ABSTRACT
Adverse transfusion reactions (ATRs) are unexpected reactions to transfusion. This study examined the frequency, types of ATRs, and related blood products retrospectively in pediatric patients with less information than in adult patients. Four hundred and forty transfusions were performed for two months at a children’s hospital: 247 units of red blood cell (RBC) products, 142 units of platelet products, and 41 units of fresh frozen plasma (FFP) were used.Five adverse reactions occurred in five patients, three cases were allergic reactions, and two were febrile nonhemolytic reactions. The frequency was 1.13%, and apheresis platelets and leukocyte-reduced RBC were transfused. Two patients’ ATRs were found in the previous transfusions, and ATRs were repeated in subsequent transfusions in one patient. One of the ATRs was not reported to the blood bank and was then discovered during the study. Because pediatric patients may have limitations in recognizing or expressing their symptoms compared to adults, medical staff rely solely on vital signs and laboratory results rather than symptoms, causing difficulty in noticing ATRs. Information on ATRs and education on appropriate blood products will improve awareness of ATRs and blood management among medical staff at transfusion sites and blood banks.
ABSTRACT
The Dia and Mia antigens have been detected in Koreans with a frequency of 6.4∼14.5% and 0.9%, respectively. This study evaluated the effectiveness of different screening cells using the cells with Diaand Mia antigens for unexpected antibody screening. An unexpected antibody-screening test was performed separately using different screening cells, including the Dia antigen (Panel D) and Mia antigen (Panel M). A total of 2,077 specimens from 1,847 patients were collected, among which 49 (2.32%) and 43 (2.08%) were positive using Panel D and Panel M, respectively. Twenty-seven patients were positive with both panels, 2012 were negative with both panels, and thirty-eight patients showed a discordant result. The suspected anti-Diaand anti-Mia were detected in 4 (0.19%) and 5 (0.24%) patients, respectively. Therefore, the frequency of anti-Dia and anti-Mia antibodies in this study may be helpful for selecting unexpected antibody screening reagents.
ABSTRACT
To increase the success rate of heart and lung transplantation, appropriate transfusion and desensitization treatment should be performed. In each hospital, transfusion should be performed according to the patient and hospital situation and monitored to ensure that an appropriate amount of transfusion is achieved is necessary. If HLA desensitization treatment is performed using plasmapheresis and immunosuppressants, the incidence of rejection and complications after transplantation can be reduced. For desensitization treatment that considers individual patient characteristics, close cooperation between clinical medical staff, blood bank personnel, and medical staff will be required.
ABSTRACT
The anti-K antibody has a role in transfusion reactions or hemolytic disease of the fetus and newborns. The K antigen is rarely expressed in Koreans. On the other hand, the distribution of blood group antigens has changed in recent years owing to the increased number of immigrants. This study examined the prevalence of the Kell group antigens according to their parents’ birth region. In this study, 4% of participants whose parents were born in America, Europe, South Asia, and other countries expressed the K antigen. No participants whose parents were born in Korea or East Asia expressed the K antigen. The frequency of the anti-K is expected to increase because of blood donors with the K antigen. Therefore, it is necessary to consider the K antigen frequency and anti-K in transfusions and pregnancy cases in Korea.
ABSTRACT
Background@#In Korea, there were issues regarding the use of immunoassays for anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibodies to detect infection. So, we compared antibody results of eight kinds of commercial immunoassays using clinical remnant specimens. @*Methods@#We compared the results of several immunoassay kits tested on 40 serum samples from 15 confirmed patients and 86 remnant serum samples from clinical laboratory.Eight kinds of IVD kits—four enzyme-linked immunosorbent assay, two lateral flow rapid immunochromatographic assays, and two chemiluminescent immunoassays with one RUO kit were tested. @*Results@#Among 40 serum samples from 15 coronavirus disease 2019 (COVID-19) patients, 35 yielded at least one positive result for detecting antibodies in the combined assessment. There were inconsistent results in 12 (28%) samples by single immunoassay. Forty samples collected in 2019 before the first COVID-19 Korean case showed negative results except for one equivocal result. @*Conclusion@#The discrepant results obtained with different immunoassay kits in this study show that serological assessment of SARS-CoV-2 by a single immunoassay requires caution not only in detecting infection but also in assessing immunologic status.
ABSTRACT
To increase the success rate of heart and lung transplantation, appropriate transfusion and desensitization treatment should be performed. In each hospital, transfusion should be performed according to the patient and hospital situation and monitored to ensure that an appropriate amount of transfusion is achieved is necessary. If HLA desensitization treatment is performed using plasmapheresis and immunosuppressants, the incidence of rejection and complications after transplantation can be reduced. For desensitization treatment that considers individual patient characteristics, close cooperation between clinical medical staff, blood bank personnel, and medical staff will be required.
ABSTRACT
The anti-K antibody has a role in transfusion reactions or hemolytic disease of the fetus and newborns. The K antigen is rarely expressed in Koreans. On the other hand, the distribution of blood group antigens has changed in recent years owing to the increased number of immigrants. This study examined the prevalence of the Kell group antigens according to their parents’ birth region. In this study, 4% of participants whose parents were born in America, Europe, South Asia, and other countries expressed the K antigen. No participants whose parents were born in Korea or East Asia expressed the K antigen. The frequency of the anti-K is expected to increase because of blood donors with the K antigen. Therefore, it is necessary to consider the K antigen frequency and anti-K in transfusions and pregnancy cases in Korea.
ABSTRACT
Background@#In Korea, there were issues regarding the use of immunoassays for anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibodies to detect infection. So, we compared antibody results of eight kinds of commercial immunoassays using clinical remnant specimens. @*Methods@#We compared the results of several immunoassay kits tested on 40 serum samples from 15 confirmed patients and 86 remnant serum samples from clinical laboratory.Eight kinds of IVD kits—four enzyme-linked immunosorbent assay, two lateral flow rapid immunochromatographic assays, and two chemiluminescent immunoassays with one RUO kit were tested. @*Results@#Among 40 serum samples from 15 coronavirus disease 2019 (COVID-19) patients, 35 yielded at least one positive result for detecting antibodies in the combined assessment. There were inconsistent results in 12 (28%) samples by single immunoassay. Forty samples collected in 2019 before the first COVID-19 Korean case showed negative results except for one equivocal result. @*Conclusion@#The discrepant results obtained with different immunoassay kits in this study show that serological assessment of SARS-CoV-2 by a single immunoassay requires caution not only in detecting infection but also in assessing immunologic status.
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Background@#An increasing number of blood banks use an automated analyzer in ABO blood typing to reduce the high workload and impact of human error. On the other hand, the automated system often causes ABO discrepancies, where cell and serum typing do not match. Hence, the manual method is used for confirmation.This study evaluated the appropriateness of retesting with the manual method. In addition, the causes of ABO discrepancies were analyzed. @*Methods@#A total of 77,590 blood samples were tested with the AutoVue Innova for ABO typing. Among them, 1280 samples were retested manually due to ABO discrepancies. The causes of the discrepancies were analyzed further through additional tests. The serum reaction grades in both methods were compared. @*Results@#ABO typing of 76,906 samples (99.12%), which included 596 manually confirmed samples could be confirmed by the AutoVue system, while 403 samples (0.52%) continued to yield discrepant results. Weak serum reactions in the AutoVue system were observed, as previously reported. One hundred and thirty samples (66.7%), which were graded 0.5+ in the automated analyzer, yielded a negative serum reaction in the manual method, showing a greater serum reaction with the AutoVue system than with the manual method. @*Conclusion@#The AutoVue Innova performs reliably for blood typing. On the other hand, the manual method is still useful as retesting to address the ABO discrepancies and weak or strong serum reactions. In particular, it is important to confirm samples with 0.5+ grade serum reactions manually.
ABSTRACT
BACKGROUND: Tumor markers are useful for detection and preoperative evaluation of ovarian tumors. We evaluated the clinical usefulness of cancer antigen (CA) 125, human epididymis 4 (HE4), and CA72-4 levels and Risk of Ovarian Malignancy Algorithm (ROMA) values for differential diagnosis of malignant and borderline tumors among suspected ovarian tumors, and the effects of endometriosis on these tumor markers. METHODS: In a total of 266 patients (213, 14, and 39 with benign, borderline and malignant tumors, respectively), CA125, HE4, and CA72-4 levels were measured, and ROMA values were calculated. Medians of each marker were compared among the three groups. The area under the ROC curve (AUC), sensitivity, and specificity were calculated to analyze the diagnostic performance of each marker. RESULTS: All markers were significantly higher in the malignant group than in the benign group. HE4 levels and ROMA values were significantly higher in the malignant group than in the borderline group. ROMA value had the highest AUC for distinguishing the malignant and borderline groups from the benign group in premenopausal (0.773) and postmenopausal (0.927) patients. CA125 level was significantly higher in patients with endometriosis than in those without (P<0.001), whereas HE4 and CA72-4 levels were not affected by endometriosis (P=0.128 and 0.271, respectively). CONCLUSIONS: ROMA value is the best marker to distinguish malignant and borderline tumors from benign tumors in pre- and postmenopausal patients. HE4 and CA72-4 levels provide information on possible CA125 elevation due to endometriosis.
Subject(s)
Female , Humans , Male , Area Under Curve , Biomarkers, Tumor , Diagnosis, Differential , Endometriosis , Epididymis , ROC Curve , Rome , Sensitivity and SpecificityABSTRACT
PURPOSE: We investigated the clinical relevance and spectrum of BRCA1/2 mutations in Korean ovarian cancer (KoOC) patients. MATERIALS AND METHODS: Two hundred seventy-nine KoOC patients were enrolled from three university hospitals between 2012 and 2017. Their peripheral blood samples were obtained for BRCA1/2 mutation analysis by direct sequencing. Clinicopathological characteristics were retrospectively reviewed, and spectrum analyses of BRCA1/2 mutation were assessed by systematic literature review. RESULTS: Frequency of BRCA1/2 mutations was 16.5% in KoOC patients. BRCA1/2 mutations were significantly associated with family history of breast/ovarian cancer (pT of BRCA2 in KoBC). CONCLUSION: The clinical relevance of BRCA1/2 mutations in KoOC patients was confirmed but that of early age-of-onset was not. Possible inconsistency in the ratio of BRCA1-to-BRCA2 mutations and the most common mutation between KoOC and KoBC may probably suggest presence of mutation sequence-associated penetrance tendency in hereditary Korean breast and ovarian cancer. These data may provide insights for optimal genetic counseling and prophylactic treatment for at-risk relatives of KoOC patients.
Subject(s)
Humans , Asian People , Breast , Breast Neoplasms , Genes, BRCA1 , Genes, BRCA2 , Genetic Counseling , Germ-Line Mutation , Gynecology , Hospitals, University , Obstetrics , Ovarian Neoplasms , Penetrance , Retrospective StudiesABSTRACT
BACKGROUND: In pregnant women, the frequency of irregular antibodies that cause hemolytic disease of the fetus and newborn (HDFN) vary between study populations. The clinical manifestations of HDFN differ according to the specificities and degree of irregular antibodies. This study examined the frequency and nature of maternal alloimmunization and neonatal outcomes. METHODS: Pregnant women, who underwent irregular antibody screening for prenatal testing at an obstetrics clinic in a single center, were enrolled. Those who screened positive for irregular antibodies were selected as the test group, and age- and obstetrics history-matched pregnant women were selected as the control group to evaluate the pregnancy outcomes according to irregular antibodies. RESULTS: The prevalence of irregular antibodies was 2.78% (42/1,508). With the exception of an unidentified antibody, anti-D was the most frequently identified antibody, followed in order by anti-E and anti-Le(a). The rate of fetal death was higher in the test group (6/37, 16.2%) than in the control group (1/37, 2.7%) (P=0.047). Eight pregnant women had anti-C or anti-D, one woman had a stillbirth, and four living neonates developed hyperbilirubinemia. Of six pregnant women with anti-E alone or with other alloantibodies, three experienced a spontaneous abortion or stillbirth. Among the six newborns with maternal anti-Le(a) and anti-Jk(a), four developed hyperbilirubinemia, but their mothers did not experience a spontaneous abortion or stillbirth. CONCLUSION: The prevalence of unexpected antibodies among pregnant Korean women was 2.78%. A significant difference in neonatal outcomes was observed, including the death rate, prematurity, and hyperbilirubinemia, depending on the specificity of the unexpected antibody.
Subject(s)
Female , Humans , Infant, Newborn , Pregnancy , Abortion, Spontaneous , Antibodies , Fetal Death , Fetus , Hyperbilirubinemia , Isoantibodies , Mass Screening , Mortality , Mothers , Obstetrics , Pregnancy Outcome , Pregnant Women , Prevalence , Sensitivity and Specificity , StillbirthABSTRACT
BACKGROUND: Disasters themselves can increase the blood transfusion requirements due to an increase in injuries, and can lead to deficiencies in the blood transport system. To prepare for a disaster, it is important to know the actual blood requirements at the time of the disaster and the changes in blood supply according to the type of disaster. METHODS: From March 2018 to May 2018, all RBC transfusion cases at Pusan National University Yangsan Hospital were analyzed retrospectively. The patients were divided into Categories 1 to 3 according to the urgency of transfusion by disease. Priority one was defined as having only a category 1 patient receiving a transfusion, and priority two was defined as an emergency situation where only category 1 and 2 patients could receive transfusions. RESULTS: The amount of RBC concentrates used in this hospital was 53.1 units per day, which was 19.4%, 42.2%, and 38.4% in category 1, 2, and 3, respectively. The results of simulating the number of blood products that can be used according to the priorities when having a blood product inventory held by the blood banks are as follows: 2.45 days (normal), 12.64 days (P1), and 3.97 days (P2) can be used. CONCLUSION: The simulation showed the time of blood transfusion without additional blood supply in the event of a crisis, and will help establish the transfusion countermeasures in the event of a disaster.
Subject(s)
Humans , Blood Banks , Blood Transfusion , Disaster Planning , Disasters , Emergencies , Korea , Retrospective Studies , Tertiary HealthcareABSTRACT
BACKGROUND: Massive hemorrhage due to trauma is one of the major causes of death in trauma patients, and the quick supply of appropriate blood products is critical in order to reduce the mortality rate. We introduced a massive transfusion protocol (MTP) for safe and rapid transfusion of trauma patients. Using records collected since its adoption, we compared the characteristics of MTP applied group (MTP group) and MTP not applied group (non-MTP group) to determine whether there is an indicator for predicting patients to be treated with MTP. METHODS: We retrospectively reviewed the electronic medical records and laboratory findings of patients who received massive transfusions in the trauma emergency room of a single tertiary hospital from February to August 2018. We analyzed various laboratory test results, the amount and ratio of the transfused blood products, and the time required for blood products to be released for the MTP group and the non-MTP group. RESULTS: Of the 54 trauma patients who received massive transfusions, 31 were in the MTP group and 22 in the non-MTP group. There was no significant difference in initial vital signs (except blood pressure) and laboratory test results. Also there was no difference in the amount and ratio of blood products, but the time required for blood product release was shorter in the MTP group. CONCLUSION: There was no significant difference in clinical findings such as initial vital signs and laboratory test results between the MTP and non-MTP groups, but required blood products were prepared and released more quickly for the MTP group.
Subject(s)
Humans , Cause of Death , Electronic Health Records , Emergency Service, Hospital , Hemorrhage , Mortality , Retrospective Studies , Tertiary Care Centers , Vital SignsABSTRACT
Patients with sickle cell anemia are chronically transfused. Therefore, it is important to prevent the alloimmunization of RBC antigens. The authors identified a high frequency antigen-negative blood group in patients with sickle cell anemia. As the number of foreigners residing in Korea is increasing, it is necessary to know what to consider when transfusing blood to sickle cell anemia patients. Patients with sickle cell anemia should be informed of the exact blood group type using extended RBC typing to confirm the ABO, Rh, Kell, and Duffy blood types at diagnosis or before the first blood transfusion. Extended matched blood transfusion can reduce the risk of alloimmunization of RBC antigens.
Subject(s)
Humans , Anemia , Anemia, Sickle Cell , Blood Transfusion , Diagnosis , Duffy Blood-Group System , Emigrants and Immigrants , Erythrocytes , KoreaABSTRACT
A 1q21.1 microdeletion is an extremely rare chromosomal abnormality that results in phenotypic diversity and incomplete penetrance. Patients with a 1q21.1 microdeletion exhibit neurological-psychiatric problems, microcephaly, epilepsy, facial dysmorphism, cataract, and thrombocytopenia absent radius syndrome. We reported a neonate with confirmed intrauterine growth restriction (IUGR), micrognathia, glossoptosis, upper airway obstruction, facial dysmorphism, and eye abnormality at birth as well as developmental delay at the age of 1 year. These clinical manifestations, except for the IUGR and upper airway obstruction, in the neonate indicated a 1q21.1 microdeletion. Here, we report a rare case of a 1q21.1 microdeletion obtained via paternal inheritance in a newborn with upper airway obstruction caused by glossoptosis and tracheal stenosis.
Subject(s)
Humans , Infant, Newborn , Airway Obstruction , Cataract , Chromosome Aberrations , Chromosome Deletion , Epilepsy , Eye Abnormalities , Fetal Growth Retardation , Glossoptosis , Microarray Analysis , Microcephaly , Micrognathism , Parturition , Penetrance , Radius , Thrombocytopenia , Tracheal Stenosis , WillsABSTRACT
Frequencies of red blood cell (RBC) blood group antigens differ by ethnicity. Since the number of immigrants is increasing in Korea, RBC antigens should be assessed in children/youths with parents of different ethnicities to ensure safe transfusions. We investigated the frequency of RBC antigens, except for ABO and RhD, in 382 children and youths with parents having Korean and non-Korean ethnicities. Subjects were divided into those with ethnically Korean parents (Korean group; N=252) and those with at least one parent of non-Korean ethnicity (non-Korean group; N=130). The 37 RBC antigens were genotyped using the ID CORE XT system (Progenika Biopharma-Grifols, Bizkaia, Spain). The frequencies of the Rh (E, C, e, hr(S), and hr(B)), Duffy (Fy(a)), MNS (Mi(a)), and Cartwright (Yt(b)) antigens differed significantly between the two groups. Eight and 11 subjects in the Korean and non-Korean groups, respectively, exhibited negative expression of high-frequency antigens, whereas 14 subjects in the non-Korean group showed positive expression of low-frequency antigens. The frequency of RBC antigens has altered alongside demographic changes in Korea and might lead to changes in distribution of RBC antibodies that cause acute or delayed hemolytic transfusion reaction.
Subject(s)
Adolescent , Child , Humans , Antibodies , Blood Group Antigens , Emigrants and Immigrants , Erythrocytes , Korea , Molecular Typing , Parents , Transfusion ReactionABSTRACT
No abstract available.
Subject(s)
Adolescent , Humans , Korea , Oxidoreductases , PrevalenceABSTRACT
BACKGROUND: Blood transfusion is important when treating patients with anemia or bleeding; thus, supply of blood components should be stable prior to transfusion. To recruit donors, blood donation sites should be conveniently located. This study evaluated factors responsible for increased donation rates in hospitals and the characteristics of the donors in hospital blood banks without a fixed blood collection site nearby. METHODS: We retrospectively reviewed 687 blood donations at a blood donation center in Pusan National University Yangsan Hospital (PNUYH) from March 2011 to June 2016. A total of 3,053,695 blood donors listed in the 2014 Korean Red Cross Annual Report were compared to donors in PNUYH. We analyzed the age distribution of donor at blood donation centers from Korean Red Cross according to presence and number of high school and college. RESULTS: Comparison with total blood donors in Korea revealed that there were more blood donors in their thirties, office workers and business owners at PNUYH (P<0.001). The percentage of younger donors in their twenties differed significantly according to the presence of a college within a 4 km radius of the blood donation center (P=0.03). The presence of a high school did not affect the proportion of teenage donors (P=0.833). CONCLUSION: The blood donation rate at our medical institution without fixed blood collection sites nearby increased. A regional hospital may be used as a blood collection site to recruit donors in areas in which there are no fixed blood donation centers.