sabato 18 luglio 2015
Specifications for anti-A and anti-B in intravenous immunoglobulin: history and rationale
Intravenous immunoglobulin (IVIG) products are generally safe and efficacious, although treatment-related adverse reactions can occur in recipients. Adverse reactions include hemolysis in non–blood group O recipients linked to the passive transfer of anti-A and/or anti-B present in the fractionated immunoglobulin product. In light of the recent increase in reported cases of severe hemolysis associated with anti-A and/or anti-B, this article traces the development of pharmacopoeial specifications, tests, and reference reagents to control their titers in IVIG products (read more)
A population-based study on blood lead levels in blood donors
BACKGROUND : Recent studies suggested that blood transfusion may represent a significant source of lead exposure in premature infants. Objectives of this study were to determine blood lead levels (BLLs) in a representative sample of blood donors and to identify risk factors associated with BLLs of 0.15 µmol/L or more.
STUDY DESIGN AND METHODS : A study was conducted in 2006 to 2007 in 49 drive sites in Quebec. Individuals who qualified for blood donation were eligible to participate. Information was harvested from blood donor file and a standardized self-administered questionnaire. Lead analysis was performed by inductively coupled plasma mass spectrometry. Data on Quebec blood donors from 2003 to 2006 (n = 320,543) were used to establish a reference population. Geometric mean (GM) and 95% confidence interval (CI) were used to describe the results. The project was approved by an ethics committee.
RESULTS : Of 6715 eligible individuals, 3490 participated (1392 women and 2098 men). Their mean age was 46.5 years. Results were weighted for region, sex, and age. The GM of BLLs was 0.082 µmol/L (95% CI, 0.027-0.247; range, 0.011-2.90 µmol/L). BLLs of more than 0.15 µmol/L were found in 15.5% of participants. In multivariate analysis, BLLs were mainly explained by age and sex of participants (p < 0.001). A significant association was also found between BLLs and the region of residence, education level, dwelling age, occupational and leisure activities at high risk for lead exposure, smoking, and alcohol intake (p < 0.001).
CONCLUSION : BLL in blood donors is strongly explained by sex and age, a fact that can be taken into consideration when transfusing neonates (read more)
STUDY DESIGN AND METHODS : A study was conducted in 2006 to 2007 in 49 drive sites in Quebec. Individuals who qualified for blood donation were eligible to participate. Information was harvested from blood donor file and a standardized self-administered questionnaire. Lead analysis was performed by inductively coupled plasma mass spectrometry. Data on Quebec blood donors from 2003 to 2006 (n = 320,543) were used to establish a reference population. Geometric mean (GM) and 95% confidence interval (CI) were used to describe the results. The project was approved by an ethics committee.
RESULTS : Of 6715 eligible individuals, 3490 participated (1392 women and 2098 men). Their mean age was 46.5 years. Results were weighted for region, sex, and age. The GM of BLLs was 0.082 µmol/L (95% CI, 0.027-0.247; range, 0.011-2.90 µmol/L). BLLs of more than 0.15 µmol/L were found in 15.5% of participants. In multivariate analysis, BLLs were mainly explained by age and sex of participants (p < 0.001). A significant association was also found between BLLs and the region of residence, education level, dwelling age, occupational and leisure activities at high risk for lead exposure, smoking, and alcohol intake (p < 0.001).
CONCLUSION : BLL in blood donors is strongly explained by sex and age, a fact that can be taken into consideration when transfusing neonates (read more)
lunedì 6 luglio 2015
Implementing mass-scale red cell genotyping at a blood center
BACKGROUND : When problems with compatibility beyond ABO and D arise, currently transfusion services search their inventories and perform time-consuming serologic testing to locate antigen-negative blood. These clinically important blood group antigens can be detected reliably by red cell genotyping, which is a technology whereby DNA-based techniques are used to evaluate gene polymorphisms that determine the expression of blood group antigens. We introduced mass-scale genotyping and measured availability of genotyped blood.
STUDY DESIGN AND METHODS : All non-Caucasian donors qualified for genotyping along with donors who had a history of repeat donation. Mass-scale red cell genotyping, performed on an electronic interfaced open array platform, was implemented to screen blood donors for 32 single-nucleotide polymorphisms that predicted 42 blood group antigens. Genotype screening results were confirmed by phenotyping, when needed for antigen-negative transfusion, before release of the red blood cell (RBC) unit.
RESULTS : Approximately 22,000 donors were red cell genotyped within 4 months and a total of 43,066 donors in 4 years. There were 463 discordances (0.52% of 89,596 genotypes with a phenotype). Among the 307 resolved discordances, approximate equal numbers represented historical serologic or genotyping discrepancies (n = 151 and n = 156, respectively). In the final year of the study, a mean of 29% of the daily inventory had a genotype.
CONCLUSIONS : Red cell genotyping of blood donors using an electronic interface created a large and stable supply of RBC units with historical genotypes. The database served the needs of antigen-negative blood requests for a large regional blood center and allowed us to abandon screening by serology (read more)
STUDY DESIGN AND METHODS : All non-Caucasian donors qualified for genotyping along with donors who had a history of repeat donation. Mass-scale red cell genotyping, performed on an electronic interfaced open array platform, was implemented to screen blood donors for 32 single-nucleotide polymorphisms that predicted 42 blood group antigens. Genotype screening results were confirmed by phenotyping, when needed for antigen-negative transfusion, before release of the red blood cell (RBC) unit.
RESULTS : Approximately 22,000 donors were red cell genotyped within 4 months and a total of 43,066 donors in 4 years. There were 463 discordances (0.52% of 89,596 genotypes with a phenotype). Among the 307 resolved discordances, approximate equal numbers represented historical serologic or genotyping discrepancies (n = 151 and n = 156, respectively). In the final year of the study, a mean of 29% of the daily inventory had a genotype.
CONCLUSIONS : Red cell genotyping of blood donors using an electronic interface created a large and stable supply of RBC units with historical genotypes. The database served the needs of antigen-negative blood requests for a large regional blood center and allowed us to abandon screening by serology (read more)
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