Bajos niveles de inhibidores de la coagulación: un factor de alto riesgo trombogénico en pacientes talasémicos / Low levels of coagulation inhibitors: a high-risk thrombotic factor in thalassemic patients

ANTECEDENTES Y OBJETIVO: La β-talasemia mayor (β-TM) se define como una enfermedad hereditaria relacionada con las células rojas sanguíneas. En los pacientes adultos, los eventos trombóticos se asocian con la talasemia. Así, el objetivo de esta investigación fue examinar algunos de los parámetros hemostáticos, incluyendo la antitrombina III (AT-III), la proteína C (PRC) y la proteína S (PRS), en pacientes β-TM. MÉTODOS: Se seleccionó a 30pacientes β-TM remitidos para un ingreso de seguimiento de rutina en la clínica de talasemia del Centro Especial de Enfermedades Kerman, junto con otros 30 sujetos sanos. Tras el registro y 3 semanas después de la última transfusión, se recogieron especímenes de sangre periférica, y se midió la concentración plasmática de AT-III, PRC y PRS. RESULTADOS: Hemos observado que la concentración de inhibidores naturales de la coagulación (PRC y PRS) estaba ligeramente disminuida en los pacientes β-TM (p < 0,05), mientras que el nivel plasmático de AT-III no era muy diferente en los pacientes β-TM cuando se los comparaba con los sujetos sanos. CONCLUSIÓN: Conforme a los hallazgos obtenidos en el presente trabajo, podríamos considerar los cambios significativos en las PRC, PRS y AT-III, que se observan en pacientes β-TM multitransfundidos, como factores de riesgo críticos para el desarrollo de eventos tromboembólicos futuros a lo largo de su vida

BACKGROUND AND AIM: The β-thalassemia major (β-TM) is defined as a hereditary red blood cell-related disease. Thrombotic events are associated with thalassemia in adult patients. Thus, the present investigation was aimed to examine some hemostatic parameters, including anti thrombin-III (AT-III), protein-C (PRC) and protein-S (PRS) in β-TM patients. METHODS: Thirty B-TM patients who referred for routine follow-up admission to the thalassemia clinic of Kerman Special Disease Center alongside with 30 healthy subjects were selected and enrolled in the present study. Further registration, the peripheral blood specimens were collected after 3 weeks of last transfusion and then the plasma concentrations of AT-III, PRC and PRS were measured in them. RESULTS: We have observed that the concentrations of natural coagulation inhibitors (PRC and PRS) were significantly attenuated in β-TM patients (P<0.05), while the plasma level of AT-III was not remarkably differed in β-TM patients in compare to healthy subjects. CONCLUSION: According to the findings of present work, significant changes in the PRC, PRS and AT-III which could be observed in multi transfused β-TM patients may attribute as critical risk factors for the development of upcoming thromboembolic events in their future life

Low levels of coagulation inhibitors: A high-risk thrombotic factor in thalassemic patients. / Bajos niveles de inhibidores de la coagulación: un factor de alto riesgo trombogénico en pacientes talasémicos.

BACKGROUND AND AIM: The ß-thalassemia major (ß-TM) is defined as a hereditary red blood cell-related disease. Thrombotic events are associated with thalassemia in adult patients. Thus, the present investigation was aimed to examine some hemostatic parameters, including anti thrombin-III (AT-III), protein-C (PRC) and protein-S (PRS) in ß-TM patients. METHODS: Thirty B-TM patients who referred for routine follow-up admission to the thalassemia clinic of Kerman Special Disease Center alongside with 30 healthy subjects were selected and enrolled in the present study. Further registration, the peripheral blood specimens were collected after 3 weeks of last transfusion and then the plasma concentrations of AT-III, PRC and PRS were measured in them. RESULTS: We have observed that the concentrations of natural coagulation inhibitors (PRC and PRS) were significantly attenuated in ß-TM patients (P<0.05), while the plasma level of AT-III was not remarkably differed in ß-TM patients in compare to healthy subjects. CONCLUSION: According to the findings of present work, significant changes in the PRC, PRS and AT-III which could be observed in multi transfused ß-TM patients may attribute as critical risk factors for the development of upcoming thromboembolic events in their future life.

Evaluating the effect of tariff on wastage and return of blood products in Kerman province.

BACKGROUND: In Iran blood products had been available to health care centers on free order to reduce the wastage they were tariffed in 2016. Thus, health care centers must pay for the blood products and take back the payment from the insurance. The aim of this study was to examine the effects of the tariff on consumption, wastage and return rates of blood products in health care centers in Kerman province. MATERIALS AND METHODS: In this retrospective cross-sectional study, demand, delivery and return rates of blood products (fresh frozen plasma, red blood cell and platelet) were examined in 23 health care centers and hospitals before and after the tariff. RESULTS: After the tariff in 2016, the return of unused units of fresh frozen plasma and platelet to the blood transfusion organization was increased and the increase was not statistically significant, but a significant increase was observed in red blood cell return rate and return/delivery ratio. CONCLUSION: Fresh frozen plasma and platelet return rates increased after the tariff resulting in less wastage of unused products but were not statistically meaningful. Tariff was highly effective on the wastage and return of red blood cell therefore it can be considered as a sparing action in the management of red blood cell.