Asian Journal of Transfusion Science
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   2012| July-December  | Volume 6 | Issue 2  
    Online since July 24, 2012

 
 
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CME ARTICLE
Automation in Immunohematology
Meenu Bajpai, Ravneet Kaur, Ekta Gupta
July-December 2012, 6(2):140-144
DOI:10.4103/0973-6247.98914  PMID:22988378
There have been rapid technological advances in blood banking in South Asian region over the past decade with an increasing emphasis on quality and safety of blood products. The conventional test tube technique has given way to newer techniques such as column agglutination technique, solid phase red cell adherence assay, and erythrocyte-magnetized technique. These new technologies are adaptable to automation and major manufacturers in this field have come up with semi and fully automated equipments for immunohematology tests in the blood bank. Automation improves the objectivity and reproducibility of tests. It reduces human errors in patient identification and transcription errors. Documentation and traceability of tests, reagents and processes and archiving of results is another major advantage of automation. Shifting from manual methods to automation is a major undertaking for any transfusion service to provide quality patient care with lesser turnaround time for their ever increasing workload. This article discusses the various issues involved in the process.
  14 8,233 154
ORIGINAL ARTICLES
True positivity of anti-Hepatitis C Virus Enzyme-linked immunosorbent assay reactive blood donors: A prospective study done in western India
Sunita Tulsiani, Nabajyoti Choudhury, Priti Desai, Ripal Shah, Ankit Mathur, V Harimoorthy, Jwalant Shah
July-December 2012, 6(2):165-168
DOI:10.4103/0973-6247.98927  PMID:22988383
Background: A significant number of safe donations are removed from the blood supply, because of the reactive anti-HCV screening test results. This study aimed to assess if the HCV (Hepatitis C Virus) seropositive donors were confirmed positive or not. Materials and Methods: More than 68,000 blood donors' samples were routinely screened and 140 samples were found to be anti-HCV ELISA reactive. These 140 samples were tested by NAT. The NAT negative samples were tested by RIBA. Analysis of samples reactive in single ELISA kit vs. two ELISA kits was done. Results: Out of 140 anti-HCV ELISA reactive samples, a total of 16 (11.43%) were positive by NAT. The results of 124 RIBA showed 6 (4.84%) positive, 92 (74.19%) negative, and 26 (20.97%) indeterminate results. None of the sample which was reactive in only single ELISA kit was positive by NAT or RIBA. Conclusion: Only a minority of blood donors with repeatedly reactive anti-HCV screening test is positive by confirmatory testing, but all these blood units are discarded as per existing legal provisions in India. Efforts should be made to retain these donors and also donor units.
  10 4,467 37
Analysis of adverse events and predisposing factors in voluntary and replacement whole blood donors: A study from north India
Naveen Agnihotri, Neelam Marwaha, Ratti R Sharma
July-December 2012, 6(2):155-160
DOI:10.4103/0973-6247.98922  PMID:22988381
Background: Lack of awareness and community motivation, compounded with fragmented blood transfusion services in our country, Often leads to shortage of blood. Donor recruitment and retention are essential for ensuring adequate blood supply. However, adverse events (AEs) in donors have a negative impact on donor return. Aims and Objectives: The present study was aimed to assess the frequency of AEs in whole blood donors and analyze the predisposing factors for AEs. Material and Methods: The study was conducted on allogeneic whole blood donors over a period of 14 months, i.e., from January 2002 to February 2003. A total of 37,896 donors were monitored for any AEs: 22587 (59.6%) were voluntary donors (VD) and 15,309 (40.4%) were replacement donors (RD). Results: Overall reaction rate was 2.5% with vasovagal reactions constituting 63.5% and hematomas 35.0% of all reactions. Vasovagal reactions showed a significant association with young age, lower weight, first time donation status, female gender, and nature of blood donation camps. Amongst male donors, RDs had more reactions (P=0.03) than VDs. Majority of donors (85%) with vasovagal reactions admitted to some fear or anxiety prior to donation. Hematoma formation occurred significantly more when less trained staff performed phlebotomy. Conclusion: Donor safety is an essential prerequisite to increase voluntary blood donation. AE analysis helps in identifying the blood donors at risk of donor reactions and adopting appropriate donor motivational strategies, pre-donation counseling, and care during and after donation.
  8 3,992 39
A prospective study for prevalence and/or development of transfusion-transmitted infections in multiply transfused thalassemia major patients
Roopam Jain, Jim Perkins, Susan T Johnson, P Desai, Anil Khatri, U Chudgar, N Choudhury
July-December 2012, 6(2):151-154
DOI:10.4103/0973-6247.98919  PMID:22988380
Objective: To evaluate the rate of seropositivity to hepatitis B and C and Human Immunodeficiency Virus (HIV) infections among children with β-thalassemia major receiving multiple transfusions in Ahmedabad, India, compared with healthy controls. Materials and Methods: The study was performed during January 2007 to January 2009 on multi-transfused children suffering with β-thalassemia major registered in the Prathama Blood Centre, Ahmedabad; Jeevandeep hospital, Ahmedabad; and Red Cross Blood Centre, Ahmedabad, and investigated for the prevalence and development of transfusion-transmitted infections. Hepatitis B surface Antigen (HBsAg), anti-Hepatitis C Virus (HCV) Antibodies (Ab), and HIV Ab were checked using a fourth-generation Enzyme-Linked Immunosorbent Assay (ELISA). Positive tests were confirmed by western blots. Healthy blood donors were used for the control group. Results: Hepatitis B surface antigen, anti-HCV Ab, and HIV Ab were positive in one of 96 (1.04%; 95% Confidence Interval (CI) = 0.17-1.3), 24 of 96 (25%; 95% CI = 11.4-14.2), and one of 96 (1.04%; 95% CI = 0.12-1.3), respectively. The rate of anti-HCV Ab was significantly higher in multi-transfused children suffering with β-thalassemia major. In thalassemia patients, the rate of positive anti-HCV Ab was significantly higher than that for positive HBsAg (P<0.001) and HIV Ab (P<0.001). Conclusion: It is concluded that HCV is the current major problem in multi-transfused children with thalassemia major and more careful pretransfusion screening of blood for anti-HCV must be introduced in blood centers.
  6 6,011 49
Seroprevalence of malaria in blood donors and multi-transfused patients in Northern India: Relevance to prevention of transfusion-transmissible malaria
Anju Dubey, Priti Elhence, Ujjala Ghoshal, Anupam Verma
July-December 2012, 6(2):174-178
DOI:10.4103/0973-6247.98937  PMID:22988385
Background: Transfusion-transmissible malaria (TTM) is a major concern in malaria endemic countries. A study was therefore conducted to know sero-prevalence of malaria in blood donors and the risk of TTM to multi-transfused patients at our hospital. Materials and Methods: Study subjects were: eligible blood donors (n = 1000), donors deferred due to history of fever in the last 3 months (n = 100), and multi-transfused patients (n = 200). Screening for malaria was done by slide microscopy, immunochromatographic rapid diagnostic test (RDT) for malaria antigen, and anti-malaria antibody by enzyme linked immunosorbent assay. Results: Malaria antibody prevalence in eligible donors and donors with history of fever, thalassemia patients, and in other multi-transfused patients was 16.9%, 22%, 6%, and 15%, respectively. None of the donors were positive for malaria on microscopic examination. None of the blood donors except one donor with history of fever, tested positive with RDT. Conclusion: Malaria antibody prevalence in blood donors at our center is high. As blood units donated by such donors have high-risk potential, special processing may be undertaken to reduce the risk of TTM.
  4 3,745 32
Neonatal thrombocytopenia and platelets transfusion
Anil K Gupta, Sudarshan Kumari, Abhishek Singhal, Aruna Bahl
July-December 2012, 6(2):161-164
DOI:10.4103/0973-6247.98924  PMID:22988382
Background: Neonates often develop thrombocytopenia at some time during hospital stay. Platelet transfusion are frequently given to them and are likely to result in unnecessary transfusion. Material and Methods: Thus, we analyzed thrombocytopenia in neonates, its prevalence, and relationship if any, between clinical condition and platelet transfusion in neonates, which would have been helpful in developing guidelines and/or protocols for platelet transfusion (and reducing the donor exposure) in neonates. Results: A total of 870 neonates who were admitted in Neonatal Intensive Care Unit (NICU) with various morbidities had platelets count done; of these, 146 (16.7%) neonate revealed thrombocytopenia. Discussion: Low birth weight babies (P 0.009) and babies born with mother having hypertension (P 0.04) showed significant thrombocytopenia. Neonates with intrauterine growth retardation (IUGR) diagnosed during antenatal screening showed lower platelet count (P 0.022). Neonates having associated illness, such as sepsis, gastrointestinal, and respiratory problems, and on vasopressor drugs were found to be associated with low platelet count. Conclusion: In our study, 16.40% of thrombocytopenic neonates required platelet transfusion either alone or with other blood component during their stay in NICU.
  3 4,246 51
EDITORIAL
Hemovigilance and blood safety
Ashish Jain, Ravneet Kaur
July-December 2012, 6(2):137-138
DOI:10.4103/0973-6247.98911  PMID:22988376
  2 4,205 116
LETTERS TO THE EDITOR
Audit of use of blood and its components in a tertiary care center in South India
Gopal Gomathi, Renu G'Boy Varghese
July-December 2012, 6(2):189-189
DOI:10.4103/0973-6247.98952  PMID:22988390
  2 2,537 27
Ahead to 100% of voluntary nonremunerated blood donation at a tertiary referral hospital blood bank in South India
Umakanth Siromani, Molly Rajaiah, Dolly Daniel, Joy J Mammen, SC Nair
July-December 2012, 6(2):190-190
DOI:10.4103/0973-6247.98954  PMID:22988391
  2 21,174 73
ORIGINAL ARTICLES
Effectiveness of blood donor questionnaire directed at risk factor for transfusion transmitted infections in Pakistani population
Nuzhat Salamat
July-December 2012, 6(2):169-173
DOI:10.4103/0973-6247.98929  PMID:22988384
Background: Deferring blood donors who admit to high-risk behavior on questioning are likely to eliminate those in window period for transfusion transmitted infections (TTI). However, many questions have been implemented in some countries as part of donor history questionnaire, based on precautionary principle and not on evidence, and can result in increased donor losses. This study aims to identify effective risk-directed questions having high predictive value, in local context which can form part of blood donor deferral policies. For this, a case control study in a hospital blood bank having donation services was carried out prospectively over a period of three years. Materials and Methods: Two hundred and twenty donors, who were repeatedly reactive for HBsAg, anti-HCV, anti-HIV with EIA, and syphilis with TPHA, were the cases. Eight hundred and eighty four controls were the donors who tested negative for all TTI test. All donors answered seven hepatitis risk directed questions and their responses and reactivity status for TTI were used for statistical analysis with SPSS ver. 15. Results: Positive predictive value for history of jaundice at any age for HBsAg was 20%, while PPV for history of surgery in previous six months for both HBsAg and anti-HCVHCV was also around 20%, based on pretest probability of 7%. The post-test probability for these questions was around 30%. Odds ratios with 95% CI did not reveal any significant association of hepatitis with any of seven questions. Donor losses after deferring on basis of two questions were 5.3% per year, while deferral rate after all seven questions was 20%. Conclusions: Donors should be permanently deferred if there is history of jaundice at any age, while deferral period after surgery should be one year. Other risk-directed questions should not be used to defer donors. Donor deferral policies should be evidence based and questions with proven efficacy should be made part of donor history questionnaire to minimize donor losses.
  2 3,411 45
ILLUSTRATION
Visual inspection of platelet concentrates; still an essential prerelease check
Suchet Sachdev, Hari Krishan Dhawan, Dheeraj Khetan, Ashish Jain, RR Sharma, Neelam Marwaha
July-December 2012, 6(2):139-139
DOI:10.4103/0973-6247.98912  PMID:22988377
  1 4,616 69
LETTERS TO THE EDITOR
Hemolytic disease of fetus and newborn due to anti-E alloantibody in a newborn of Rh (D)-positive mother
Vijay Kumawat, Ashish Jain, RR Sharma, Neelam Marwaha
July-December 2012, 6(2):187-187
DOI:10.4103/0973-6247.98946  PMID:22988388
  1 3,252 33
ORIGINAL ARTICLES
Deferral pattern in voluntary blood donors on basis of low hemoglobin and effect of application of digital hemoglobinometer on this pattern
Ankit Mathur, Ripal Shah, Priti Shah, V Harimoorthy, Nabajyoti Choudhury
July-December 2012, 6(2):179-181
DOI:10.4103/0973-6247.98939  PMID:22988386
Background: One of the responsibilities of blood center is to provide safety to blood donors. It is mandatory to screen a blood donor for hemoglobin (Hb) or hematocrit which should not be less than 12.5 g/dl or 38% Hct. Most commonly applied method for hemoglobin estimation is copper sulphate method, but this method has chances of false acceptance as well as false deferral. In order to avoid this chance of error, digital hemoglobinometer is used. This study was planned to analyze effect of application of digital hemoglobinometer for detection of Hb on donors, who are deferred by copper sulphate method. Materials and Methods: Total 35,339 voluntary non renumareted altruistic donors were included in this study between the periods of September 2005 to July 2006. Total deferred donors were 8622 (24.39%) and donors deferred due to hemoglobin by copper sulphate method were 4391 (50.92%). Digital hemoglobinometer was applied on 3163 deferred donors (72.03%). Results of digital hemoglobinometer were validated by known controls. Result: Digital hemoglobinometer was applied on 3163 donors who were deferred by copper sulphate method. Out of this, donors accepted by digital hemoglobinometer were 1196 (37.01%). Total repeat donors were 629 (52.50%) and first time were 567 (47.40%). Male donors were 891 (74.44%) and females were 305 (25.50%). Donors deferred with digital hemoglobinometer were 2135, out of them 1097 (51.14%) were repeat, 1038 (48.38%) were first time, 1349 (60.79%) were male, 786 (34.47%) donors were female donors. Range of hemoglobin in deferred donors was 7.0 to 12.4 and in accepted donors 12.5 to 16.4. Conclusion: By the application of digital hemoglobinometer 37.81% donors were found hemoglobin >12.5 which were deferred with copper sulphate method and unnecessary deferral of donors can be reduced to a great extent. In country like India, where blood supply is always less than the requirement, this new technique may be helpful to increase donor population but cost benefit ratio should be analyzed.
  1 4,471 32
LETTERS TO THE EDITOR
IgA-induced autoimmune hemolytic anemia in a patient with antiphospholipid syndrome
Laura Scaramucci, Marco Giovannini, Pasquale Niscola, Massimiliano Palombi, Luca Cupelli, Andrea Tendas, Alessio Pio Perrotti, Paolo de Fabritiis
July-December 2012, 6(2):188-188
DOI:10.4103/0973-6247.98950  PMID:22988389
  - 2,655 25
Effective implementation of regulations and facilitation in improving blood transfusion services in Gujarat state
A Ramkishan, VK Gupta, HG Koshia, KK Goswami, KK Shah, Ripal J Shah
July-December 2012, 6(2):190-192
DOI:10.4103/0973-6247.98955  PMID:22988392
  - 2,435 29
Rapid decreasing of transfused platelet in a cancerous patient: Anti-platelet antibody
Beuy Joob, Viroj Wiwanitkit
July-December 2012, 6(2):192-193
DOI:10.4103/0973-6247.98956  PMID:22988393
  - 3,197 42
Blood cell MicroRNAs and blood product safety
Somsri Wiwanitkit, Viroj Wiwanitkit
July-December 2012, 6(2):193-194
DOI:10.4103/0973-6247.98957  PMID:22988394
  - 1,822 20
Role of transfusion medicine in post-crisis nuclear leakage
Viroj Wiwanitkit
July-December 2012, 6(2):194-194
DOI:10.4103/0973-6247.98958  PMID:22988395
  - 1,924 25
ORIGINAL ARTICLES
Expanding role of a blood center
Jaisy Mathai, Sulochana P Vasu, Sathyabhama Subhadramma
July-December 2012, 6(2):182-186
DOI:10.4103/0973-6247.98945  PMID:22988387
Materials and Methods: The study was performed on prospective donors who reported to the Department of Transfusion Medicine. Individuals deferred due to hypertension contributed the study population. They were compared with age and sex matched donor controls. Demographic details were recorded in a proforma. On identification of a hypertensive individual, consequent two comparable donors were taken as controls with a total of 50 hypertensive subjects. Hypertensive status of the subjects were assessed based on the criteria formulated by the WHO-ISH and US Seventh Joint National Committee report on prevention, detection, evaluation and treatment of high blood pressure. Results: About 0.95% of healthy blood donors had undetected hypertension. Mean age at detection of hypertension in the study group was 35.44 ± 7.69 years. Higher BMI was observed in the hypertensive group compared to normotensive control group with P value significant at 0.0001. Conclusion: About 1% of healthy individuals were found to have undetected hypertension. Though the study was not designed to determine the prevalence of hypertension in the region, it is a rough estimate of the proportion of undetected hypertension in the local population as donors are considered as representative of healthy population.
  - 2,776 20
Code development of the national hemovigilance system and expansion strategies for hospital blood banks
Kim Jeongeun, Kim Sukwha, Han Kyusup, Lee Kyungsoon
July-December 2012, 6(2):145-150
DOI:10.4103/0973-6247.98916  PMID:22988379
Objectives : The aims of this study were to develop reportable event codes that are applicable to the national hemovigilance systems for hospital blood banks, and to present expansion strategies for the blood banks. Materials and Methods : The data were obtained from a literature review and expert consultation, followed by adding to and revising the established hemovigilance code system and guidelines to develop reportable event codes for hospital blood banks. The Medical Error Reporting System-Transfusion Medicine developed in the US and other codes of reportable events were added to the Korean version of the Biologic Products Deviation Report (BPDR) developed by the Korean Red Cross Blood Safety Administration, then using these codes, mapping work was conducted. We deduced outcomes suitable for practice, referred to the results of the advisory councils, and conducted a survey with experts and blood banks practitioners. Results : We developed reportable event codes that were applicable to hospital blood banks and could cover blood safety - from blood product safety to blood transfusion safety - and also presented expansion strategies for hospital blood banks. Conclusion : It was necessary to add 10 major categories to the blood transfusion safety stage and 97 reportable event codes to the blood safety stage. Contextualized solutions were presented on 9 categories of expansion strategies of hemovigilance system for the hospital blood banks.
  - 3,134 32
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2006 - Asian Journal of Transfusion Science | Published by Wolters Kluwer - Medknow
Online since 10th November, 2006