Non-physician health-care workers and voluntary blood donation: an ambiguous relationship.

OBJECTIVES: This study aims to assess the knowledge, attitude and practice (KAP) of voluntary blood donation (BD) among the non-physician health-care workers of our institution, to investigate the relationship between these parameters and to determine the predictors of BD practice. BACKGROUND: KAP surveys provide a popular context-specific evidence base for the development of blood transfusion services' strategies and interventions to promote voluntary, non-remunerated BD. However, there are just few studies worldwide assessing KAP of BD among health-care workers. METHODS: This is a cross-sectional exploratory study, which took place at the 'Ippokrateio' General Hospital of Thessaloniki, Greece, a tertiary health-care institution. A specially designed, pre-tested questionnaire was distributed to all non-physician health-care workers of the hospital. A total of 1140 questionnaires were distributed. Participation in the study was optional and anonymous. Regarding data analysis, a binary logistic regression analysis was performed to describe the relationship between different elements of KAP of BD and to determine possible predictors of BD practice. RESULTS: The response rate was 25·5% (291 respondents). Logistic regression analysis revealed a positive attitude towards family replacement as an important predictor of both regular and voluntary BD, with male gender also a predictor of the latter. An inconsistency between knowledge, attitude and practice of BD was revealed. CONCLUSIONS: The present study adds valuable data on KAP of BD among health-care workers. This will help blood transfusion services to improve management practices among this group as they have the potential to provide a reliable, stable and safe source of blood products.

Factor IX replacement to cover total knee replacement surgery in haemophilia B: a single-centre experience, 2000-2010.

Total knee replacement (TKR) is a well recognized treatment for haemophilic arthropathy. Successful haemostasis can be achieved by bolus doses or continuous infusion (CI) using either recombinant (r) or plasma-derived (pd) factor IX (FIX). We retrospectively analysed our experience of factor replacement to cover TKR in haemophilia B patients and explored factors related to FIX use during surgery. Between 2000 and 2010, 13 primary TKRs were performed in 11 haemophilia B patients. Operations were performed by the same surgeon using standard techniques. Median age was 58 years (42-79). An adjusted CI protocol was used for 5 days followed by bolus doses. FIX:C was maintained at 100 IU dL(-1) in the immediate postoperative period. There was no excess haemorrhage. There was no evidence of thrombosis or infection. All patients received mechanical thromboprophylaxis and only one chemical. CI was used in seven cases. Ten patients received pdFIX. Median hospital stay was 14 days (8-17). Median factor usage was 999 IU kg(-1) (768-1248). During CI, factor consumption was 695 IU kg(-1), 691 IU kg(-1) and 495 IU kg(-1) for BeneFix®, Replenine® and Haemonine, respectively. Clearance of both pdFIX and rFIX reduced during CI. All operations were uncomplicated. The decreased clearance in the CI setting reduced the amount of FIX required to maintain a therapeutic level. This reduction was greater with pdFIX and may be related to pharmacokinetic differences between pdFIX and rFIX. Given the excellent safety profile of the pdFIX products, CI of FIX and particularly pdFIX is safe, efficacious and convenient.