Impact of COVID-19 in the attendance of blood donors and production on a Brazilian Blood Centres.

BACKGROUND: One of the effects of the coronavirus disease 2019 (COVID-19) pandemic is the risk of shortages in Blood Centres. OBJECTIVES: To verify the impact of the COVID-19 pandemic on the blood donor's attendance and production of blood components in Fundação Hemominas, a Brazilian public institution was formed by several Blood Centres. METHODS: A cross-sectional study was carried out from January to June 2020. Data collected were compared to a historical series from 2016 to 2019. RESULTS: The study showed a reduction in the attendance of blood donors, whole blood collections and blood component production from March 2020, when the first case of COVID-19 was notified in Minas Gerais, Brazil. The results evidenced that Hemominas Blood Centres were affected in a very distinct way by the pandemic with a general mean reduction around 17% in attendance of blood donors and in production of blood components in the period of March to June. On the other hand, the return of blood donors rate increased. CONCLUSION: The reduction in blood donation during the pandemic period was significant, despite the measures adopted. Still, the recruitment of return donors appears to be an important measure to be considered to decrease the pandemic's effect on blood stocks.

Predictive factors for the development of anemia after hematopoietic stem cell donation.

BACKGROUND: Although Hematopoietic Stem Cells (HSC) donation through bone marrow (BM) and peripheral blood (PB) are usually safe procedures, adverse events are expected. One of the most common events especially among BM donors (BMD) is the development of anemia. To protect the BMD and preserve the hemoglobin levels, many centers collect autologous pre-procedure blood, but the actual benefits of this procedure is controversial. METHODS AND MATERIALS: This study analyzed retrospectively data to observe what factors may influence the occurrence of post-donation anemia and also evaluate the relevance of autologous red blood cell pre procedure donation (PAD). RESULTS: The development of immediately post donation anemia (IP) was higher in BMD than in PB donors (64.2% BMD and 10.7% PBD, P < .001) and also in late post donation (LP) (28.4% BMD and 3.6% PBD, P = .007). The study demonstrated an association between PAD and anemia in IP (72.7% with anemia and 27.3% without anemia, P = .006) and an association between the volume of red blood cells in the donated hematopoietic product and the development of anemia in LP (356.3 mL and 297.8 mL, P = .037). CONCLUSION: In conclusion, collection of HSC through BM is a risk factor for anemia and PAD is a risk factor for IP anemia.

Procederes de aféresis en el Instituto de Hematología e Inmunología / Apheresis procedures at the Institute of Hematology and Immunology

Introducción: en los últimos decenios el interés por las aféresis se ha incrementado debido a que los avances tecnológicos han puesto a disposición de los profesionales de la salud equipamiento dotado de especificidad, seguridad, efectividad y rapidez para la realización de estos procederes en función de la transfusión y la terapéutica. Objetivo: presentar la experiencia acumulada en el Instituto de Hematología e Inmunología en la realización de los diferentes tipos de aféresis. Métodos: se realizó un estudio descriptivo retrospectivo que incluyó a todos los pacientes a los que se les realizó algún proceder de aféresis, en el período comprendido entre enero de 2008 y diciembre de 2013. Se analizaron las variables: datos generales del paciente, centro de procedencia, modalidad de aféresis empleada, método que se empleó y enfermedades que requirieron el proceder. Resultados: se realizaron 3 332 procederes de aféresis, 1 057 de producción con prevalencia de las tromboféresis que representó el 96,68 por ciento. De las 1 078 aféresis terapéuticas realizadas, el primer lugar correspondió a las plasmaféresis con el 26,5 por ciento, seguida de las exanguinotransfusiones (15,8 por ciento). Se realizaron, además, 1 197 aféresis de células mononucleares y plaquetas para su empleo en la Medicina Regenerativa. Conclusiones: los resultados de este primer trabajo muestran el desarrollo paulatino de las aféresis en la institución, tanto de producción como terapéutica, que por una parte promueven la producción de componentes por aféresis, lo que pone a disposición de médicos y pacientes necesitados de hemocomponentes con mayor calidad y seguridad para el tratamiento sustitutivo; y por otra, aporta información sobre las posibilidades reales de esta alternativa terapéutica para algunas enfermedades(AU)

Introduction: in recent decades, interest in apheresis has increased due to advances in technology that have made them available to health professionals with access to specific equipment, safety, effectiveness and speed to perform these procedures in terms of transfusion and therapeutics. Objective: to present the experience gained at the Institute of Hematology and Immunology in performing different types of apheresis. Methods: adescriptive retrospective study was performed which included all patients who underwent an apheresis procedure between January 2008 and December 2013. Variables were: patient´s general data, the establishment of provenance, method where analyzed apheresis was performed, method used, and diseases requiring the proceeding. Results: 3 332 apheresis proceedings were done : 1 057 for production with thrombopheresis prevalence which ranked 96,68 percent. Of the 1 078 therapeutic apheresis performed, the first place went to plasmapheresis with 26,5 percent, followed by exchange transfusions (15,8 percent); 1 197 apheresis of mononuclear cells and platelets to be used in regenerative medicine were also conducted. Conclusions: the results of this preliminary study show the gradual development in the use of apheresis procedures in our institution, with both production and therapy aims, which not only allows the diffusion of production of components by apheresis which provides physicians and patients in need of blood products with higher quality and security replacement therapy, but also provides knowledge about the actual possibilities for alternative therapy in some diseases(AU)

Analysis of inventory strategies for blood components in a regional blood center using process simulation.

BACKGROUND: The storage of blood components is an important concern in the blood supply chain. Because these are perishable products, the definition of good inventory policies is crucial to reduce shortages and spills. STUDY DESIGN AND METHODS: To analyze and propose inventory policies in a regional blood center, a discrete event simulation model was created using simulation software (Arena 12.0, Rockwell Software). The model replicates the activities that are performed along the supply chain including donation arrivals, testing, production, inventory management, and dispatching. RESULTS: Twelve different scenarios were analyzed, with each one representing different inventory policies composed of a combination of an optimal inventory, a reorder point, and a level of extra donations. The best scenario demonstrates that it is possible to decrease unsatisfied demand and wastage of red blood cell units by 2.5 and 3%, respectively, when compared to current practices. CONCLUSIONS: This study shows that simulation is an alternative that can be used to model inventory components in blood centers. A responsible selection of inventory variables can improve the capability of the system to respond to the final patient requirements.

Apheresis technologies and clinical applications: the 2005 International Apheresis Registry.

The developments in apheresis technologies and techniques and their clinical applications worldwide are technologically, sociologically, and economically motivated. In past apheresis surveys the statistics have highlighted both the differences by geographic region in clinical practice and in the types of technologies utilized. While a national view of apheresis is very important, an international view may be more representative overall of this therapeutic modality than national results that are highly dependent on the local economics and the available technologies. These regional differences have provided a basis for scientific and clinical assessment of these apheresis technologies and their clinical outcomes, and have impacted the marketing and business developments of new technologies worldwide. The results of the International Apheresis Registry for 2005 reporting from 22 centers on 5 continents are presented. The survey collected data exclusively via a secure internet website on 1133 patients for a total of 6501 treatments. Unlike our prior registries, information on stem cell infusions was gathered. Information gathered included patient demographics, medical history, treatment diagnoses, treatment specifics (type, methodology, access type, anticoagulants, drugs, and equipment usage), side-effects, clinical response, and payment provider. As in the prior International Apheresis Registries for 1983, 2000, and 2002 the survey results highlight the regional differences in apheresis usage and treatment methodologies, indicating that an international overview of apheresis may be more representative of the impact of this therapeutic modality.

Apheresis activity in Venezuela.

Interest for apheresis activity has been growing in Venezuela. In 1976 there were only a few devices; in 2003, 80 apheresis machines performed 27,675 donor apheresis procedures and 547 therapeutic procedures countrywide. We report the activity at the Metropolitan Blood Bank (the largest one of the country) in the period 1999-2003: 597 therapeutic procedures were performed in 171 patients, during 212 crisis episodes. The average age was 38 +/- 16 years, 65% male and 35% female. Most of the therapeutic procedures were therapeutic plasma exchange for hematology diseases (mainly thrombotic thrombocitopenic purpura and hemophilia inhibitors), including 184 therapeutic procedures with the Autopheresis-C (Baxter Healthcare Corp., Deerfield, IL). Most common adverse effects (3.9%) were hypotension and allergic reactions to the plasma.

Púrpura trombótica trombocitopénica. Experiencia del Hospital Privado de Córdoba / Purpura thrombotic trombocytopenic. Experiences from a Private Hospital in Córdoba

El reemplazo plasmático terapéutico (RPT) es el tratamiento de elección en Púrpura Trombótica Trombocitopénica - Síndrome Urémico Hemolítico (PTT-SUH) y debe ser instituído lo antes posible. Presentamos nuestra experiencia en el manejo de esta patología en los últimos diez años. Entre 1995 y 2004, tratamos 11 pacientes con diagnóstico de PTT-SUH con RPT. Hubo una preeminencia de mujeres (8:3); la edad media fue 40±17 años (16-75). En los pacientes tratados entre 1995 y 2000, la demora para iniciar las aféresis luego del diagnóstico fue de 9±9.3 días, mientras que en los pacientes tratados entre 2001 y 2004 la demora fue de 0.3±0.5 días (p=0.05). Efectuamos 114 aféresis en los 11 pacientes, recambiando 0.88±0.23 (0.58 a 1.19) veces la plasmemia teórica. El promedio de aféresis por paciente fue de 10.4±10.3 (2 a 37). Se presentaron 29 eventos adversos que motivaron la interrupción de los procedimientos en seis oportunidades. El 51.7 por ciento fueron reacciones alérgicas, de las cuales 4 fueron graves. De los 11 pacientes, 9 (81.8 por ciento) alcanzaron remisión completa luego de un promedio 12.4±9.9 aféresis (5 a 32). Un paciente tuvo una recaída y 2 pacientes fallecieron durante el tratamiento. En conclusión, nuestra serie muestra que el cuadro de PTT-SUH se beneficia ampliamente del recambio plásmatico terapéutico. Es indispensable reconcoer y tratar rápidamente las complicaciones para no interrumpir el tratamiento hasta lograr la normalización de los parámetros hematológicos.

Púrpura trombótica trombocitopénica. Experiencia del Hospital Privado de Córdoba / Purpura thrombotic trombocytopenic. Experiences from a Private Hospital in Córdoba

El reemplazo plasmático terapéutico (RPT) es el tratamiento de elección en Púrpura Trombótica Trombocitopénica - Síndrome Urémico Hemolítico (PTT-SUH) y debe ser instituído lo antes posible. Presentamos nuestra experiencia en el manejo de esta patología en los últimos diez años. Entre 1995 y 2004, tratamos 11 pacientes con diagnóstico de PTT-SUH con RPT. Hubo una preeminencia de mujeres (8:3); la edad media fue 40±17 años (16-75). En los pacientes tratados entre 1995 y 2000, la demora para iniciar las aféresis luego del diagnóstico fue de 9±9.3 días, mientras que en los pacientes tratados entre 2001 y 2004 la demora fue de 0.3±0.5 días (p=0.05). Efectuamos 114 aféresis en los 11 pacientes, recambiando 0.88±0.23 (0.58 a 1.19) veces la plasmemia teórica. El promedio de aféresis por paciente fue de 10.4±10.3 (2 a 37). Se presentaron 29 eventos adversos que motivaron la interrupción de los procedimientos en seis oportunidades. El 51.7 por ciento fueron reacciones alérgicas, de las cuales 4 fueron graves. De los 11 pacientes, 9 (81.8 por ciento) alcanzaron remisión completa luego de un promedio 12.4±9.9 aféresis (5 a 32). Un paciente tuvo una recaída y 2 pacientes fallecieron durante el tratamiento. En conclusión, nuestra serie muestra que el cuadro de PTT-SUH se beneficia ampliamente del recambio plásmatico terapéutico. Es indispensable reconcoer y tratar rápidamente las complicaciones para no interrumpir el tratamiento hasta lograr la normalización de los parámetros hematológicos. (AU)

Apheresis technologies and clinical applications: the 2000 International Apheresis Registry.

The developments in apheresis technologies and techniques and their clinical applications worldwide are technologically, sociologically, and economically driven. In the past, apheresis survey statistics have highlighted both the differences by geographical region in clinical practices and in the types of technologies utilized. While a national view of apheresis is critically important, an international view of apheresis may be more representative overall of this therapeutic modality than national results that are highly dependent on the local economics and the available technologies. These regional differences have provided a basis for the scientific and clinical assessments of these apheresis technologies and their clinical outcomes and have impacted the marketing and business developments of new technologies worldwide. The results of the International Apheresis Registry for 2000 reporting on 39 centers on 4 continents are presented. This survey collected data on 1,080 patients for a total of 15,257 treatments. Information gathered included patient demographics, medical history, treatment diagnoses, treatment specifics (type, methodology, access type, anticoagulants, drugs, equipment usage), side effects, clinical response, and payment provider. As in the prior International Apheresis Registry for 1983, the survey results highlighted the regional differences in apheresis usage and treatment specifics, indicating that an international overview of apheresis may be more representative of the impact of this therapeutic modality.