不同血液分析仪测定机采血小板计数结果的比较分析

目的观察不同血液分析仪测定机采献血者采前与成品标本中血小板（PLT）数量的准确性。方法先对绍兴市中心血站2台仪器（三分类分析仪及五分类分析仪）计数PLT的批内、批间精密度进行测定,再对68例采前静脉血标本和52例机采后样管标本分别用绍兴市中心血站2台仪器与手工镜检法进行PLT计数,并取其中的各20例标本用其他品牌仪器进行比对,对数据进行统计分析。结果绍兴市中心血站2台仪器计数PLT均有较好的批内、批间精密度;在采前静脉血标本检测上,不同仪器间,仪器与手工镜检间比较,差异无统计学意义（P〉0.05）;在采后样管检测上,三分类分析仪与五分类分析仪、手工镜检间比较,差异有统计学意义（P〈0.01）。结论采后成品PLT数量检测应该用五分类血液分析仪进行计数,如用三分类血液分析仪计数,则需特别注意测定值低于实际值的现象,可通过每月一次与五分类仪器或手工法比对的方法 ,调整检测系数或增大稀释倍数加以克服。     

献血400ml后献血者血液学指标观察

目的了解献血400ml后献血者相关血液学指标恢复情况。方法选择年龄、体格检查及献血前血液检验指标均符合我国现行法规要求的各种年龄的自愿无偿献血者123名,每人采血400ml,在献血后24h、7d、1个月和3个月时各采集血样1次,观察其白细胞、红细胞、血红蛋白、红细胞比积、血小板、血浆总蛋白、白蛋白和血清铁的动态变化与恢复情况。结果献血者献血400ml后,其白细胞、血小板、血浆总蛋白和白蛋白水平,同献血前比较变化无统计学意义(P>0.05);献血400ml后,其红细胞、血红蛋白、红细胞比积和血清铁在3个月内均可恢复到献血前水平。结论无论男女,只要符合我国现行规定的年龄与健康标准,每人每次献血400ml,且间隔3个月献1次血是安全的。     

单采血小板献血者发生献血反应的原因分析及处理措施

目的通过分析单采血小板献血者发生献血反应的原因,以便采取相应措施减少献血反应的发生,保证单采血小板献血者的安全与健康。方法统计2009年1月至2011年12月本站单采血小板献血者的总人数和各型献血反应人次,并就出现献血反应的诱因进行统计分析。结果 6 206例单采血小板献血者中,发生献血反应133例,总反应率2.14%,其中轻度献血反应108例（1.74%）、中度献血反应19例（0.31%）、重度献血反应6例（0.10%）,各类比率均逐年下降,但仍以轻度献血反应为主,枸橼酸盐中毒、心理、精神因素为献血反应的最主要诱因。结论献血反应与枸橼酸盐中毒、心理、精神因素密切相关。因为献血反应的产生与多种因素相关,医务人员应具备识别特征表现应对处理的能力,同时血站应该加强献血知识宣教,从而避免献血反应的发生。     

承德市 2008 ~2013 年无偿献血现状分析简

目的了解承德市无偿献血现状，挖掘更多的潜在献血者，为献血者招募策略制定提供依据。方法收集2008—2013年承德市无偿献血者献血信息，统计各采血点献血人次、献血总量及400ml献血比率等数据。结果承德市2008—2013年共采血164451人次，县城采血点献血人数达到73375人次，占献血总人数的44．6％，献血量占到总献血量的49．5％，均排在第一位。结论在用血量快速增长、血源招募相对乏力的情况下，保持并提高400ml献血比率是保障供血的关键。同时，根据各采血点的特点，采取多种宣传形式，提倡献血过程中的人性化服务，打动潜在献血者，提高招募实效，才能确保充足的血液供应。     

2012-2015年山东省东营市个体和团体无偿献血者的血液不合格影响因素分析

目的 探讨山东省东营市个体和团体无偿献血者的血液不合格影响因素的差异,从而保证献血者和血液安全.方法 选择2012年1月至2015年12月东营市中心血站的91 534例无偿献血者作为研究对象.按照献血者的献血组织模式不同,将其分为个体献血者组(n=66 012)和团体献血者组(n=25 522).按照《血站技术操作规程》(2012版、2015版),《血站质量管理规范》(2006版)及《血站实验室质量管理规范》(2006版)的相关规定,对献血者的血液进行丙氨酸氨基转氨酶(ALT)、乙型肝炎表面抗原(HBsAg)、抗-丙型肝炎病毒(HCV)、抗-梅毒螺旋体(TP)及抗-人类免疫缺陷病毒(HIV)5项血液检验性因素项目进行检测.按照《全血及成分血质量要求》(GB 18469-2012)及国际输血协会(ISBT)的相关规定,对血液的采血量、脂肪血发生情况,以及献血者的献血反应3项非血液检验性因素项目进行调查.并且采用x2检验和趋势x2检验的统计学方法对各个项目的不合率进行比较.结果 ①2012-2015年,东营市献血者血液的ALT、HBsAg、抗HCV、抗-TP、抗-HIV、献血反应、脂肪血及采血量不足项目不合格率基本稳定,差异均无统计学意义(x2趋势=0.25、-0.14、-0.12、0.09、0.13、0.41、0.83、0.28,P＞0.05).5项血液检验性因素项目中,ALT的不合格率最高,为3.31％(3 032/91 534),并且差异有统计学意义(x2=127 560.72,P＜0.05);3项非血液检验性因素项目中,脂肪血的不合格率最高,为6.52％(5 969/91 534),并且差异有统计学意义(x2=169 443.63,P＜0.05).②个体献血组血液检验性因素项目的总不合格率为3.90％(2 573/66 012),低于团体献血组的5.70％(1 455/25 522),并且差异有统计学意义(x2=138.20,P＜0.05);2组献血者ALT、HBsAg、抗-HCV、抗-TP、抗-HIV的不合格率分别比较,差异亦均有统计学意义(x2 =345.42、31.31、24.55、14.22、4.01,P＜0.05).③个体献血组非血液检验性因素项目的总不合格率为9.26％(6 115/66 012),低于团体献血组的15.9％(4 067/25 522),并且差异有统计学意义(x2=828.72,P＜0.05);2组献血者献血反应、脂肪血、采血量不足项目的不合格率分别比较,差异亦均有统计学意义(x2 =162.47、603.23、828.72,P＜0.05).结论 针对个体献血者,应加强对其献血前健康征询,从低危人群中采集更为安全的血液.针对团体献血者,建议采取减少每次献血人数,或者增加采血车及工作人员的方式进行血液采集,杜绝人员过于集中的采集方式,降低献血反应和采血量不足;并且加强团体献血前的注意事项宣传,降低脂肪血和ALT不合格率.     

This article has been retracted: Trends in the frequency of blood donors donating blood to be tested for HIV in Shiraz from 2004 to 2006

RETRACTION The following article from Transfusion Medicine, ‘Trends in the frequency of blood donors donating blood to be tested for HIV in Shiraz from 2004 to 2006’ by L. Kasraian and published online on November 3, 2009 (DOI: 10.1111/j.1365-3148.2009.00975.x ), in Wiley InterScience ( www.interscience.wiley.com ), has been retracted by agreement between the author, the journal Editor in Chief, and Blackwell Publishing Ltd. The retraction has been agreed due to inclusion of data without prior approval. Professor Jean‐Pierre Allain
Editor in Chief
Transfusion Medicine REFERENCE L. Kasraian (2009). Trends in the frequency of blood donors donating blood to be tested for HIV in Shiraz from 2004 to 2006. Transfusion Medicine. [E‐pub ahead of print, DOI: 10.1111/j.1365‐3148.2009.00975.x] A number of studies have indicated that some blood donors may donate blood in order to obtain an HIV test. These particular donors pose a serious hazard to the health care system by increasing the risk of HIV being transmitted through the donated blood. The study was undertaken to discover the effectiveness of new measures introduced to reduce the number of donors using blood donation centres to obtain an HIV test. The measures included increased educational information regarding the hazards of HIV transmission through donated blood, and the availability of special HIV clinics offering free services and anonymity. A survey of blood donors was undertaken over a period of 3 years, from 2004 to 2007. The cross‐sectional survey involved 14 752 volunteers and all the participants were asked to complete a questionnaire which covered areas such as demographic characteristics and their motivation for donating blood. During the first year of the survey, it was discovered that 14· 2% of donors donated blood in order to be tested for HIV, and in the following 2 years it was 11· 2 and 9· 3%, respectively. A significant decrease was shown during the survey (P < 0· 05). The majority of these particular donors were found to be young, single, men with poor educational backgrounds and first‐time blood donors. Over the period of this study, a reduction in the number of donors using blood donation centres in order to be tested for HIV was clearly evident. This positive downward trend may be attributed to the success of the new measures introduced.     

The watching-eyes phenomenon and blood donation: Does exposure to pictures of eyes increase blood donation by young adults?

This study examined the effectiveness of exposure to a “watching-eyes image” in increasing blood donation rates among young people, a segment of the population that is particularly underrepresented among blood donors. Participants were 454 first-year university students, each of who was given a blood-donation flyer at the beginning of a lecture. Participants were randomly assigned to one of two conditions depending on whether the flyer they received bore a picture of eyes (experimental condition) or a neutral picture (control condition). We recorded the numbers of participants who promised to give blood and who actually gave blood during the blood drive. Results show that the number of people who gave blood was significantly higher in the experimental condition than in the control condition. These findings provide the first evidence of the effectiveness of the watching-eyes strategy in encouraging young people to give blood. We discuss the processes underlying the “watching-eyes effect” with respect to blood donation.     

巴中市2006-2007年无偿献血者血液检测结果分析

目的通过对无偿献血者5项检验结果的分析，探求无偿献血管理的有效方法，从根本上降低血液报废率。方法对2006年1月至2007年12月巴中市无偿献血者丙氨酸氨基转移酶（ALT）、乙型肝炎病毒表面抗原（HBsAg）、丙型肝炎病毒抗体（抗-HCV）、人类免疫缺陷病毒抗体（抗-HIV）、梅毒抗体（抗-TP）的血液检验结果进行分析。结果无偿献血者血液检验总不合格率呈上升趋势，从2006年初的3．78％上升到2007年底的4．67％。抗-TP、抗-HIV、抗-HCV及ALT的不合格率呈上升趋势，HBsAg的不合格率呈下降趋势。检测项目不合格主要集中在抗-TP、HBsAg和ALT。结论无偿献血总不合格率呈上升趋势，但HBsAg的不合格率呈下降趋势。     

The psychosocial aspects of donating blood stem cells: the sibling donor perspective

The collection of peripheral blood progenitor cells (PBPC) by apheresis has become common in related allogeneic donors. However, the acceptability of the procedure to donors has not been documented. The purpose of this baseline case series study was to evaluate the psycho-social dimensions of apheresis from the perspective of healthy sibling donors and to explore issues surrounding fully informed consent including voluntary donation. At the first interview to discuss donation, 17 consecutive human leucocyte antigens (HLA) identical sibling donors who chose to donate PBPC were recruited to the study. They then completed both scales of the State-Trait Anxiety Inventory. The state scale was completed again immediately before first apheresis. At the end of the final apheresis, the donors were interviewed again by an independent researcher using a standardised questionnaire. All aspects of the procedure were well tolerated, including levels of anxiety and pain. Donors donated even if the relationship with their sibling was poor. However, some areas for improvement were highlighted. Eight (47%) donors were asked to donate by their sibling or another close relative, and this gave them no real volunteer status. Written information was judged important by 11 (65%) donors, but the material used was limited. The possibility of a poor outcome for the recipient was not well understood. The content of the written documentation and the management of confidentiality in terms of donor volunteer status needed to be addressed. A further study regarding the follow-up needs of donors, including those where the outcome is poor, is underway.     

An alternative method for custom prime: A case report of successful peripheral blood stem cell harvesting from two low-weight child donors

Allogeneic peripheral blood stem cell (APBSCs) transplantation is an effective treatment for hematological malignancies. However low-weight donor children meet some complications. In the current report, PBSCs were harvested from a 14-month-old child (9.8 Kg) for a 6 years old sibling recipient suffering from pre-B type of acute lymphoblastic leukemia (ALL) and also 24 months old male child donor (12 Kg) for a haploidentical recipient suffering from acute myeloid leukemia (AML-M4EO). The PBSC harvesting was performed using Spectra? Optia^® apheresis software with continuous mononuclear cell (CMNC) procedure. The results were completely promising and both recipients underwent an acceptable transplantation.     

Organization of the outdoor blood donation drives amid novel coronavirus pandemic and national lockdown: An experience from a tertiary care oncology institution in India

The conduct of blood donation drives became difficult amid novel coronavirus disease pandemic and national lockdown. Despite no restriction for the outdoor blood donation drives, voluntary blood donor organizations (VBDOs) and individual donors became apprehensive regarding the possible risk of spread of the infection during blood donation. Various confidence-building measures were taken to decrease this hesitation. Numerous preventive measures were taken at the blood bank and at the donation venue to limit the possible risk of the spread of infection. With the help of these measures, the confidence of the individual blood donors and the VBDOs was restored and multiple blood drives were organized.     

A study of an educational intervention to decrease inappropriate preoperative autologous blood donation: its effectiveness and the effect on subsequent transfusion rates in elective hysterectomy

BACKGROUND: Decreasing the overcollection of preoperative autologous blood is difficult to achieve. The purpose of this study was to determine whether an educational intervention designed to outline the risks of preoperative autologous collection can decrease such donations and, if so, to determine how this decrease will affect subsequent transfusion rates. STUDY DESIGN AND METHODS: An educational intervention consisting of a didactic presentation to the Department of Gynecology staff about the risks and benefits of autologous blood was implemented. Written material with similar information was given to patients. Subsequently, the percentage of patients donating autologous blood, the number of autologous units donated, and the rates of transfusion in patients eligible for autologous donation who were admitted for elective abdominal or vaginal hysterectomy were measured. These rates were compared to those in similar patients admitted in the 2 years before the educational intervention. RESULTS: After an educational intervention, the proportion of patients donating autologous blood decreased from 53 percent to 26 percent (p<0.01), and the number of units collected per patient decreased from 0.86 to 0.31 (p<0.01); this resulted in a savings of 80 autologous donations per year. Despite no difference in estimated blood loss (p = 0.46), the overall transfusion rate decreased from 10 percent to 3.7 percent (p = 0.03), while the allogeneic transfusion rate demonstrated no significant change (1.1% vs. 2.2%; p = 0.40). CONCLUSIONS: Unnecessary preoperative autologous donations by elective hysterectomy patients can be decreased by educating physicians and patients about the risks of preoperative autologous blood donation. Decreasing such unnecessary donations can decrease the subsequent autologous transfusion rate, with its attendant risks, without increasing the risk of allogeneic transfusion.     

Screening for Zika virus in US armed services blood program donors: An opportunity to compare emerging infectious disease risk between the general US population and military donors

Background

The U.S. Department of Defense (DoD) collects blood from volunteer DoD donors in U.S. Food and Drug Administration (FDA)-regulated centers, and from emergency donor panels in overseas operations. Emerging infectious diseases could reduce DoD access to blood products. In August 2016, FDA determined that Zika virus was transfusion-transmitted and advised that donated blood should be screened for Zika utilizing one of two investigational new drug (IND) applications. The Armed Services Blood Program (ASBP) tested blood using its own protocol concurrently with the IND study sponsored by Roche Molecular Systems, Inc., titled “A Prospective Study to Evaluate the Specificity of the cobas Zika test for use on the cobas 6800/8800 System for Screening of Blood Donations for the Presence of Zika virus RNA.”

Study Design and Methods

This prospective clinical trial (September 2016–August 2017) evaluated the specificity of the cobas Zika 6800/8800 System. Consenting volunteers were screened for Zika by participating reference labs. Participants with positive screens were offered a follow-up study using alternative PCR and serology assays.

Results

92,618 DoD donors enrolled; four tested positive on screening (0.0043%; CI 0.001176896%, 0.01105894%). Three enrolled in follow-up testing and none were positive. These results were comparable to all U.S. donors: 3,858,114 enrolled (excluding Puerto Rico) with 459 positive screens (0.0119%; CI 0.01083582%, 0.01303962%).

Conclusion

The study demonstrated the effectiveness of the cobas Zika test. DoD donors, who are included in emergency donor panels during military operations, were at no higher risk for Zika than the overall U.S. donor population.     

How to implement of patient blood management pillar 1: An Italian expert opinion based on a “bundles” approach

Worldwide iron anemia is a common disorder with a significant economic burden on health-care systems. Red blood cell transfusion is the mainstay to correct anemia in surgical settings, but it is also an overused procedure and recent data support its possible role in worsening patient outcomes. Patient Blood Management (PBM) is a multidisciplinary approach to optimize hemostasis, manage anemia, minimize iatrogenic blood loss, and improve tolerance to anemia. The present paper aims to provide a “bundles” approach, based on several preoperative anemia management measures, to implement PBM Pillar 1 in clinical practice.     

Clinical prediction rules for bacteremia and in-hospital death based on clinical data at the time of blood withdrawal for culture: An evaluation of their development and use

RATIONALE, AIMS AND OBJECTIVES: To develop clinical prediction rules for true bacteremia, blood culture positive for gram-negative rods, and in-hospital death using the data at the time of blood withdrawal for culture. METHODS: Data on all hospitalized adults who underwent blood cultures at a tertiary care hospital in Japan were collected from an integrated medical computing system. Logistic regression was used for developing prediction rules followed by the jackknife cross validation. RESULTS: Among 739 patients, 144 (19.5%) developed true bacteremia, 66 (8.9) were positive for gram-negative rods, and 203 (27.5%) died during hospitalization. Prediction rule based on the data at the time of blood withdrawal for culture stratified them into five groups with probabilities of true bacteremia 6.5, 9.6, 21.9, 30.1, and 59.6%. For blood culture positive for gram-negative rods, the probabilities were 0.6, 4.7, 8.6, and 31.7%, and for in-hospital death, those were 6.7, 15.5, 26.0, 35.5, and 56.1%. The area of receiver operating characteristic for true bacteremia, blood culture positive for gram-negative rods, and in-hospital death were 0.73, 0.64, and 0.64, respectively, in original cohort and 0.72, 0.64, and 0.64 in validation respectively. CONCLUSIONS: The clinical prediction rules are helpful for improved clinical decision making for bacteremia patients.     

The 24-h reporting of Gram stains from positive blood cultures contributes to physician's use of appropriate antimicrobials: Experience at a university hospital

Although recent technological advances for the diagnosis of bloodstream infection (BSI) provide rapid and accurate results, blood culture maintains a key role in the diagnosis of BSI. The objective of this study was to determine whether 24-h reporting by telephone to disclose the suspected microorganism based on the Gram stain morphology from positive blood cultures (first laboratory report) affects a physician's use of appropriate antimicrobials. A total of 627 (14%) out of 4413 blood samples, excluding duplicate samples from the same patient on the same day, were positive for blood cultures between January and December 2016. The contamination rate of blood cultures during the study period was 2.3%. Among 627 patients with positive blood cultures, 538 (86%) were receiving antibiotics at the time of the first laboratory report, of which 502 (80%) thereafter continued the same antimicrobials, and the remaining 36 (6%) were changed to appropriate antimicrobials after the first laboratory report. An additional 25 (4%) were newly administered appropriate antimicrobials after the first laboratory report, whereas an additional 21 (3%) were newly administered appropriate antimicrobials after infection control team (ICT)-intervention. The median time lag (interquartile ranges) from flagging culture bottles as positive to a physician's use of appropriate antimicrobials after the first laboratory report (4 h, 2–7) was significantly (p < 0.001) shorter than that after ICT-intervention (12 h, 10–17). During the study period, no cases of discrepancy between the Gram stain morphology in the first laboratory report and definitive identification of microorganisms in the final laboratory report were observed. Because the timing of flagging culture bottles as positive tends to fall outside normal working hours, immediate 24-h reporting by telephone to disclose the suspected microorganism based on the Gram stain morphology from positive blood cultures may contribute to an early recognition of bacteremia and the physician's use of appropriate antimicrobials.