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1.
Rev Med Inst Mex Seguro Soc ; 61(Suppl 1): 52-58, 2023 01 01.
Artigo em Espanhol | MEDLINE | ID: mdl-36378143

RESUMO

After the first successful blood transfusion, different difficulties of a liquid tissue were overcome; this liquid required special conditions to keep its characteristics with minimal alterations and, thus, to be able to be used in patients who needed it. Subsequently, techniques that also made possible to separate this liquid into its different components for its use were discovered, allowing a more specific treatment of the deficiencies of patients when administering cellular or non-cellular elements. With this, a new area arose within the blood banks to obtaining components. This area became the central point of convergence of all the processes involved in obtaining components, which include the biological qualification of each one of the units, as well as their labeling and release for the different distribution in transfusion services. It is important to highlight that the main source of components is obtained from whole blood; its processing for several decades was an artisanal operator-dependent process; however, with the evolution of technology, now it is possible to carry it out in an automated manner; likewise, today it is possible to obtain components directly from the donor's whole blood by separating it in real time by means of apheresis, which allows obtaining the component of interest and returning the remainder to the donor.


Tras la primera transfusión de sangre exitosa, se fueron superando diferentes dificultades de un tejido líquido que fue requiriendo condiciones especiales para mantener sus características con mínimas alteraciones y así pudiera ser utilizado en los pacientes que lo necesitaran. Posteriormente, se descubrieron técnicas que además posibilitaban separar este líquido en sus diferentes componentes para su empleo, lo cual permitió tratar de manera más específica las deficiencias de los pacientes al administrar los elementos celulares o acelulares. Con esto surgió dentro de los bancos de sangre el área de obtención de componentes. Esta se convirtió en el punto central de convergencia de todos los procesos involucrados en la obtención de componentes, que incluyen la calificación biológica de cada una de las unidades, así como su etiquetado y liberación para la distribución en los diferentes servicios de transfusión. Es importante resaltar que la principal fuente de componentes se obtienen por sangre total; su procesamiento durante varias décadas era un proceso artesanal con operador dependiente, pero con la evolución de la tecnología actualmente es posible llevarla a cabo de manera automatizada; asimismo, es posible obtener componentes directamente de la sangre total del donador por medio de la separación de la misma en tiempo real por medio de aféresis, la cual permite obtener el componente de interés, con lo que se devuelve el remanente al donador.


Assuntos
Bancos de Sangue , Remoção de Componentes Sanguíneos , Humanos , Transfusão de Componentes Sanguíneos , Transfusão de Sangue , Doadores de Sangue
2.
Rev Med Inst Mex Seguro Soc ; 61(Suppl 1): 1-3, 2023 01 01.
Artigo em Espanhol | MEDLINE | ID: mdl-36377981

RESUMO

In 2022, 2 years on from the start of the pandemic, the Instituto Mexicano del Seguro Social (IMSS, Mexican Institute for Social Security) has been reorganizing its services at full, out of which blood banks play a key role. In addition, on June 14 it is celebrated the World Blood Donor Day by the World Health Organization and this year Mexico was the host country for the celebration. Therefore, it is important to highlight the work carried out in blood banks, ranging from their main activity, which is the recruitment of blood donors and the blood components production, to the different interventions they have in the field of transplantation, diseases emerging diagnosis and the development of new therapeutic modalities, such as, for example, cell therapy.


En 2022, a dos años de la pandemia por COVID-19, el Instituto Mexicano del Seguro Social ha estado en plena recuperación de servicios, de la que los bancos de sangre son elementos clave. Además, el 14 de junio se celebró el Día Mundial del Donante de Sangre bajo iniciativa de la Organización Mundial de la Salud y en este año México fue el país anfitrión de la celebración. Por lo tanto, es importante poner de manifiesto el trabajo que se realiza en los bancos de sangre, desde su principal actividad, que es la captación de donadores y la obtención de hemocomponentes, hasta las diferentes intervenciones que tienen en el campo del trasplante, el diagnóstico de enfermedades emergentes y el desarrollo nuevas modalidades terapéuticas, como, por ejemplo, la terapia celular.


Assuntos
Bancos de Sangue , Previdência Social , Humanos , Academias e Institutos , Doadores de Sangue , México
3.
Rev Med Inst Mex Seguro Soc ; 61(Suppl 1): 37-45, 2023 01 01.
Artigo em Espanhol | MEDLINE | ID: mdl-36378105

RESUMO

The detection of the most significant erythrocyte antigens present in each one of the individuals is fundamental when carrying out a transfusion or a transplant. Detection to date is performed by conventional serological methods through the antigen-antibody reaction. But several drawbacks may arise depending on the pathology under study, limiting the availability of blood components. Molecular methods such as genotyping is a tool that complements sensitivity and specificity and has come to revolutionize immunohematology in the blood bank, allowing not only the detection of erythrocyte antigens but also platelet antigens. These methodologies are applicable in patients and in large-scale donors, starting from the allelic variants present in each of the genes that code for the antigens of clinical interest, using microarray systems or systems based on particles labeled with specific probes or their variants that allow an analysis from the immunohematological point of view.


La detección de los antígenos eritrocitarios más significativos presentes en cada uno de los individuos es fundamental cuando se lleva a cabo una transfusión o un trasplante. La detección a la fecha se realiza mediante métodos serológicos convencionales a través de la reacción de antígeno-anticuerpo. Pero se pueden presentar varios inconvenientes dependiendo de la patología en estudio, lo cual limita la disponibilidad de los hemocomponentes. Los métodos moleculares, como la genotipificación, son una herramienta que complementa la sensibilidad y especificidad y que han venido a revolucionar la inmunohematología en el banco de sangre, lo cual permite no solo la detención de antígenos eritrocitarios sino también la de antígenos plaquetarios. Estas metodologías son aplicables en pacientes y en donantes a gran escala, partiendo de las variantes alélicas presentes en cada uno de los genes que codifican para los antígenos de interés clínico, utilizando los sistemas de microarreglos o los sistemas basados en partículas marcadas con sondas específicas o sus variantes que permiten un análisis desde el punto de vista inmunohematológico.


Assuntos
Antígenos de Plaquetas Humanas , Humanos , Genótipo , Antígenos de Plaquetas Humanas/análise , Antígenos de Plaquetas Humanas/genética , Bancos de Sangue , Transfusão de Sangue , Técnicas de Genotipagem/métodos
4.
Rev Med Inst Mex Seguro Soc ; 61(Suppl 1): 72-80, 2023 01 01.
Artigo em Espanhol | MEDLINE | ID: mdl-36378157

RESUMO

The Blood Bank of the 21th Century National Medical Center is an important piece in the field of transfusion medicine at the national level. Its history shows that it has been in constant change to be able to meet the needs in an adequate and safe manner for both donors and patients. This article shows the advances that the Central Blood Bank has had since its inauguration. This bank has areas of Immunohematology, Donors Assistance, Serology, Fractionation and Storage Studies. These areas have been improving constantly and areas dedicated to molecular biology have been implemented, which makes the bank remain a reference center at the national level. The bank has qualified personnel who have also been involved in teaching courses for personnel from other units of the Instituto Mexicano del Seguro Social (Mexican Institute for Social Security), as well as in disseminating research studies carried out within the bank. The Blood Bank of the 21th Century National Medical Center is a pillar in transfusion medicine care at the national level and it is a reference center for specialized studies.


El Banco de Sangre del Centro Médico Nacional Siglo XXI es una pieza importante en el ámbito de la medicina transfusional a nivel nacional. Su historia nos muestra que se ha mantenido en un cambio constante para poder solventar las necesidades de manera adecuada y segura tanto para los donadores como para los pacientes. En este artículo se muestran los avances que ha tenido el Banco Central de Sangre desde su inauguración. Este banco cuenta con áreas de Inmunohematología, Atención a Donadores, Estudios de Serología, Fraccionamiento y Almacenamiento. Dichas áreas se han mantenido en mejora constante y se han ido implementando áreas dedicadas a la biología molecular, lo cual hace que el banco se mantenga como un centro de referencia a nivel nacional. El banco cuenta con personal calificado que también se ha involucrado en la impartición de cursos para personal de otras unidades del Instituto Mexicano del Seguro Social, así como en la divulgación de estudios de investigación llevados a cabo en su seno. El Banco Central de Sangre del Centro Médico Nacional Siglo XXI es un pilar de la medicina transfusional en la atención a nivel nacional y es un centro de referencia de estudios especializados.


Assuntos
Academias e Institutos , Bancos de Sangue , Humanos , História do Século XX , Previdência Social , México
5.
Rev Med Inst Mex Seguro Soc ; 61(Suppl 1): 46-51, 2023 01 01.
Artigo em Espanhol | MEDLINE | ID: mdl-36378106

RESUMO

Medicine has had a vertiginous advance in the last two centuries. After the first successful transfusions, transfusional medicine and blood banks arose. The ladder perform vital functions, from donor screening to the studies for the analysis of blood that are carried out before its use for transfusion and the follow-up of patients who receive blood components. Molecular biology is highly relevant in these activities, since it has allowed the reduction of window periods for the detection of diseases transmissible by blood; it has allowed the complete study of the typing of blood groups and HLA molecules, and it has allowed the adequate phenotypic interpretation of patients and donors by being able to have their genotype. The most relevant impact of the implementation of molecular biology techniques was the screening for the detection of transfusion-transmissible diseases in blood donors, which has allowed improving the safety of the components obtained. Molecular biology techniques applied in the study of the donor-recipient have allowed better care of patients who have required a transfusion or transplant. In this work, it is reviewed the importance of molecular biology in blood banks, with which the care for the Instituto Mexicano del Seguro Social beneficiaries has improved, as well as for the blood donors who are mostly not insured.


La medicina ha avanzado vertiginosamente en los últimos dos siglos. Después de las primeras trasfusiones exitosas, surgió la medicina transfusional en conjunto con los bancos de sangre. Estos últimos desempeñan funciones vitales, desde la valoración de los donadores hasta los estudios actuales para analizar la sangre antes de su uso transfusional y el seguimiento de los pacientes que reciben componentes sanguíneos. La biología molecular tiene una gran relevancia en estas actividades, pues ha permitido el acortamiento de los periodos ventana para detectar enfermedades transmisibles vía sanguínea; ha posibilitado completar el estudio de la tipificación de grupos sanguíneos y las moléculas de HLA, y ha permitido la adecuada interpretación fenotípica de los pacientes y donadores al estar en condiciones de tener a la mano su genotipo. El impacto más relevante del uso de técnicas de biología molecular fue el cribado o tamizaje para la detección de enfermedades transmisibles por transfusión en los donantes de sangre, con lo que ha mejorado la seguridad de los componentes obtenidos. Estas técnicas aplicadas en el estudio del donador-receptor han posibilitado una mejor atención a los pacientes que requieren una trasfusión o trasplante. En este trabajo se revisa la importancia que ha tenido esta herramienta en los bancos de sangre, con lo que ha mejorado la atención a los derechohabientes del Instituto Mexicano del Seguro Social, así como a los donadores de sangre que en su mayoría no son derechohabientes.


Assuntos
Bancos de Sangue , Doadores de Sangue , Humanos , Transfusão de Sangue , Seleção do Doador , Biologia Molecular
6.
Rev Med Inst Mex Seguro Soc ; 61(Suppl 1): 59-64, 2023 01 01.
Artigo em Espanhol | MEDLINE | ID: mdl-36378144

RESUMO

For the proper functioning of the Immunohematology Area, an External Quality Control was established since 1973 through a program that evaluates the performance of the laboratories of the Blood Bank and transfusion services that carry out immunohematology tests. This program consists of sending panel cells to participating blood banks or services, which are phenotyped erythrocyte samples previously studied as problem cases but whose results are unknown by the participating laboratories. The processes in which the program is of most importance are determination of the ABO group, determination of Rh, performance of the direct and indirect Coombs test, and pre-transfusion compatibility tests. It was carried out an observational and retrospective study of the results obtained in the 2020 period from 104 units participating in the Immunohematology Quality Control Program of the National Medical Center's Blood Bank. A panel of cells was sent for external quality control of immunohematology every 45 days, resulting in 9 panels for each unit in the studied period. Compliance with the program was observed in the general result (79.6%), i.e., there was a decrease in the participation of the registered units. Of a maximum score of 100% to be obtained, it was observed a general result of 95.3% compliance of the participating units. The results obtained confirm the good general training of the immunohematology laboratories of the participating units. Yet, as in any external control program, it becomes clear that obtaining an erroneous result is a risk that can occur in any laboratory.


Para el buen funcionamiento del Área de Inmunohematología, desde 1973 se instauró el Control de Calidad Externo con un programa que evalúa los laboratorios del Banco de Sangre y los servicios de transfusión que hacen pruebas de inmunohematología. El programa consiste en enviar a los bancos de sangre, o servicios participantes, células panel, que son muestras de eritrocitos fenotipados y previamente estudiados como casos problema, pero cuyos resultados son desconocidos por los laboratorios participantes. Los procesos en los que el programa es de suma importancia son determinación del grupo ABO, determinación del Rh, realización de la prueba de Coombs directa e indirecta y las pruebas de compatibilidad pretransfusionales. Se hizo un estudio observacional y retrospectivo de los resultados de 2020 de 104 unidades participantes en el Programa de Control de Calidad de Inmunohematología del Banco de Sangre del Centro Médico Nacional Siglo XXI. Se envió un panel de células para el control de calidad externo de inmunohematología cada 45 días y dio como resultado nueve paneles para cada unidad. El cumplimiento del programa se observó en el resultado general (79.6%), es decir, disminuyó la participación de las unidades inscritas. De una calificación máxima de 100%, hubo un resultado general de las unidades participantes del 95.3% de cumplimiento. Los resultados confirman la buena capacitación general de los laboratorios de inmunohematología de las unidades participantes. Aun así, como en cualquier programa de control externo, obtener un resultado erróneo es un riesgo que puede presentarse en cualquier laboratorio.


Assuntos
Bancos de Sangue , Laboratórios , Humanos , Estudos Retrospectivos , Controle de Qualidade
7.
Rev Med Inst Mex Seguro Soc ; 61(Suppl 1): 65-71, 2023 01 01.
Artigo em Espanhol | MEDLINE | ID: mdl-36378156

RESUMO

The application of quality and its scope have diversified. From this perspective, quality assurance applied to analytical tests (performed in clinical laboratories or blood banks) for the detection of infectious markers is one of the concepts that has gained strength in the last 10 years. The official Mexican standards require ensuring the quality of the published results and for their compliance it is recommended the use of international guides and guidelines that describe good practices that can be applied when carrying out this activity, without losing sight of the fact that everything related to quality assurance must be supported by the implementation of a quality management system. Thus, by using materials selected correctly and in accordance with official regulatory requirements, a good statistical analysis and the appropriate tools, the quality assurance of the analytical phase of the laboratory process in the screening of infectious markers can bring great benefits to the emission of clinically useful results by monitoring indicators and applying the necessary corrective actions, in order to reduce the risk of unfavorable results for patients and donors.


La aplicación de la calidad y su alcance se han diversificado. Bajo esta perspectiva, el aseguramiento de la calidad aplicado a las pruebas analíticas (que se hacen en laboratorios clínicos o bancos de sangre) para detectar marcadores infecciosos es uno de los conceptos que ha tomado fuerza en los últimos 10 años. Las normas oficiales mexicanas exigen asegurar la calidad de los resultados emitidos y para su cumplimiento se recomienda el uso de guías y lineamientos internacionales que describan las buenas prácticas que se pueden aplicar al llevar a cabo esta actividad, sin perder de vista que todo lo relacionado con el aseguramiento de la calidad debe estar sustentado mediante la implementación de un sistema de gestión de la calidad. Es así que mediante el uso de materiales seleccionados de manera correcta y acorde a los requerimientos normativos oficiales, un buen análisis estadístico y las herramientas adecuadas, el aseguramiento de la calidad de la fase analítica del proceso del laboratorio en el tamizaje de marcadores infecciosos puede aportar grandes beneficios a la emisión de resultados clínicamente útiles, mediante el seguimiento de indicadores y la aplicación de las acciones correctivas necesarias, con la finalidad de reducir el riesgo de resultados que desfavorezcan a pacientes y donadores.


Assuntos
Serviços de Laboratório Clínico , Laboratórios , Humanos , Controle de Qualidade , Bancos de Sangue , México , Garantia da Qualidade dos Cuidados de Saúde
8.
Clin Lab ; 68(11)2022 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-36377988

RESUMO

BACKGROUND: Apart from the wasted resource, canceled tests cause delay of test results thus affecting patient care. The study aimed to identify the reasons for the test cancellation of samples received in a blood bank laboratory and determine the improvement target. METHODS: The study retrospectively reviewed the canceled tests in a blood bank laboratory of a hospital in Hail, Saudi Arabia, from January 2017 to December 2020. Records of the canceled test taken from the quality assurance database were utilized to identify the various reasons. RESULTS: A total of 2,017 (2.7%) test cancellations were recorded in the 4-year study period with increasing rates noted. The two primary reasons were specimen quality issues (61.9%) and problems related to test orders (33.9%). The main reason for test cancellation was clotted specimen (48.5%) followed by incorrect test order (15.6%) and duplicate test order (13.9%). Statistically, a significant difference exists between the annual rates and reasons of cancellation, X2 (6, n = 2,017) = 83.24, p < 0.001. CONCLUSIONS: Test cancellations due to various reasons remain a significant challenge for clinical laboratories. Detailed analyses on these major reasons can aid in displaying an effective approach to decrease the cancellation rates. Harmonization among inter-professional health workers concerning specimen collection and handling, and involving clinical laboratory personnel could minimize laboratory errors and avoid test cancellations.


Assuntos
Bancos de Sangue , Laboratórios , Humanos , Estudos Retrospectivos , Arábia Saudita
9.
Transfusion ; 62(11): 2324-2333, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-36190148

RESUMO

BACKGROUND: Storage of platelet concentrates (PCs) has an impact on platelet quality and possibly affects their functions after transfusion. The influence of processing and storage conditions of PCs on their in vivo function upon transfusion is unknown. One option for investigating this question is to implement an ex vivo labeling of human platelets, to analyze them after transfusion into heathy volunteers and/or patients. In this study, we developed two labeling methods employing biotin. METHODS: Two methods of biotinylation were compared to a control (standard PC). The "Bio-Wash" process used washing steps to label all platelets within the PC; for the other method, "Bio-Direct," one fifth of the PC were directly labeled without washing steps. The control and the two biotinylated PCs were analyzed over 7 days of storage. Labeling efficiency, platelet counts, phenotypes, and functions, along with time and costs, were evaluated to select the best process. RESULTS: Both methods achieved a stable labeling through the storage, with similar platelet counts and metabolism in comparison to control PCs. Bio-Wash showed higher activation phenotype and lower aggregation response in comparison to the Bio-Direct method. The Bio-Direct was performed within 1.5 h versus 3 h for the Bio-Wash. However, the Bio-Direct required 12 mg of biotin instead of 8 mg for the other process. CONCLUSION: We set up two methods of biotinylation that can be easily implemented in a blood bank environment. The Bio-Direct process was preferred to the Bio-Wash because of its similarity, from a functional and phenotypic point of view, with standard PCs.


Assuntos
Plaquetas , Transfusão de Plaquetas , Humanos , Plaquetas/metabolismo , Transfusão de Plaquetas/métodos , Bancos de Sangue , Biotinilação , Biotina/farmacologia , Biotina/metabolismo , Preservação de Sangue/métodos
10.
Transfusion ; 62(11): 2297-2303, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-36250474

RESUMO

BACKGROUND: Our cord blood banking facility planned and executed a transferral of its entire operation to a new site in the South of Brazil. Transporting LN2 freezers is a complex process in which extensive planning is essential to minimize the risks of damaging products or storage units. METHODS: To fulfill this objective, we constructed a detailed relocation plan consisting of four phases and risk mitigation measures, collaborated with the representatives of all departments, regulating agencies, and professionals from the transport company, and assembled a validation plan for cryogenic freezers and the viability of cord blood units. RESULTS: The new facility was prepared in accordance with the project plan, local legislation, quality system program requirements, and accreditation agency guidance. A 12-h operation of moving the cryogenic freezers was conducted successfully, with no loss or damage of client samples or equipment. CONCLUSION: Through the development and execution of a transferral plan, the engagement of appropriate partners, and compliance with security measures from health and government agencies, a successful transferral of a cord blood banking facility operation in its entirety can be successfully accomplished.


Assuntos
Bancos de Sangue , Sangue Fetal , Humanos , Brasil , Acreditação
11.
Arch Med Res ; 53(6): 625-633, 2022 09.
Artigo em Inglês | MEDLINE | ID: mdl-36109203

RESUMO

BACKGROUND: The true prevalence of Chagas disease in Mexico is unknown. However, it has been estimated that 1.1-4 million people are infected with Trypanosoma cruzi, which represents a potential risk for transmission of the disease via contaminated blood. AIM OF THE STUDY: To determine the Chagas disease seroprevalence in donors from eight blood banks in the north of Mexico City, and the northeast of the State of Mexico. STUDY DESIGN AND METHODS: Serum samples from blood donors (n = 515,038) were tested to detect the presence of anti-Trypanosoma cruzi antibodies in eight blood banks. The serologic screening test was performed in each of the blood banks. To confirm the seropositive blood donors, only two out of the eight blood banks used a test with a different principle with the aim of identifying anti-Trypanosoma cruzi antibodies. All tests were validated by the Mexican Institute for Epidemiological Diagnosis and Reference. RESULTS: One thousand two hundred and ten blood donors were seropositive for Trypanosoma cruzi, which represents a 0.23% seroprevalence (95% CI 0.22-0.25%). Of the seropositive blood donors, 97.03 % resided in the northeast area of the State of Mexico, Mexico City, and southern part of the State of Hidalgo. CONCLUSIONS: Active transmission of Chagas disease may be occurring in non-endemic regions in the northeast of the State of Mexico.


Assuntos
Doença de Chagas , Trypanosoma cruzi , Anticorpos Antiprotozoários , Bancos de Sangue , Doença de Chagas/diagnóstico , Doença de Chagas/epidemiologia , Humanos , México/epidemiologia , Estudos Soroepidemiológicos
12.
Transfusion ; 62(10): 2068-2075, 2022 10.
Artigo em Inglês | MEDLINE | ID: mdl-36053780

RESUMO

BACKGROUND: On-site deferral for low hemoglobin (Hb) is common in most countries and deferral rates commonly vary between 1% and 20%. Blood banks continuously strive to reduce deferral rates as these imply an immediate loss of products, a waste of materials, a waste of staff and donor time, and potential loss of donors. Despite many efforts, the main cause of donor deferral-the variability in hemoglobin measurement outcomes-remains largely unaddressed. STUDY DESIGN AND METHODS: Repeated hemoglobin measurements obtained at donor intake were used to estimate the variability in measurement outcomes (measurement variability). This information is incorporated in a new algorithm for donor deferral where the mean hemoglobin level of a donor is used to determine both donor eligibility and the deviance of individual measurement outcomes. The algorithm was tested on a cohort of new Dutch donors that started between 2012 and 2022 to evaluate its impact on the donor deferral rate. RESULTS: Historical data from 439,376 new donors with a deferral rate of 5.3% were analyzed by applying the new donor deferral algorithm. It was found that 92% of all deferrals were unnecessary as Hb levels were within the range of expected measurement variability. Contrarily, it appeared that 460 donors (0.10%) made 704 donations (0.06%) whilst not complying with donor eligibility criteria. DISCUSSION: Not accounting for measurement variability can be shown to not only result in unnecessary on-site deferrals but also results in donations by donors that can be shown not to comply with the legally required minimum Hb levels.


Assuntos
Doadores de Sangue , Hemoglobinas , Bancos de Sangue , Estudos de Coortes , Testes Hematológicos , Hemoglobinas/análise , Humanos
13.
BMC Med Ethics ; 23(1): 92, 2022 09 12.
Artigo em Inglês | MEDLINE | ID: mdl-36096840

RESUMO

BACKGROUND: The Act Regarding the Promotion of the Appropriate Supply of Hematopoietic Stem Cells for Transplant regulates only how public banks store and provide umbilical cord blood (UCB) for research or transplantation. Japan had no laws to regulate how the private banks manage the procedures, harvesting, preparation, and storage of such blood. As a result, the status of UCB distribution remains unknown. We conducted a survey to investigate the current status of UCB storage and provision to private biobanks by Japanese institutions that handle childbirth. METHODS: Questionnaire forms were mailed to 3,277 facilities handling childbirth that were registered in the Japan Council for Quality Health Care website. RESULTS: Of the 1,192 institutions handling childbirth that participated in the survey (response rate: 36.7%), 34.4% responded that they currently provide UCB to private biobanks, while 16.1% of facilities did so in the past. Moreover, some institutions currently provide or formerly provided UCB to medical treatment facilities (2.6%), research institutions (5.9%), companies (2.2%), or overseas treatment facilities, research institutions, or companies (0.3%). A certain number of institutions handling childbirth did not even provide explanations or obtain consent when the UCB was harvested from private bank users. CONCLUSIONS: This is the first study to determine the status of UCB provision to private banks by Japanese institutions handling childbirth. Future studies will need to examine in detail how institutions handling childbirth provide explanations to private bank users and UCB providers as well as how these institutions obtain consent.


Assuntos
Bancos de Sangue , Sangue Fetal , Bancos de Espécimes Biológicos , Parto Obstétrico , Feminino , Humanos , Japão , Gravidez
14.
Vox Sang ; 117(11): 1262-1270, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-36102148

RESUMO

BACKGROUND AND OBJECTIVES: Accurate predictions of haemoglobin (Hb) deferral for whole-blood donors could aid blood banks in reducing deferral rates and increasing efficiency and donor motivation. Complex models are needed to make accurate predictions, but predictions must also be explainable. Before the implementation of a prediction model, its impact on the blood supply should be estimated to avoid shortages. MATERIALS AND METHODS: Donation visits between October 2017 and December 2021 were selected from Sanquin's database system. The following variables were available for each visit: donor sex, age, donation start time, month, number of donations in the last 24 months, most recent ferritin level, days since last ferritin measurement, Hb at nth previous visit (n between 1 and 5), days since the nth previous visit. Outcome Hb deferral has two classes: deferred and not deferred. Support vector machines were used as prediction models, and SHapley Additive exPlanations values were used to quantify the contribution of each variable to the model predictions. Performance was assessed using precision and recall. The potential impact on blood supply was estimated by predicting deferral at earlier or later donation dates. RESULTS: We present a model that predicts Hb deferral in an explainable way. If used in practice, 64% of non-deferred donors would be invited on or before their original donation date, while 80% of deferred donors would be invited later. CONCLUSION: By using this model to invite donors, the number of blood bank visits would increase by 15%, while deferral rates would decrease by 60% (currently 3% for women and 1% for men).


Assuntos
Doadores de Sangue , Hemoglobinas , Masculino , Humanos , Feminino , Pré-Escolar , Hemoglobinas/análise , Bancos de Sangue , Aprendizado de Máquina , Ferritinas
15.
Vox Sang ; 117(11): 1279-1286, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-36102215

RESUMO

BACKGROUND AND OBJECTIVES: Despite declining transfusion rates, overuse of O RhD-negative red blood cells (RBCs) risks the secure supply of this limited resource. A nationwide prospective audit was performed in Finland to understand the clinical use and inventory management of O RhD-negative units. Our aim was to identify areas where policy changes could help alleviate the shortage of O RhD-negative RBCs. MATERIALS AND METHODS: The use of every O RhD-negative unit in Finland during a period of 1 month was reviewed. For each issued unit (n = 1105), unit age, urgency of transfusion, hospital and patient demographics, and specific reasons for issuing O RhD-negative units were recorded. RESULTS: Almost half of the O RhD-negative units (n = 529, 47.9%) were issued to non-O RhD-negative patients. Only 22.3% (n = 118) were issued for females under the age of 50. Of the units for ABO-nonidentical transfusion, one-third (32.5%, n = 172) were issued for emergency transfusion, two-thirds (67.5%, n = 357) for non-urgent transfusions. The most common reason for issuing an O RhD-negative unit was inventory management (n = 172, 48.2% of units issued for non-urgent transfusion). Most of these units were issued close to the unit expiry date. CONCLUSION: This nationwide audit revealed that a significant proportion of O RhD-negative RBCs are used inappropriately. Clinicians should be educated on the appropriate use of O RhD-negative RBCs, and blood banks should develop strategies for inventory management to avoid issuing O RhD-negative units purely to prevent outdating.


Assuntos
Transfusão de Eritrócitos , Eritrócitos , Feminino , Humanos , Bancos de Sangue , Transfusão de Sangue , Contagem de Eritrócitos
16.
Stem Cells Transl Med ; 11(10): 1052-1060, 2022 Oct 21.
Artigo em Inglês | MEDLINE | ID: mdl-36073721

RESUMO

We aim to create a bank of clinical grade cord blood-derived induced pluripotent stem cell lines in order to facilitate clinical research leading to the development of new cellular therapies. Here we present a clear pathway toward the creation of such a resource, within a strong quality framework, and with the appropriate regulatory, government and ethics approvals, along with a dynamic follow-up and re-consent process of cord blood donors from the public BMDI Cord Blood Bank. Interrogation of the cord blood bank inventory and next generation sequencing was used to identify and confirm 18 donors with suitable HLA homozygous haplotypes. Regulatory challenges that may affect global acceptance of the cell lines, along with the quality standards required to operate as part of a global network, are being met by working in collaboration with bodies such as the International Stem Cell Banking Initiative (ISCBI) and the Global Alliance for iPSC Therapies (GAiT). Ethics approval was granted by an Institutional Human Research Ethics Committee, and government approval has been obtained to use banked cord blood for this purpose. New issues of whole-genome sequencing and the relevant donor safeguards and protections were considered with input from clinical genetics services, including the rights and information flow to donors, and commercialization aspects. The success of these processes has confirmed feasibility and utility of using banked cord blood to produce clinical-grade iPSC lines for potential cellular therapies.


Assuntos
Sangue Fetal , Células-Tronco Pluripotentes Induzidas , Humanos , Células-Tronco Pluripotentes Induzidas/metabolismo , Doadores de Sangue , Bancos de Sangue , Consentimento Livre e Esclarecido
17.
Anesth Analg ; 135(3): 448-458, 2022 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-35977355

RESUMO

Our understanding of the risks associated with perioperative anemia and transfusion, in terms of increased morbidity and mortality, has evolved over the past 2 decades. By contrast, our understanding of the potential mechanisms of injury and optimal treatment strategies remains incomplete. As such, the important role of effective patient blood management (PBM) programs, which address both the effective treatment of anemia and minimizes the need for red blood cell (RBC) transfusion, is of central importance to optimizing patient care and improving patient outcomes. We report on important clinical outcomes of the Ontario Transfusion Coordinator (ONTraC Program), a network of 25 hospital sites, working in coordination over the past 20 years. Transfusion nurse coordinators were assigned to apply multimodal best practice in PBM (including recommended changes in surgical approach; diagnosis, assessment, and treatment of anemia; and adherence to more restrictive RBC transfusion thresholds). Data were collected on various clinical parameters. We further described lessons learned and difficulties encountered in this multisite PBM initiative. A significant reduction in RBC transfusions was observed for numerous indexed surgeries. For example, RBC transfusion rates for knee arthroplasty decreased from 25% in 2002 to 0.4% in 2020. For coronary artery bypass graft (CABG) surgery, transfusion rates decreased from 60% in 2002 to 27% in 2020. We also observed a decrease in RBC units utilized per transfused patient for knee (2.1 ± 0.5 [2002] vs 1.0 ± 0.6 [2020] units per patient) and CABG surgery (3.3 ± 0.6 [2002] vs 2.3 ± 1.9 [2020] units per patient). These reductions were associated with favorable clinical outcomes, including reduced length of hospital stay (P = .00003) and a reduced rate of perioperative infections (P < .001) for nontransfused versus transfused patients. These advances have been achieved with estimated savings in the tens of millions of dollars annually. Our experience and data support the hypothesis that instituting an integrated network of transfusion nurse coordinators can provide an effective provincewide PBM program, reduce RBC transfusions, improve some patient outcomes, and reduce health care costs, as an example of a "win-win-win" medical program.


Assuntos
Anemia , Objetivos , Anemia/tratamento farmacológico , Anemia/terapia , Bancos de Sangue , Transfusão de Sangue , Transfusão de Eritrócitos , Humanos
18.
Tidsskr Nor Laegeforen ; 142(11)2022 08 16.
Artigo em Norueguês | MEDLINE | ID: mdl-35997184
19.
Afr Health Sci ; 22(1): 641-647, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-36032446

RESUMO

Background: Blood is an essential body fluid for the transport of substances to all parts of the body. Knowledge of blood group distribution within any population is important in determining the direction of blood bank inventory for emergency blood services. Objective: We report for the first time the blood group distribution pattern for the Volta region of Ghana. Method: Data were extracted and analyzed from 14,360 medical records of blood donors and recipients at seven major hospitals within the Volta region for a period of seven years (2012 to 2018). Results: ABO distribution within the region was 46.3%, 18.9%, 24.4%, 3.1%, 4.4%, 1.7%, 1.3% and 0.1% for O+, A+, B+, AB+, O-, A-, B- and AB- blood groups respectively. Rh (D)+ to Rh (D)- ratio was 92.5/7.5% respectively. Blood group O+ (>35 %) was highest in all ethnic groups in the region. Conclusion: Healthcare facilities in the region should adopt a strategy to stock-pile sufficient O+ blood which is the prevalent blood group in the region. All types of blood groups were reported hence our findings should provide information to guide clinical practice and/or blood transfusion services in the region.


Assuntos
Etnicidade , Sistema do Grupo Sanguíneo Rh-Hr , Sistema ABO de Grupos Sanguíneos , Bancos de Sangue , Gana , Humanos
20.
Stem Cell Res Ther ; 13(1): 408, 2022 08 12.
Artigo em Inglês | MEDLINE | ID: mdl-35962457

RESUMO

BACKGROUND: The increasing number of clinical trials for induced pluripotent stem cell (iPSC)-derived cell therapy products makes the production on clinical grade iPSC more and more relevant and necessary. Cord blood banks are an ideal source of young, HLA-typed and virus screened starting material to produce HLA-homozygous iPSC lines for wide immune-compatibility allogenic cell therapy approaches. The production of such clinical grade iPSC lines (haplolines) involves particular attention to all steps since donor informed consent, cell procurement and a GMP-compliant cell isolation process. METHODS: Homozygous cord blood units were identified and quality verified before recontacting donors for informed consent. CD34+ cells were purified from the mononuclear fraction isolated in a cell processor, by magnetic microbeads labelling and separation columns. RESULTS: We obtained a median recovery of 20.0% of the collected pre-freezing CD34+, with a final product median viability of 99.1% and median purity of 83.5% of the post-thawed purified CD34+ population. CONCLUSIONS: Here we describe our own experience, from unit selection and donor reconsenting, in generating a CD34+ cell product as a starting material to produce HLA-homozygous iPSC following a cost-effective and clinical grade-compliant procedure. These CD34+ cells are the basis for the Spanish bank of haplolines envisioned to serve as a source of cell products for clinical research and therapy.


Assuntos
Células-Tronco Pluripotentes Induzidas , Antígenos CD34/genética , Antígenos CD34/metabolismo , Bancos de Sangue , Sangue Fetal , Homozigoto , Células-Tronco Pluripotentes Induzidas/metabolismo
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