[Trace back of thalassemic patients with positive HCV markers to their donors in adult thalassemia center]

Transfusion transmitted infection is one of the most important transfusion reactions. In this study, we tried to find new cases of HCV in thalassemic patients having referred to Adult Thalassemia Clinic after 1996 and to trace them back for sources of infection. This was a descriptive study in which all patients were studied; census method of data collection was used. Those patients with no test record before 1996 that appeared to be positive in their first test attempt were not considered a new HCV positive case. The new cases were just those whose past negative HCV Ab test results changed into positive in new test. For data analysis, SPSS version 14 was used. Out of 395 file records, 274[69.4%] were thalassemia major, and 110 [27.8%] intermediate. We had 109 HCV positive cases [27.5%] out of whom 21 were those infected after 1996. Out of the latter, 5 had complete medical records by which 54 blood donors were identified; however, only 37 [68.5%] were traced and found to be negative for HCV Ab. Noteworthy that 81% of these safe donors were shown to be repeated donors. Since there had been one or more donors whose donations had been administered to each patient with no possibility for them to be traced, we were not able to prove the transmission of HCV from donors to recipients. Other possibilities including hospital transmission, patient to patient transmission, and transmission by nurses involved in blood administration should be taken into account

[Evaluation of transfusion reactions in thalassemic patients referred to the Tehran adult thalssemia clinic]

Thalassemia is a hereditary hemolytic anemia requiring life-long transfusion treatment. The frequent blood transfusion has some side effects, including immunologic reaetions and nonimmunologics such as iron overload and transmission of some infections such as HBV, HCV and HIV. This cross-sectional study was aimed to investigate the transfusion effects in patients referred to the Adult Thalassemia Clinic, Tehran. For data collection, the patients were asked for the history of transfusion reactions, their files of medical records were surveyed with concern to transfusion status and reactions, and some laboratory data including serum ferritin and TTI were also collected. The results were analyzed using SPSS software. Foun hundreds and forty one patients comprises of 53% males and 47% females with mean age of 22.6 years were studied. They consisted of 362 [82.1%] thalassemia major and 79 [17.9%] thalassemia intermediate. The mean of ferritin level was 1856.4 ng/dl. From the studied subjects, 7 [1.6%] had history of delayed hemolytic disorder, 25 [6.1%] presented with allergy and 41 [9.9%] showed febrile transfusion reaction. The remaining 368 subjects [82.4%] showed no evidence of transfusion reactions. The records showed that 117 patients [28.4%] were HCV Ab positive, 369 [88.7%] were HBsAb positive and 80 [19.2%] were HBcAb positive, 3[0.7%] HBsAg positive. According to this results, 300 patients [70.3%] were vaccinal positive; 66 [15.5%] were immune to HBV from past infections; 40 [9.4%] were negative and 3 [0.7%] were carrier of HBV. Totally, 366 [85%] patients were immune to HBV. We had no case of HIV positive. Transfusion reaction and their documentation are very important for blood transfusion services and programming. Unfortunately, there is no statistic records of these reactions in the hospitals or there may be some unclassified data in the patients. files. Regular co-operation between hospitals and blood transfusion centers is required for collecting the information and finding total incidence of transfusion reactions. Hemovigilance or computerized network between blood bank centers in hospitals and Iran transfusion organization is the best way for collecting such data