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Transfusion Medicine Reviews Oct 2020
Topics: Blood Platelets; Blood Preservation; Humans; Platelet Transfusion; Platelet-Rich Plasma; Thrombocytopenia
PubMed: 33129605
DOI: 10.1016/j.tmrv.2020.09.009 -
Chinese Medical Journal Sep 2015Blood transfusion saves lives but may also increase the risk of injury. The objective of this review was to evaluate the possible adverse effects related to transfusion... (Review)
Review
OBJECTIVE
Blood transfusion saves lives but may also increase the risk of injury. The objective of this review was to evaluate the possible adverse effects related to transfusion of red blood cell (RBC) concentrates stored for prolonged periods.
DATA SOURCES
The data used in this review were mainly from PubMed articles published in English up to February 2015.
STUDY SELECTION
Clinical and basic research articles were selected according to their relevance to this topic.
RESULTS
The ex vivo changes to RBC that occur during storage are collectively called storage lesion. It is still inconclusive if transfusion of RBC with storage lesion has clinical relevance. Multiple ongoing prospective randomized controlled trials are aimed to clarify this clinical issue. It was observed that the adverse events related to stored RBC transfusion were prominent in certain patient populations, including trauma, critical care, pediatric, and cardiac surgery patients, which leads to the investigation of underlying mechanisms. It is demonstrated that free hemoglobin toxicity, decreasing of nitric oxide bioavailability, and free iron-induced increasing of inflammation may play an important role in this process.
CONCLUSION
It is still unclear whether transfusion of older RBC has adverse effects, and if so, which factors determine such clinical effects. However, considering the magnitude of transfusion and the widespread medical significance, potential preventive strategies should be considered, especially for the susceptible recipients.
Topics: Blood Preservation; Erythrocyte Transfusion; Erythrocytes; Humans; Nitric Oxide; Time Factors
PubMed: 26315088
DOI: 10.4103/0366-6999.163384 -
Clinical and Experimental Immunology Jan 2011Autoimmune T cell responses directed against insulin-producing β cells are central to the pathogenesis of type 1 diabetes (T1D). Detection of such responses is... (Review)
Review
Isolation and preservation of peripheral blood mononuclear cells for analysis of islet antigen-reactive T cell responses: position statement of the T-Cell Workshop Committee of the Immunology of Diabetes Society.
Autoimmune T cell responses directed against insulin-producing β cells are central to the pathogenesis of type 1 diabetes (T1D). Detection of such responses is therefore critical to provide novel biomarkers for T1D 'immune staging' and to understand the mechanisms underlying the disease. While different T cell assays are being developed for these purposes, it is important to optimize and standardize methods for processing human blood samples for these assays. To this end, we review data relevant to critical parameters in peripheral blood mononuclear cell (PBMC) isolation, (cryo)preservation, distribution and usage for detecting antigen-specific T cell responses. Based on these data, we propose recommendations on processing blood samples for T cell assays and identify gaps in knowledge that need to be addressed. These recommendations may be relevant not only for the analysis of T cell responses in autoimmune disease, but also in cancer and infectious disease, particularly in the context of clinical trials.
Topics: Animals; Antigens, Surface; Autoimmune Diseases; Blood Preservation; Cell Separation; Clinical Trials as Topic; Cryopreservation; Diabetes Mellitus, Type 1; Humans; Infections; Insulin-Secreting Cells; Mice; Monocytes; Neoplasms; T-Lymphocytes
PubMed: 20939860
DOI: 10.1111/j.1365-2249.2010.04272.x -
Transfusion Oct 2014Emily Cooley was a highly regarded medical technologist and morphologist. The "Emily Cooley Lectureship and Award" was established to honor her, in particular, and... (Review)
Review
Emily Cooley was a highly regarded medical technologist and morphologist. The "Emily Cooley Lectureship and Award" was established to honor her, in particular, and medical technologists, in general. This article reviews some basic concepts about the "life of a red blood cell" (RBC) and uses these to discuss the actual and potential consequences that occur in patients after clearance of transfused refrigerator storage-damaged RBCs by extravascular hemolysis.
Topics: Animals; Blood Preservation; Erythrocyte Transfusion; Erythrocytes; Hemolysis; Humans; Immunity; Infections; Inflammation; Iron
PubMed: 25196845
DOI: 10.1111/trf.12848 -
Tropical Medicine & International... Jan 2019Blood component transfusion is increasingly promoted in sub-Saharan Africa (SSA), but is resource-intensive so whole blood is often used. We examined SSA recommendations... (Review)
Review
Packed red cells versus whole blood transfusion for severe paediatric anaemia, pregnancy-related anaemia and obstetric bleeding: an analysis of clinical practice guidelines from sub-Saharan Africa and evidence underpinning recommendations.
OBJECTIVE
Blood component transfusion is increasingly promoted in sub-Saharan Africa (SSA), but is resource-intensive so whole blood is often used. We examined SSA recommendations about whole blood and packed red cell transfusions for pregnancy-related bleeding or anaemia, and paediatric anaemia, and evaluated the evidence underpinning these recommendations.
METHOD
Relevant SSA guidelines were identified using five electronic databases, websites for SSA Ministries of Health, blood transfusion services and WHO. To facilitate comparisons, indications for transfusing packed red cells or whole blood within these guidelines and reasons given for these recommendations were recorded on a pre-designed matrix. The AGREE II tool was used to appraise guidelines that gave a reason for recommending either packed red cells or whole blood. We systematically searched MEDLINE, CINAHL, Global Health, Cochrane library and NHSBT Transfusion Evidence Library, using PRISMA guidelines, for clinical studies comparing whole blood with packed red cells or combined blood components in obstetric bleeding or anaemia, or paediatric anaemia. Characteristics and findings of included studies were extracted in a standardised format and narratively summarised.
RESULTS
32 English language guidelines from 15 SSA countries mentioned packed red cell or whole blood use for our conditions of interest. Only seven guidelines justified their recommendation for using packed red cells or whole blood. No recommendations or justifications had supporting citations to research evidence. 33 full-text papers, from 11 234 citations, were reviewed but only one study met our inclusion criteria. This was a single-centre study in post-partum haemorrhage.
CONCLUSION
Evidence comparing whole blood and packed red cell transfusion for common paediatric and maternal indications is virtually absent in SSA. Therefore, it is unclear whether policies promoting red cells over whole blood transfusion are clinically appropriate. Building a relevant evidence base will help develop effective policies promoting the most appropriate use of blood in African settings.
Topics: Africa South of the Sahara; Blood Preservation; Blood Transfusion; Erythrocyte Transfusion; Female; Humans; Obstetric Labor Complications; Postpartum Hemorrhage; Pregnancy
PubMed: 30347486
DOI: 10.1111/tmi.13173 -
Blood Transfusion = Trasfusione Del... Mar 2016Platelet concentrates account for near 10% of all labile blood components but are responsible for more than 25% of the reported adverse events. Besides factors related... (Review)
Review
Platelet concentrates account for near 10% of all labile blood components but are responsible for more than 25% of the reported adverse events. Besides factors related to patients themselves, who may be particularly at risk of side effects because of their underlying illness, there are aspects of platelet collection and storage that predispose to adverse events. Platelets for transfusion are strongly activated by collection through disposal equipment, which can stress the cells, and by preservation at 22 °C with rotation or rocking, which likewise leads to platelet activation, perhaps more so than storage at 4 °C. Lastly, platelets constitutively possess a very large number of bioactive components that may elicit pro-inflammatory reactions when infused into a patient. This review aims to describe approaches that may be crucial to minimising side effects while optimising safety and quality. We suggest that platelet transfusion is complex, in part because of the complexity of the "material" itself: platelets are highly versatile cells and the transfusion process adds a myriad of variables that present many challenges for preserving basal platelet function and preventing dysfunctional activation of the platelets. The review also presents information showing--after years of exhaustive haemovigilance--that whole blood buffy coat pooled platelet components are extremely safe compared to the gold standard (i.e. apheresis platelet components), both in terms of acquired infections and of immunological/inflammatory hazards.
Topics: Blood Preservation; Blood Safety; Humans; Platelet Transfusion
PubMed: 26674828
DOI: 10.2450/2015.0042-15 -
Proceedings of the National Academy of... Aug 2023Transfusion of red blood cells (RBCs) is one of the most valuable and widespread treatments in modern medicine. Lifesaving RBC transfusions are facilitated by the cold...
Transfusion of red blood cells (RBCs) is one of the most valuable and widespread treatments in modern medicine. Lifesaving RBC transfusions are facilitated by the cold storage of RBC units in blood banks worldwide. Currently, RBC storage and subsequent transfusion practices are performed using simplistic workflows. More specifically, most blood banks follow the "first-in-first-out" principle to avoid wastage, whereas most healthcare providers prefer the "last-in-first-out" approach simply favoring chronologically younger RBCs. Neither approach addresses recent advances through -omics showing that stored RBC quality is highly variable depending on donor-, time-, and processing-specific factors. Thus, it is time to rethink our workflows in transfusion medicine taking advantage of novel technologies to perform RBC quality assessment. We imagine a future where lab-on-a-chip technologies utilize novel predictive markers of RBC quality identified by -omics and machine learning to usher in a new era of safer and precise transfusion medicine.
Topics: Blood Transfusion; Humans; Blood Preservation; Lab-On-A-Chip Devices; Erythrocytes; Machine Learning; Microchip Analytical Procedures
PubMed: 37494421
DOI: 10.1073/pnas.2115616120 -
Blood Transfusion = Trasfusione Del... Jul 2011Umbilical cord blood (CB) banking and therapeutic use raise several ethical issues: medical indications, legal framework, public versus private biobanks, autologous... (Comparative Study)
Comparative Study Review
BACKGROUND AND OBJECTIVES
Umbilical cord blood (CB) banking and therapeutic use raise several ethical issues: medical indications, legal framework, public versus private biobanks, autologous versus allogeneic use, ownership, commercialisation, quality assurance and many others. Surrogate informed consent is one of the most notable controversial ethical issues. The aim of this study was to analyse and compare informed consent forms for CB collection, storage and use in the 18 accredited biobanks of the Italian Network.
MATERIAL AND METHODS
The first part of the article gives a brief overview of the scientific framework, the comparison of allogeneic and autologous use and Italian regulations. In the second part the contents of the consent forms from the 18 Italian biobanks are compared with the "NetCord-FACT International Standards for Cord Blood Collection, Banking, and Release for Administration".
RESULTS
Most of the Italian consent forms differ significantly from the NetCord-FACT Standards, with regards both to formal and substantial aspects.
CONCLUSION
Italian forms for CB collection, storage and use need standardisation to meet international criteria.
Topics: Bioethical Issues; Blood Banks; Blood Donors; Blood Preservation; Consent Forms; Fetal Blood; Humans; Italy; Blood Banking
PubMed: 21251456
DOI: 10.2450/2010.0083-10 -
Hematology. American Society of... 2011Transfusion of RBCs is often clinically necessary--and life-saving--for anemic patients. RBCs can be stored for up to 42 days between the time of donation and the time... (Review)
Review
Transfusion of RBCs is often clinically necessary--and life-saving--for anemic patients. RBCs can be stored for up to 42 days between the time of donation and the time of transfusion. For many years, investigators have studied the biochemical changes that occur in RBCs stored before transfusion (the RBC "storage lesion"). More recently, clinical studies have suggested that RBC units stored for long periods (often described as > 14-21 days) may mediate adverse effects in the recipient, leading to morbidity and mortality. Unfortunately, these effects are difficult to identify and study because there are no agreed-upon mechanisms for these adverse events and few good assays to study them in individual transfusion recipients. We have proposed the hypothesis of insufficient NO bioavailability (INOBA) to explain the adverse events associated with transfusion of older RBC units. INOBA postulates that the combination of impaired NO production and increased NO scavenging by stored RBCs, together with reduced NO synthesis by dysfunctional endothelial cells, collectively reduce NO levels below a critical threshold in vascular beds. In this situation, inappropriate vasoconstriction occurs, leading to reduced blood flow and insufficient O(2) delivery to end organs. If confirmed, the INOBA hypothesis may lead to improved methods for blood storage and collection, as well as new screening and matching tools for blood donors and transfusion recipients.
Topics: Blood Preservation; Blood Transfusion; Blood Vessels; Erythrocytes; Humans; Nitric Oxide; Vasodilation
PubMed: 22160077
DOI: 10.1182/asheducation-2011.1.475 -
Blood Sep 2016
Topics: Blood Preservation; Erythrocyte Membrane; Erythrocyte Transfusion; Erythrocytes; Humans
PubMed: 27658701
DOI: 10.1182/blood-2016-08-729541