[Pre-hospital red blood cells transfusions : Logistical aspects]. / Aspects logistiques de la transfusion de concentrés érythrocytaires en milieu préhospitalier.

Pre-hospital red blood cell transfusion is already used in many countries, both in military and civilian settings, and provides a better chance of survival for patients suffering from massive bleeding. However, this is not a current practice in Switzerland. This article aims to study Swiss specificities and provide a turnkey concept for the implementation of red blood cell transfusion in an emergency pre-hospital setting, by road or by air. The transfusion benefits and risks, the logistical aspect and the costs are discussed.

La transfusion de concentrés érythrocytaires (CE) en milieu préhospitalier est déjà réalisée dans de nombreux pays tant dans un contexte militaire que civil et permet d'augmenter les chances de survie des patients souffrant d'hémorragie massive. En Suisse, cette pratique n'est pas courante. Cet article a pour but d'étudier les spécificités suisses et de proposer un concept clé en main pour l'implémentation de la transfusion de CE dans un service de sauvetage médicalisé terrestre ou héliporté. Les bénéfices et les risques de la transfusion, les modalités logistiques et les coûts y sont abordés.

Metagenomics analysis of the virome of 300 concentrates from a Swiss platelet bank.

BACKGROUND AND OBJECTIVES: Platelet concentrates are frequently transfused to patients with reduced immunity. An exhaustive description of their viral content is needed to prevent unwanted infection. MATERIAL AND METHODS: To track viral sequences, a shotgun metagenomics approach was used on a bank of 300 platelets concentrates. Sequences were analysed through the diagnostics-oriented pipeline ezVIR. RESULTS: We only observed viruses commonly described in healthy individuals. CONCLUSION: Herein is reported the first viral landscape of a platelet concentrates bank.

Cell-free nucleic acids are present in blood products and regulate genes of innate immune response.

BACKGROUND: Extracellular nucleic acids circulate in plasma. They are expected to be present in manufactured blood products eligible for transfusion, but little is known about their biological activity on human cells. The aim of this study is to investigate whether cell-free nucleic acids (CFNAs) are present and biologically active in red blood cell units (RBCUs), fresh frozen plasmas, and platelet concentrates. STUDY DESIGN AND METHODS: CFNAs were extracted from RBCUs, fresh frozen plasma, and platelet concentrates. Their nature and structure were analyzed by regular methods of nucleic acid detection/quantification. A normalized polymerase chain reaction combining amplification of a CFNA marker (Alu 115) and amplification of an internal nonhuman DNA control spiked in all samples (phiX 174) was developed to study CFNA release after RBCU storage. The impact of CFNAs on gene regulation was tested by microarray after coculture with peripheral blood mononuclear cells and macrophages. RESULTS: Extracellular double-stranded DNA was present in all blood products, with higher amounts found in cellular suspensions (RBCUs and platelet concentrates). Storage up to 40 days did not influence release from RBCUs, and CFNA amount varied considerably from one unit to another. Microarray experiments showed that exposition of macrophages to CFNA increased the expression of genes involved in the innate immune response including chemokines, chemokine receptors, and receptors of the innate response. CONCLUSION: CFNAs are present in blood products. Immunoregulatory properties of CFNA are shown in vitro, providing new insights on biologically active components of blood products besides those for intended therapeutic use.