Risk factors analysis of blood type unexpected antibody in large sample of inpatients / 中国输血杂志

【Objective】 To observe and analyze the detection results of blood type unexpected antibody and its risk factors in inpatients, so as to provide reference for promoting the safety of clinical blood transfusion. 【Methods】 Clinical data of 22 800 inpatients were collected retrospectively and unexpected antibody screening was performed by microcolumn gel method and saline method. According to the screening results, the inpatients were divided into positive group (n = 62) and negative group (n = 22 738). Clinical data of the two groups were collected and analized by univariate analysis, and specificity identification of unexpected antibody was performed in the positive group. The specific distribution characteristics of antibody were statistically analyzed, and the risk factors of unexpected antibody were analyzed by binary logistic regression. 【Results】 Among the 22 800 inpatients, the yield rate of unexpected antibody was 0.27% (62/22 800), with Rh, MNS, Lewis, Kidd blood group antibody, mixed antibody, autoantibodies and others accounted for 40.32% (25/62), 14.52% (9/62), 6.45%(4/62), 1.61%(1/62), 20.97%(13/62), 6.45%(4/62) and 9.68%(6/62), respectively. Univariate analysis showed that there were significant differences in gender, age, pregnancy history, blood transfusion history, blood transfusion frequency and disease type between the positive group and the negative group by chi-square test (χ2 = 11.142, 6.994, 12.453, 4.762, 5.493, 92.381, all P<0.05), while there was no significant difference in nationality (χ2 = 3.719, P>0.05 ) . Binary logistic regression analysis showed that female, age >60 years old, with history of blood transfusion, number of blood transfusion >3 times, history of pregnancy, solid tumor and blood diseases, severe internal medical diseases were independent risk factors for unexpected antibody(P<0.05) . 【Conclusion】 For patients who need blood transfusion, especially those with the above risk factors, conducting unexpected antibodies screening and identification before transfusion, avoiding corresponding antibodies and selecting antigen-negative blood for cross-matching were suggested to ensure the effectiveness and safety of clinical blood transfusion.

Establishment of Shaanxi rare blood group information supply platform / 中国输血杂志

【Objective】 To establish a rare blood group information supply platform in Shaanxi Province. 【Methods】 The rare blood group information supply platform consists of sample registration, result registration, donor files and inventory blood. The blood donation codes of voluntary blood donors were recorded for blood typing, and the antigen identification results of each blood group system were registered, all stored in the rare blood type information supply platform. When receiving an application for unusual or rare blood type missing multiple conventional antigens or a certain high-frequency antigen, the corresponding antigen negative blood donors and their blood status (in stock or not) were queried from the donor profile module of the platform, and the inventory of blood of rare blood type was monitored dynamically. 【Results】 The results showed that 5.060% (273/5 398) of rare Rh phenotype donors, 1.540‰ (51/33 010) of donors lacking multiple regular antigens, and 13 O-type donors lacking high-frequency antigens were recorded in the rare blood type information supply platform. Among them, 0.019‰ (3/158 484) of Jk(a-b-) phenotype, 0.436‰ (2/4 586) of Di(a+b-) phenotype, and 4.030‰ (8/1 983) of Fy (a-b+) phenotype were stored in the blood bank for rare blood type. 【Conclusion】 The establishment of rare blood group information supply platform can meet the urgent demand for blood of rare blood types in clinical practice and ensure the safety of blood transfusion.

Optimization of quality assessment system of clinical blood transfusion records / 中国输血杂志

【Objective】 To determine the value of quality assessment system in supervising standard clinical blood use and improving the quality of clinical blood transfusion medical records. 【Methods】 The clinical blood transfusion records of Children′s Hospital, Zhejiang University School of Medical every quarter from January 2019 to December 2022 were selected and extracted for evaluation by 5% to 10% for the current season. These blood transfusion medical records were scored and graded A(≥90 points)/B(80-89 points)/C(<80 points)according to the Evaluation Table of Clinical Science Rational Use of Blood in Children′s Hospital of Zhejiang University, and the annual A rate was statistically analyzed. After summarizing the deduction points, a rectification plan was submitted to the medical department and publicized on the hospital network. 【Results】 A total of 1 975 blood transfusion medical records were analyzed from January 2019 to December 2022, including 343 in 2019 (17.37%), 517 in 2020 (26.18%), 556 in 2021 (28.15%) and 559 in 2022 (28.30%), with Grade A rates at 67.06%, 92.07%, 93.17% and 91.06%, respectively. According to Pearson Chi-square test, the Grade A rates of blood transfusion records in 2020, 2021 and 2022 were significantly higher than those in 2019 (P<0.000 1). In the assessment, the main reasons for deduction of points were missed pre-transfusion immunization tests and missed blood transfusion course records. From 2019 to 2022, the missed rates of pre-transfusion immunization tests were 22.68%, 6.47%, 1.26% and 2.49%, and the missed rates of blood transfusion course records were 32.21%, 10.59%, 5.57% and 6.61%, respectively. 【Conclusion】 The regular and reasonable assessment and publicity system of blood transfusion medical records is conducive to improving the quality of blood transfusion medical records, promoting rational blood use and ensuring the safety of blood use for children.

Blood matching incompatibility caused by cold autoantibodies and IgG anti S antibody: a case report / 中国输血杂志

【Objective】 To analyze the serological characteristics of an anemia patient with cold autoantibodies and IgG anti S antibody. 【Methods】 Unexpected antibody screening was performed on screening cells, autologous cells and panel cells with patient serum in saline and anti human globulin card media at room temperature and 37 ℃, respectively. At the same time, the serum that destroying IgM antibodies and acid elution solution were respectively screened for unexpected antibodies in anti human globulin card media. The absorption-elution test was used to treat patients′ red blood cells and serum, and the unexpected antibody identification and cross matching were performed after excluding the interference of cold autoantibodies. 【Results】 Cold autoantibodies and IgG anti S antibody were found in the serum of this patient. 【Conclusion】 When a patient is found to have cold autoantibodies, it is necessary to screen the alloantibody, in order to avoid post transfusion immune reactions due to missed detection of alloantibody.

Study on the safety of homotype transfusion of military blood donors with negative unexpected antibodies / 中国输血杂志

【Objective】 To analyze the safety of homotypic transfusion in military donors with negative unexpected antibody. 【Methods】 Blood samples (4 mL/person)of eligible military blood donors from November 2018 to October 2019 in our hospital (also working as forces blood station) were conducted for RBC antigen typing, unexpected antibody screening, direct antiglobulin test and cross-match test using microcolumn gel technology, and the compatibility of homotype blood samples was statistical analyzed. 【Results】 A total of 1 577 samples from eligible military blood donors were collected, including A RhD (+ ), B RhD (+ ), O RhD (+ ) and AB RhD (+ ), accounting for 31.39% (495/1 577), 34.37% (542/1 577), 24.10% (380/1 577) and 10.15% (160/1 577), respectively. Six samples presenting positive unexpected antibodies (0.38%, 6/1 577) were screened out, and a total of 7 141 cross-matching tests were performed on 1 571 unexpected antibody negative samples, including A RhD (+ ) [37.36% (2 668/7 141)], B RhD (+ ) [34.81% (2 486/7 141)], O RhD (+ ) [17.71% (1265/7 141)] and AB RhD (+ ) [10.11% (722/7 141)]. There was only 1 case of incompatible cross-matching presented between other donors and clinical patients, and the direct antiglobulin test was 1+ , therefore suspended red blood cells of the donor were scrapped. 【Conclusion】 There was high compatibility and good security of homotype transfusion of military blood donors with negative unexpected antibody.

Human parvovirus B19 infection in blood donors: a meta-analysis / 中国输血杂志

【Objective】 To analyze the current situation of human parvovirus B19 infection in blood donors in different regions of China, so as to provide basis for formulating reasonable screening programs of B19 virus for blood donors in various cities and regions. 【Methods】 The literatures related to human parvovirus B19 infection in whole blood and plasma donors published from 1998 to 2021 were searched in the database, and meta-analysis of literatures that satisfied the inclusion criteria was conducted by R4.1.0 software. 【Results】 A total of 35 literatures were obtained, 20 literatures involving 56 846 blood donor samples and 8 literatures involving 1 608 pooled raw plasma samples were subjected to Meta analysis of the positive rates of B19 DNA; 17 literatures involving 12 308 blood sample were subjected to the Meta analysis of the positive rate of B19 IgG antibody.The positive rates of B19 DNA in blood donors(I2=96%, τ2=0.026 0, P<0.01)and pooled raw plasma (I2=98%, τ2=0.124 5, P<0.01), as well as the positive rate of B19 IgG antibod (I2=98%, τ 2 =0.021 0, P < 0.01) presented significant heterogeneity between regions. The combined positive rate of B19 DNA was estimated to be 2.0% (95%-CI: 0.007~0.039), that of pooled raw plasma for production was 66.6% (95%-CI: 0.476~0.832), and that of B19 IgG antibody was 30.2% (95%-CI: 0.246~0.357). 【Conclusion】 Low HPV B19 infection rate and high positive rate of IgG antibody were found in blood donors. Therefore, the risk of B19 virus infection due to blood transfusion is low, but B19 infections in blood donors varied significantly between regions. Domestic cities and regions should reasonably evaluate their own B19 virus infection status to formulate appropriate B19 virus screening programs for blood donors, so as to reduce blood transfusion transmitted risk of B19 virus. In addition, the infection rate of B19 virus in pooled plasma for production is somewhat high. Recipients should be screened for B19 virus antibodies, and appropriate blood transfusion schemes should be formulated for blood recipients lacking neutralizing B19 IgG antibodies to reduce the exposure of B19 virus.

Research progress in the clearance mechanism of platelets stored at 4℃ / 中国输血杂志

Platelets transfusion is one of the most important methods to prevent and treat hemorrhagic diseases.At present, the vitro storage of platelets with gentle agitation at (22±2)℃ is short and susceptible to bacterial contamination, which greatly affects the availability and safety of clinical platelets transfusion.Studies at home and abroad have shown that storage at 4°C could prolong the preservation period of platelets.However, refrigeration may aggravate platelets storage lesion (PSL) and accelerate the clearance mechanism after transfusion, which seriously restricts the clinical application of refrigerated platelets.This paper reviews the research advances in PSL caused by 4℃ storage and the clearance mechanism after transfusion.

Distribution characteristics of unexpected antibody in 1 779 patients and corresponding blood transfusion strategy / 中国输血杂志

【Objective】 To observe the distribution of the unexpected antibodies in order to study the safety and strategies in 1 779 cases of clinical blood transfusion. 【Methods】 A total of 1 779 patients with unexpected antibodies were enrolled from transfusion candidates in various hospitals in Xi′an during a 10-year period(from 2012 to 2022.5). 【Results】 The unexpected antibodies were detected in 926(52.05%) of 1779 samples. The detected antibodies were mainly from 8 blood group systems and their distributions were as follows: Rh antibodies in 69.76%(646/926), Kidd in 2.59%(24/926), Lewis in 4.21%(39/926), MNS in 12.53%(116/926), P in 0.43%(4/926), Diego in 0.65%(6/926), Duffy in 0.54%(5/926), I in 0.97%(9/926), Rh+ MNS in 1.30%(12/926), Rh+ Lewis in 0.65%(6/926), Rh+ Kidd in 3.24%(30/926), Rh+ Diego in 1.51%(14/926), Rh+ Duffy in 0.86%(8/926), MNS+ Diego in 0.11%(1/926), Rh+ MNS+ Kidd in 0.22%(2/926), Rh+ Lewis+ Kidd in 0.22%(2/926), Rh+ Kidd+ P in 0.11%(1/926), Rh+ Kidd+ Diego in 0.11%(1/926). 【Conclusion】 According to the distribution of unexpected antibodies in Xi′an, antibodies from Rh system, were the most common ones.First, the production of unexpected antibodies can be effectively reduced by establishing Rh compatible blood transfusion. Secondly, antibody screen cells containing low-frequency antigens, such as Mur, Dia and Wra, should be reasonably selected to prevent missing detection of anti-low frequency antigen antibodies in Xi′an. Furthermore, the genotyping technology of rare blood group should be promoted and a rare blood group red blood cell bank be established to optimize the blood inventory and ensure the safety of blood transfusion.

Analysis on phenotype and genotyping of CisAB subtypes: 12 Cases / 中国输血杂志

【Objective】 To analyze and master the serological and genetic characteristics of the samples with CisAB subtype and their genetic background. 【Methods】 From January 2018 to January 2022, blood samples with discrepant ABO blood typing results, from Zhengzhou voluntary blood donors and hospital patients, were subjected to phenotypic classification using micro column gel card and tube method, as well as amplification of exons 6 and 7 in ABO gene using PCR. The pedigrees of individuals with the same CisAB subtype but different serological typing results in the same family were analyzed. 【Results】 11 The forward typing of 12 samples was AB type, and unexpected antibodies against weaker antigens were found in 11 serum samples, including 9 cases with strong antigen A, 2 cases with strong antigen B, and 1 case with consistent forward and reverse typing results. Gene sequencing confirmed that 11 cases were CisAB01 subtype and 1 case was CisAB05 subtype.Among them, 7 cases had the genotype of CisAB01/O and serological phenotype of A2B3; 2 cases had the genotype of CisAB01/B and phenotype of A2B; 2 cases had the genotype of CisAB01/A and serological phenotype of A1Bx and A1B3; 1 case had the phenotype of AxB. In the CisAB01 family, 1 case of CisAB01/O with A2B3 phenotype and 1 case of CisAB01/B with A2B phenotype were detected. In the CisAB05 family, 2 CisAB05/O01 and 1 CisAB05/O02 were detected. 【Conclusion】 The serological phenotypes of different individuals in the same CisAB01 family can be different when paired with different ABO alleles. It is advisable to accurately identify the CisAB subtype genes with molecular biological methods to ensure blood transfusion safety.

Em busca do melhor aproveitamento de bolsas de concentrado de hemácia de baixo volume / In search of the best use of bags low-volume red blood cells concentrate

RESUMO: Introdução: A produção de bolsas de sangue total com volume inferior ao esperado é prevista na Portaria de Consolidação no 05/2017, porém, a sua dispensação hoje leva em consideração apenas o teor de hemoglobinas e hematócrito da bolsa. Objetivo: Determinar, a partir dos parâmetros técnicos brasileiros existentes, os critérios para o melhor aproveitamento para bolsas de concentrados de hemácias de baixo volume (CHBV) produzidas na Fundação HEMOPA. Material e métodos: Foram analisados volume, teor de hemoglobina e hematócrito de 525 bolsas de CHBV provenientes de bolsas duplas sem adição de conservante; triplas convencional com adição de SAG-M (soro fisiológico, adenina, glicose e manitol); triplas top and bottom (TAB) com adição de SAG-M; e quádruplas TAB com filtro "in line" e adição de SAG-M. Resultados: Foi observado que 71,43% (375/525) das bolsas de CHBV, independente do tipo da bolsa, apresentavam-se em conformidade para hematócrito e teor de hemoglobina em relação à legislação. As bolsas duplas e triplas convencionais apresentaram os maiores valores de teor de hemoglobina. Observou-se ainda que as bolsas de sangue total coletadas com volumes entre 350 e 404 ml geraram bolsas de CHBV com os menores índices de descarte. O maior descarte das bolsas de CHBV ocorreu quando o volume final ≤250 mL e hemoglobina ≤ 16 g/dL. Conclusão: Observou-se que o melhor aproveitamento das bolsas de CHBV ocorreu quando as bolsas de sangue total se encontravam com volumes entre 350 e 404 mL e as bolsas de CHBV apresentavam volume final ≥ 250 mL e hemoglobina ≥ 16g/dL.(AU)

ABSTRACT: Introduction: The production of whole blood bags with a lower volume than expected is approved in the Consolidation Ordinance number 05/2017; however, its dispensation today takes into account only the hemoglobin and hematocrit content of the bag. Objective: From the existing Brazilian technical parameters, determine the criteria for the best clinical use for low-volume red cell concentrate (LVRCC) bags produced at the HEMOPA Foundation. Material and methods: We analyzed volume, hemoglobin content, and hematocrit of 525 LVRCC bags from double bags without addition of preservative; conventional triple bags with the addition of SAG-M (saline, adenine, glucose, and mannitol); triples bags top and bottom (TAB) with the addition of SAG-M, and quadruple bags TAB with "in line" filter and the addition of SAG-M. Results: It was observed that 71.43% (375/525) of bags of LVRCC, regardless of bag type, were in conformance with hematocrit and hemoglobin content concerning Brazilian legislation. With the double and conventional triple bags, they had the highest values of hemoglobin content. It was also observed that the bags of whole blood collected with volumes between 350 and 404 mL generated LVRCC bags with the lowest rate of discard. The greatest discard of LVRCC bags occurred when the final volume ≤ 250 mL and hemoglobin ≤ 16 g/dL. Conclusion: It was observed that the best use of LVRCC bags occurred when the whole blood bags were between 350 and 404 mL and the LVRCC bags had a final volume ≥ 250 mL and hemoglobin ≥ 16 g/dL. (AU)

Quality analysis of platelet concentrates prepared with optimized blood collection bags / 中国输血杂志

【Objective】 To evaluate the quality of platelet concentrates prepared by two different blood collection bags, so as to provide references for the development of high-quality platelet preparation. 【Methods】 Platelet concentrates were prepared using buffy coating from the whole blood collected by conventional and optimized single-use blood collection bags with leukoreduction filter, respectively. The volume of whole blood collected was 400 mL, and 60 bags in total. They were divided into group A (conventional collection bags, n=30), and the size of buffy coating pouch was 15 cm×12 cm; group B (optimized collection bags, n=30), and the size of buffy coating pouch was 11 cm×9 cm. 【Results】 There were significant differences between group A and group B in the amount of red blood cells contamination, platelet content, and platelet yielding rate (P<0.05), which were (2.62±0.57)×109/mL vs (1.37±0.35)×109/mL, (4.41±0.31)×1010/mL vs (6.21±0.63)×1010/mL, and (55.03±0.06)% vs (79.23±0.09)%, respectively. 【Conclusion】 The buffy coating pouch with the size of 11 cm×9 cm can produce better platelet concentrates, thus improves the safety and efficacy of clinical blood transfusion.

Zika virus infection and transfusion safety / 中国输血杂志

Zika virus(ZIKV) is an arbovirus transmitted mainly by mosquitoes. ZIKV infection usually causes mild self-limiting disease, and most of the infected patients only developed relatively mild symptoms which were often easily overlooked. However, serious damage of the central nervous system is observed in a few of the infected patients, and microcephaly of embryos and fetuses in pregnant women infected by ZIKV has attracted wide attention in recent years. Although there is a high proportion of asymptomatic infection and a high incidence of viremia, ZIKV has not been included in the routine pathogen screening before blood donation in China yet, and there is a risk of transmission through blood transfusion. This article briefly introduces the biological characteristics, epidemic characteristics, and pathogenic mechanisms of ZIKV,, and discusses ZIKV infection and the safety of blood transfusion.

Pre-transfusional screening and identification of irregular red blood cell antibody in different nationalities, Guizhou, China / 中国输血杂志

【Objective】 To analyze the frequency and profile of irregular antibodies in different ethnic groups through screening and identification of irregular antibodies in 67 552 blood recipients in the Affiliated Hospital of Guizhou Medical University. 【Methods】 Irregular antibody screening was carried out in patients with different ethnic groups from August 1, 2016 to July 31, 2019 by microcolumn gel anti human globulin method, and the irregular antibody specificity were identified by panel cells. 【Results】 1)307 out of 67 552 cases were positive for irregular antibody, with the positive rate at 0.45%(307/67 552). Among them, Chuanqing was 1.27%(6/473), Yi 1.15%(4/348), Buyi 1.03%(10/975), Dong 0.58%(3/514), Han 0.44%(273/62 365), Miao 0.42%(5/1 187) and Tujia 0.34%(2/596), with significant differences among nationalities. Irregular antibody detection: the positive rate of female patients(0.56%, 223/41 359) was higher than that of male patients(0.32%, 84/26 193)(P0.05). The yields of irregular antibodies did not differ by ABO blood groups(P>0.05). 3)The specificity of 307 irregular antibody positive cases involved 7 blood group systems, including Rh system 59.28%(182/307), MNSs system 9.12%(28/307), Kidd system 0.65%(2/307), Duffy system 0.98%(3/307), Lewis system 5.86%(18/307), P system 0.65%(2/307), and Digeo system 0.33%(1/307). In addition, 15.64%(48/307) of autoantibodies, 0.65%(2/307) of cold antibodies and 4.93%(15/307) of unclear antibodies were detected. 4)The distribution of anti-D, anti-C and autoantibodies were statistically significant among the Han, Buyi, Chuanqing, Miao, Yi and Dong nationalities(P0.05). 【Conclusion】 The distribution of irregular antibodies in Guizhou is different by nationalities. Routine screening of irregular antibodies for transfused or pregnant patients can increase the safety and efficacy of blood transfusion. Most of the irregular antibodies detected are Rh blood group system. The exposure to irregular antibodies can be reduced by additional detection of blood group antigen other than RhD for blood recipients and donors, as well as the blood transfusion with matched blood group antigens.

An Audit on Overnight Transfusion Practice in A Teaching Hospital in Malaysia

@#Introduction: Overnight transfusion (OT) is the blood transfusion taking place from 9pm to 8am. During this period, patients are exposed to increased risk of errors. This cross-sectional study aims to determine the incidence and practice of OT in Universiti Kebangsaan Malaysia Medical Centre. Materials & Methods: Data from all OT in June and mid-July 2017 were collected from recipients’ cards, transfusion request forms and patient’s case files, regarding discipline involved, indications, time intervals from request of blood transfusion to the completion of OT on patients, monitoring of patients and adverse reactions. Results: A total of 1285 transfusion cases were identified during the study period. 216 (16.8%) cases were OT while the 1069 (83.2%) cases were non-OT. Surgery discipline has the highest (30.1%) OT. The indications of OT were acute clinical need: 82.9%, less acute clinical need: 13.9% and no clinical need: 3.2%. A huge delay (average: 5 hours 40 minutes) in starting transfusion after grouping and crossmatching (GXM) completion was noted. Besides, 25.9% cases took >4 hours to complete OT; 83.4% cases did not have proper transfusion monitoring and three transfusion reactions were reported. Discussion: Although most of the OT cases had appropriate clinical indications, the transfusion can be commenced earlier at day time rather than overnight. Cases without absolute indication should avoid OT. The poor monitoring of patient during OT had posed risks to patients’ life if an adverse transfusion reaction happened. The major reason for OTs was a huge delay in starting transfusion after the GXM completion. The contravention of 4-hour infusion rule increased the patients’ risk of developing bacterial sepsis. The practice of OT should be discouraged wherever possible except for clinically indicated cases.

Acute Hemolytic Transfusion Reaction due to ABO-Incompatible Blood Transfusion: A Fatal Case Report and Review of the Literature / 대한수혈학회지

A 77-year-old female patient who was suspected to have had an acute hemolytic transfusion reaction was admitted to the emergency room. She received one unit of type A red blood cells in a type B patient during a total knee arthroplasty operation at another medical institution. ABO-incompatible transfusion was carried out due to an identification error between the patient and blood product. At the time of admission, acute hemolytic reaction, lactic acidosis, and disseminated intravascular coagulation were observed. She was admitted to the intensive care unit and received continuous renal replacement therapy. She maintained renal function and was moved to the general ward on the 7th day. Complications such as pulmonary edema, gastrointestinal bleeding, and ischemic colitis persisted, and the patient died on the 111th after admission. This case is the first report of death due to an ABO-incompatible transfusion in Korea. Efforts to establish a safe transfusion environment are necessary not only at individual medical institutions but also at the national level.

Risk management in blood transfusion compatibility testing: effect appraisal / 中华医院管理杂志

Objective To explore the implementing process and application effect of risk management in blood transfusion compatibility testing.Methods 16 957 patients receiving transfusion therapy along with blood transfusion compatibility testing at our hospital between July,2013 and June,2015 were selected as the control group,without any risk control in place.19 011 patients receiving such therapy yet with blood transfusion compatibility testing between July, 2015 and June, 2017 were selected as the observation group,and managed by the risk management procedure.The risk incidence and satisfactory rate of doctors,nurses and patients were analyzed between the two groups.Results The risk incidence was zero in the observation group, and 0.09% in the control group, indicating the risk incidence rate in the observation group significantly lower than the control group(P<0.05).The satisfactory rate of doctors, nurses and patients in the observation group(98.33%)was significantly higher than the control group (71.25%)(P <0.05).Conclusions Implementing risk management procedure in blood transfusion compatibility testing may effectively prevent and reduce the risk incidence, enhance the satisfactory rate of doctors,nurses and patients,and ensure the clinical transfusion safety.

Avaliação da correlação de sorologia e teste de ácido nucleico em doadores de sangue reagentes para o Vírus da Imunodeficiência Humana / Evaluation of the correlation of serology and nucleic acid testing in Anti-HIV reagent blood donors

Introdução: As transfusões sanguíneas começaram a ser realizadas no Brasil no século XX como forma de tratamento terapêutico. Com a descoberta do vírus HIV, a segurança do sangue doado passou a ser prioritária. Assim, candidatos à doação de sangue são submetidos a uma triagem clínica e sorológica, além do teste de ácido nucleico (NAT), obrigatório desde 2014 nos bancos de sangue. Métodos: Estudo retrospectivo através da análise de dados dos doadores de sangue de um Serviço de Hemoterapia em Porto Alegre/RS, nos anos de 2015 a 2017. Avaliando resultados sorológicos e da técnica NAT para HIV. Resultados: Das 28.625 amostras de usuários do serviço de hemoterapia, 41 (0,14%) foram reagentes para o HIV e 21 (0,07%) foram reagente para o teste NAT. Estes dados demonstram uma reatividade duas vezes maior nas amostras de bolsas testadas sorologicamente quando comparadas com a metodologia utilizada no NAT. Conclusão: O avanço científico e tecnológico tem auxiliado no que se refere a redução dos riscos de transmissão de doenças infecto-contagiosa por transfusão sanguínea. O teste NAT teve um acréscimo significativo na pesquisa dos vírus para a segurança na liberação de hemocompoentes. O teste foi introduzido nas rotinas de banco de sangue no intuito de reduzir o período de janela imunológica quando comparado aos testes sorológicos, fato este não observado nos anos de coleta de dados no Serviço de Hemoterapia referido neste estudo. (AU)

Introduction: Blood transfusions began to be performed in Brazil in the twentieth century as a form of therapeutic treatment. With the discovery of the HIV, the safety of donated blood became a priority. Therefore, candidates for blood donation are subjected to clinical and serological screening, in addition to the nucleic acid test (NAT), which has been mandatory since 2014 in blood banks. Methods: We conducted a retrospective study using data from blood donors at one hemotherapy service in Porto Alegre, state of Rio Grande do Sul, from 2015 to 2017. Serological and NAT results for HIV were evaluated. Results: Of the 28,625 samples of users of the hemotherapy service, 41 (0.14%) were HIV reagents and 21 (0.07%) had a reagent result for the NAT test. These data demonstrate a two-fold higher reactivity in the samples of serologically tested units as compared to the methodology used in NAT. Conclusions: Studies with different time periods are needed to further explain this association. The NAT test had a significant increase in the search for viruses and the safety in the release of blood components. The test was introduced in the blood bank routines in order to reduce the window period when compared to serological tests, a fact that was not observed in the years of data collection in the hemotherapy service referred to in this study. (AU)

Segurança e intervenção: a assistência de enfermagem em hemotransfusão / Safety and intervention: nursing assistance in blood transfusion / Seguridad e intervención: la asistencia de enfermería en Hemotransfusion

O estudo nasceu do campo de trabalho com a necessidade de orientação e monitoramento da prática hemoterapia em enfermagem. Objetivo Geral: Elaborar um instrumento como uma lista de verificação para orientar a assistência de enfermagem ao cliente submetido à hemotransfusão. Traçamos como objetivos específicos: Identificar a função da enfermeira que atua na Agência Transfusional; Analisar a conformidade dos conhecimentos da equipe de enfermagem sobre intervenções assistenciais ao cliente em hemoterapia e sobre Hemovigilância; Aprimorar a Lista de Verificação (Checklist) Seguro para a Assistência de Enfermagem ao Cliente Receptor de Hemocomponentes (Produto deste estudo) e Testar o produto. Trata-se de um estudo qualitativo, exploratório e descritivo cujo campo de pesquisa foi um hospital universitário público, no estado do Rio de Janeiro, desenvolvido segundo a metodologia administrativa proposta por Cury (2005): Fase I Diagnóstico da função da enfermeira na Agência Transfusional e o conhecimento específico da equipe de enfermagem. Fase II ­ Elaboração da Lista de Verificação Segura para o Cliente Submetido à Hemotransfusão. Fase III - Teste da Lista de Verificação. Os participantes foram 52 enfermeiros e 79 técnicos de enfermagem atuantes na assistência a clientes submetidos à hemotransfusões. O projeto foi aprovado pelo Comitê de Ética e Pesquisa da UNIRIO sob o nº 463207, CAAE: 52779315.7.0000.5285. Na fase diagnostica ocorrida em maio de 2016, foi identificada a função da enfermeira com base na legislação e elaborados dois fluxogramas de trabalho e foi aplicado o teste de Conhecimento a 131 profissionais. As respostas foram codificadas e analisadas pelo sistema SPSS 21,0 e mostraram que apenas 34,35% dos participantes obtiveram acertos acima de 70%, o que reforça a necessidade de treinamentos e implementação de um instrumento assistencial específico. Fase 2 ­ realizada em junho de 2016. Os resultados da fase diagnóstica permitiram as adequações à Lista de Verificação (Checklist) Seguro para a Assistência de Enfermagem ao Cliente Receptor de Hemocomponentes já existente e em uso no hospital e desenvolvido treinamentos voltados para os 131 profissionais de enfermagem. Na terceira fase foi realizada a testagem da Lista de Verificação (Checklist) Segura para a Assistência de Enfermagem ao Cliente Receptor de Hemocomponente corrigida de acordo com as sugestões dos profissionais de enfermagem que utilizaram o impresso proposto em 40 quarenta transfusões. Conclui-se que é de suma importância ter o enfermeiro na agência transfusional com atuação em todo o processo hemoterápico, visto que o sangue é um transplante de órgão que necessita de cuidados intensivos para garantir a segurança do cliente. O estudo respondeu às questões de pesquisa, e evidenciou que a lista de verificação aproxima a assistência e a evolução de enfermagem na transfusão de hemocomponente de uma sistematização, que reduz riscos e danos ao cliente e possibilita a qualidade assistencial de enfermagem

The study was born from the field of work with the need for guidance and monitoring of hemotherapy practice in nursing. General Objective: To devise an instrument such as a checklist to guide nursing care to the transfused client. We outline specific objectives: Identify the role of the nurse working in the Transfusional Agency; To analyze the conformity of the knowledge of the nursing team about healthcare interventions to the client in hemotherapy and on hemovigilance; Improve the Safe Check List for the Hemotransferred Customer. (Product of this study) and Test the product. This is a qualitative, exploratory and descriptive study whose field of research was a public university hospital, in the state of Rio de Janeiro, developed according to the administrative methodology proposed by Cury (2005): Phase I- Diagnosis of the nurse's role in the Transfusional Agency and the specific knowledge of the nursing team. Phase II - Elaboration of the Safe Check List for the Hemotransfusion Customer. Phase III - Checklist Test. The participants were 52 nurses and 79 nursing technicians working in the care of clients submitted to blood transfusion. The project was approved by the Ethics and Research Committee of UNIRIO under nº 463207, CAAE: 52779315.7.0000.5285. In the diagnostic phase that occurred in May 2016, the nurse's role was identified based on legislation and two workflows were elaborated and the Knowledge test was applied to 131 professionals. The responses were coded and analyzed by the SPSS 21.0 system and showed that only 34.35% of the participants obtained scores above 70%, which reinforces the need for training and implementation of a specific care instrument. Phase 2 - carried out in June 2016. The results of the diagnostic phase allowed for adjustments to the existing Checklist for the Client submitted to Hemotransfusion and in use in the hospital and developed training aimed at the 131 nursing professionals. In the third phase, the testing of the Safe Verification List for the Client submitted to Hemotransfusion was performed, corrected according to the suggestions of the nursing professionals who used the proposed form in 40 transfusions. It is concluded that it is of paramount importance to have the nurse in the transfusional agency with a role in the entire hemotherapy process, since blood is an organ transplant that requires intensive care to ensure client safety. The study answered the research questions and showed that the checklist approximates nursing care and evolution in the transfusion of blood components of a systematization, which reduces risks and damages to the client and enables nursing care quality

El estudio nació del campo de trabajo con la necesidad de orientación y monitoreo de la práctica hemoterapia en enfermería. Objetivo General: Elaborar un instrumento como una lista de verificación para orientar la asistencia de enfermería al cliente sometido a la hemotransfusión. Trazamos como objetivos específicos: Identificar la función de la enfermera que actúa en la Agencia Transfusional; Analizar la conformidad de los conocimientos del equipo de enfermería sobre intervenciones asistenciales al cliente en hemoterapia y sobre Hemovigilancia; Mejorar la Lista de Verificación (Checklist) Seguro para la Asistencia de Enfermería al Cliente Receptor de Hemocomponentes (Producto de este estudio) y Probar el producto. Se trata de un estudio cualitativo, exploratorio y descriptivo cuyo campo de investigación fue un hospital universitario público, en el estado de Río de Janeiro, desarrollado según la metodología administrativa propuesta por Cury (2005): Fase I - Diagnóstico de la función de la enfermera en la Agencia Transfusional y el conocimiento específico del equipo de enfermería. Fase II - Elaboración de la Lista de Verificación Segura para el Cliente Sometido a la Hemotransfusión. Fase III - Prueba de la Lista de Verificación. Los participantes fueron 52 enfermeros y 79 técnicos de enfermería actuantes en la asistencia a clientes sometidos a las hemotransfusiones. El proyecto fue aprobado por el Comité de Ética e Investigación de UNIRIO bajo el nº 463207, CAAE: 52779315.7.0000.5285. La fase diagnóstica ocurrió en mayo de 2016, fue identificada como una función de enfermería con base en la legislación y elaborado dos fundamentos de trabajo y fue aplicada en el ensayo de Conhecimento a 131 profesionales. Las respuestas fueron codificadas y analizadas por el sistema SPSS 21,0 y muestran que sólo 34,35% de los participantes obtiveram acertos superiores a 70%, que requieren una formación básica y una implementación del instrumento assistencial específico. Fase 2 - realizada en junio de 2016. Resultados de la fase diagnóstica permitida como adecuaciones a la Lista de Verificación (Lista de Verificación) Seguro para una Asistencia de Enfermería al Cliente Receptor de Hemocomponentes ya existente en el uso no hospital y desarrolló entrenamientos voltios para los 131 profesionales De enfermagem Em la fase anterior se realizó una prueba de la Lista de Verificación (Lista de comprobación) Segura para una Asistencia de Enfermería en el Receptor de Hemocomponente. Conclui-se que es de suma importancia para el enfermo en la agencia de transfusión en todo el proceso de hemoterápico, en el cuidado de la salud del paciente. El estudio responde a las preguntas de investigación y muestra que una lista de casos se aproxima a un estudio y una evolución de la enfermería en una transfusión de hemocomponente de una sistematización, que reduce lós riesgos y los daños al cliente y posibilita una calidad asistencial de enfermería

Preliminary evaluation of reducing residual risk of blood transfusion-transmitted infection by using HBV DNA detection / 中华实验和临床病毒学杂志

Objective@#To evaluate the reduction of the residual risk of blood transfusion- transmitted hepatitis B virus (HBV), using nucleic acid detection(NAT)test for enzyme linked immunosorbent assay (ELISA) qualified volunteer-donor bloods in Quzhou area after NAT was developed.@*Methods@#Specimens were collected from March 2016 to March 2017, detected by ELISA twice with two different reagents and NAT only once. The residual risks of blood transfusion-transmitted HBV infection were calculated by mathematical model of risk evaluation.@*Results@#Totally 27 646 specimens were collected from March 2016 to March 2017, which included 76 specimens that were both ELISA and NAT positive, 31 specimens were ELISA negative but NAT positive.The total number of NAT positive specimens was 107.The residual risk of HBV by ELISA test was 28.2×10 -5and NAT test was 13.0×10-5.@*Conclusions@#NAT detection can greatly reduce the residual risk of blood transfusion-transmitted HBV infection, and provide effective value for bloods safety in practice.

Prevalence of HIV infection, syphilis, and syphilis/HIV coinfection in blood donors from a blood bank of Porto Alegre, Southern Brazil

Introduction: Hemotherapy consists of therapeutic treatments performed through blood transfusion. Clinical and serological screening of donors is an essential strategy to avoid transmission of infectious agents in blood transfusion. The objective of this study is to assess the seroprevalence of HIV infection, syphilis and syphilis/HIV coinfection in blood donors from a blood bank in Porto Alegre from 2014 to 2016. Methods: Retrospective analysis of all blood donors registered on a software for managing hemotherapy services (Hemodot) of the Blood Bank in the Marques Pereira Laboratory, Porto Alegre / RS, from 2014 to 2016. Results: Of the 28,173 users of the hemotherapy service during the study period, 198 (0.70%) were positive for syphilis, HIV infection, or syphilis/HIV co infection. The prevalence of positive results for syphilis was 0.3%, 0.57% and 0.70% in 2014, 2015 and 2016, respectively, and for HIV infection was 0.18%, 0.14%, and 0.16% for the same period. However, the prevalence of syphilis/HIV coinfection was not statistically significant. Conclusions: The prevalence of syphilis increased significantly from 2014 to 2016. Hovever, this did not occur with HIV infection or with coinfection. This finding may reflect the requirement of the nucleic acid technique (NAT) for HIV screening in blood banks, a procedure that has been increasing transfusion safety and reducing the window period. Further studies may shed new light on the combined use of serological tests and NAT assays in blood banks to diagnose HIV cases and syphilis/HIV coinfection (AU)