Reconditioned monocytes are immunomodulatory and regulate inflammatory environment in sepsis.

Sepsis is caused by dysregulated immune response to severe infection and hyper inflammation plays a central role in worsening the disease. The immunomodulatory properties of mesenchymal stem cells (MSCs) have been evaluated as a therapeutic candidate for sepsis. Reconditioned monocytes (RM), generated from healthy human peripheral blood mononuclear cells (PBMCs) exhibit both macrophage and MSCs-like properties. RM were administered at different stages of sepsis in a mouse model. It reduced serum levels of IL6, MCP-1, IL-10, improved hypothermia, increased survival, and recovery from 0 to 66% when combined with antibiotics in the mouse model. The reduced human leucocyte antigen DR molecules expression on RM enables their co-culture with PBMCs of sepsis patients which resulted in reduced ROS production, and up-regulated TGF-ß while down-regulating IL6, IL8, and IL-10 in-vitro. RM are potentially immunomodulatory, enhance survival in sepsis mouse model and modulate inflammatory behaviour of sepsis patient's PBMCs.

Outcome of type and screen versus crossmatch in cardiovascular surgery patients: A comparative study.

BACKGROUND: The need for an anti-human globulin (AHG) cross-match (XM) when the antibody screen (ABS) is negative is debatable and a matter of policy. AIM: (1) To compare the outcomes of type and screen (T and S) method versus the AHG-XM in terms of posttransfusion alloimmunization and hemolytic reactions. (2) Calculation of XM transfusion ratio in both groups. MATERIALS AND METHODS: The study included 200 patients undergoing elective cardiovascular surgery. Group I patients (n = 100) were issued packed red blood cell units after ABO and RhD typing, an ABS followed by an immediate spin XM (T and S protocol), while Group II (n = 100) patients by an AHG-XM. In Group II patients, if incompatibility was found, then an ABS and identification were performed. A posttransfusion ABS and a direct antiglobulin test (DAT) was done on the 4th day. The XM, ABS (3-cell panel) and DAT were done using the gel technique (Bio-Rad, Switzerland). Thus, the outcomes of T and S method versus the AHG-XM in terms of posttransfusion alloimmunization and hemolytic reactions was measured. The XM transfusion ratio was also calculated in both groups. RESULTS: In each of Groups I and II, 99 patients (99%) were transfused. There was no significant difference between the two groups based on previous transfusion (P = 0.621) or combined history of transfusion and pregnancy (P = 1). In Group I, all the patients were negative for ABS. In Group II, an AHG-XM was incompatible for 1 patient (1%) due to anti-c and anti-E alloantibodies and had a history of pregnancy as well as transfusion. In both the groups, none of the patients had any adverse transfusion reaction and the posttransfusion ABS and DAT were negative. CONCLUSION: ABS is a better tool than AHG-XM in detecting alloantibodies in patients having the previous history of transfusion and/or pregnancy.

Activity Wise Unit Cost of Blood Components in a Tertiary Care Hospital Blood Bank for the Year 2018.

The present study on cost of a unit of blood was conducted in blood bank of a tertiary care public hospital with an annual collection of 20,748. A retrospective chart review was done to calculate the activity wise annual unit cost of blood, based on WHO guidelines (Blood Safety Unit. safe blood and blood products: costing blood transfusion services, World Health Organization, Geneva, 1998). Cost of blood collection, processing and storage were included. Annualized economic cost of equipments, maintenance, personnel salaries, and consumables were enlisted. It was assumed that all component units prepared carried equal cost. The cost of building, maintenance and office stationary were excluded. Data extracted from records was compiled and analysed using MS Excel. The annual unit cost of blood with component preparation and NAT testing was Rs 1829. Unit cost of blood without NAT testing was Rs 1255. Unit cost of blood if total collection was in-house, that is, excluding expenditure on camps was Rs 1738. The cost of whole blood (that is, if no components were prepared) with ELISA testing, done to ascertain cost at basic functioning was Rs 2521. With NAT testing the unit cost increased by Rs 575, the additional expenditure being equally divided among all components. Expenditure on NAT was high which was 1/3rd of the total expenditure on consumables. The additional cost incurred on each unit due to expenditure on camps was small i.e. only Rs 91 with 30% collection from camps. Voluntary camps ensures safe blood at minimal cost increment and component separation reduces cost and permits judicious use. Hence these activities should be promoted.

Rare case of Auto immune haemolytic anaemia in an infant with auto "f & kidd antibodies".

BACKGROUND: "f" antigen is a compound antigen in Rh blood group system. Anti f has haemolytic potential as described in literature. Its occurrence in an infant as autoantibody with another blood group system ie Jka is very rare. Case report We report a case of 10-month-old infant diagnosed with AIHA with autoantibodies directed towards "f" and Jka antigen. Antibody identification was done and antigen negative blood units were crossmatched & transfused with demonstrable haemoglobin rise and subsequent decrease in DAT grading. RESULT: Auto anti f + Jka was identified in a 10 months old infant. Autoantibodies were identified by identification 3 & 11 cell panel and select cell panel. Results were later confirmed by allogenic adsorption & elution. Patient was transfused antigen negative blood unit which lead to haemoglobin rise & gradual decrease in direct coombs test grading CONCLUSION: To our knowledge, this is the first case report of auto anti f + Jka having haemolytic potential in an infant which shows the importance of extensive immmunohaematology workup in providing compatible blood unit in patients with autoantibody.