ISBT Science Series via MedWorm.com

Pathogen inactivation

ISBT Science Series — Sat, 22 Oct 2011 23:26:50 +0100

(Source: ISBT Science Series)

XMRV and blood safety: a case study of science and public pressure

ISBT Science Series — Sat, 22 Oct 2011 23:26:49 +0100

XMRV is a recently discovered virus, related to mouse endogenous leukemia viruses. It was originally discovered in tissue from human prostate tumours and has been reported to be associated with chronic fatigue syndrome (CFS). Accumulating data suggest that the virus itself is a laboratory artifact and that many, if not all of the reported associations may be due to contamination of samples and or reagents. However, the association of this (and similar) viruses with chronic disease has attracted a great deal of public attention, particularly from CFS patients. Additionally, it was hypothesized that the virus might offer a risk to blood safety, generating additional pressures. Current data and perspectives on the issue will be discussed. (Source: ISBT Science Series)

Developing blood services in the Philippines

ISBT Science Series — Sat, 22 Oct 2011 23:26:47 +0100

The goal of achieving reforms in the Philippine healthcare system has moved our government to push regulations in all key areas. With the objective of ensuring access to safe, quality and affordable blood products, improved facilities and services, the transfusion system in the Philippines is now in focus. Hence, the issuance of several administrative memos to guarantee the achievement of an effective blood service network in the country. (Source: ISBT Science Series)

Managing thalassaemia‐ indian experience

ISBT Science Series — Sat, 22 Oct 2011 23:26:45 +0100

(Source: ISBT Science Series)

Modern management of thalassemia

ISBT Science Series — Sat, 22 Oct 2011 23:26:43 +0100

(Source: ISBT Science Series)

Bacterial contamination of blood products

ISBT Science Series — Sat, 22 Oct 2011 23:26:41 +0100

(Source: ISBT Science Series)

TRALI‐risk‐reduction strategies: Japanese approach

ISBT Science Series — Sat, 22 Oct 2011 23:26:39 +0100

Transfusion‐related acute lung injury (TRALI) is one of the most serious complications of blood transfusion. We have been gathering information about TRALl in Japan since 1997 through our national haemovigilance system. Recently, we have 20–40 TRALI cases per year (five million bags issued per year). Although TRALI is a rare complication of transfusion, it may become severe and may sometimes be fatal. A substantial number of TRALI cases have been caused by donor HLA or HNA antibodies, which were generated in alloimmunized, i.e. parous females. Considering this mechanism, TRALI mitigation strategies such as the use of male‐only‐plasma have been implemented in many blood centres or countries. Because of the availability of male plasma and the time limit for the production of fresh fr...

Evidence behind the pathophysiology of TRALI

ISBT Science Series — Sat, 22 Oct 2011 23:26:37 +0100

Transfusion‐related acute lung injury (TRALI) is a serious transfusion complication that may lead to significant morbidity and mortality. This has driven a significant research effort focused on understanding why and how TRALI develops. The ultimate goal must be prevention or at least mitigation of the clinical consequences of TRALI.The underlying pathophysiology of TRALI is presently best described by two hypotheses which are not mutually exclusive. These are the antibody mediated TRALI mechanism and the two‐event or priming TRALI mechanism. One of the key initial findings in TRALI research was the frequent presence of leucocyte antibodies in associated blood products, providing strong evidence for an antibody driven pathogenesis. In contrast, the two‐event mechanism proposed that t...

The challenges of managing donor haemoglobin

ISBT Science Series — Sat, 22 Oct 2011 23:26:36 +0100

Haemoglobin screening has long provided blood services with a means to determine the eligibility of prospective donors. Screening aims to protect donors from donating whilst anaemic, minimise the risk of anaemia developing as a result of donation and ensure an adequate red cell component for the transfusion recipient.Addressing the limitations, risks and benefits of haemoglobin screening to both donor and recipients requires continuous surveillance and an evidence‐based response to evolving clinical research and technological innovations. Challenges include determination of appropriate thresholds in specific populations, management of donors with low haemoglobin, realising the limitations of haemoglobin as a predictor of iron status, and the assessment and selection of alternative screen...

Centralized quality control inspections for blood bags and leukocyte reduction at the Japanese Red Cross Society

ISBT Science Series — Sat, 22 Oct 2011 23:26:34 +0100

The Japanese Red Cross is now emphasizing an intense quality control procedure for testing blood bags and for leukocyte counts in blood components. The inspections and tests are described and the effects and significance these have on blood product management of the supply of safe blood are presented. (Source: ISBT Science Series)

Blood group molecular genotyping

ISBT Science Series — Sat, 22 Oct 2011 23:26:32 +0100

DNA‐based typing methods of red cell antigens are applied in several fields. Genotyping is used to clarify problems in patient serology. It is also increasingly applied for routine mass‐scale typing of blood donors for minor red cell antigens and screening for donors with rare blood types. An advance in this field is the non‐invasive fetal RHD diagnostics in pregnancies of D‐negative women to determine the fetal RHD.Reference centres for immunohaematology commonly use molecular methods to clarify problems, discrepancies or unusual results in patient serology. It is often applied in individuals with variant RhD expression to detect the contributing weak D or partial D types. Genotyping is also used to identify the individual ABO and RhD blood group in patients after mismatched trans...

Molecular genetic basis for I antigen expression

ISBT Science Series — Sat, 22 Oct 2011 23:26:30 +0100

The rapid conversion of the i to the I phenotype on postnatal red blood cells (RBCs) reflects the elaborate functions of cell surface branched‐chain I antigenic structure. The adult i phenotype has been noted to be partially associated with congenital cataracts. These phenomena make the molecular genetics of the blood group I system and the regulation mechanism for I antigen expression in postnatal RBCs intriguing. It has been demonstrated that the human I locus expresses three IGnT forms, designated IGnTA, IGnTB, and IGnTC, which have different exon 1, but identical exons 2 and 3, coding regions. The uncommon molecular genetics of the I locus offers a new perspective of the formation and expression of the I antigen in different cells, and provides an insight into the questions derived f...

Human neutrophil antigen and antibody studies: a Taiwanese experience

ISBT Science Series — Sat, 22 Oct 2011 23:26:28 +0100

This article is a review on neutrophil alloantigen in the Taiwanese population, and case investigations related to allo/auto neutrophil antibodies over a period of 20 years in the immunohaematology reference laboratory of Mackay Memorial Hospital, Taiwan.In Taiwanese populations, HNA‐1a is more frequent than HNA‐1b (90% and 50% respectively) and HNA‐1c is not seen. Furthermore, the FcgRIIIb‐deficient individual homozygous for FCGR3B gene deletion is estimated to be approximately 1 in 180 and is not as rare as previously thought.Although mothers homozygous for either HNA‐1a or HNA‐1b are commonly found in Taiwan, the number of patients with neonatal neutropenia caused by HNA‐1 alloantibodies is seldom seen. In a search among our previous laboratory requests of neonatal cases...

Granulocyte antibody detection – the role of MPHA

ISBT Science Series — Sat, 22 Oct 2011 23:26:26 +0100

Human neutrophil antigens (HNA) are involved in the pathogenesis of a variety of clinical conditions, such as neonatal immune neutropenia (NIN), refractoriness to granulocyte transfusions, alloimune neutropenia after bone marrow transplantation, febrile transfusion reactions, and transfusion‐related acute lung injury (TRALI). The accurate detection of granulocyte antibodies is essential for the diagnosis and prevention of the clinical conditions in which these antibodies are involved, especially TRALI. The international granulocyte immunology workshop recommends the use of granulocyte agglutination test (GAT) and granulocyte immunofluorescence test (GIFT) for the screening of granulocyte antibody, and the use of monoclonal antibody‐specific immobilization of granulocyte antigen (MAIGA)...

The fundamentals of neutrophil antigen and antibody investigations

ISBT Science Series — Sat, 22 Oct 2011 23:26:24 +0100

Background The neutrophil population makes up the largest proportion (40–70%) of white blood cells and is crucial to our innate immune response. An unexpectedly significant proportion of neutrophils (∼28%) is located in the pulmonary circulation. This is an immune system front line wherein neutrophils guard an important interface between the external environment and the body. Neutrophils migrate to sites of infection and/or inflammation, where they phagocytose and destroy foreign microorganisms and mediate inflammation and eventual healing. Therefore, a decrease in neutrophil numbers often results in increased susceptibility to infection. Sustained or transient immune neutropenia occurs when neutrophil‐reactive alloantibodies or autoantibodies destroy neutrophils, or significantly...

Harmonization in donor management – the Asia–Pacific perspective

ISBT Science Series — Sat, 22 Oct 2011 23:26:22 +0100

(Source: ISBT Science Series)

Lecture: Blood Donation Program in the Asia Pacific Region

ISBT Science Series — Sat, 22 Oct 2011 23:26:20 +0100

As part of the Asia Pacific Blood Network (APBN) comparison of practice program, member countries review blood donor management practices to understand emerging trends in the region, and identify good practice opportunities which may benefit other members.Our membership includes Australia, Beijing, Hong Kong, Japan, New Zealand, Singapore, South Korea, Taiwan and Thailand. From 2006, we have jointly collected information for a range of donor related measures, including age and sex distribution of donors, criteria for donation, donation volumes and frequencies, transfusion transmitted disease rates, additional donor health screening initiatives and donor deferrals.Analysis of the donor management information both among member countries, and for individual countries over a period of 4 year...

Plasma fractionation in Asia–Pacific: challenges and perspectives

ISBT Science Series — Sat, 22 Oct 2011 23:26:18 +0100

Patients in every country should have access to quality blood products. National health authorities play a critical role in ensuring that patients’ needs are met with safe and cost‐effective products. Fractionated plasma products, as other blood products, are essential therapeutics used in the prevention, management, and treatment of life‐threatening conditions resulting from trauma, metabolic congenital deficiencies, immunological disorders or infections. A few high development index (HDI) countries in the region have sufficient access to a broad portfolio of plasma products (coagulation factors, immunoglobulin, albumin) through domestic (e.g. Australia, Japan, Korea) or contract (e.g. Singapore, New Zealand) plasma fractionation programmes. China is gradually establishing a modern ...

Modern human migrations in insular Asia according to mitochondrial DNA and non‐recombining Y chromosome

ISBT Science Series — Sat, 22 Oct 2011 23:26:17 +0100

(Source: ISBT Science Series)

Polymorphism and uniqueness of Taiwanese in HLA and beyond

ISBT Science Series — Sat, 22 Oct 2011 23:26:15 +0100

HLA allelic polymorphism among different ethnic groups and racial populations is widely observed and the patterns of linkage disequilibrium among various alleles differ significantly among human populations have been shown in many studies. The population composition of Taiwanese comprises four major ethnic groups, namely, Minnan, Hakka, Aborigines and Chinese Mainlanders, and other minority ethnic groups. Thus, the database of our haematopoietic stem cell donor registry comprises volunteer donors bearing HLA alleles and haplotypes with its unique polymorphism and characteristics. In our donors, we have discovered new alleles, rare frequency alleles and Taiwanese conserved alleles and haplotypes. In addition, beyond the HLA system, we found genetic expression of Oriental restricted white bl...

Impact of the Great East Japan Earthquake/Tsunami on blood services and the countermeasures adopted

ISBT Science Series — Sat, 22 Oct 2011 23:26:13 +0100

(Source: ISBT Science Series)

Reflections on the Christchurch earthquake

ISBT Science Series — Sat, 22 Oct 2011 23:26:11 +0100

Conclusions Pre‐existing emergency plans are an essential component of emergency preparedness. These must however be flexible to respond to rapidly changing situations. The blood service plan must be integrated into regional and national response plans. Access to timely and accurate information is an important contributor to effective management. (Source: ISBT Science Series)

Hepatitis E virus infection and blood transfusion in Japan

ISBT Science Series — Sat, 22 Oct 2011 23:26:09 +0100

(Source: ISBT Science Series)

The New Zealand national haemovigilance programme: the first step is the hardest

ISBT Science Series — Sat, 22 Oct 2011 23:26:07 +0100

Blood transfusion is an important component of modern day medicine. As doctors our first consideration must always be the interests and safety of our patients. Haemovigilance programmes collect and analyse data on untoward events associated with transfusion. The information collated should be shared with health professionals who prescribe and administer blood products so that they can continue to deliver the good without unintended negative consequences.The European Directorate for the Quality of Medicines and Healthcare (EQDM) defines the standards for haemovigilance and acknowledges that it is a shared responsibility of the professionals in the field and the competent national authorities for blood safety. It includes the surveillance of donor‐related events, epidemiological assessment...

The Importance of the Workshop of the Asian Platelet Immunology Working Party (APIWP)

ISBT Science Series — Sat, 22 Oct 2011 23:26:05 +0100

(Source: ISBT Science Series)

Complications of haematopoietic stem cell transplantation

ISBT Science Series — Sat, 22 Oct 2011 23:26:03 +0100

This article reviews the major complications of HSCT. (Source: ISBT Science Series)

Alternative donor hematopoietic stem cell transplantation: current concepts

ISBT Science Series — Sat, 22 Oct 2011 23:26:01 +0100

Hematopoietic stem cell transplantation (HSCT) is a curative therapy for many diseases such as hematological malignancies, bone marrow failure, immunodeficiency and other disorders. Unrelated donor and haploidentical family member are important alternative donors for the patients who need HSCT for otherwise incurable disease but without identical sibling donor. Since the first unrelated HSCT in 1974, the number and the clinical outcomes of unrelated transplant have been progressed significantly over time. More than 16 million adult unrelated donors have been registered worldwide. Near half of the donations from unrelated donors are international in recent years. HLA disparity between donor and recipient and disease status before transplant are key factors on survival after unrelated HSCT. ...

Cord blood banking and transplantation

ISBT Science Series — Sat, 22 Oct 2011 23:25:59 +0100

The availability of umbilical cord blood (UCB) as a source of haematopoietic stem cells (HSC) for transplantation has met an important niche in the field of HSC transplantation (HSCT) as patients unable to find a HLA‐matched sibling or unrelated donor have been able to receive less well‐matched UCB transplantation (UCBT) with equivalent outcomes. This has led to significant growth in this field resulting in more than 20 000 unrelated donor UCBTs performed to date with about 3000 more performed annually. Growth of UCBT has been further supported by the proliferation of public cord blood banks throughout the world which store UCB at no cost to the donor, making these available for patients all round the world through global search registries like the US National Marrow Donor Program (N...

What motivates regular blood donations?

ISBT Science Series — Sat, 22 Oct 2011 23:25:57 +0100

Conclusion These findings suggested that regular blood donors are self‐motivated. The more they give, the more they value their contributions. This motivation is not related to their income or education levels, but reflected the sense of ‘upmanship’. This revelation can be used to strengthen retention strategies in better acknowledging the contributions of regular blood donors and in enhancing the quality of donor services and donor care, as delighted blood donors will make many happy returns. (Source: ISBT Science Series)

Predicted future blood demand and donor recruitment strategy in Japan

ISBT Science Series — Sat, 22 Oct 2011 23:25:56 +0100

(Source: ISBT Science Series)

Transfusion transmission risk of dengue viruses in an endemic area

ISBT Science Series — Sat, 22 Oct 2011 23:25:54 +0100

It is believed that dengue virus (DENV) is transfusion transmittable, only a few transfusion associated cases were reported so far in spite of at least 50 million dengue infections occur globally each year. The equation for calculating DENV transfusion transmission probability was proposed following the West Nile Virus model. In consideration of reported case number, population size in the region around the designated cases, symptomatic infection rate, blood donation rate, and mosquito biological characteristics together, a relative low rate of DENV transmittable donations was presumed in a low‐grade endemic area. Both the apparent clinical presentation and the relative short viremia period of DENV infection prevent dengue viruses from being a highly potential transfusion transmittable a...

Designing peptide‐based FSL constructs to create Miltenberger kodecytes

ISBT Science Series — Sat, 22 Oct 2011 23:25:52 +0100

Conclusion: Provided possible complications/issues have been taken into account, FSL‐peptides can be easily synthesized and used to make kodecytes representative of selected protein blood antigens/epitopes. (Source: ISBT Science Series)

Physiological Implications of Miltenberger blood group antigen subtype III (Mi.III)

ISBT Science Series — Sat, 22 Oct 2011 23:25:50 +0100

In Taiwan, Miltenberger blood group antigen subtype III (Mi.III) is the second most important blood group antigen following ABO. Mi.III presumably evolved from homologous recombination between GYPA and GYPB, and expresses a hybrid configuration of glycophorin B‐A‐B and the Mur antigen in the crossover region.GPA and GPB oligomerize on the erythrocyte cell membrane. GPA also forms protein complexes with band 3 and facilitates band 3 expression. GPB is believed not to involve in the GPA‐band 3 interaction. In Mi.III+ blood, half or all GPB is replaced with the glycophorin BAB hybrid, Gp.Mur. We previously showed that upon heterologous expression in HEK‐293 cells, Gp.Mur, like GPA, facilitates the protein expression of band 3. Quantitative proteomics by iTRAQ revealed 25–67% more ba...

Miltenberger phenotypes are glycophorin variants: a review

ISBT Science Series — Sat, 22 Oct 2011 23:25:48 +0100

(Source: ISBT Science Series)

Application of quality principles in clinical transfusion laboratory practice

ISBT Science Series — Sat, 22 Oct 2011 23:25:46 +0100

Quality systems and principles are essential aspects of high quality clinical transfusion laboratory practice. Many frameworks provide the structure for quality systems, some of which are specific to transfusion laboratory practices such as codes of practice and others are more general including ISO9001 and ISO15189. All these systems follow the same core principles incorporating quality assurance activities, quality control and continual quality improvement processes. The application of quality principles may be divided into five categories: processes, people, material, equipment and management. Specifically these categories must encompass laboratory procedures and analysis, storage and transportation of blood products, documentation of all results, selection, validation and maintenance o...

Application of a quality principle in component production

ISBT Science Series — Sat, 22 Oct 2011 23:25:44 +0100

(Source: ISBT Science Series)

Application of quality principles in transfusion microbiology

ISBT Science Series — Sat, 22 Oct 2011 23:25:42 +0100

(Source: ISBT Science Series)

Application of quality principles to managing donor services

ISBT Science Series — Sat, 22 Oct 2011 23:25:40 +0100

Conclusion QP can be adopted by BE to guide the organization towards better and improved performance. The principles of QP would certainly benefit the BDS to function as an efficient service provider in meeting the demand of the healthcare services that depend on a sustainable blood supply. (Source: ISBT Science Series)

Quality systems management and overview Quality Management, 20 November 2011

ISBT Science Series — Sat, 22 Oct 2011 23:25:38 +0100

A generic definition of quality system describes the organizational structure, responsibilities, processes, procedures and resources required to maintain high quality products and/or services. In blood transfusion chain setting, a quality system provides a framework in a supply chain setting from a donor’s vein to a patient’s vein through the collection, processing, testing, distribution and administration of high quality, safe and effective blood and blood products. (Source: ISBT Science Series)

The role of the transfusion nurse in the hospital and blood centre

ISBT Science Series — Sat, 22 Oct 2011 23:25:36 +0100

Conclusion The specialist transfusion practitioner/Transfusion Nurse is an integral part of a multidisciplinary team, supporting efforts at institutional and national levels to reduce transfusion risks and improve practice. (Source: ISBT Science Series)

Current concepts in pre‐transfusion serological compatibility testing

ISBT Science Series — Sat, 22 Oct 2011 23:25:34 +0100

(Source: ISBT Science Series)

Foetal and neonatal alloimmune thrombocytopenia (FNAIT)

ISBT Science Series — Sat, 22 Oct 2011 23:25:32 +0100

Thrombocytopenia is detected in around one percent of newborns. In otherwise healthy term newborns, thrombocytopenia is most often caused by alloantibodies transferred from the mother to the foetus. In the Caucasian populations human platelet antigen (HPA)‐1a is the most immunogenic HPA. In Japan and China antibodies in the HPA‐4 system are the most frequent cause of FNAIT. The immune response against the HPA must be understood in order to avoid immunization or prevent induction of FNAIT where mothers are already immunized. (Source: ISBT Science Series)

Blood grouping by molecular genetics

ISBT Science Series — Sat, 22 Oct 2011 23:25:30 +0100

It is possible to predict most clinically important blood group phenotypes from genomic DNA. Clinical applications include the following: determining foetal blood group to assess risk of haemolytic disease of the foetus and newborn or whether the pregnant woman requires antenatal anti‐D prophylaxis; testing multiply transfused and autoimmune haemolytic anaemia patients; defining D variants; detecting donors with very weak D antigens; testing donors and patients when appropriate antisera are not available; RHD zygosity testing; zygosity testing of panel cells; assisting in solving difficult serological problems; and, with the use of high‐throughput technologies, extended blood grouping of donors. Over the last 7 years, ISBT Workshops have provided external quality assurance. Future te...

Appropriate blood component usage

ISBT Science Series — Sat, 22 Oct 2011 23:25:28 +0100

Blood transfusion (which includes FFP, platelets, cryoprecipitate and any other blood‐derived product) remains an important modality of treatment across all clinical disciplines. A blood transfusion is deemed appropriate when used in an evidence‐based fashion and where the effects of the transfusion are felt to outweigh any potential risks and complications that may arise from the transfusion. In certain cases, it may be the best treatment option available, for example plasma exchange in thrombotic thrombocytopenic purpura. However, blood transfusion can result in acute or delayed complications, as well as the risk of transmission of infectious agents. The inappropriate use of blood and blood products increases the risk of transfusion‐related complications and adverse events to recip...

Platelet transfusion in the 21st century: where we’ve been and where we’re going

ISBT Science Series — Sat, 14 May 2011 20:53:25 +0100

(Source: ISBT Science Series)

New approaches to managing anaemia

ISBT Science Series — Sat, 14 May 2011 20:53:24 +0100

(Source: ISBT Science Series)

Transfusion transmission of hepatitis B virus: still learning more about it

ISBT Science Series — Sat, 14 May 2011 20:53:23 +0100

Background Despite continuous technical improvement in blood donation testing, hepatitis B infection remains a major risk of transfusion‐transmitted viral infection. The residual risk of hepatitis B virus (HBV) transmission is related to the pre‐seroconversion window period (WP), infection with immunovariant viruses, and with occult carriage of HBV infection (OBI).Results and discussion Reduction of HBV residual risk is achieved by developing more sensitive HBsAg test, by adopting anti‐HBc screening when appropriate, and recently by implementing HBV nucleic acid testing (NAT), either in minipools or more efficiently in individual donations. Compared with serological testing, HBV NAT combines the ability to significantly reduce the window period and to detect OBIs. Clinical obse...

Recent insights in testing for transfusion transmissible viral infections

ISBT Science Series — Sat, 14 May 2011 20:53:22 +0100

(Source: ISBT Science Series)

Donor management – ethics, culture and minority involvement in the blood supply

ISBT Science Series — Sat, 14 May 2011 20:53:21 +0100

(Source: ISBT Science Series)

Is intravenous immunoglobulin effective to reduce exchange transfusion in Rhesus haemolytic disease of the newborn?

ISBT Science Series — Sat, 14 May 2011 20:53:19 +0100

Conclusions Although current guidelines support the therapeutic effect of the intravenous immunoglobulin effect on decreasing the need for ET in newborns with Rhesus haemolytic disease it shall not yet be routinely recommended. (Source: ISBT Science Series)

Madrid train bombings: what we have learnt from that sad event

ISBT Science Series — Sat, 14 May 2011 20:53:19 +0100

(Source: ISBT Science Series)

Contingency planning for natural disasters

ISBT Science Series — Sat, 14 May 2011 20:53:18 +0100

(Source: ISBT Science Series)

Transfusion‐related acute lung injury investigation insights

ISBT Science Series — Sat, 14 May 2011 20:53:16 +0100

This article will discuss:– TRALI investigation strategy,– assays for detection of antibodies to HNA and HLA,– how to differentiate associated from implicated donors,– and provide thoughts on the remaining 20% of TRALI events (i.e. non‐immune mediated). (Source: ISBT Science Series)

Use fresh‐frozen plasma in newborns, older infants and adolescents on the outcome of bleeding

ISBT Science Series — Sat, 14 May 2011 20:53:16 +0100

(Source: ISBT Science Series)

Blood Donors: Red Cells Sufficiency

ISBT Science Series — Sat, 14 May 2011 20:53:15 +0100

(Source: ISBT Science Series)

The minimum requirements for red cell serological testing

ISBT Science Series — Sat, 14 May 2011 20:53:14 +0100

(Source: ISBT Science Series)

Update on the status of pathogen inactivation methods

ISBT Science Series — Sat, 14 May 2011 20:53:12 +0100

Conclusions The decision whether to implement PI is a complex one with ethical, societal and financial aspects. The ability to improve the safety of transfusion for recipients, particularly with respect to bacteria and emerging threats, is an important augmentation to our commitment to patients. (Source: ISBT Science Series)

Feasibility and safety of multicomponent apheresis donation

ISBT Science Series — Sat, 14 May 2011 20:53:11 +0100

Conclusion Previous definitions of blood component yield and volume as well as the flexibility to collect those multicomponents allow the blood centre to collect those components that maximize donors’ contribution and to meet the demands of its area hospitals for blood components. Blood transfusion services are progressively increasing their reliance on apheresis technology to optimize the number of blood components collected per donor visit and to reduce the number of donors a patient is exposed to. The use of these systems has shown at the same time that multicomponent donations have been well tolerated by the donors and are cost‐effective. (Source: ISBT Science Series)

Prophylaxis in haemophilia and other inherited bleeding disorders

ISBT Science Series — Sat, 14 May 2011 20:53:09 +0100

(Source: ISBT Science Series)

Guidelines versus evidence based transfusion medicine. A perspective from Australasia

ISBT Science Series — Sat, 14 May 2011 20:53:07 +0100

(Source: ISBT Science Series)

AABB cellular therapy initiatives

ISBT Science Series — Sat, 14 May 2011 20:53:06 +0100

As applications in cellular therapies (CT) increase, so does the importance of international cooperation to facilitate the development of resources that best serve donors, healthcare professionals, and patients. Towards this goal, the AABB and International Society of Blood Transfusion (ISBT) cellular therapies have formed a CT working party and have jointly committed to the collaboration on a series of papers on donor selection, microbiological principles and product release. To identify other potential areas for collaboration, an overview of AABB CT initiatives is presented. AABB activities in CT encompass international projects and collaborations, standards development, accreditation, member activities focused on specific topic areas, educational programs, publications and research fund...

Uniform examination of stem cell donors

ISBT Science Series — Sat, 14 May 2011 20:53:05 +0100

In contrast to unrelated donors who are counselled and examined according to international guidelines, related donors of allogeneic bone marrow (BM) or mobilized peripheral blood stem cells (PBSC) often are recruited, examined and followed otherwise. Currently, mostly PBSC instead of BM donation is used. The higher CD34+ yield is preferred for non‐myeloablated recipients, allowing transplantation of older patients. Consequently related sibling donors are aging and prone to suffer more co‐morbidity as compared to unrelated donors. With respect to counselling it is obvious that donor recruitment and motivation between related and unrelated donors differ. The related donor however needs protection by an independent physician safeguarding the health of the donor. Although financial and log...

Maternal antibody titration as a predictive parameter for fetal status and therapy effectiveness in pregnancies associated with alloimmune thrombocytopenia

ISBT Science Series — Sat, 14 May 2011 20:53:03 +0100

In conclusion, our work gives new insights into maternal predictive parameters for fetal status and therapy effectiveness, allowing non‐invasive strategies. Follow‐up of the antibody concentration during pregnancy could help to predict the outcome of the pregnancy, so as to prevent severe hemorrhagic disorders in the neonate. (Source: ISBT Science Series)

New insights in fetal and neonatal alloimmune thrombocytopenia

ISBT Science Series — Sat, 14 May 2011 20:53:01 +0100

During the recent years considerable advances in the clinical and laboratory diagnosis of alloimmune thrombocytopenia have been done. Feto‐maternal alloimmunization is the commonest cause of severe isolated fetal and neonatal thrombocytopenia. The condition results from maternal immunization against specific fetal platelet antigens (HPA). Unlike the haemolytic disease of the fetus and newborn the first newborn was found to be affected. The diagnosis is usually made at birth when an otherwise ‘well’ term infant exhibits bleeding at delivery or few hours afterwards. The most feared complication of this disorder is the occurrence of intracranial haemorrhage (ICH) as a result of severe thrombocytopenia leading to death or neurological sequelae. The diagnosis of alloimmune thrombocytopeni...

Successes in Catalonia from World Blood Donor Day 2010

ISBT Science Series — Sat, 14 May 2011 20:53:00 +0100

(Source: ISBT Science Series)

Globalization and blood donors: How to improve the blood donation in the European Union (EU)

ISBT Science Series — Sat, 14 May 2011 20:52:58 +0100

Conclusions • It is necessary to have effective cooperation between nations and between all professionals in this new world that is the European Union, and begin now to invest in youth of each country to become blood donors. (Source: ISBT Science Series)

Tailored blood collections

ISBT Science Series — Sat, 14 May 2011 20:52:57 +0100

(Source: ISBT Science Series)

Therapeutic apheresis

ISBT Science Series — Sat, 14 May 2011 20:52:56 +0100

(Source: ISBT Science Series)

How Does the Global Economic Crisis Affect the Quality of Blood Services?

ISBT Science Series — Sat, 14 May 2011 20:52:55 +0100

(Source: ISBT Science Series)

Challenges in testing for platelet‐related adverse events

ISBT Science Series — Sat, 14 May 2011 20:52:53 +0100

(Source: ISBT Science Series)

XMRV, Q fever and other emerging infections: impact on management of blood safety

ISBT Science Series — Sat, 14 May 2011 20:52:51 +0100

As a result of continuous improvement efforts, the blood supply is now extremely safe. However, emerging infections offer a real or potential challenge to such safety. Since 2003, two new tests have been implemented in the United States in order to reduce the risk of transfusion transmission of West Nile virus and Trypanosoma cruzi. In addition, Babesia microti and dengue viruses are considered to be high‐priority threats. Q fever outbreaks in the Netherlands illustrate a localized threat that has been assessed and managed through human and agricultural public health measures and by selective testing of blood donors. The recently recognized gammaretrovirus XMRV has generated scientific and social controversy and illustrates a number of problems in managing blood safety policy. (Source: I...

Arboviruses and TTID

ISBT Science Series — Sat, 14 May 2011 20:52:50 +0100

(Source: ISBT Science Series)

Definition of emerging infectious diseases

ISBT Science Series — Sat, 14 May 2011 20:52:49 +0100

(Source: ISBT Science Series)

Human cord blood reprogrammed into embryonic‐like stem cells

ISBT Science Series — Sat, 14 May 2011 20:52:48 +0100

Embryonic stem (ES) cell therapies are often promoted as the optimal stem cell source for regenerative medicine applications. Although the first clinical trail involving hES progenitors has been approved, ES cell applications are currently limited by ethical, political and regulatory hurdles. In addition, the use of hES cell‐derived progenitors has been fraught with difficulties associated with immunological incompatibility, due in part to the increase in expression of major histocompatibility complex molecules during differentiation of hES cells. Induced pluripotent stem (iPS) cells could solve both the ethical problem of human embryo use and the immunological rejection problem. Patient‐specific iPSC have been hailed as an enormous development for regenerative medicine since transplan...

The value of the human genome project to transfusion medicine

ISBT Science Series — Sat, 14 May 2011 20:52:47 +0100

(Source: ISBT Science Series)

Transitioning from ‘blood’ safety to ‘transfusion’ safety: addressing the single biggest risk of transfusion

ISBT Science Series — Sat, 14 May 2011 20:52:45 +0100

This article will review the interventions that have been studied by transfusion medicine services in attempt to improve transfusion safety at every link in the transfusion chain. The most important and indispensable safety step is the introduction of an error tracking system. Such a system should capture all deviations from standard operating procedures, including near‐misses that are captured before the blood product is issued. Near‐misses are 300‐fold more common and represent latent safety concerns requiring urgent attention. The system should be anonymous to ensure that there is no barrier to reporting and no‐fault to recognize that the vast majority of errors are due to latent system errors. The errors should be coded by type and location to allow for the ability to query the...

Changing educational paradigms in transfusion medicine

ISBT Science Series — Sat, 14 May 2011 20:52:44 +0100

Over the past decades, the fields of activity and knowledge in transfusion medicine have evolved into an array of diverse areas and sub‐specialities including immunohaematology, blood component production, haemapheresis, pathogen detection, methods of cell and tissue collection and manipulation, cell conservation and banking, transplant immunology and haemostaseology. Physicians in most clinical disciplines require basic or more advanced knowledge in these fields to meet the requirements of modern medicine. Specialist physicians in transfusion medicine are valuable and competent partners for these related disciplines when it comes to safe, effective and tailored haemotherapy. Transfusion medicine is thus an important qualification at the interfaces of analytical laboratory medicine, phar...

Haemovigilance: a tool for quality improvement

ISBT Science Series — Sat, 14 May 2011 20:52:43 +0100

(Source: ISBT Science Series)

Appropriate use of red cell transfusion

ISBT Science Series — Sat, 14 May 2011 20:52:42 +0100

(Source: ISBT Science Series)

Complications of the transfusion of blood and blood components

ISBT Science Series — Sat, 14 May 2011 20:52:41 +0100

(Source: ISBT Science Series)

Steps for a safety clinical transfusion

ISBT Science Series — Sat, 14 May 2011 20:52:40 +0100

(Source: ISBT Science Series)

Current concepts in molecular testing

ISBT Science Series — Sat, 14 May 2011 20:52:39 +0100

(Source: ISBT Science Series)

Current concepts in serological testing – TTID

ISBT Science Series — Sat, 14 May 2011 20:52:38 +0100

Conclusion In Germany, blood donor screening is performed using parallel serological assays (antigen and antibody detection) and by MP‐NAT for hepatitis B, hepatitis C and HIV‐1. The risk of false‐negative test results due to mutations in primer and probe binding regions is higher for NAT systems than for antibody/antigen detection tests. Therefore, the manufactures of the NAT systems are advised to improve their systems by utilising amplification in at least two conserved regions (dual‐ or triple‐targeting). The diagnostic window period for new screening strategies (e.g., antigen screening for HCV) (Source: ISBT Science Series)

Current concepts in transfusion transmitted diseases

ISBT Science Series — Sat, 14 May 2011 20:52:37 +0100

(Source: ISBT Science Series)

Quality risk management: a valuable tool in implementing, maintaining and improving a quality management system

ISBT Science Series — Sat, 14 May 2011 20:52:36 +0100

(Source: ISBT Science Series)

The EuBIS manual and training guide. Guidelines and standards for quality management and inspection of blood establishments

ISBT Science Series — Sat, 14 May 2011 20:52:34 +0100

Conclusion The EuBIS manuals have been used by its partners organising national and international seminars, experimental and regulatory audits assisting the national implementation and further harmonisation of quality standards. In some member states elements of EuBIS have been adapted to national or local quality management systems. The implementation of good practice will improve the quality of blood and ensure that patients receiving blood transfusions are given safe blood. (Source: ISBT Science Series)

Quality indicators in Transfusion Medicine: the building blocks

ISBT Science Series — Sat, 14 May 2011 20:52:32 +0100

Conclusion Quality indicators are indispensible tools which various stakeholders in the Blood Transfusion establishment now demand to adjudge and improve on quality performance. Practitioners as well as policy makers in Transfusion Medicine need to ensure that the quality indicators they institute are appropriately selected and analyzed to be effective and efficient monitors of quality. Knowledge of basic building blocks discussed here is therefore a fundamental prerequisite. (Source: ISBT Science Series)

The management of nonconformities in blood establishments

ISBT Science Series — Sat, 14 May 2011 20:52:31 +0100

With the introduction of quality management system as either a voluntary activity or based on legal regulation, a transfusion establishment is committed to consistent use of nonconformity management in all its activities. Nonconformities are mostly detected in blood products, in all steps of the manufacturing process. A product in broad sense also refers to the services offered. Nonconformities may be found in input materials, devices and equipment as well. Efficient management of these nonconformities is one of the key elements of the materiovigilance system. A special category are the nonconformities that need not be identified directly in the products, materials or equipment, but their occurrence may have adverse effects on the product and service quality, safety of those involved in th...

The building blocks of a quality management system, experiences from South Africa

ISBT Science Series — Sat, 14 May 2011 20:52:28 +0100

Quality management systems (QMS), like houses, come in many different styles and sizes and an organization should design and build a system that accommodates its particular needs, depending on the resources available. The recommendation is to start small and add‐on over time until you have the desired structure. As with any building project, one needs plans, materials and a good construction crew to start with. A strong foundation is critical to a QMS and this can be attained with management support and staff buy‐in. (Source: ISBT Science Series)

Key elements of a blood transfusion quality management system, the tools and objectives

ISBT Science Series — Sat, 14 May 2011 20:52:27 +0100

(Source: ISBT Science Series)

Can genetic engineering of red blood cells and transfusion become close friends?

ISBT Science Series — Sat, 14 May 2011 20:52:25 +0100

(Source: ISBT Science Series)

Application of recombinant antigens to blood group diagnostics

ISBT Science Series — Sat, 14 May 2011 20:52:24 +0100

Conventional red blood cells (RBC)‐based assays use panels of human RBCs carrying a huge number of blood group antigens at the same time and require negative reactions of samples with antigen‐negative cells for indirect determination of antibody specificity. This particularly renders the identification of antibody mixtures and rare RBC antibodies difficult. Many blood group proteins have been recombinantly expressed in sufficient quantity and quality for RBC antibody testing. Recombinant blood group proteins can be used as single antigens in antibody identification assays so that a positive reaction of a serum with the recombinant protein directly indicates the presence and specificity of the target antibody. Recombinant proteins may have wide applications in blood group serology; they...

Molecular testing for platelet and granulocyte antigens

ISBT Science Series — Sat, 14 May 2011 20:52:22 +0100

Human platelet antigen (HPA) genotyping is a valuable tool in confirming platelet antigen specificities of alloantibodies detected in patient sera, complementing the clinical history in the diagnosis of alloimmune platelet disorders such as neonatal alloimmune thrombocytopenia (NAIT), post‐transfusion purpura (PTP) and platelet transfusion refractoriness (PR). Likewise, human neutrophil antigen (HNA) typing also plays a critical role in the investigation and diagnosis of some clinical conditions induced by granulocyte alloantibodies, like neonatal alloimmune neutropenia (NAIN) and transfusion‐related acute lung injury (TRALI).Up to now, 27 HPA alloantigens have been described, including the 6 most clinically relevant biallelic systems and a significant number of low‐frequency or rare...

Technologies involved in molecular blood group genotyping

ISBT Science Series — Sat, 14 May 2011 20:52:20 +0100

Conclusions Although serology may be superior for some blood group typing, genotyping assays offer a good alternative for problems encountered by serology. In many laboratories, blood group genotyping is already used at a low‐throughput level for diagnostics in cases of problematic serology. Especially in case of weak expression of antigens, the presence of rare antigens or auto‐antibodies or after multiple transfusions, genotyping is superior. The non‐invasive determination of the foetal RHD analysis in maternal plasma by real‐time PCR is well established and already offered as a clinical service in a number of countries.The recent availability of automated, high throughput, DNA‐array platforms, allows to introduce into the hospital and donor centres this DNA‐based typing m...

Stem cell and cord blood transplantation – state of the art

ISBT Science Series — Wed, 30 Jun 2010 23:00:00 +0100

Recent advances have broadened the application of allogeneic hematopoietic stem cell (HSC) transplantation and contributed to the continuously increasing numbers of transplantations performed worldwide. These include (1) greater utilization of reduced intensity conditioning and improvement of supportive care allowing transplantation of patients up to 70 years of age and with pre‐existing medical problems, and (2) expansion of the acceptable stem cell donor pool to unrelated cord blood HSC. Thus, selection of the particular transplant procedure should be guided by patient characteristics such as type and stage of the disease, previous therapies, age and comorbidities. HLA typing of patient and siblings at diagnosis is essential to allow the timely initiation of an unrelated donor search...

Risk modelling in blood safety – review of methods, strengths and limitations

ISBT Science Series — Wed, 30 Jun 2010 23:00:00 +0100

Identification of therapeutically relevant mHags and strategies for mHag‐based immunotherapy after allogeneic HSCT: where do we stand?

ISBT Science Series — Wed, 30 Jun 2010 23:00:00 +0100

Minor histocompatibility antigens (mHags) play a major role in graft‐versus‐host disease (GvHD) and graft‐versus‐leukaemia (GvL) effect following human leucocyte antigen (HLA)‐matched hematopoietic stem cell transplantation (HSCT). These antigens are defined as immunogenic peptides derived from polymorphic proteins and can be recognized by allogeneic cytotoxic T cells (CTLs) in the context of HLA molecules. The tissue distribution of mHags and HLA molecules influences the clinical outcome of T‐cell responses to these antigens. Differential T‐cell recognition of mHags specifically expressed in hematopoietic cells, including malignant cells from the recipient, may result in a beneficial GvL effect without detrimental GvHD. Furthermore, T‐cell responses against proteins solely...

Pathogen inactivation – regulators aspects

ISBT Science Series — Wed, 30 Jun 2010 23:00:00 +0100

(Source: ISBT Science Series)

Side‐effects of blood products

ISBT Science Series — Wed, 30 Jun 2010 23:00:00 +0100

As infectious complications from blood transfusion have decreased because of sophisticated blood screening, non‐infectious side‐effects have emerged as the most common complications of transfusion in industrialized countries. Despite making every endeavour, quite a number of these side‐effects are very difficult to control. Some of these side‐effects present as acute transfusion reactions, the most important of which are transfusion‐related acute lung injury, circulatory overload, sepsis, and allergic and anaphylactic reactions. Acute adverse events require immediate action, but are often difficult to evaluate. On the other hand, transfusion recipients may experience delayed non‐infectious side effects, including, non‐ABO haemolytic transfusion reactions, graft‐versus‐hos...

Regulation of cell‐based medicine – the German experience

ISBT Science Series — Wed, 30 Jun 2010 23:00:00 +0100

In the member states of the European Union, the field of cell‐based medicine and tissue preparations is determined by the law of the European Community (EC). The implementation of the EC directives is mandatory and makes Community law binding in the EU Member States. The Tissues and Cells Act of July 20, 2007 transposed the Directive 2004/23/EC, which is setting standards for human tissues and cells, into German law. This Tissue Act is not a law on its own, but makes significant amendments of the Medicinal Products Act, the Transplantation Act and the Transfusion Act. According to the Amsterdam Treaty (1997) and the Directive 2004/23/EC itself, the national legislators may stipulate stricter provisions, thus exceeding the minimum requirements specified in this EC directive. Accordingly, ...

Regulation of cell‐based medicine: the European experience

ISBT Science Series — Wed, 30 Jun 2010 23:00:00 +0100

Cell‐based medicine is regulated in Europe by Regulation no. 1394/2007 of the European Parliament and of the Council. This regulation defines a new category of products named ‘advanced therapy medicinal products’ and provides rules for their marketing authorization, instructions for the definition of product characteristics, specifications on product labelling and product package leaflet. Moreover, it defines the types of cell or tissue manipulations that are not associated to the category of ‘engineered’ cells or tissues. Finally, it describes the composition and function of the Committee for Advanced Therapies, which can be consulted for the categorization of novel biomedicine products. (Source: ISBT Science Series)

Donor management: DOMAINE – the European perspective

ISBT Science Series — Wed, 30 Jun 2010 23:00:00 +0100

(Source: ISBT Science Series)

‘Thank you! please visit us again’. Reflecting on the donor retention literature – implications for retention practices

ISBT Science Series — Wed, 30 Jun 2010 23:00:00 +0100

(Source: ISBT Science Series)

ROTEM and multiplate – a suitable tool for POC?

ISBT Science Series — Wed, 30 Jun 2010 23:00:00 +0100

(Source: ISBT Science Series)

The challenge to develop blood transfusion medicine to high standards in resource‐limited countries

ISBT Science Series — Wed, 30 Jun 2010 23:00:00 +0100

(Source: ISBT Science Series)

Occult B hepatitis – still a risk for transfusions?

ISBT Science Series — Wed, 30 Jun 2010 23:00:00 +0100

NAT screening for HBV has been introduced when multiplex technology was available only in countries where the endemic of HBV was on medium/high level and where the screening with other serological tests, like anti‐HBc, was impossible without impair self‐sufficiency in blood procurement. The first goal of NAT testing introduction in blood screening was to increase the sensibility of screening tests in order to impair transfusion of blood units from subjects in initial acute phase of infection with no other serological markers (window period shortage). But after HBV NAT implementation the great majority of NAT HBV positive/HBsAg negative subjects are represented by repeat donors with other serological markers of previous contact with HBV (anti‐HBc and anti‐HBs), with low viral load a...

Treatment of patients with haemophilia and the patients’ perspective

ISBT Science Series — Wed, 30 Jun 2010 23:00:00 +0100

(Source: ISBT Science Series)

Blood group antigens and immune responses–detailed knowledge is necessary to prevent immunization and to follow up immunized individuals

ISBT Science Series — Wed, 30 Jun 2010 23:00:00 +0100

Background (Source: ISBT Science Series)

Established ways to keep donor’s interest alive

ISBT Science Series — Wed, 30 Jun 2010 23:00:00 +0100

Background (Source: ISBT Science Series)

Intrauterine blood transfusion

ISBT Science Series — Fri, 11 Jun 2010 13:28:09 +0100

(Source: ISBT Science Series)

Stem cell and cord blood transplantation – state of the art