How do I implement pathogen reduced Cryoprecipitated fibrinogen complex in a tertiary Hospital's blood Bank.

BACKGROUND: Kaiser-Permanente Los Angeles Medical Center (LAMC) is a 560 licensed bed facility that provides regional cardiovascular services, including 1200 open heart surgeries annually. In 2021, LAMC explored alternative therapies to offset the impact of pandemic-driven cryo AHF shortages, and implemented Pathogen Reduced Cryoprecipitated Fibrinogen Complex (also known as INTERCEPT Fibrinogen Complex or IFC). IFC is approved to treat and control bleeding associated with fibrinogen deficiency. Unlike cryo AHF, IFC has 5-day post-thaw shelf life with potential operational and clinical benefits. The implementation steps and the operational advantages to the LAMC Blood Bank are described. STUDY DESIGN AND METHODS: Eighteen months post-implementation, the institution reviewed their product implementation experience and compared IFC with cryo AHF with a retrospective review of transfusion service and cardiac post-op data. RESULTS: IFC significantly decreased product wastage rates and order-to-issue time. It did not significantly impact post-op product utilization or hospital length of stay (LOS) in cardiac surgery patients when compared with cryo AHF. DISCUSSION: Implementation of IFC provides improved product supply stability, shorter turnaround times, and reduced wastage.

The thin red line: Blood planning factors and the enduring need for a robust military blood system to support combat operations.

ABSTRACT: Battlefield lessons learned are forgotten; the current name for this is the Walker Dip. Blood transfusion and the need for a Department of Defense Blood Program are lessons that have cycled through being learned during wartime, forgotten, and then relearned during the next war. The military will always need a blood program to support combat and contingency operations. Also, blood supply to the battlefield has planning factors that have been consistent over a century. In 2024, it is imperative that we codify these lessons learned. The linchpins of modern combat casualty care are optimal prehospital care, early whole blood transfusion, and forward surgical care. This current opinion comprised of authors from all three military Services, the Joint Trauma System, the Armed Services Blood Program, blood SMEs and the CCC Research Program discuss two vital necessities for a successful military trauma system: (1) the need for an Armed Services Blood Program and (2) Planning factors for current and future deployed military ere is no effective care for wounded soldiers, and by extension there is no effective military medicine.

Criteria for storage of cord blood units at Japan's largest cord blood bank.

BACKGROUND AND OBJECTIVES: In Japan, cord blood transplantations exceed those done with adult-sourced unrelated stem cells. This study analyses cord blood (CB) storage criteria to maintain high-quality CB units. MATERIALS AND METHODS: The Kanto-Koshinetsu Cord Blood Bank received 29,795 units from 2014 to 2021, mostly >60 mL, and 5486 (18.4%) were stored as transplantable units. We investigated the mother's gestational period, CB volume, total nucleated cells (TNCs), CD34+ cells, total colony-forming units (CFUs), time from collection to reception and cryopreservation, cell viability, and the reasons for not storing a unit. RESULTS: The average time from collection to reception of 29,795 units was 18.0 h. The most common reason for not storing a CB unit was low cell numbers (pre-processing TNC count <1.2 billion), accounting for 67.9% of the units received. There was no correlation between the CB volume and the CD34+ cell count. The shorter the gestational period, the lower the TNC count, but the higher the CD34+ cell count. There was no correlation between the time from collection to cryopreservation, within a 36-h time limit, and the CD34+ cell recovery rate. CONCLUSION: We could accept units with a TNC count <1.2 billion and a CB volume <60 mL from a gestational period of 38 weeks or less if we did a pre-processing CD34+ cell count. This would secure more units rich in CD34+ cells.

Hybrid cord blood banking in a private-public-partnership: Women's perspectives.

BACKGROUND: The increasing demand for umbilical cord blood (UCB) used in stem cell transplantation led to the establishment of cord blood (CB) banks worldwide. These include public foreign donor banks and private family-directed donor banks. Recently, our department has introduced a third banking model within a private-public-partnership. This hybrid banking allows for storage of family-directed CB units, while also getting Human leukocyte antigen (HLA)-typed and included in the national stem cell donor registry. So if the need arises, the HLA-compatible CB unit can be released to an unrelated recipient as a foreign donor stem cell graft. OBJECTIVES: The aim of this study was to evaluate women's perspectives on the different CB banking options as well as retrospective satisfaction with their decisions. METHODS: We performed a prospective survey study in postpartum women, using a validated questionnaire. RESULTS: A total of 157 women were included in this survey study; 68% of them decided to have their UCB stored or donated. Among those women, 25% of them opted for hybrid storage, 72% of respondents stored UCB publicly, and 3% decided for private family-directed storage. CONCLUSIONS: Our study shows the potential of hybrid banking as an attractive UCB storage option, as an alternative to family-directed banking rather than a substitute for public donation. Hybrid storage potentially combines advantages of family-directed banking as well as unrelated CB donation expanding the number of registered CB units available for transplantation and giving every pregnant woman the possibility to store UCB.

Development and characterization of a cell donor registry for virus-specific T cell manufacture in a blood bank.

Adoptive cell therapy using virus-specific T cells (VST) is a strategy for treating common opportunistic viral infections after transplantation, particularly when these infections do not resolve through antiviral drug therapy. The availability of third-party healthy donors allows for the immediate use of cells for allogeneic therapy in cases where patients lack an appropriate donor. Here, we present the creation of a cell donor registry of human leukocyte antigen (HLA)-typed blood donors, REDOCEL, a strategic initiative to ensure the availability of compatible cells for donation when needed. Currently, the registry consists of 597 healthy donors with a median age of 29 years, 54% of whom are women. The most represented blood groups were A positive and O positive, with 36.52% and 34.51%, respectively. Also, donors were screened for cytomegalovirus (CMV) and Epstein-Barr virus (EBV). Almost 65% of donors were CMV-seropositive, while less than 5% were EBV-seronegative. Of the CMV-seropositive donors, 98% were also EBV-seropositive. High-resolution HLA-A, -B, -C, -DRB1 and -DQB1 allele and haplotype frequencies were determined in the registry. Prevalent HLA alleles and haplotypes were well represented to ensure donor-recipient HLA-matching, including alleles reported to present viral immunodominant epitopes. Since the functional establishment of REDOCEL, in May 2019, 87 effective donations have been collected, and the effective availability of donors with the first call has been greater than 75%. Thus, almost 89% of patients receiving an effective donation had available at least 5/10 HLA-matched cell donors (HLA-A, -B, -C, -DRB1, and -DQB1). To summarize, based on our experience, a cell donor registry from previously HLA-typed blood donors is a useful tool for facilitating access to VST therapy.

Impact of FDA's HCT/P ZIKV Recommendations on Cord Blood Unit Eligibility and Utilization in a Large Public Cord Blood Bank.

BACKGROUND: Cord blood units (CBUs) that are ineligible for licensure due to incomplete compliance with FDA recommendations may be used for hematopoietic stem cell transplantation under urgent medical need and an Investigational Drug Application. The largest reason for CBU donor ineligibility is Zika virus (ZIKV) risk. The study's objective was to analyze the impact of current FDA recommendations for ZIKA risk on a large public cord blood bank and propose updated recommendations. METHODS: We performed a retrospective analysis of Carolinas Cord Blood Bank (CCBB), an FDA licensed public CBB, using data from January 1, 2016 to November 21, 2023 and compared FDA recommendations for transfusion transmitted infections (TTI) for blood products and relevant communicable disease agents or diseases for human cell, tissue, or cellular or tissue-based products (HCT/Ps). RESULTS: CCBB: 9057 (84.3% licensed) CBUs were banked. 984/1682 (58.5%) of unlicensed CBUs had ZIKV risk. 22.0% of CBUs with ZIKV risk were from Hispanic parents, compared to 16.1% of all units. 31 of IND CBUs (11 due to ZIKV risk without reported ZIKV transmission) were safely infused. FDA Guidance: HCT/P ZIKV, HIV, and vCJD recommendations have not been updated since 2018 in contrast to FDA removal of ZIKV as a relevant TTI in 2021 and updating HIV and vCJD guidance related to TTI in 2023 and 2022, respectively. DISCUSSION: The FDA should consider new data to revise the HCT/P donor eligibility recommendations, which will increase the number of eligible HCT/P donors, and potentially improve access to therapies for a more diverse patient population.

Impact of COVID-19 pandemic on cord blood banking and transplantation.

Umbilical cord blood is a rich source of hematopoietic stem cells that has been used for transplantation for over 30 years, especially when there is no compatible hematopoietic stem cell donor available. Its use has decreased more recently, since the development of methods to improve haploidentical transplants has allowed the use of mobilized peripheral blood as a source of hematopoietic stem cells. Public cord blood banks collect, process and store cord blood samples from voluntary donations. In addition, many public banks are involved in research to enhance hematopoietic stem cell therapies and develop new treatments for haematological and genetic diseases. The COVID-19 pandemic, which emerged in 2019, has had a profound and wide-ranging impact on human health and treatment. The area of hematopoietic stem cell transplantation was deeply affected by reductions in bone marrow, peripheral blood and cord blood donations; logistical challenges; exposure of healthcare workers and other challenges. The present study reviews the impact of the COVID-19 pandemic on cord blood banking and transportation around the world with a special focus on Brazil.

Determinantes externos de la disponibilidad de sangre / External Determinants of Blood Availability

El acceso universal a las transfusiones de sangre depende de diversos factores localizados dentro y fuera de los servicios de salud. Motivados por ser este un tema infrecuente, el trabajo tiene el objetivo de analizar desde una perspectiva multidimensional y holística los determinantes externos de la disponibilidad de sangre para las transfusiones. El desarrollo socioeconómico constituye un importante factor dinamizador porque condiciona, de cierta manera, la infraestructura del sistema sanitario e incide sobre los factores epidemiológicos, sociodemográficos y jurídicos. A su vez, estos influyen en la organización de las actividades y la complejidad de la asistencia sanitaria, factores que otorgan un sentido positivo o negativo a la disponibilidad de sangre. Tomarlos en consideración al diseñar las políticas de salud relacionadas con el uso de la sangre permite una mayor precisión en las intervenciones locales que contribuyan a mejorar la seguridad de las transfusiones(AU)

Universal access to blood transfusions depends on a number of localized factors both inside and outside health services. Motivated by being an infrequent topic, this work aims to analyze from a multidimensional and holistic perspective the external determinants of the availability of blood for transfusions. Socio-economic development is an important dynamic factor because it conditions, in a certain way, the infrastructure of the health system and affects epidemiological, sociodemographic and legal factors. In turn, these influence the organization of activities and the complexity of health care, factors that give a positive or negative meaning to the availability of blood. Taking them into consideration when designing health policies related to the use of blood allows greater precision in local interventions that contribute to improving the safety of transfusions(AU)

Serological ineptitude in blood banks: is there an association with sexually transmitted infections? / Inaptidão sorológica em bancos de sangue: existe associação com infecções sexualmente transmissíveis?

Introduction: Sexually transmitted infections (STIs) are a serious public health problem, and some of these infections are also transmitted through blood transfusions. Objective: To identify publications in scientific journals in Brazil and in the world showing if there is an important association between serological inadequacy due to sexually transmitted infections traced in blood and blood products used for medical use. Methods: Systematic review of articles published from 2018 to 2023, using the LILACS, SciELO and PubMed databases, with a concomitant approach to the issues of serological disability and STI. Original studies or review articles in Portuguese, English and Spanish with Brazilian and international data were included. Editorial publications, letter to the editor, letter from the editor or comments on the subject were excluded. Results: The search found 571 articles, of which 106 (18.40%) met the inclusion criteria, that is, Serological disability and STI. In studies with international data, the prevalence of donors with hepatitis C ranged from 0.12 to 4.8%; with hepatitis B, from 1.3 to 8.2%; with HIV, from 0.0021 to 2.5%; with syphilis, from 1.73 to 2.4%; with HTLV, 0.66%; and with Chagas disease, from 0.017 to 2.76%. Among articles with Brazilian data, the prevalence of donors with seroreactive tests for hepatitis C ranged from 0.18 to 1.76%; with hepatitis B, from 0.05 to 7.9%; with HIV, from 0.03 to 0.82%; with syphilis, from 0.37 to 3.51%; with HTLV, from 0.02 to 0.3%, and with Chagas disease, from 0.8 to 0.5%. Conclusion: STIs are rarely discussed in the scientific literature in studies on serological inadequacy. In addition, a minority of articles were with Brazilian data. However, results show that STIs, despite being little discussed in the scientific literature in studies on the subject of serological inadequacy, have statistically significant percentages of seropositivity for STIs. Moreover, hepatitis C and B have a relevant seroprevalence, reaching 8.2% and 4.8%, respectively, in the international scenario. In Brazil, hepatitis B continues to occupy a prominent place with a seroprevalence of up to 7.9%. However, syphilis now holds a very important role, with a maximum percentage of 3.51%. More studies are needed for further reflection: although STIs are little addressed in studies about serological inadequacy in human blood banks, would they contribute to the maintenance and non-reduction of the general frequency of infections transmitted by blood transfusion

Introdução: As infecções sexualmente transmissíveis (IST) são um grave problema de saúde pública e algumas dessas infecções, também, transmitidas por intermédio de transfusões de sangue. Objetivo: Identificar publicações em periódicos científicos no Brasil e no mundo sobre se existe importante associação entre inaptidão sorológica por infecções sexualmente transmissíveis rastreadas em sangue e hemoderivados usados para uso médico. Métodos:Revisão sistemática de artigos publicados no período de 2018 a 2023, usando as bases de dados Literatura Latino-Americana e do Caribe em Ciências da Saúde (Lilacs), Scientific Electronic Library Online (SciELO) e United States National Library of Medicine (PubMed) com abordagem concomitante para os assuntos de inaptidão sorológica e IST. Incluíram-se estudos originais ou artigos de revisão nos idiomas português, inglês e espanhol com dados brasileiros e internacionais. Foram excluídas publicações do tipo editorial, carta ao editor, carta do editor ou comentários sobre o tema. Resultados:A busca localizou 571 artigos dos quais 106 (18,40%) se encaixavam nos critérios de inclusão, ou seja, inaptidão sorológica e IST. Em estudos com dados internacionais, a prevalência de doadores com hepatite C variou de 0,12 a 4,8%; com hepatite B de 1,3 a 8,2%; com HIV de 0,0021 a 2,5%; com sífilis de 1,73 a 2,4%; com HTLV 0,66%; e com doença de Chagas de 0,017 a 2,76 %. Já entre os artigos com dados brasileiros, a prevalência de doadores com exames soro-reatores para hepatite C variou de 0,18 a 1,76%; com hepatite B de 0,05 a 7,9%; com HIV de 0,03 a 0,82%; com sífilis de 0,37 a 3,51%; com HTLV 0,02 a 0,3%, e com doença de Chagas de 0,8 a 0,5%. Conclusão: As IST são pouco abordadas na literatura científica em estudos com o tema inaptidão sorológica. Além disso, uma minoria de artigos era com dados brasileiros. Entretanto, resultados demonstram que, apesar de pouco abordadas na literatura científica em estudos com o tema inaptidão sorológica, as IST possuem percentuais de soropositividade estatisticamente significativos. Além disso, as hepatites C e B possuem soroprevalência relevante, podendo chegar a 8,2 e 4,8%, respectivamente, no cenário internacional. Já no cenário nacional, brasileiro, a hepatite B continua ocupando um lugar de destaque, com soroprevalência de até 7,9%. Todavia, a sífilis passa a ocupar um papel de altíssima relevância, com percentual máximo de 3,51%. São necessários mais estudos para mais reflexão: apesar de as IST serem pouco abordadas em estudos acerca da inaptidão sorológica em bancos de sangue humano, seriam elas contribuintes para a manutenção e a não redução da frequência geral de infecções transmitidas por transfusão sanguínea?

Frequency and Underlying Causes of Alloimmunization Against Red Blood Cell Antigens in Patients Referred to the Blood Bank of the Tertiary Referral Hospital of Tehran from 2018 to 2020.

BACKGROUND: Alloimmunization against blood group antigens is an important non-infectious complication of blood transfusion, and early detection of these alloantibodies by antibody screening before transfusion is crucial. Identifying which underlying factors will affect the occurrence of alloimmunization will be necessary to manage this event as accurately as possible. We aimed to assess the prevalence rate and main determinants of RBC alloimmunization among patients referred to a large referral blood bank in Iran. METHODS: This retrospective cross-sectional study was conducted on all patients referred to a blood bank at Imam Khomeini Hospital between October 2018 and September 2020. Information was collected by referring to the archives of the hospital information system as well as the documents recorded at the blood bank ward and reviewed by two pathologists and completed documents. RESULTS: In total, 39270 cases were cross-matched. Accordingly, the frequency of alloimmunization cases was equal to 220 cases, which indicated a prevalence of 0.56%. The most common alloantibodies were anti-K (43.2%, 95% CI: 36.8‒49.5), anti-E (34%, 95% CI: 27.7‒40.5), and anti-C (16.3%, 95% CI: 11.4‒21.4). Among patients with positive alloimmunization, the most common blood groups were blood group B (34.6%), followed by blood group A (34.1%). Most of these patients were Rh-positive (77.3%). In patients with positive alloimmunization, the frequency of hemoglobinopathy was estimated to be 37.7%. Frequent blood transfusions were found in 42.2%, a history of malignancy in 17.3%, graft history in 11.3%, and a history of pregnancy in 35.0%. CONCLUSION: Alloimmunization was more prevalent and more predictable among patients with hemoglobinopathies and those receiving recurrent transfusions. Therefore, a history of repeated blood transfusions should be regarded as a risk factor contributing to alloimmunization.

Evaluación de la eficacia en la colecta de plaquetas por un separador celular / Evaluation of the efficacy in the collection of platelets by a cell separator / Avaliação da eficiência da coleta de plaquetas por um separador de células separador de células

La aféresis es el procedimiento más utilizado para la obtención de concentrados plaquetarios de alto rendimiento, calidad y para mejorar las terapias transfusionales en pacientes trombocitopénicos, oncohematológicos,cirugias e incluso, en pacientes con factores clínicos adversos a la refractariedad. Objetivo. Determinar la eficacia de un separador celular en la colecta de plaquetas en un Instituto Nacional de Salud de Lima. Material y métodos. Estudio descriptivo; la muestra fue de 80 concentrados plaquetarios, obtenidos por plaquetoaferesis y utilizando el equipo de separador celular americano. La colecta de plaquetas se realizó en un servicio de Hemoterapia y Banco de Sangre de una institución de salud de Lima, durante los meses de febrero a julio de 2018. La eficacia se realizó evaluando el rendimiento, la eficiencia y el cumplimiento de estándares de calidad aprobados. Uno de los parámetros utilizados fue el recuento de plaquetas y leucocitos residuales, procesados en el analizador hematológico. Resultados. Las evaluaciones fueron: concentración promedio de plaquetas por concentrado plaquetario (rendimiento)= 3,4 x 1011 plaquetas /ml, recuento de leucocitos residuales = 0,07 x 10 6 leucocitos/ml, volumen promedio de sangre procesado = 2480 ml, volumen final promedio = 217,5 ml, eficiencia en la colecta = 56,9 a 63,9 %, el tiempo medio por procedimiento de colecta = 72 minutos. Conclusiones. Los concentrados plaquetarios obtenidos con el procedimiento de plaquetoaferesis cumplen con los estándares de calidad nacional e internacionales, por lo que, se concluye que este procedimiento es eficaz en la colecta de productos de alta calidad que logran la eficacia en la transfusión.

Apheresis is the most widely used procedure to obtain high yield and quality platelet concentrates and to improve transfusion therapies in thrombocytopenic patients, oncohematological patients, surgical patients and even patients with adverse clinical factors to refractoriness. Objective. To determine the efficacy of a cell separator in the collection of platelets in a National Health Institute in Lima. Material and methods. Descriptive study; the sample consisted of 80 platelet concentrates, obtained by plateletpheresis and using American cell separator equipment. The platelet collection was performed in a Hemotherapy and Blood Bank service of a health institution in Lima, during the months of February to July 2018. Effectiveness was performed by evaluating performance, efficiency and compliance with approved quality standards. One of the parameters used was the residual platelet and leukocyte count, processed in the hematological analyzer. Results. The evaluations were: average platelet concentration per platelet concentrate (yield)= 3.4 x 1011 platelets/ml, residual leukocyte count = 0.07 x 10 6 leukocytes/ml, average volume of blood processed = 2480 ml, average final volume = 217.5 ml, collection efficiency = 56.9 to 63.9 %, average time per collection procedure = 72 minutes. Conclusions. The platelet concentrates obtained with the plateletpheresis procedure comply with national and international quality standards, therefore, it is concluded that this procedure is effective in the collection of high quality products that achieve transfusion efficiency.

A aférese é o procedimento mais utilizado para obter concentrados plaquetários de alto rendimento e alta qualidade e para melhorar as terapias transfusionais em pacientes trombocitopênicos, oncohematológicos, cirúrgicos e até mesmo pacientes com fatores clínicos adversos à refratariedade. Objetivo. Para determinar a eficácia de um separador de células na coleta de plaquetas em um Instituto Nacional de Saúde em Lima. Material e métodos. Estudo descritivo; a amostra consistiu de 80 concentrados de plaquetas, obtidos por plaquetaferese e utilizando equipamento separador de células americano. A coleta de plaquetas foi realizada em um serviço de Hemoterapia e Banco de Sangue de uma instituição de saúde em Lima, durante os meses de fevereiro a julho de 2018. A eficácia foi avaliada através da avaliação do desempenho, eficiência e conformidade com os padrões de qualidade aprovados. Um dos parâmetros utilizados foi a contagem residual de plaquetas e leucócitos, processada no analisador hematológico. Resultados. As avaliações foram: concentração média de plaquetas por concentrado de plaquetas (rendimento) = 3,4 x 1011 plaquetas/ml, contagem de leucócitos residuais = 0,07 x 10 6 leucócitos/ml, volume médio de sangue processado = 2480 ml, volume final médio = 217,5 ml, eficiência da coleta = 56,9 a 63,9%, tempo médio por procedimento de coleta = 72 minutos. Conclusões. Os concentrados de plaquetas obtidos com o procedimento de plaquetférese atendem aos padrões de qualidade nacionais e internacionais, portanto, conclui-se que este procedimento é eficaz na coleta de produtos de alta qualidade que alcançam eficiência transfusional.

Análisis de la problemática resultante de los tipos de donación de sangre, producida en el Banco de Sangre de la Seguridad Social en La Paz durante la gestión 2020 / Analysis of the problems resulting from the types of blood donation, produced at the social security Blood Bank in La Paz during the 2020 administration

INTRODUCCIÓN: actualmente la sangre continúa siendo un elemento vital para la vida, su fabricación aún no ha sido optimizada, por lo tanto, solo puede obtenerse a través de donaciones humanas. Por ello, para los Bancos de Sangre, contar con personas de confianza que aporten sangre constituye uno de los principales problemas éticos. Actualmente existen tres tipos de donación de sangre: la donación voluntaria y altruista, la donación de reposición o familiar y la donación remunerada, siendo esta última inaceptable en términos económicos y sanitarios, además de estar prohibida en el marco legal vigente en nuestro país. OBJETIVOS: analizar la problemática de la donación de sangre, haciendo énfasis en los tipos de donaciones que existen en nuestro país, considerando cuál es el tipo de donación más seguro para el receptor y cuáles son los menores de las pruebas de tamizaje inmunoserológico. MATERIALES Y MÉTODOS: se realizó un estudio transversal analítico, retrospectivo, en el que se revisaron las historias clínicas y los formularios electrónicos de trabajo utilizados en la recolección de datos de las donaciones de sangre obtenidas en el Banco de Sangre. de la seguridad social. Para el análisis estadístico se realizó la media y la varianza. RESULTADOS: de un total de 7787 personas que se presentaron a donar sangre, solo 5166 realizaron una donación efectiva. El resto fueron diferidos temporalmente por causas subsanables, 147 fueron diferidos definitivamente por enfermedades e infecciones que pudieran suponer un riesgo para el receptor y en 19 de ellos la extracción de sangre fue difícil por dificultad de acceso venoso. Según el tipo de donaciones, el 52,8 % fueron donaciones solidarias de reposición, el 43,3 % donación exijida y el 3,71 % donación voluntaria. Finalmente, el 68 % del total de las donaciones de sangre provino de hombres. CONCLUIONES: los datos obtenidos demuestran porcentajes muy bajos de donantes voluntarios y valores altos de donantes obligados a donar, muy en relación a países con programas deficientes de donación voluntaria y altruista de sangre.

INTRODUCTION: currently blood is a vital element for life, its manufacture has not yet been optimized, therefore, it can only be obtained through human donations. For this reason, for Blood Banks, having reliable people who provide blood constitutes one of the main ethical problems. There are currently three types of blood donation: voluntary and altruistic donation, replacement or family donation, and paid donation, the latter being unacceptable in economic and health terms, as well as being prohibited under the current legal framework in our country. OBJECTIVES: analyze the problem of blood donation, emphasizing the types of donations that exist in our country, considering what is the safest type of donation for the recipient and what are the minors of immunoserological screening tests. MATERIALS AND METHODS: this was a retrospective, analytical cross-sectional study, in which, we reviewed clinical histories and electronic work forms used in the collection of data on blood donations obtained in the Blood Bank. of social security. For statistical analysis we performed the mean and variance. RESULTS: in a total of 7787 people who presented themselves to donate blood, only 5166 made an effective donation. The rest were temporarily deferred for rectifiable reasons, 147 were permanently deferred due to diseases and infections that could cause a risk to the recipient and in 19 of them it was difficult to draw blood due to difficult venous access. According to the type of donations, 52.8 % were solidarity replacement donations, 43.3 % required donation, and 3.71 % voluntary donation. Finally, 68 % of the total blood donations came from men. CONCLUSIONS: the data obtained show very low percentages of voluntary donors and high values of required donors, these results are in accordance with countries with deficient voluntary and altruistic blood donation programs.

Implementation of a patient blood management program based on a low-income country-adapted clinical decision support system

ABSTRACT Introduction: Patient blood management (PBM) programs are associated with better patient outcomes, a reduced number of transfusions and cost-savings The Clinical Decision Support (CDS) systems are valuable tools in this process, but their availability is limited in developing countries This study assesses the feasibility and effectiveness of an adapted CDS system for low-income countries. Methods: This was a prospective study of the PBM program implementation, in a 200-bed tertiary hospital, between February 2019 and May 2020. Outcome measures were red blood cell (RBC), fresh frozen plasma (FFP) and platelet unit transfusions, the transfusion of a single unit of red blood cells and an RBC adequacy index (RAI). Results: Comparing the post-PBM program era with the pre-PBM system era, there was a decrease in red blood cell transfusions (p = 0.05), with an increase in single unit red blood cell transfusions (p = 0.005) and RAI (p < 0.001). Conclusions: The PBM programs, including electronic transfusion guidelines with pre-transfusion medical auditing, was associated with improved transfusion practices and reduced product acquisition-related costs.

Calidad de vida relacionada con la salud de personas con hemofilia en el noreste de Brasil / Quality of life related to the health of people with hemophilia in Northeast Brazil

Introducción: La hemofilia se caracteriza por la ocurrencia de hemorragias frecuentes y afecciones del aparato locomotor graves en los pacientes que causan daños físicos, sociales y psicológicos y afecta directamente su calidad de vida relacionada con la salud. Objetivo: Evaluar la calidad de vida de personas con hemofilia en el noreste de Brasil. Métodos: Estudio epidemiológico transversal cuantitativo realizado con 13 personas con hemofilia de un Banco de Sangre en el noreste de Brasil. La recolección de datos se realizó mediante la aplicación de un cuestionario sociodemográfico y clínico y de Haem-A-Qol, utilizado para evaluar la calidad de vida de las personas con hemofilia. Los valores brutos y medios se calcularon en general para todos los dominios y luego para cada dominio para que pudieran mostrarse. Resultados: Se obtuvo un promedio total de 30,94 en relación a los diez dominios evaluados. Los dominios con los promedios más altos fueron "salud física" con 49,23 y "afrontamiento" con 35,89 y con el promedio más bajo fue "planificación familiar". Conclusiones: Los participantes de la investigación tienen una calidad de vida insatisfactoria en relación con la salud física y el afrontamiento y, satisfactoria en relación con las relaciones y la sexualidad(AU)

Introduction: Hemophilia is characterized by the occurrence of frequent bleeding and serious musculoskeletal conditions in patients that cause physical, social and psychological damage and directly affect their health-related quality of life. Objective: To evaluate the quality of life of people with hemophilia in the northeast of Brazil. Methods: Quantitative cross-sectional epidemiological study conducted with 13 people with hemophilia from a Blood Bank in northeastern Brazil. Data collection was performed by applying a sociodemographic and clinical questionnaire and Haem-A-Qol, used to assess the quality of life of people with hemophilia. Raw and mean values were calculated overall for all domains and then for each domain so that they could be displayed. Results: A total average of 30,94 was obtained in relation to the ten domains evaluated. The domains with the highest averages were "physical health" with 49,23 and "coping" with 35,89 and with the lowest average was "family planning". Conclusions: The research participants have an unsatisfactory quality of life in relation to physical health and coping, and satisfactory in relation to relationships and sexuality(AU)

Advances in the recruitment and loyalty of blood donors: A critical outlook over the Brazilian scenario / Avanços no recrutamento e fidelização de doadores de sangue: um olhar crítico sobre o panorama brasileiro

The growing need for more stringent methods of safe blood transfusion has engendered blood banks in Brazil. The transfusion appears, then, as an alternative path for blood-related pathologies and their components. Followed by the enforcement of altruistic principles, blood donation has become resistant within society due to its myths and prejudices. Thus, the implementation of public policies became more evident in tracing the social profile of blood donors, and the public power started regulating, supervising and controlling the rational use of blood and blood products. This way, the indices of blood donation in the Unified Health System (SUS) result from various means of interaction with both the potential donor and with the loyal donor, through digital media, school lectures, symposia, congresses and visual media. This process hitched the recruitment to the peculiarities of potential donors, mostly promoted by Health professionals. There is a need to gradually increase such measures to facilitate the donation process, adapting it to the reality of these people, to amplify the number of loyal donors (AU)

A crescente necessidade de métodos mais rígidos de segurança na transfusão sanguínea engendrou os bancos de sangue no Brasil. A transfusão aparece, então, como via alternativa para tratamento de patologias relacionadas ao sangue e aos seus componentes. A partir da aplicação de princípios altruístas, a doação de sangue tornou-se mais resistente pela sociedade, devido aos mitos e preconceitos. A aplicação de políticas públicas, dessa forma, tornaram-se mais evidentes para traçar o perfil social do doador de sangue, e o poder público passou a regulamentar, fiscalizar e controlar o uso racional de hemoderivados e hemocomponentes. Nesse sentido, os índices de doação de sangue no Sistema Único de Saúde (SUS) são resultados de diversos meios de interação tanto com o potencial doador quanto com o fidelizado, por intermédio de mídias digitais, palestras em centros escolares, simpósios, congressos e meios audiovisuais. Esse processo atrelou o recrutamento às peculiaridades dos potenciais doadores, promovido principalmente pelos profissionais da saúde. Surge a necessidade de aumentar, cada vez mais, tais medidas de modo a facilitar e flexibilizar o processo de doação, adaptando-o, assim, à realidade dessas pessoas, para amplificar o número de doadores fidelizados (AU)

COVID-19 pandemic and blood transfusion services: The impact, response and preparedness experience of a tertiary care blood center in southern Karnataka, India

Abstract Introduction With the outbreak of COVID-19 and its containment measures, blood centers faced a huge challenge in balancing blood demand and supply and devising a preparedness plan to withstand the uncertain situation. This study assesses the effect of the COVID-19 pandemic on blood transfusion services and discusses the appropriate mitigation strategies adopted. Methods We analyzed our center's blood transfusion services during the first half-period of the pandemic (Y3) and non-pandemic years 2018(Y1) and 2019(Y2) in two-quarters Q1 (pre-lockdown), from January to March and Q2 (post-lockdown), from April to June. The blood donation variables, the packed red blood cells (PRBCs) demand and the utilization pattern were compared between pandemic (Y3) and non-pandemic years (Y1 and Y2) in each quarter. The mitigation strategy adopted at every step of the transfusion service is highlighted. Results During post-lockdown (Q2) of the pandemic year (Y3), the blood donation was majorly by repeat donors (83%) from the in-house site (82.5%). Furthermore, the proportion of outdoor donation, deferral, blood collection, demand and issue demonstrated a significant drop of 50%, 32.6%, 33%, 31.8% and 32.3%, respectively, in comparison to Q2 of the non-pandemic years (Y1 and Y2), with a statistically significant difference for surgical and hemorrhagic indications (p < 0.05). Coping strategies, such as blood donor education and motivation using e-platforms emphasizing eligibility during the pandemic, staggering of donor in-flow, postponement of elective surgeries and donor and staff' COVID-19 safety assurance, were followed. Conclusion The timely adoption of coping strategies played a crucial role in the better handling of shortcomings at our center's blood transfusion services caused by the COVID-19 pandemic.

Prevalencia de marcadores infecciosos y factores asociados en donantes de un banco de sangre peruano / Prevalence of infection markers and associated factors in donors of a peruvian blood bank

RESUMEN Se buscó determinar la prevalencia de marcadores infecciosos en donantes de un banco de sangre en Perú y valorar si las variables sociodemográficas del donante se asocian con la presencia de estos marcadores. Se realizó un estudio transversal analítico en 5942 donantes de un banco de sangre durante el 2018. Se determinó la positividad a inmunodeficiencia humana (VIH), hepatitis B (VHB), hepatitis C (VHC) y HTLV I-II; además de sífilis y enfermedad de Chagas. La prevalencia de VIH fue 0,81%, VHB 6,19%, VHC 0,12%, HTLV I-II 0,66%, enfermedad de Chagas 2,76% y sífilis 1,73%. Diversos factores sociodemográficos se asociaron con la positividad de marcadores infecciosos. El tipo de donación predominante fue no voluntaria (96%) y el 53% presentó historia de donación previa. Las prevalencias de marcadores infecciosos de VIH, VHB, enfermedad de Chagas y sífilis en los donantes de sangre fueron altas comparadas con otros países de la región.

ABSTRACT We aimed to determine the prevalence of infection markers in donors of a Peruvian blood bank and to assess whether donor sociodemographic variables are associated with the presence of these markers. An analytical cross-sectional study was carried out in 5942 donors of a blood bank, whose data was collected during 2018. Positivity to human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV) and HTLV I-II was determined, in addition to syphilis and Chagas disease. The prevalence of HIV was 0.81%; for HBV it was 6.19%; for HCV, 0.12%; for HTLV I-II, 0.66%; for Chagas disease, 2.76% and for syphilis it was 1.73%. Several sociodemographic factors were associated with infection markers positivity. The predominant donation type was non-voluntary (96%) and 53% had history of previous donation. The prevalence of infection markers for HIV, HBV, Chagas disease and syphilis in blood donors was high compared to other countries in the region.

Optimization of red blood cell unit storage during SARS-COV-2 Pandemic: adopting new strategies to ensure supply in a decentralized blood bank in Brazil

ABSTRACT Introduction: As coronavirus disease-2019 (COVID-19) spread worldwide and social restrictions were intensified, difficulties in blood supply were expected to result in a shortage of blood donors, logistic issues and a change in blood consumption. Consequences could be detrimental to the meeting of the blood supply demand, especially in a decentralized blood bank in the State of São Paulo responsible for providing blood to more than 100 hospitals, mostly of the public health system. Aiming to minimize negative effects and focusing on maintenance of the blood supply, a different approach was discussed and adopted. Materials and methods: Briefly, strategies were related to monitoring and promoting measures to achieve a positive RBC unit balance. Thus, the number of donors, transfusions, RBC unit inventory, RBC unit loss and RBC units within up to 5 days from the expiration date were evaluated. Results: Several strategies were adopted to ensure sufficient availability of RBC units: blood donation was improved with social media and extra blood collections, a restrictive transfusion protocol was implemented, a new logistic process to use RBC units closer to the expiration date was established and non-isogroup transfusions were avoided. Conclusion: Altogether, described strategies were crucial to optimize blood storage during the pandemic. Investing in monitoring and logistics contributed to a positive RBC unit balance and conserving these strategies could be useful.