approach in treating these infections, has been available for many years, and several controlled studies have shown this therapy to be useful. However, granulocyte transfusion therapy fell out of favor because the results were not clinically impressive, and adverse results were reported. These disappointing results were felt to be, in part, because of the low doses of granulocytes provided. More recent studies have attempted to increase the numbers of transfused cells by stimulating normal granulocyte donors with G-CSF (+/-cortico...



[Blood transfusion: The challenges for tomorrow?]

Thu, 08 Jan 2015 00:00:00 +0100

Authors: Folléa G, Garraud O, Tiberghien P Abstract As any therapeutic means, blood transfusion requires regular evaluation, particularly for its indications, effectiveness and risks. The availability of randomized clinical trials, the evolution of the quality of blood components, and the economic constraints shared by all countries, all lead to rethink both transfusion therapy as a whole and the organization of the transfusion chain from donor to recipient. The main tools available to improve transfusion and the transfusion chain management are the following: programs of patient blood management (PBM) to optimize the use of blood products with a patient centred approach, blood supply management tools to improve the effectiveness and efficiency of the transfusion chain, donor mana...



The pathophysiology and consequences of red blood cell storage

Mon, 01 Dec 2014 00:00:00 +0100

Summary Red cell transfusion therapy is a common treatment modality in contemporary medical practice. Although blood collection and administration is safer and more efficient than ever before, red cells undergo multiple metabolic and structural changes during storage that may compromise their functionality and viability following transfusion. The clinical relevance of these changes is a hotly debated topic that continues to be a matter of intense investigation. In the current review, we begin with an in‐depth overview of the pathophysiological mechanisms underlying red cell storage, with a focus on altered metabolism, oxidative stress and red cell membrane damage. We proceed to review the current state of evidence on the clinical relevance and consequences of the red cell storage lesion,...



Detection and Identification of Red Cell Alloantibodies in Multiply Transfused Thalassemia Major Patients: A Prospective Study

Wed, 26 Nov 2014 01:38:14 +0100

Abstract Life long red blood transfusion remains the main treatment for β thalassemia major patients. The development of alloantibodies complicates transfusion therapy in thalassemia patients. Alloimmunization to red cell antigens is one of the most important immunological transfusion reaction and causes delayed type of transfusion reaction. A prospective study was conducted from January 2007 to January 2010. This was a cohorts of 115 patients were selected from regular transfusion group and they were followed for two and half year. They were followed up for the effect of transfusion during study period. There was a decline in patient number from 115 to 96 due to mortality and transfer of patient. A total of 96 multiply transfused thalassemia patients were prospectively included...



Guidance on Platelet Transfusion for Patients with Hypoproliferative Thrombocytopenia

Wed, 26 Nov 2014 00:00:00 +0100

Patients with hypoproliferative thrombocytopenia are at an increased risk of hemorrhage and alloimmunization to platelets. Updated guidance for optimizing platelet transfusion therapy is needed as data from recent pivotal trials have the potential to change practice. This guideline, developed by a large international panel using a systematic search strategy and standardized methods to develop recommendations, incorporates recent trials not available when previous guidelines were developed. We found that prophylactic platelet transfusion for platelet counts less than or equal to 10 x 109/L is the optimal approach to decrease the risk of hemorrhage for patients requiring chemotherapy or undergoing allogeneic or autologous transplantation. (Source: Transfusion Medicine Reviews)

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Hypertransfusion therapy in sickle cell disease in Nigeria.

Sun, 16 Nov 2014 14:58:20 +0100

Conclusion. Improved knowledge of the benefits and practice of hypertransfusion will effectively translate into improved health status even among Nigerian sickle cell disease patients. PMID: 25177350 [PubMed] (Source: Advances in Hematology)



Mesenchymal stromal cell density is increased in higher grade myelodysplastic syndromes and independently predicts survival.

Sun, 16 Nov 2014 09:55:30 +0100

CONCLUSIONS: High CD271+ MSC density is characteristic of higher grade MDS and is associated with poor risk independent of known prognostic factors. PMID: 25389333 [PubMed - in process] (Source: American Journal of Clinical Pathology)



Allogeneic Umbilical Cord Blood Red Cell Concentrates: An Innovative Blood Product for Transfusion Therapy of Preterm Infants

Sat, 15 Nov 2014 03:38:06 +0100

Conclusions: Transfusing allogeneic UCB-RBC units in preterm infants appears a feasible and safe approach, although the transfusion needs of our study population were not completely covered. More data are necessary to validate this novel transfusion practice.Neonatology 2015;107:81-86 (Source: Neonatology)



Allogeneic Umbilical Cord Blood Red Cell Concentrates: An Innovative Blood Product for Transfusion Therapy of Preterm Infants.

Sat, 15 Nov 2014 00:00:00 +0100

Conclusions: Transfusing allogeneic UCB-RBC units in preterm infants appears a feasible and safe approach, although the transfusion needs of our study population were not completely covered. More data are necessary to validate this novel transfusion practice. © 2014 S. Karger AG, Basel. PMID: 25401961 [PubMed - as supplied by publisher] (Source: Neonatology)



Primary stroke prevention in Nigerian children with sickle cell disease (SPIN): Challenges of conducting a feasibility trial

Fri, 14 Nov 2014 00:00:00 +0100

ConclusionA hydroxyurea trial (NCT01801423) for children with SCD is feasible in sub‐Saharan Africa; however, extensive training and resources are needed to build a global patient oriented multi‐disciplinary research team with a common purpose. Pediatr Blood Cancer. © 2014 Wiley Periodicals, Inc. (Source: Pediatric Blood and Cancer)

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How I treat patients with massive hemorrhage

Thu, 13 Nov 2014 00:00:00 +0100

We present how we in Copenhagen and Houston, today, manage patients with massive hemorrhage. (Source: Blood)



Transfusion therapy for sickle cell disease: a balancing act.

Tue, 11 Nov 2014 12:15:10 +0100

Authors: Chou ST Abstract Transfusion therapy is a key intervention in decreasing morbidity and mortality in patients with sickle cell disease (SCD). Current indications for acute and chronic transfusion therapy have significantly increased the number of RBC units transfused to patients with SCD worldwide. This review summarizes transfusion management for the treatment or prevention of neurologic and perioperative complications, acute chest syndrome, and acute anemia associated with SCD. Despite the recognized benefits of transfusion therapy, it is not without the risks of iron overload, alloimmunization, and delayed hemolytic transfusion reactions. Transfusional iron overload management includes automated RBC exchange, noninvasive imaging to monitor iron burden, and iron chelation...



Transfusion guidelines: when to transfuse.

Tue, 11 Nov 2014 12:15:10 +0100

Authors: Szczepiorkowski ZM, Dunbar NM Abstract Transfusion of blood and blood components has been a routine practice for more than half a century. The rationale supporting this practice is that replacement of blood loss should be beneficial for the patient. This assumption has constituted the underpinning of transfusion medicine for many decades. Only over the past 20 years, we have seen a more concerted effort to answer very basic questions regarding the value of transfusion therapy. An assessment of the value of transfusion based on well-designed and appropriately powered randomized, controlled trials is the first step in optimizing transfusion practices. Systematic reviews provide the second step by building the knowledge base necessary to assess the impact of transfusion pract...



[Kinetic and organization of granulocytes transfusion: A case report.]

Thu, 06 Nov 2014 00:00:00 +0100

CONCLUSION: In 2014, granulocyte transfusion therapy is indicated for severe infection associated with long-term neutropenia. Minimal circulation of transfused cells in our observation and fast clinical improvement suggest the concentration of granulocytes on the infected area. PMID: 25441453 [PubMed - as supplied by publisher] (Source: Transfusion Clinique et Biologique)



Sickle cell disease and pregnancy: analysis of 34 patients followed at the Regional Blood Center of Ribeirão Preto, Brazil

Tue, 04 Nov 2014 21:39:43 +0100

Conclusions: Pregnancy in sickle cell patients is still associated with complications. Although no statistical difference was observed between transfused and non-transfused women, there were no deaths (fetal or maternal) in transfused patients whereas one maternal death and three stillbirths occurred in non-transfused women. A larger study of sickle cell pregnant women will be necessary to elucidate the actual role of transfusion during pregnancy in sickle cell disease. (Source: Revista Brasileira de Hematologia e Hemoterapia)

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Coagulopathy in newborns with hypoxic ischemic encephalopathy (HIE) treated with therapeutic hypothermia: a retrospective case-control study

Mon, 03 Nov 2014 00:00:00 +0100

Background: Newborns with hypoxic ischemic encephalopathy (HIE) are at risk for coagulopathy due to systemic oxygen deprivation. Additionally, therapeutic hypothermia (TH) slows enzymatic activity of the coagulation cascade, leading to constitutive prolongation of routinely assessed coagulation studies. The level of laboratory abnormality that predicts bleeding is unclear, leading to varying transfusion therapy practices. Methods: HIE infants treated with TH between 2008-2012 were included in this retrospective study. Initial, minimum (min) and maximum (max) values of International Normalized Ratio (INR), activated partial thromboplastin time (aPTT), fibrinogen (Fib) and platelet (PLT) count (measured twice daily during TH) were collected. Bleeding was defined as clinically significant if ...



A meta-analysis of cytokine-induced killer cells therapy in combination with minimally invasive treatment for hepatocellular carcinoma

Sun, 02 Nov 2014 00:00:00 +0100

Conclusion CIK cells transfusion therapy truly showed a synergistic effect for HCC patients after minimally invasive treatment especially for a long-term survival. (Source: Clinics and Research in Hepatology and Gastroenterology)



Health‐related quality of life in children with sickle cell anemia: Impact of blood transfusion therapy

Mon, 27 Oct 2014 21:35:18 +0100

This study provides the first evidence that children with SCA who received regular blood transfusion therapy felt better and had better overall HRQL than those who did not receive transfusion therapy. (Source: American Journal of Hematology)



Thalassemia Bone Disease: A 19‐Year Longitudinal Analysis

Mon, 20 Oct 2014 00:00:00 +0100

In conclusion, the FN is the preferred site for follow‐up of BMD. Male patients with β‐thalassemia experienced a greater loss of BMD and had a higher prevalence of fractures compared with females. Transfusing patients (particularly males) to a higher Hb target may reduce the decline in BMD. Whether deferasirox is implicated in bone loss warrants further study. © 2014 American Society for Bone and Mineral Research. (Source: Journal of Bone and Mineral Research)



An overview of thrombelastography research

Sun, 12 Oct 2014 00:00:00 +0100

Conclusion The application of TEG as a diagnostic tool and as a guide in transfusion therapy is increasing. Its use is still in development in different clinical fields and the advantages and limitations of this technique still have to be defined. It is evident that thrombelastography should be used with caution, and its strengths and weaknesses as well as new applications must continue to be explored. (Source: Colombian Journal of Anesthesiology)

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Management of Non-Transfusion-Dependent Thalassemia: A Practical Guide

Fri, 26 Sep 2014 00:00:00 +0100

Abstract Despite their transfusion-independence, non-transfusion-dependent thalassemia (NTDT) patients experience a variety of serious clinical complications that require prompt and comprehensive management. Transfusion therapy may still be an important part of management of this disease, in cases of acute stress, to support growth and development in childhood, or to prevent clinical morbidities stemming from ineffective erythropoiesis or hemolytic anemia. Although splenectomy is associated with improvements in hemoglobin levels, it leads to several short- and long-term adverse events, warranting caution in application of this intervention. Fetal hemoglobin induction therapy has been evaluated in non-randomized studies, with benefits extending beyond hematologic improvements to lo...



[In Context] News in brief

Tue, 16 Sep 2014 14:54:06 +0100

Stroke and silent cerebral infarcts are common in children with sickle cell anaemia. Although the incidence of silent cerebral infarcts can be reduced with regular blood transfusions, it is unknown whether regular transfusions can prevent the recurrence of an infarct (stroke or new or enlarged silent cerebral infarction). In a multicentre, randomised, single-blind, controlled trial of 196 children aged 5 to 15 years with sickle cell anaemia who had silent cerebral infarcts, 6 of 99 (6%) children who received transfusion therapy had an end-point event (one had stroke and five had new or enlarged silent cerebral infarcts) over a follow-up of 3 years. (Source: Lancet Neurology)



Antibody screening & identification in the general patient population at a tertiary care hospital in New Delhi, India.

Mon, 01 Sep 2014 00:00:00 +0100

CONCLUSIONS: Since clinically significant antibodies are frequently detected in our patient population, antibody screening and if required, identification is the need of the hour. Since antibodies against the common Rh and Kell blood group antigens are the most frequent, provision of Rh and Kell matched red cells may be of protective value. PMID: 25366208 [PubMed - in process] (Source: Indian J Med Res)



The clinical and biological impact of new pathogen inactivation technologies on platelet concentrates

Sat, 23 Aug 2014 00:00:00 +0100

Since 1990, several techniques have been developed to photochemically inactivate pathogens in platelet concentrates, potentially leading to safer transfusion therapy. The three most common methods are amotosalen/UVA (INTERCEPT Blood System), riboflavin/UVA–UVB (MIRASOL PRT), and UVC (Theraflex-UV). We review the biology of pathogen inactivation methods, present their efficacy in reducing pathogens, discuss their impact on the functional aspects of treated platelets, and review clinical studies showing the clinical efficiency of the pathogen inactivation methods and their possible toxicity. (Source: Blood Reviews)



Massive Hemorrhage: A Report from the Anesthesia Closed Claims Project

Tue, 19 Aug 2014 17:17:27 +0100

Conclusions: Hemorrhage is a rare, but serious, cause of anesthesia malpractice claims. Understanding which patients are at risk can aid in patient referral decisions, design of institutional systems for responding to hemorrhage, and education of surgeons, obstetricians, and anesthesiologists. (Source: Anesthesiology)

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Alloimmunization and autoimmunization in transfusion dependent thalassemia major patients: Study on 319 patients

Thu, 24 Jul 2014 00:00:00 +0100

Conclusion: Alloimmunization was detected in 5.64% of multitransfused thalassemia patients. Rh and Kell blood group system antibodies accounted for more than 80% of alloantibodies. This study re-emphasizes the need for RBC antigen typing before first transfusion and issue of antigen matched blood (at least for Rh and Kell antigen). Early institution of transfusion therapy after diagnosis is another means of decreasing alloimmunization. (Source: Asian Journal of Transfusion Science)



Resolution of alloimmunization and refractory autoimmune hemolytic anemia in a multi-transfused beta-thalassemia major patient

Thu, 24 Jul 2014 00:00:00 +0100

Joseph Philip, Neelesh JainAsian Journal of Transfusion Science 2014 8(2):128-130Beta-thalassemia is one of the most prevalent autosomal disorders, which affect more than 400,000 newborn per year worldwide. In India, the carrier rate of beta-thalassemia varies from 3-17%. The overall rate of alloimmunization in thalassemia patients has been reported to be 5-30% in the world, which is mostly contributed by the alloimmunization to minor blood group antigen. Among Asians, the incidence of red cell alloimmunization is 22%. The recommended treatment for beta-thalassemia major is regular blood transfusion every 3 to 4 weeks. The development of anti-red cell antibodies (alloantibodies and/or autoantibodies) can significantly complicate transfusion therapy. Alloantibodies are ...



Molecular matching for Rh and K reduces red blood cell alloimmunisation in patients with myelodysplastic syndrome.

Thu, 12 Jun 2014 00:00:00 +0100

DISCUSSION: In our population molecular matching for C, c, E, e, K was able to reduce RBC alloimmunisation in MDS patients. An association of HLA-DRB1*13 and protection from RBC alloimmunisation should be confirmed. PMID: 24960644 [PubMed - as supplied by publisher] (Source: Blood Transfusion)



[Current practice in coagulation and transfusion therapy in multiple trauma patients : A German nation-wide online survey.]

Thu, 05 Jun 2014 00:00:00 +0100

CONCLUSION: The current study suggests that in Germany strategies and principles regarding management of trauma-associated coagulopathy are standardized only poorly. Level 1 centres appear to apply a more advanced approach, however to much variability exists with respect to the components of the transfusion protocols. The low response rate indicates that most German trauma surgeons consider coagulation and hemorrhage as "expert-topics" beyond their field of duty. PMID: 24893728 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg)



Biochemical assessment of red blood cells during storage by (1)H nuclear magnetic resonance spectroscopy. Identification of a biomarker of their level of protection against oxidative stress.

Thu, 05 Jun 2014 00:00:00 +0100

DISCUSSION: We proved the analytical power of (1)H-NMR spectroscopy to study red blood cell metabolism under blood bank conditions. A potential biomarker able to provide information on the level of cellular oxidative stress protection was identified. Our data support the hypothesis that a more detailed knowledge of metabolic modifications during storage opens the way to the development of new and more effective protocols for red blood cell conservation and patient-oriented transfusion therapy. PMID: 24960643 [PubMed - as supplied by publisher] (Source: Blood Transfusion)

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