共找到 20 条结果
暂无摘要（点击查看详情）
Social movements in favour of greater diversity, equity and inclusion have led societies to re-examine the concepts of sex assigned at birth and gender identity. These have also impacted healthcare systems and blood operators. Gender identities extending beyond the concept of cisgender binary individuals might have an impact on the safety of blood components for recipients, and on the safety of the donation process itself. Furthermore, the procedures put in place by blood operators to welcome donors from sexual and gender diversity might have a major impact on donors' psychological well-being and retention. This review provides an overview of the processes used by blood operators to mitigate potential health risks for both donors and recipients associated with trans and non-binary donors. It also examines how blood operators address sexual and gender diversity in the donor registration process. Regarding the theoretical risks of human immunodeficiency virus (HIV) transmission and of transfusion-related acute lung injury arising from trans donors, the available evidence suggests that the hypothetical increases would be negligible. Recent studies show that adapting the donor history questionnaire for sexual and gender diversity is still an ongoing process. Improvements are needed, especially in communication with stakeholders, staff training and reducing health risks for donors. The broadening of sexual and gender identities provides an opportunity for blood operators to act as agents of positive social change towards greater safety, diversity, equity and inclusion in our societies.
In Poland, human immunodeficiency virus (HIV) prevalence in the general population is lower than in other developed countries, and men who have sex with men (MSM) are not deferred from donating blood. The aim of the study was to analyse the epidemiology of HIV in Polish blood donors after the introduction of mandatory HIV RNA screening (for the period 2005-2023). HIV test results using anti-HIV (third- or fourth-generation tests) and HIV RNA using transcription-mediated amplification or PCR methods (individual donations [IDT]-minipool [MP] 24) were analysed in 23,215,295 donations from 11,179,429 donors. The mean infection rate per 100,000 donors was 6.48 for all and 6.22 and 0.26 for seropositive and seronegative infections, respectively. Seronegative infections occurred 5.8 (1.4-25)-fold more often in repeat donors than in first-time donors. Almost 25% of HIV-infected donors donated blood within 100 days since HIV acquisition (analysis of Fiebig scale). In four donors, discordant results were identified, indicating elite controller infection, antiretroviral treatment (ART) or HIV prophylaxis and vaccination. No HIV transmission by transfusion was recorded in look-back, and the residual risk for red blood cells (RBCs) (Weusten model) dropped from 0.129 for MP24 at the beginning to 0.019 for MP6 and 0.0051 per million units for - Individual donation-nuclec acid testing, recently. The HIV incidence in blood donors in Poland, compared to other developed countries, was high, despite the low rates reported by epidemiological surveillance. NAT is an effective addition to serological screening in reducing residual risk of HIV transmission by possible test-seeking blood donors in Poland.
University students are a vital yet underutilized donor population, constrained by a knowledge-attitude-practice (KAP) gap. We sought to assess the KAP status and identify modifiable determinants of blood donation among university students in a major Chinese city to inform targeted recruitment strategies. A cross-sectional online survey was conducted from September to November 2023, involving students from all 17 universities in Wuxi, China. The questionnaire covered socio-demographic data, blood donation knowledge, attitudes and influencing factors. Data were analysed using descriptive statistics, chi-square tests and multivariable logistic regression. Among 8537 valid respondents, 917 (10.7%) reported a history of blood donation. Attitudes were generally positive, but knowledge gaps were evident, particularly regarding operational details. Despite this positive outlook, a pronounced attitude-behaviour gap was observed: 59.8% expressed willingness to donate, yet only 10.7% had actually done so. Multivariable analysis identified political/league membership, student leadership roles and club participation as significant positive predictors of donation behaviour. Notably, while experiential factors (sense of glory/honour, donation environment, staff competence) were significant predictors, perceived physical eligibility was not, implying that for non-donors, this commonly cited barrier may be overridden by positive experiential factors. A significant gap between willingness to donate (59.8%) and reported donation behaviour (10.7%) exists among students, shaped by distinct factors for donors and non-donors. Bridging this gap requires a strategic shift from general awareness campaigns to tailored, experiential interventions that address specific cognitive and experiential barriers and reinforce positive donor experiences.
暂无摘要（点击查看详情）
Paediatric patients with haematological disorders frequently require multiple blood transfusions, increasing their risk of developing irregular antibodies. Because of the immunohaematological differences from adults, patterns of alloimmunization in children may vary. This study aimed to determine the prevalence and characteristics of irregular antibodies in paediatric patients with haematological disorders at the National Institute of Hematology and Blood Transfusion (NIHBT). A total of 2663 paediatric patients with haematological disorders were screened for irregular antibodies using column agglutination technology. Positive samples underwent antibody identification. Associations between alloimmunization and clinical or transfusion-related factors were assessed using univariate analyses and multivariable logistic regression. The prevalence of irregular antibodies was 8.04% (95% confidence interval [CI]: 7.0-9.1). Among positive cases, 66.82% had a single antibody, most commonly anti-E (35.51%) and anti-Mia (14.02%). The most frequent antibody combination was anti-c and anti-E (13.08%). Factors significantly associated with antibody formation after adjustment included a higher number of transfused red cell units (57.65 vs. 44.53 units, p = 0.000), absence of phenotype-matched transfusions (p = 0.017), non-Kinh ethnicity (p = 0.0003) and a diagnosis of thalassaemia (p = 0.0013). A relatively high prevalence of irregular red cell alloantibodies was observed in paediatric patients, predominantly involving antibodies of the Rh blood group system and anti-Miᵃ. These findings support the relevance of targeted antigen matching in settings where fully phenotype-matched red blood cells are not consistently available.
Bacterial contamination of blood components is an ongoing problem in transfusion medicine. We analysed the bacterial screening data of platelets from England, 2014-2023, and compared this with data on reported near-misses and transfusion-transmitted infections (TTIs). Anonymized data on bacterial screening of pooled and apheresis platelet donations were reviewed, including the number of donations collected yearly, results from bacterial screening and time from sampling to detection. The findings were compared with data on near-misses and TTIs reported during the same period. Screening of 1249,513 apheresis and 1,495,707 pooled platelet donations identified bacterial contamination in 2949 donations, including 78 bacterial species. Over four-fold higher frequency of confirmed bacterial contamination was observed in pooled platelets compared to apheresis donations (0.09% [1096/1,249,513] vs. 0.02% [362/1,495,707], p < 0.0001). Rates of bacterial contamination of pooled platelet doubled during the study period. Staphylococcus aureus was the most commonly detected highly pathogenic bacterial contaminant (29/147, 19.7%; 15/29, 52% in apheresis platelets). It was also implicated in 1 confirmed case of bacterial TTI and in 8 of 10 reported bacterial near-miss cases. Increasing frequencies of bacterial contamination, mostly related to skin flora, were noted in pooled platelets. Furthermore, S. aureus was notably associated with near-miss events. Our findings demonstrate a limitation of bacterial screening, with evidence of bacterial growth after platelets were likely supplied for clinical use.
Females undergoing cardiac surgery frequently require allogeneic blood transfusion, yet sex-specific haemoglobin (Hb) thresholds may underestimate physiological vulnerability in these patients. Recent evidence suggests that Hb values between 12.0 and 12.9 g/dL may represent marginal anaemia with clinically relevant consequences. This study assessed the impact of preoperative Hb on perioperative transfusion in females undergoing elective cardiac surgery. Anaemia categories were defined as follows: World Health Organization (WHO) anaemia (<12 g/dL in females); marginal anaemia (Hb 12.0-12.9 g/dL in females); and patient blood management (PBM)-defined anaemia (<13 g/dL irrespective of sex). We conducted a retrospective analysis of 1174 cardiac surgery patients, including 399 females. Females were stratified into three groups: Hb ≥13 g/dL, 12-13 g/dL and <12 g/dL. Perioperative outcomes and predictors of packed red blood cell (PRBC) transfusion were evaluated using multivariable logistic regression. Model performance was assessed using receiver operating characteristic (ROC) curve analysis. Transfusion rates increased stepwise across Hb strata: 57.3% (≥13 g/dL), 69.6% (12.0-12.9 g/dL) and 87.0% (<12 g/dL) (p <0.001). Females with marginal anaemia (12.0-12.9 g/dL) received more PRBC units per patient than both non-anaemic females and males in the same Hb range. In multivariable analysis, marginal anaemia (odds ratio [OR] 2.05; 95% confidence interval [CI]: 1.39-3.03) and overt anaemia (OR 6.33; 95% CI: 4.40-9.97) remained independent predictors of transfusion. Marginal anaemia in females undergoing cardiac surgery is associated with an increased risk of perioperative transfusion. Females with marginal anaemia had higher transfusion rates than those with Hb ≥13 g/dL, although quantitatively distinct from overt anaemia.
暂无摘要（点击查看详情）
暂无摘要（点击查看详情）
Immunoglobulin A (IgA) deficiency is common and typically defined as <5-7 mg/dL. Individuals with absolute IgA deficiency (aIgA def) have extremely low levels, can produce allo-anti-IgA and may be at risk for anaphylactic transfusion reactions. There is no globally-accepted definition of aIgA def. We sought to determine how rare donor programmes define IgA deficiency (IgA def), how they test for it and how they manage requests for aIgA def blood products. We queried rare blood donor programmes that participate in the International Society of Blood Transfusion Working Party on Rare Donors using an email survey sent to 39 members representing 35 programmes in 28 countries. Responses were obtained from 23 programmes in 16 countries. Seventeen included IgA def as a rare phenotype, with nine classifying IgA def as levels <0.05 mg/dL. Eight of the 14 programmes indicated that fulfilment of requests for IgA-deficient products requires clinical consultation and 8 programmes require patients to have detectable anti-IgA. Programmes reported provision of a small number of IgA-deficient products in the past 5 years. While respondents from rare donor programmes in 17 countries include aIgA def as a rare blood phenotype, programmes in 5 countries do not. The level of IgA used to define IgA def varies among programmes and, in some cases, across programmes within the same country. Further study is needed to better understand IgA-mediated anaphylactic transfusion reactions. A recommendation is provided for managing transfusion support of patients considered at risk.
Men who have sex with men (MSM) historically faced legal restrictions in accessing blood donation systems. While recent policy changes aim to reduce discriminatory barriers, empirical evidence on prosocial engagement patterns among MSM remains limited. This study examines whether MSM differ from heterosexual men in their prosocial engagement in monetary donations, in-kind support, caretaking and volunteering, and whether these differences vary across age. We rely on data from the Socio-Economic Panel (SOEP), which is a representative survey of the German population. MSM are compared to heterosexual men with respect to prosocial behaviour using propensity score matching. We estimate regression models, including interaction terms between sexual orientation and age, to assess the differences in prosocial engagement. MSM exhibit a higher likelihood of engaging in money donations and in-kind support compared to heterosexual men. When accounting for interaction effects of sexual orientation and age, we find differences in in-kind support, caretaking and the amount of monetary donations. These differences decrease with increasing age. Although a higher proportion of MSM is engaged in in-kind support, there are no differences in the amount of money donated for in-kind support. We find no differences between the groups with respect to volunteering. MSM represent a relevant target group for non-profit engagement, particularly in the domains of financial (amount) and in-kind contributions (likelihood). Blood establishments should leverage recent reforms to build trust through inclusive communication and diversity training. Alternative engagement channels can enhance social participation for those deferred for medical reasons.
Large language models (LLMs) show promise for clinical decision support but remain vulnerable to factual errors. Retrieval-augmented generation (RAG) mitigates this limitation by grounding outputs in authoritative domain knowledge. Therapeutic plasma exchange (TPE) requires consistent, guideline-driven decisions based on the 2023 American Society for Apheresis (ASFA) recommendations. This study aimed to evaluate whether an RAG-based framework could improve accuracy, reliability and standardization of decision support for TPE, compared to conventional LLMs. We built a hybrid RAG pipeline combining BAAI/bge-base-en-v1.5 embeddings with Chroma and BM25, coupled with structured prompts that encode ASFA categories and grades, Health Insurance Review and Assessment (HIRA) service criteria, and plasma volume computation rules. Thirty de-identified real-world consultation cases were converted into standardized queries. Across six RAG and three non-RAG generative pre-trained transformer (GPT)-series model configurations, each case was answered five times (1,350 outputs). Performance was assessed by item-level accuracy for six elements (diagnosis, ASFA category, grade, insurance applicability, plasma volume, and replacement fluid) and reproducibility on 14 disease-name prompts. Response time and output length were also analyzed. RAG configurations consistently outperformed non-RAG baselines across items, with the largest gains in plasma-volume calculation and ASFA classification. Reproducibility was markedly higher with RAG across repeated runs. Among all configurations, RAG GPT-4.1-mini showed the most balanced and superior performance, delivering high accuracy with low latency. A guideline-grounded RAG approach substantially enhances the accuracy, stability and standardization of TPE consultation compared with conventional LLMs. This RAG-TPE framework demonstrates the feasibility of reliable, clinically oriented decision support in transfusion medicine, warranting further evaluation in prospective clinical workflows.
Chagas disease (Trypanosoma cruzi), prevalent in Mexico, Central and South America, can be transfusion-transmitted. Selective serological testing of blood donors was implemented over 15 years ago. We describe the trends in infections and characteristics of donors selected for testing. Donor selection for testing was based on birth in Latin America and/or mother/grandmother born in Latin America and/or travel to Latin America (30 days duration at Héma-Québec [HQ], 6 months at Canadian Blood Services [CBS]). All first-time donors (2010-2024) were analysed. Frequencies were compiled by gender, age group, region and residential material deprivation and ethnocultural composition indices. Multiple logistic regression compared donors with risk factors (tested) versus those without risk factors (not tested). Of the 67,490 tested donors, most were born in Mexico, Central or South America (71% at CBS). Of the 27 donors positive for T. cruzi antibodies, more were from Ontario, materially deprived and ethnocultural concentrated neighbourhoods. One had mother/grandmother birth, but none had travel as the sole risk factor. Tested donors were similar to non-tested donors except more likely to be aged 30-49 (odds ratio [OR] 1.4, 1.37-1.44 CBS, 1.57, 1.51-1.63 HQ) and live in more ethnoculturally concentrated neighbourhoods (OR 2.09, 2.01-2.18 CBS, 3.46, 3.29-3.64 HQ). Birth in Latin America captures most T. cruzi antibody positive donations. Mother/grandmother risk occasionally yields a positive donation, but travel history does not. Infections in donors are rare, but selective testing interdicts a small risk of T. cruzi positive blood products being released into inventory.
The global blood product shortage is a persistent problem that urgently needs addressing. Research has investigated the effects of incentives, different interventions and different modes of communication on promoting blood donation; yet, there has been no systematic review comparing interactive communication-based interventions. Identifying effective methods to recruit and retain blood donors could inform future intervention design and improve resource allocation, thereby reducing strain on blood-product supply. This review brings together relevant literature found on Medline, CENTRAL, Embase and PsychINFO to address the following questions: 'What are the most effective interactive interventions for promoting blood donation?' and 'Are these different between encouraging first-time and returning blood donors?' A total of 36 studies were included in this review. Overall, the quality of research on interactive communication-based interventions was poor, with several studies lacking sufficient detail to make clear conclusions. Evidence for three common interventions (phone calls, educational sessions and motivational interviews) was conflicting. Additionally, there was limited research into web-based interventions and recruitment of first-time donors. Reporting of communication interventions for blood donation could be improved, and our review suggests that a more heterogeneous approach to donor recruitment may be advantageous.
Liquid plasma (LQP) stands out as an alternative to thawed plasma (TP) for emergent transfusions due to its longer shelf-life. We aimed to measure fibrinogen, protein C (PC), protein S (PS), factor V (FV), factor VII (FVII) and factor VIII (FVIII) activity in LQP, quantify how these factors' levels change during storage and characterize how they compare in LQP and TP. Coagulation factor activities were measured on days 15, 26 and 27 for LQP (n = 26) and Day 5 for TP (n = 31). Bayesian statistics was used to compare coagulation factor activity and quantify changes in activity during storage. Fibrinogen and PC activity on Day 26 in LQP (LQP26) was comparable to that on Day 5 in TP (TP5) with posterior mean activity of 257 versus 246 mg/dL and 100.4% versus 108.7%, respectively. FV, FVII and FVIII had lower activity in LQP26 compared to TP5, with posterior mean activities of 42.6% versus 72.0%, 55.0% versus 59.7% and 48.8% versus 59.2%, respectively. PS in LQP26 was low, with posterior mean activity of 28.0%, which was less than half that of TP5 at 66.4%. From Day 15 to Day 26, FVII in LQP decreased at a rate of 3.49% per day, whereas fibrinogen, PC, PS, FV and FVIII activity in LQP remained relatively stable. LQP26 has comparable activities of fibrinogen, PC and FVII as TP5, lower activities of FV and PS and slightly lower activity of FVIII. LQP is a viable alternative for use in emergency transfusions and massive transfusion protocols.
Bedside transfusion errors, especially positive patient identification (PPID), are a risk to patient safety. Bedside electronic transfusion checks (BETC), using barcode-enabled personal digital assistants (PDAs), are recommended to improve safety and efficiency. This study assessed staff satisfaction with BETC versus manual transfusion checks in three large London hospitals. The surveys aimed to compare clinical staff satisfaction with BETC versus the manual system. A cross-sectional survey was conducted immediately after training and 6 months after routine BETC use. The initial (21 questions) and follow-up (15 questions) surveys assessed usability, accuracy, workflow efficiency and patient care impact. Responses were collected via Microsoft Forms and analysed using descriptive statistics and logistic regression, adjusting for job role, experience and hospitals. A total of 2085 staff completed the initial survey (55% response) and 514 the follow-up (13%), predominantly nurses (75%). For group and screen (G&S) labelling, ratings of 'ease of use' and 'accuracy' improved significantly between surveys, while perceived impact on reducing mislabelling remained consistently high (96.2% vs. 94.7%). Compared with manual checks, BETC was rated significantly by clinicians for ease of use (89% → 94%) and accuracy (89% → 95%; both p < 0.001). Improvements were also observed for the time saved by clinical staff (75% → 89%), patient care (77% → 89%), fewer nurses required (79% → 91%) and traceability (80% → 87%), all statistically significant (p < 0.001). BETC was associated with significantly greater clinical staff satisfaction than manual transfusion checks, providing large-scale evidence for their adoption to enhance transfusion safety, efficiency and staff experience.
Malaria still poses a public health burden in India despite ongoing elimination efforts. Blood donor screening for malaria is mandated in India, yet data on transfusion-transmitted malaria (TTM) are lacking. We sought to evaluate testing practices for malaria, associated rates of positivity in donors and reported cases of TTM in India. We conducted a cross-sectional survey of blood collection facilities in India from May to September 2025. Facilities were recruited through professional networks and direct outreach; responses were de-identified. Data were collected on screening practices, malaria endemicity, quality control measures and TTM cases from 2020 to 2024. Among 262 facilities, 256 (97.7%) reported routine malaria screening of all donations, most commonly using antigen rapid diagnostic tests (RDTs) (228/256, 89.1%). From 2020 to 2024, facilities tested 9,275,688 donations, with 1231 confirmed positive donations (overall 13.27 per 100,000 units) and a rising annual positivity rate from 3.4 to 22.0 per 100,000 units. Only eight facilities (3.1%) reported TTM cases, and less than half of facilities (116/256, 45.3%) participated in external quality assessment (EQA) and/or performed lookback investigations (88/262, 33.6%). In this national survey sample in India, almost all facilities reported routine malaria screening of blood donations, mostly using RDT. The findings suggest that rates of donor positivity may have increased, yet TTM is under-recognized and/or unreported. Strengthening EQA and haemovigilance, particularly in malaria endemic regions, is needed to safeguard the blood supply, particularly as India strives towards malaria elimination.
暂无摘要（点击查看详情）
This study aimed to investigate the evolving data trends of the Chinese Haemovigilance Network (CHN) and provide insights into its future development. Data were collected from the CHN covering the period of 2018-2023. The data were subdivided into three phases and analysed from several aspects. We also compared the percentage distribution of adverse transfusion reactions (ATRs) between the CHN and other national haemovigilance reports. Overall, the number of hospitals participating in reporting ATRs has increased, from a total of 188 in 2018-2019 to 206 in 2020-2021 and 222 in 2022-2023. The CHN received 6410 ATRs cases: 1915 in 2018-2019, 2265 in 2020-2021 and 2230 in 2022-2023. The reports for all three phases covered 11 types of ATRs that involved transfusion of nine blood components. The highest percentage of ATRs was caused by apheresis platelets (591/1915 in 2018-2019, 756/2265 in 2020-2021 and 760/2230 in 2022-2023). In terms of ATR severity, no severity was overwhelming (91.70% in 2018-2019, 95.74% in 2020-2021 and 93.34% in 2022-2023). The CHN report showed a higher proportion of allergic reactions compared to serious hazards of transfusion. Similarly, differences in the distribution of ATRs were also observed between the CHN system and both the Australian and transfusion and transplantation reactions in patients haemovigilance systems. Over the past 6 years, the CHN has established a relatively advanced haemovigilance system. Comparison of the CHN and other national haemovigilance reports revealed differences in the classification and percentage distribution of ATRs, underscoring the need for standardized reporting to enhance global transfusion safety.