Regular whole blood donaion in Tianjin from 2013 to 2022 / 中国输血杂志

【Objective】 To analyze the situation of regular whole blood donation in Tianjin between 2013 and 2022, in order to provide data support for improving the recruitment and retention measures of regular blood donors and ensuring safe clinical blood supply. 【Methods】 From 2013 to 2022, 185 639 regular whole blood donors in Tianjin were selected as the study group and 1 015 312 other whole blood donors in the same period were selected as the control group. The demographic data, blood collection volume and blood retest screening of blood donors in the two groups were statistically analyzed. 【Results】 The number of regular blood donors and the volume of blood donated in Tianjin increased year by year from 2013 to 2022, with an average annual growth rate of 6.22% and 6.18%, respectively. From 2013 to 2021, the retention rate of regular blood donors increased first and then decreased. The proportion of male blood donors in the study and control groups showed a decreasing trend but the proportion of female donors showed an increasing trend, with the proportion of male donors in the study group higher than that in the control group and the proportion of female donors lower than that in the control group (both P<0.05). In the study group, the majority of blood donors were in the age of 26-35 years old, followed by those of 36-45 years old; in the control group, the majority of blood donors were in the age of 18-25 years old, followed by those of 26-35 years old; the proportion of blood donors in the study group in the age of 18-25 years old was lower than that in the control group, while the proportion of blood donors of other age group was higher than that in the control group, and the difference was statistically significant (P<0.05). The rates of 200 mL and 300 mL blood donations and insufficient blood donations in the study group were lower than those in the control group, while the rate of 400 mL blood donations was higher than that in the control group, and the differences were statistically significant. Among the blood donors in the study group, the proportion of students, civil servants, medical workers, military personnel, teachers and others was lower than that of the control group, while the proportion of the rest occupations was higher in the study group than that of the control group, and the differences were all statistically significant. There was a significant difference in the proportion of regular blood donors among blood donors of different professions. The re-test deferral rates of ALT and anti-TP in the study group showed a decreasing trend followed by an increasing trend, and the re-test deferral rates of HBV, HCV and HIV showed an increasing trend followed by a decreasing trend, and all the re-test deferral rates in the study group were lower than those in the control group, and the differences were statistically significant (P<0.05) . 【Conclusion】 From 2013 to 2022, the situation of regular blood donors in Tianjin has a certain regularity, and there is certain room for growth. Precise recruitment strategies targeting different populations should be adopted to have more regular blood donors.

HIV antiretroviral therapy among blood donors: the impact on blood safety / 中国输血杂志

【Objective】 To explore the the potential risks of antiretroviral therapy(ART) drugs on blood safety among blood donors in Shenzhen. 【Methods】 High pressure liquid chromatography coupled with tandem mass spectrometry (HPLC-MS/MS) was used to measure ART drugs concentrations in the plasma of regular blood donors (negative control group, n=86) and anti-HIV positive individuals (experimental group, n=98, detected from approximately 440 000 blood donors during 2019—2023). The baseline plasma concentrations of ART drugs in the negative control group were clarified, and the impact of ART drugs on blood safety was analyzed. 【Results】 The baseline concentrations of ART drugs were not detected in 86 samples of negative control group. Four positive ART drugs samples were detected in 1∶2 pooled plasma samples of 98 anti-HIV positive blood donors plasma in the resolution test. The ART positive rate of anti-HIV positive donors was 4.08%, with tenofovir, lamivudine and efavirenz detected in three blood donors and lamivudine, lopinavir, ritonavir and zidovudine detected in one blood donor. 【Conclusion】 ART drugs were found among anti-HIV positive blood donors in Shenzhen. Additional research is needed to investigate the motivation of these specific donors, so as to ascertain the groups most susceptible to potential risks, and guarantee blood safety.

A study of centralized blood testing in Sichuan province based on cost analysis / 中国输血杂志

【Objective】 With the development of blood transfusion technology, the blood testing model is relatively decentralized, inefficient and costly in blood stations in China. Blood centralized detection not only effectively improves the quality of blood testing, but is also more cost-effective in labor and equipment.The purpose of this paper is to create a minimum cost model for blood testing that integrates the transportation cost, testing cost and center operating cost. 【Methods】 A mixed-integer planning model was developed with the annual cost of blood testing as the objective function, and sample processing capacity, sample allocation, logistic relationship between transportation and center construction, and consistency of transportation decisions with transportation volume as constraints.The empirical analysis takes Sichuan province as an example, collects data through expert interviews and research, does linear processing and adjustments to the segmented data to meet the modeling needs, and carries out modeling operations and verifies the optimal solution through python coding. 【Results】 A mixed integer programming model suitable for the number and location of centralized testing laboratories in China was developed.In the empirical analysis of Sichuan, the data required for the model was collected and the segmented data was linearized. A detailed cost analysis was conducted, revealing that the most cost-effective option was to establish centralized testing laboratories in Chengdu and Suining.The least cost-effective option identified in this study involved independent testing at 21 blood stations. Compared to this baseline, the most cost-effective strategy(establishing centralized testing laboratories in Chengdu and Suining) can reduce expenses by 29.433%. To ensure the reliability of these results, multiple rounds of validation were performed. Further analysis revealed that the strategy of establishing testing centers in Chengdu and Bazhong was a suboptimal choice, which can achieve a cost reduction of 29.431%. 【Conclusion】 This paper constructs a mixed-integer planning model for the number and location of centralized testing laboratories, which for the first time provides a decision-making basis for the location of regional centralized blood testing in China from the perspective of cost, and carries out an empirical analysis of Sichuan to develop the most cost-effective option.

Reentry of reactive blood donors in Changsha area: a retrospective analysis / 中国输血杂志

【Objective】 To analyze the reentry of single reagent reactive voluntary blood donors in our center, in order to provide data support and reference for the recall of single reagent reactive blood donors. 【Methods】 Collect the information of eligible blood donors from the information system of our center from January 2019 to September 2023 were collected, and the reentry were tracked and retrospectively analyzed. The demographic characteristics, active reentry rate, and re-donation rate of eligible blood donors were analyzed, and the differences between qualified reentry rates and factors affecting re-donation were compared using chi-square test. 【Results】 A total of 3 361 blood donors met the reentry criteria, with an active reentry rate of 2.7% (91/3 361) and a qualified reentry rate of 80.21% (73/91). The reentry rate of eligible blood donors showed significant differences in terms of different genders(3.3% vs 2.1%), educational background(3.7% vs 2.3%), blood donation frequency(9.3% vs 4.0% vs 1.3%), testing items(7.7% vs 2.7% vs 1.9% vs 1.3%) and blood donation types(18.1% vs 2.0%) (P<0.05). Difference was noticed in the qualified rate of blood donor reentry among different age groups (61.1% vs 94.4% vs 81.8%) (P<0.05). A total of 126 blood donors donated again, with a total volume of 47 800 mL, a re-donation rate of 49.3% (36/73) and a qualified rate of re-donation of 98.4% (124/126), showing a difference between repeat blood donors and first-time donors (P<0.05). 【Conclusion】 The active reentry rate of single reagent reactive blood donors in our center is relatively low, but the qualified rate of reentry and the re-donation rate are both high. The re-donation is mainly donation of apheresis platelets, and successful reentry blood donors have a strong willingness to donate blood.

Rechazo de donantes de sangre en un hospital peruano durante la pandemia de la covid-19 / Rejection of blood donors in a Peruvian hospital during the COVID-19 pandemic i: en

Introducción: El SARS-CoV-2 ha tenido un impacto negativo y significativo en los sistemas de salud a nivel mundial, lo cual además amenazó el suministro de sangre necesario para las transfusiones clínicas. Objetivo: Describir las causas del rechazo de donantes de sangre durante la pandemia de covid-19. Métodos: Se realizó un estudio observacional, transversal y retrospectivo en una población de donantes que acudió al Banco de Sangre del Hospital Nacional Ramiro Prialé Prialé, de Huancayo, en Perú, de julio del 2020 a igual mes del 2022. Las variables analizadas fueron sexo, grupo sanguíneo ABO, factor Rh y tipos y causas de rechazo. Resultados: Del total de 10 177 donantes de sangre, fueron diferidos y excluidos 3390 (33,3 %); la causa más frecuente de diferimiento fue el hematocrito bajo (18,0 %) y la de exclusión, la positividad por el anticuerpo del núcleo de la hepatitis B (36,8 %). Asimismo, predominó el sexo masculino entre los que fueron rechazados (55,2 %) y se evidenció un incremento de la tendencia politómica en los donantes diferidos (R²=0,2214) y excluidos (R²=0,1178). Conclusiones: La prevalencia de diferimiento y exclusión de donantes de sangre hallada en esta serie fue relativamente alta en comparación con la registrada en otros estudios, lo cual se debió principalmente, en cada caso respectivo, al hematocrito bajo y a la presencia del anticuerpo del núcleo de la hepatitis B.

Introduction: SARS-CoV-2 has had a negative and significant impact on global health systems, threatening the necessary blood supply for clinical transfusions. Objective: To describe the causes of rejection of blood donors during the COVID-19 pandemic. Methods: An observational, cross-sectional and retrospective study was carried out in a population of donors who attended the Blood Bank of Ramiro Prialé Prialé National Hospital, in Huancayo, Peru, from July, 2020 to the same month, 2022. The analyzed variables were sex, the ABO blood group, Rh factor and types and causes of rejection. Results: Of total of 10 177 blood donors, 3390 (33.3%) were differed and excluded; the most frequent cause of differing was the low hematocrit (18.0%) and the most frequent cause of exclusion was antibody to hepatitis B core antigen positivity (36.8%). Likewise, male sex predominated among those who were rejected (55.2%) and an increment of the polytomous tendency was evidenced in differed (R²=0.2214) and excluded donors (R²=0.1178). Conclusions: The prevalence of differing and exclusion in blood donors was relatively high compared to that reported in other studies, which was mainly due, in each respective case, to the low hematocrit and the presence of antibody to hepatitis B core antigen.

Indicadores para a avaliação do processo transfusional: revisão integrativa* / Indicadores para la evaluación del proceso transfusional: revisión integradora / Transfusion process assessment indicators: integrative review

Objetivo: identificar os indicadores relacionados ao processo transfusional. Método: revisão integrativa de literatura realizada entre março e maio de 2022, em nove fontes de informação no período de 2001 a 2021. Como estratégia de busca, utilizaram-se os descritores "Indicadores de Qualidade em Assistência à Saúde", "Indicadores de Serviços", "Indicadores Básicos de Saúde", "Serviço de Hemoterapia", "Transfusão de Sangue", "Segurança do Sangue", com os operadores boleanos "AND" e "OR" em três idiomas, sendo analisados 49 artigos. Resultados: foram identificados 53 indicadores, os quais se agruparam para: gestão do estoque de hemocomponentes, de produção do processo transfusional, para avaliação do processo transfusional e de suporte do processo transfusional. Conclusão: os indicadores identificados possibilitam avaliação do processo transfusional, apesar de atividades, como a avaliação do cuidado, apresentarem poucos indicadores, evidenciando a necessidade de estudos sobre a temática e construção de novos indicadores para dar sustentação à avaliação mais aprimorada do processo transfusional.

Objective: to identify transfusion-related indicators. Method: an integrative literature review carried out between March and May 2022, in nine sources of information from 2001 to 2021. As a search strategy, the descriptors "Quality Indicators in Health Care", "Service Indicators", "Basic Health Indicators", "Hemotherapy Service", "Blood Transfusion", "Blood Safety" were used, with Boolean operators "AND" and "OR" in three languages, with 49 articles being analyzed. Results: a total of 53 indicators were identified, which were grouped for: blood component stock management, transfusion process production, transfusion process assessment and transfusion process support. Conclusion: the identified indicators make it possible to assess the transfusion process, although activities, such as care assessment, present few indicators, highlighting the need for studies on the subject and the construction of new indicators to support a more improved transfusion process assessment.

Objetivo: identificar indicadores relacionados con el proceso de transfusión. Método: revisión integrativa de la literatura, realizada entre marzo y mayo de 2022, en nueve fuentes de información de 2001 a 2021. Como estrategia de busca, se utilizaron los descriptores "Indicadores de Calidad en la Atención de Salud", "Indicadores de Servicio", "Indicadores Básicos de Salud", "Servicio de Hemoterapia", "Transfusión de Sangre", "Seguridad de la Sangre", con operadores booleanos "AND" y "OR" en tres idiomas, analizando 49 artículos. Resultados: se identificaron 53 indicadores, los cuales fueron agrupados en: gestión del stock de hemocomponentes, producción del proceso transfusional, evaluación del proceso transfusional y apoyo al proceso transfusional. Conclusión: los indicadores identificados posibilitan la evaluación del proceso transfusional, aunque actividades, como la evaluación del cuidado, presenten pocos indicadores, destacando la necesidad de estudios sobre el tema y la construcción de nuevos indicadores que apoyen una evaluación más perfeccionada del proceso de transfusión.

Analysis of red blood cells supply before and after the outbreak of COVID-19 from 2018 to 2021 in 18 domestic blood centers / 中国输血杂志

【Objective】 To compare the supply data of red blood cells(RBCs) from 18 blood centers in China before and after the outbreak of COVID-19 during 2018 to 2021. 【Methods】 Eight indicators related to RBCs supply from 18 blood centers in China during 2018-2021 were collected retrospectively, including the storage of total amount of qualified RBCs (referred to as the total amount of storage), the distribution of total amount of RBCs (referred to as the total amount of distribution), the distribution amount of RBCs per 1 000 population (referred to as the amount of distribution per 1 000 population), the distribution amount of RBCs from 400 mL original blood per 1 000 population [referred to as the amount of distribution per 1 000 population (400 mL)], the average daily distribution amount of RBCs (referred to as the average daily distribution amount), the average daily storage amount of RBCs (referred to as the average daily storage amount), the average storage days of RBCs when distribute (referred to as the RBC storage days), and the expired amount of RBCs (referred to as the expired amount). Based on the outbreak time of COVID-19, the data of 2018 and 2019 were the pre-pandemic group, and the data of 2020 and 2021 were the post-pandemic group. 【Results】 Data on RBCs supply in 18 blood centers from 2018 to 2021(comparison of the pre-pandemic group and the post-pandemic group): the amount of distribution per 1 000 population (median 14.68 U>13.92 U) decreased, the amount of distribution per 1 000 population (400 mL) (median 10.16 U>9.21 U) decreased, and the difference was statistically significant (P99 084.08 U) decreased, the amount of distribution per 1 000 population (median 15.04 U>12.19 U) decreased, the amount of distribution per 1000 population (400 mL) (median 10.11 U>8.94 U), the average daily distribution amount(322.66 U>270.73 U) decreased and RBC storage days (median 10.50 d324.46 U), the average daily inventory (median 3 222.00 U0.00 U) decreased, the difference has statistical significance (P<0.05). The results of ANOVA showed that there were significant differences on the data related to RBCs supply (except expired amount) in different blood centers (P<0.05). The ratio of average daily stock to average daily distribution in the post-outbreak group (median 12.36 d) was higher than that in the pre-outbreak group (median 10.92 d), the difference has statistical significance (P<0.05), with significant difference among different blood centers (P <0.05). 【Conclusion】 The COVID-19 pandemic has a significant impact on RBCs supply in different blood centers. In the second year of the pandemic, the supply capability had recovered to some extent, and there were differences in RBCs supply in different blood centers.

Analysis of monitoring results of novel coronavirus IgM and IgG antibody levels in apheresis platelets donors and impact on blood safety / 中国输血杂志

【Objective】 To monitor the positive rates of IgM and IgG antibodies and the changes in S/CO values over time in voluntary blood donors infected with SARS-CoV-2 after recovery, in order to provide theoretical basis and data support for ensuring clinical blood safety. 【Methods】 A total of 54 platelet donors who met the inclusion criteria were selected for this study, and 359 blood samples (plasma) from T1 to T7 (at 7 time points, spanning 14 to 15 weeks) were continuously monitored for SARS-CoV-2 IgM and IgG antibodies using fully automated chemi-luminescence method. 【Results】 Among 359 blood samples (plasma) from 54 donors, 349 were with valid test results.Eleven donors were tested positive for IgM, with a positive rate of 20.37%, and IgM antibody S/CO value gradually increased during T1-T3, but gradually decreased during T4-T7. Fifty-four donors were tested positive for IgG, with the positive rate of 100%, and the S/CO value of IgG antibody gradually decreased over time. During the period of T1 -T7, there was no significant difference in SARS-CoV-2 IgG antibody S/CO value between gender (male/female) or age group (18-39 years old /40-60 years old). 【Conclusion】 The positive rate of SARS-CoV-2 IgG antibody in platelet donors after recovery from SARS-CoV-2 infection was 100% during 2-14 weeks, and the IgG S/CO value gradually decreases over time. The long-term dynamic changes of SARS-CoV-2 serologically specific IgG and IgM antibodies in blood donors are worthy of further study.

Centralized blood nucleic acid test data in Tibet: a retrospective analysis / 中国输血杂志

【Objective】 To retrospectively analyze the serological and nucleic acid testing(NAT) data of voluntary blood donors from six blood banks in Tibet, in order to explore the positive impact of NAT on reducing the risk of infective transfusion in a regional scope. 【Methods】 From 2018 to 2022, 38 718 voluntary blood donors from blood centers of Tibet, Shannan, Shigatse, Naqu, Nyingchi and Ngari were tested for hepatitis B virus surface antigen (HBsAg), hepatitis C virus antibody (anti-HCV), human immunodeficiency virus antigen (HIV) and antibody (Ag/Ab1+2) serological determination by enzyme-linked immunosorbent assay (ELISA). At the same time, Haoyuan and Daan nucleic acid detection systems were used for the combined detection of HBV-DNA, HCV-RNA and HIV-RNA. The results of NAT of reactive ELISA samples were statistically analyzed. 【Results】 A total of 178 ELISA-/NAT+ samples were detected in Tibet over the past five years, including 170 HBV-DNA positive cases, 8 HCV-RNA positive cases, and 0 HIV-RNA positive cases, with the positive rate at 0.460%.The detection rate of 624 ELISA+/NAT+ samples was 1.61%.The age of blood donors with hepatitis B in Shigatse area was slightly higher than that in other areas, and the difference was statistically significant(P<0.05) . 【Conclusion】 The centralized detection of viral nucleic acid in Blood Center of Tibet Autonomous Region can effectively reduce the missed detection of transfusion transmitted diseases and guarantee the blood safety in the region.

Application value of nucleic acid testing in syphilis screening reactive blood / 中国输血杂志

【Objective】 To evaluate the application value of nucleic acid testing (NAT) by studying the NAT-yield of syphilis screening reactive blood from five blood centers. 【Methods】 The blood samples and demographic information of syphilis screening positive donors were collected from five domestic blood centers, i. e. Chongqing, Guangxi, Luoyang, Liuzhou, Mianyang and Urumqi. The treponema pallidum particle agglutination (TPPA) and the established SYBR Green qPCR method were used to analyze the difference between the results of NAT and the other two test results. 【Results】 Among 1 679 reactive blood samples for syphilis screening, 819 were confirmed positive by TPPA, accounting for 49%, with the false positive rate exceeded 50%. As to NAT results, the NAT-yield of syphilis screening reactive samples and confirmed positive samples was the same (both 2.20%); the NAT-yield of TPPA-positive and TPPA-negative samples were 2.20% and 2.74%, respectively. 【Conclusion】 Primary syphilis screening by ELISA has high sensitivity, but also presents high false positive rate. Although TPPA confirmatory test has strong specificity, it cannot reflect the existence of T. pallidum. Therefore, NAT may be used as a supplementary test for syphilis screening so as to more effectively ensure the safety of blood transfusion and blood supply.

External quality control program in infectious diseases screening at laboratories and blood banks in Latin America: an analysis of the past 5 years / Programa de control externo de la calidad en el tamizaje de enfermedades infecciosas en laboratorios y bancos de sangre de América Latina: análisis de los últimos 5 años / Programa externo de controle de qualidade na triagem de doenças infecciosas em laboratórios e bancos de sangue da América Latina: análise dos últimos 5 anos

ABSTRACT Objective. To evaluate the screening of blood samples for infectious disease markers at laboratories and blood banks in Latin America per the findings of an External Quality Assessment Program (EQAP). Methods. This qualitative analysis used data from the EQAP coordinated by the Fundação Pro Sangue Hemocentro de São Paulo with the support of the Pan American Health Organization to assess the performance of blood screening for infectious diseases from 2014 to 2018 in Latin America. Each participating laboratory or blood bank received an identical blind panel with 24 blood samples with variable reactivity for all the screening parameters. Panels were processed at each participating facility and results were returned to the Fundação Pro Sangue Hemocentro de São Paulo for individual and joint analyses. Two types of discrepant results were potential failures: false positive results (FPRs) and false nonreactive results (FNRRs). Results. A total of 23 136 samples were evaluated. Global rates of FPR, FNRR, and concordant results were 0.3%, 1.0% and 98.7%, respectively. Seven FNRRs were found for HBsAg (1.0%), 12 for syphilis (2.6%), and 21 for Chagas disease (2.9%). No FNRRs were found for the HIV, HCV, and HTLV viruses. The average accuracy of all the laboratories and blood banks participating in the EQAP during the study period was 99.5% (standard deviation, 0.5%). Conclusion. The findings of this qualitative analysis are positive for blood safety in Latin America, with an average accuracy of 99.5% among the participating laboratories and blood banks. This report reflects an important improvement in blood bank serological screening EQAP-PAHO report since the 2003.

RESUMEN Objetivo. Evaluar el tamizaje de muestras de sangre en las que se analizan marcadores de enfermedades infecciosas en laboratorios y bancos de sangre de América Latina según los resultados de un programa de evaluación externa de la calidad (EQAP, por su sigla en inglés). Métodos. Este análisis cualitativo utilizó datos del EQAP —coordinado por la Fundação Pro Sangue Hemocentro de São Paulo con el apoyo de la Organización Panamericana de la Salud— para evaluar la eficacia del tamizaje sanguíneo para la detección de enfermedades infecciosas que se realizó entre el 2014 y el 2018 en América Latina. Cada laboratorio o banco de sangre participante recibió un panel idéntico para análisis a ciegas compuesto por 24 muestras de sangre con reactividad variable para todos los parámetros del tamizaje. Los paneles se procesaron en cada establecimiento participante y los resultados se enviaron a la Fundação Pro Sangue Hemocentro de São Paulo donde se realizaron análisis individuales y conjuntos. Había dos tipos de resultados discrepantes que eran posibles fallas del tamizaje: los positivos falsos (PF) y los negativos falsos (NF). Resultados. En total se evaluaron 23 136 muestras. Las tasas generales de PF, NF y resultados concordantes fueron, respectivamente, del 0,3%, 1,0% y 98,7%. Se obtuvieron siete NF en casos de HBsAg (1,0%), 12 en casos de sífilis (2,6%) y 21 en casos de enfermedad de Chagas (2,9%). No se obtuvieron NF en casos de infección por virus del VIH, el VHC o el VLTH. La precisión promedio de todos los laboratorios y bancos de sangre participantes en el EQAP durante el periodo de estudio fue del 99,5% (desviación típica: 0,5%). Conclusión. Los resultados de este análisis cualitativo son positivos en lo referente a la seguridad sanguínea en América Latina, con una precisión promedio del 99,5% entre los laboratorios y bancos de sangre participantes. Este informe refleja la considerable mejora del tamizaje serológico que se realiza en los bancos de sangre, en comparación con los resultados del informe del EQAP que contó con el apoyo de la OPS y se publicó en el 2003.

RESUMO Objetivo. Avaliar a triagem de marcadores de doenças infecciosas em amostras de sangue realizada em laboratórios e bancos de sangue da América Latina de acordo com os resultados de um Programa Externo de Avaliação de Qualidade (EQAP, na sigla em inglês). Métodos. Esta análise qualitativa usou dados do EQAP coordenado pela Fundação Pró-Sangue Hemocentro de São Paulo, com o apoio da Organização Pan-Americana da Saúde, para avaliar o desempenho da triagem de sangue quanto a doenças infecciosas no período de 2014 a 2018 na América Latina. Cada laboratório ou banco de sangue participante recebeu um painel cego idêntico com 24 amostras de sangue de reatividade variável para todos os parâmetros de triagem. Os painéis foram processados em cada estabelecimento participante e os resultados foram devolvidos à Fundação Pró-Sangue Hemocentro de São Paulo para análises individuais e conjuntas. Dois tipos de resultados discrepantes representavam falhas em potencial: resultados falso-positivos e resultados falso-negativos (não reativos). Resultados. Foram avaliadas 23.136 amostras. As taxas globais de resultados falso-positivos, falso-negativos e concordantes foram de 0,3%, 1,0% e 98,7%, respectivamente. Foram encontrados sete resultados falso-negativos para HBsAg (1,0%), 12 para sífilis (2,6%) e 21 para doença de Chagas (2,9%). Não houve resultados falso-negativos para os vírus HIV, HCV e HTLV. A acurácia média de todos os laboratórios e bancos de sangue que participaram do EQAP durante o período do estudo foi de 99,5% (desvio padrão de 0,5%). Conclusões. Os resultados desta análise qualitativa são positivos para a segurança do sangue na América Latina, com uma acurácia média de 99,5% entre os laboratórios e bancos de sangue participantes. Este relatório reflete uma melhoria importante na triagem sorológica dos bancos de sangue em relação aos resultados do relatório do EQAP apoiado pela OPAS que foi publicado em 2003.

Construction and validity of checklist for patient safety during the transfusion process / Construcción y validación de una lista de verificación para la seguridad del paciente durante el proceso de transfusión / Construção e validação de checklist para segurança do paciente no ato transfusional

ABSTRACT Objective: to construct and validate a checklist for patient safety during transfusion. Method: this is a methodological study whose development took place, between February 2020 and January 2021, at a teaching hospital in Santa Maria, RS, Brazil. The design was based on the survey of items in an integrative literature review, and validity, with 17 health specialists and 8 hemotherapy experts. Pre-test was carried out with 36 professionals from the target population. For data analysis, the Content Validity Index was calculated. Results: the checklist was composed of 29 items and 90 sub-items, distributed in three domains, corresponding to the transfusion act stages: Pre-transfusion (Medical prescription, Compatibility and Bedside identification); Transfusion (Blood component installation); and Post-transfusion (Monitoring). The items obtained a Content Validity Index predominantly > 0.80 in all stages. After reformulations suggested by participants, a Content Validity Index of 0.98 was obtained in its final version. Conclusion: the checklist demonstrated evidence of content validity and can be a reliable instrument to promote patient safety during transfusion.

RESUMEN Objetivo: construir y validar una lista de verificación para la seguridad del paciente durante la transfusión. Método: estudio metodológico cuyo desarrollo tuvo lugar entre febrero de 2020 y enero de 2021 en un hospital universitario de Santa María, RS, Brasil. El diseño se basó en el levantamiento de ítems en una revisión integrativa de la literatura, validación con 17 especialistas de la salud y 8 expertos en hemoterapia. La preprueba se realizó con 36 profesionales de la población objetivo. Para el análisis de los datos, se calculó el Índice de Validez de Contenido. Resultados: la lista de verificación estuvo compuesta por 29 ítems y 90 subítems, distribuidos en tres dominios, correspondientes a las etapas del acto transfusional: Pre-transfusión (Prescripción médica, Compatibilidad e Identificación al pie de la cama); Transfusión (Instalación del componente sanguíneo); y Post-transfusión (Monitoreo). Los ítems obtuvieron un Índice de Validez de Contenido predominantemente > 0,80 en todas las etapas. Luego de reformulaciones sugeridas por los participantes, se obtuvo un Índice de Validez de Contenido de 0,98 en su versión final. Conclusión: la lista de verificación demostró evidencia de validez de contenido y puede ser una herramienta confiable para promover la seguridad del paciente durante la transfusión.

RESUMO Objetivo: construir e validar um checklist para segurança do paciente no ato transfusional. Método: estudo metodológico cujo desenvolvimento ocorreu entre fevereiro de 2020 e janeiro de 2021, em um hospital de ensino de Santa Maria, RS, Brasil. A concepção se deu pelo levantamento dos itens em revisão integrativa da literatura, validação com 17 especialistas da saúde e 8 experts em hemoterapia. O pré-teste foi realizado com 36 profissionais da população-alvo. Para análise dos dados, procedeu-se ao cálculo do Índice de Validade de Conteúdo. Resultados: o checklist ficou composto de 29 itens e 90 subitens, distribuídos em três domínios, correspondentes às etapas do ato transfusional: Pré-transfusão (Prescrição médica, Compatibilização e Identificação Beira-leito); Transfusão (Instalação do hemocomponente); e Pós-transfusão (Monitoramento). Os itens obtiveram Índice de Validade de Conteúdo predominantemente >0,80 em todas as etapas. Após realizadas reformulações sugeridas pelos participantes, obteve-se Índice de Validade de Conteúdo de 0,98 na sua versão final. Conclusão: o checklist demonstrou evidências de validade de conteúdo, podendo ser uma ferramenta confiável para promover a segurança do paciente no ato transfusional.

Profile of hemotherapy care and the safety of the transfusion process

SUMMARY OBJECTIVE: This study aimed to evaluate the safety of the transfusion process in a public teaching hospital and to outline the profile of the hemotherapy care provided. METHODS: This was an exploratory, descriptive, and prospective study with a quantitative approach and grounded in field research. Data were obtained from medical and nursing records and active search. RESULTS: Concentrated red blood cells were the most transfused blood component. Inadequate indications of blood components were detected in 15% of Concentrated red blood cells transfusions, 20% of fresh plasma, 29.2% of platelet concentrates, and 36.4% of cryoprecipitates. Filling out the blood component request forms, the nursing checklist and the entry book were inadequate in 88.3, 92.8, and 69.5% of the procedures, respectively. CONCLUSIONS: Faults were identified throughout the transfusion process, revealing inadequate compliance with current standards and legislation, essential in minimizing the occurrence of errors and maximizing the safety of transfusion. Studies of this nature reinforce the need for continued research in this field.

SARS-CoV-2 epidemic and blood safety / 中国输血杂志

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the pathogen that causes novel coronavirus pneumonia. The SARS-CoV-2 mainly transmits through respiratory tract. However, RNA of this virus can be detected in blood samples of some infected cases. This paper herein reviewed the risk of transfusion transmission of SARS-CoV-2 and relevant preventive measures. The impact of SARS-CoV-2 endemic on blood supply and the corresponding strategy were also discussed in this article.

Optimization of blood testing strategies for voluntary blood donors in military blood centers / 中国输血杂志

【Objective】 To explore the optimization of blood testing strategies for voluntary blood donors in military blood centers. 【Methods】 From January 2017 to December 2020, the testing results of five serological indicators of voluntary blood donors from our center were collected via the blood transfusion management system . The positive NAT results of HBV, HCV and HIV, as well as the unqualified serological indicators, including the unqualified rate over the years, unqualified rate of military/civilian blood donor, reactive rate of dual-ELISA-reagent or one-ELISA-reagent etc., were retrospectively analyzed. 【Results】 The ratio of military blood donors to civilian blood donors in our center was 1: 4 during 2017~2020. The total unqualified rate of blood testing indicators of military blood donors was ALT>anti-HCV>HBsAg>HIV antigen/anti-HIV>anti-TP>NAT, and that of civilian blood donors was HBsAg > anti-TP > ALT > anti-HCV > HIV antigen/anti-HIV > NAT. The total unqualified rate of HBsAg, anti-HCV and anti-TP in our center decreased year by year, the HIV antigen/anti-HIV fluctuated, and the ALT increased year by year (P<0.01). The ALT deferral rate among military blood donors was the highest, accounting for 65.85%(594/902) of the donation deferral. The reactive rate of dual-ELISA-reagent to HBsAg, anti-HCV, HIV antigen/anti-HIV and anti-TP in civilian blood donors were 72.87%, 33.02%, 16.56% and 67.67%, respectively (P<0.05). Among the 123 668 ELISA negative samples during 2017~2020, 56 cases of HBV DNA(+ ) were detected by NAT, including 3 cases of military blood donors. 【Conclusion】 The current blood screening strategy of military blood centers can basically guarantee the safety of blood use in clinical. For military blood donors, ALT deferral, caused by ALT results that are higher than the ALT threshold, was the main reason for blood scrapping. Strengthening the promotion and implementation of NAT, as well as adjusting the critical value of ALT is of positive significance for reducing the risk of blood transfusion-transmitted diseases and the waste of blood sources, thereby improving the safety and security level of the clinical blood supply for the troops, promoting the treatment capabilities of officers and soldiers, and even improving the combat effectiveness of the troops.

HIV screening results of college group blood donors in Tianjin from 2012 to 2021 / 中国输血杂志

【Objective】 To analyze the infection characteristics and prevalence of HIV among college group voluntary blood donors in Tianjin, China, so as to provide data support for improving the promotion and recruitment strategies of voluntary blood donors, ensuring the safety of blood for clinical use, and formulating HIV prevention and control strategies for adolescents. 【Methods】 The college donors with anti-HIV(+ ) and HIV RNA(+ ) results in Tianjin from January 1, 2012 to December 31, 2021 were selected and analyzed. The relationships among HIV positive rate(anti-HIV+ or HIV RNA+ ), solo anti-HIV positive rate(anti -HIV+ and HIV RNA-), solo HIV RNApositive rate(anti-HIV- and HIV RNA+ ) and double positive rate(anti-HIV+ and HIV RNA+ ) between different years, gender, residence status, age and blood donation history(primary or repeated blood donation) were counted. 【Results】 The HIV positive rate and solo HIV RNA positive rate of college group blood donors from 2012 to 2021 showed a trend with significant increasing(χ2=49.266, 71.379, P<0.05). The HIV positive rate in the controls was significantly higher than that in the college blood donors(χ2=92.414, P< 0.05). The HIV positive rate and solo anti-HIV positive rate showed no differences by genders, but the male presented significant higher positive rate in solo HIV RNA and double positive results than the females(χ2=6.059, 10.900, P<0.05). The HIV positive rate of local resident was significantly lower than those nonlocal students(χ2=47.523, P<0.05). The HIV positive rate differed significantly by ages, with the highest at the age of 18 and the lowest at the age of 21(P<0.05). The difference of HIV double positive rates between the first-time and repeated donors was marginal, while the other three positive rates in thefirst-time donors were significantly higher than those in the repeated donors (P<0.05). 【Conclusion】 In recent years, the HIV positive rate and solo HIV RNA positive rate of college group blood donors present an increasing tendency. The consultation and education on HIV-related issues should be strengthened among college students during blood donation publicity, so as to ensure the safety of blood use and prevent the spread of AIDS in schools.

Analysis of the main research directions in transfusion of the U. S.military based on ClinicalTrials.gov data / 中国输血杂志

【Objective】 To explore the main development directions and research progress of blood transfusion in the U. S.military based on ClinicalTrials.gov. 【Methods】 The literature of clinical trials related to field transfusion medicine from 2002 to 2021 were retrieved based on www.clinicaltrials.gov with "United States Department of Defense" , "U.S.Army Medical Research and Development Command" and "United States Naval Medical Research Center" as the search terms, and the main characteristics were analyzed in terms of research progress, clinical stage, task allocation, regional distribution, research contents and results. 【Results】 A total of 931 clinical trials were retrieved, of which 16 were closely related to field blood transfusion medicine.Among them, pathogen reduction/inactivation of whole blood, platelet transfusion, plasma transfusion, whole blood transfusion and other types of researches accounted for 25% (4/16), 25% (4/16), 25% (4/16), 18.75 (3/16) and 6.25% (1/16), respectively.The U. S.military focused on the new technological breakthroughs in blood safety and blood storage, the evaluation of the countershock therapy, the application of whole blood early transfusion and the civil-military inosculation in research. 【Conclusion】 This study, based on ClinicalTrials.gov data, redounds to understand the research progress and current situation of the U. S.military field blood transfusion medicine.

Optimization of detection conditions of pre-donation ABO blood type screening by sliding methods in fixed blood donation sites / 中国输血杂志

【Objective】 To explore the quantitative value of key points for ABO blood group initial screening in fixed blood donation sites, so as to provide reference for standardized testing process of sliding method. 【Methods】 Several groups of experiments were carried out to illustrate the optimal conditions, including the serum dosage of monoclonal reagent, red blood cell dosage of blood sample, and reaction time in ABO blood group initial screening, by sliding method, and the quantitative value of key points of sliding method was preliminarily determined. Blood typing tests of 310 blood donor samples including type A, B, O, AB, subtype A and subtype AB were conducted to evaluate the effects of quantitative value of key points in the initial screening procedure. The test tube method would be conducted if the results are inconsistent with the fully automated blood grouping analyzer. The ABO subtypes suspected are identified by serological and molecular biological methods. 【Results】 The quantitative value of key points in initial screening procedure of sliding methods was as follows: 2 drops of reagent serum, 5-10 μL of whole blood and 3 minutes of reaction time. The concordance rate of ABO blood type screening comparison experiment in 310 blood donors was 100%. 【Conclusion】 ABO blood group initial screening by sliding method with quantitative value can effectively standardize the pre-donation blood type screening in fixed blood donation sites, and can meet the requirements of ABO blood group initial screening.

Soroprevalência de marcadores de triagem sorológica para doenças transmissíveis por transfusão em doadores de sangue em Sergipe, Brasil / Seroprevalence of serological screening markers for transfusion-transmitted diseases in blood donors in Sergipe, Brazil / Seroprevalencia de marcadores de cribado serológico para enfermedades transmisibles por transfusión en donantes de sangre en Sergipe, Brasil

A transfusão de sangue é um procedimento comum nos serviços de saúde, embora não seja isento de riscos. O descarte sorológico e a análise do perfil do doador fornecem informações essenciais para a segurança da transfusão. Este artigo avalia a prevalência e a tendência de descarte das bolsas de sangue por positividade sorológica para doenças transmissíveis por transfusão do hemocentro de Sergipe. Trata-se de um estudo observacional, relativo às doações realizadas entre janeiro de 2007 e dezembro de 2018. Das 308.953 doações, 16.828 (5,45%) foram descartadas devido à positividade em alguma sorologia de triagem. Verificou-se uma tendência de diminuição do descarte de bolsas de sangue nas sorologias testadas. As sorologias responsáveis pelo descarte foram: anti-HBc (2,09%), sífilis (1,49%), anti-HIV (0,82%), HBsAg (0,62%), anti-HCV (0,52%), anti-HTLV-1/2 (0,23%) e Chagas (0,15%). Com relação ao perfil do doador, houve maior descarte de doadores homens, de reposição e de faixas etárias avançadas. Neste estudo foi encontrada uma alta prevalência de descarte, embora com tendência decrescente para todas as sorologias, exceto sífilis, que permaneceu estacionária no período. Os resultados reforçam a necessidade dos processos de triagem sorológica para garantir a segurança transfusional, tendo em vista que essas doenças ainda são frequentes na população. Evidencia-se a importância da realização de campanhas educativas, de testagem e tratamento para as principais infecções de risco transfusional para que diminua a taxa de descarte de bolsas de sangue e melhore a qualidade transfusional.

Although a common health care procedure, blood transfusion is not risk-free. Serological disposal and donor profile analysis provide key information for transfusion safety. This study evaluates the prevalence and tendency of discarding blood bags due to serological positivity for transfusion-transmitted diseases at a blood center in Sergipe, Brazil. An observational study was conducted on donations made between January 2007 and December 2018. Of the 308,953 donations received, 16,828 (5.45%) were discarded due to positive screening serology, with a decrease trend in discard for the serologies tested. Anti-HBc (2.09%), syphilis (1.49%), anti-HIV (0.82%), HBsAg (0.62%), anti-HCV (0.52 %), anti-HTLV-1/2 (0.23%) and Chagas (0.15%) were the serologies responsible for disposal. As for donor profile, greater discard was observed for men, replacement and advanced age donors. Results showed a high prevalence of discard, but with a decreasing trend for all serologies excepting syphilis, which remained stationary in the period. They reinforce the importance of serological screening processes for ensuring transfusion safety, as these diseases are still common among the population. Carrying out educational, testing and treatment campaigns for the main transfusion risk infections is essential to reduce blood bag disposal rate and improve transfusion quality.

La transfusión de sangre es un procedimiento común en los servicios de salud, aunque no está libre de riesgos. La eliminación serológica y el análisis del perfil del donante proporcionan información esencial para la seguridad de las transfusiones. Este estudio tiene como objetivo evaluar la prevalencia y tendencia del descarte de bolsas de sangre por positividad serológica para enfermedades transmisibles por transfusión en el hemocentro de Sergipe (Brasil). Se trata de un estudio observacional, relacionado con las donaciones realizadas entre enero de 2007 y diciembre de 2018. De las 308.953 donaciones, 16.828 (5,45%) se descartaron por positividad en alguna serología de cribado. Hubo una tendencia a disminuir el descarte de bolsas de sangre en las serologías probadas. Las serologías responsables de la eliminación fueron: anti-HBc (2,09%), sífilis (1,49%), anti-VIH (0,82%), HBsAg (0,62%), anti-HCV (0,52%), anti-HTLV-1/2 (0,23%) y Chagas (0,15%). En cuanto al perfil del donante, hubo un mayor descarte en los donantes masculinos, de reemplazo y en edad avanzada. En el estudio se constató una alta prevalencia de descarte, aunque con tendencia decreciente para todas las serologías, excepto para sífilis, que se mantuvo estacionaria en el período. Los resultados refuerzan la necesidad de procesos de cribado serológico para garantizar la seguridad transfusional, dado que estas enfermedades aún son comunes en la población. Se resalta la importancia de realizar campañas de educación, testeo y tratamiento de las principales infecciones de riesgo transfusional para reducir la tasa de eliminación de bolsas de sangre y mejorar la calidad transfusional.

Hemovigilância das reações transfusionais imediatas: ocorrências, demanda e capacidade de atendimento / Hemovigilance de reacciones transfusionales inmediatas: ocurrencias, demanda y capacidad de atención / Hemovigilance of immediate transfusion reactions: occurrences, demand and care capacity

Objetivo: identificar e discutir a ocorrência de reações transfusionais imediatas, considerando o tipo de hemocomponente transfundido, demanda e capacidade de atendimento em um Hospital Universitário do estado da Bahia, Brasil. Método: estudo de caso, retrospectivo, quantitativo, realizado por meio de levantamento de registros e documentos. Análise descritiva das frequências e percentuais das ocorrências e tipologias das Reações Transfusionais, bem como da demanda e capacidade de atendimento da unidade de hemoterapia deste hospital. Resultados: frequência de 6,43% de Reações Transfusionais imediatas/1.000 hemocomponentes transfundidos. A Reação Febril Não Hemolítica e a Reação Alérgica foram as que mais ocorreram. Maior número de Reações Transfusionais foram do grau I (97,5%); os concentrados de hemácias (44,1%) e de plaquetas (41,9%) foram os hemocomponentes envolvidos na maioria das Reações Transfusionais. Conclusão: a unidade estudada mostrou capacidade de atendimento à demanda, com notificação das reações transfusionais e destaque de tais ações para contínuo aperfeiçoamento da qualidade.

Objetivo: identificar y discutir la aparición de reacciones transfusionales inmediatas, considerando el tipo de componente sanguíneo transfundido, la demanda y la capacidad de atención en un Hospital Universitario en el estado de Bahía, Brasil. Método: estudio de caso práctico, retrospectivo, cuantitativo, realizado a través de la recopilación de registros y documentos. Análisis descriptivo de las frecuencias y porcentajes de ocurrencias y tipologías de reacciones transfusiones, así como la demanda y capacidad de la unidad de hemoterapia de este hospital. Resultados: frecuencia del 6,43% de las reacciones transfusiones inmediatas/1.000 componentes sanguíneos transfundidos. La Reacción Febril No-hemolítica y la Reacción Alérgica fueron las que más ocurrieron. El mayor número de reacciones transfusionales fue el grado I (97,5%); los concentrados de glóbulos rojos (44,1%) y plaquetas (41,9%) fueron los componentes sanguíneos involucrados en la mayoría de las reacciones transfusiones. Conclusión: los resultados demostraron la importancia de comprender las potencialidades y desafíos de las familias para cuidar a los ancianos en el hogar.

Objective: to identify and discuss the occurrence of immediate transfusion reactions, considering the type of transfused blood component, demand and care capacity in a University Hospital in the state of Bahia, Brazil. Method: case, retrospective, quantitative study, performed through the collection of records and documents. Descriptive analysis of the frequencies and percentages of occurrences and typologies of Transfusion Reactions, as well as the demand and capacity of the hemotherapy unit of this hospital. Results: frequency of 6.43% of immediate Transfusion Reactions/1,000 transfused blood components. The Nonhemolytic Febrile Reaction and Allergic Reaction were the ones that most occurred. The highest number of Transfusion Reactions were grade I (97.5%); red blood cell concentrates (44.1%) and platelets (41.9%) were the blood components involved in most Transfusion Reactions. Conclusion: the unit studied showed capacity to meet the demand, with notification of transfusion reactions and highlighting such actions for continuous quality improvement.