ABSTRACT
@#Introduction: Error in blood sampling is of one the commonest causes of laboratory sample rejection and poses a great challenge particularly amongst oncology patients due to difficult venous access. This study aims to identify the main causes of blood sample rejection in the haematology and chemical pathology (CP) laboratories of an oncology institute. Method: All blood samples received and rejected in the CP and haematology laboratory from 2017 to 2019 were obtained from the laboratory information system (LIS) and sample rejection logbook. The rejection cause for each of the rejected samples was recorded and analysed. Results: Out of the total 39 495 blood samples received, 244 (0.6%) were rejected. The rejection rate in the CP was higher compared with that in the haematology laboratory (51.2% vs. 48.8%). The most frequent cause of rejection was haemolysis (49.6%), clotted sample (32.8%), and insufficient sample volume (6.1%). Conclusion: Haemolysis, clotted blood and insufficient sample were the main causes of sample rejection in our oncology centre. Effective and multidisciplinary targeted interventions to reduce blood sampling error are important to improve pre-analytical handling of blood samples from oncology patients.
ABSTRACT
Abstract@#Introduction: Inadequate mixing during the blood collection process might affect the quality of platelet concentrates (PCs). Currently, two different mixing methods are used during whole blood collection: manual mixing and mixing using an automated blood collection mixer. However, the cost between manual and automated blood collection mixer differed largely and pose a dilemma for a blood transfusion service. The objective of this study was to evaluate PCs quality using either manual mixing or automated procedure. Methods: This was a cross-sectional study conducted at the Advanced Medical and Dental Institute, Universiti Sains Malaysia. Thirty eligible participants aged 20 to 45 were included in this study, and a unit of 450 mL whole blood was collected from each participant. Fifteen units of whole blood were mixed by an automated blood collection mixer and the other 15 units were mixed using the manual mixing. All PCs were produced from platelet-rich plasma and stored at 20–24°C for 5 days. Quality parameters such as platelet count, leucocyte count, and pH were measured for each PCs on day 1 and day 5. Results: Platelet count on day 1 was significantly higher than on day 5 (p = 0.01) for both mixing methods. There was no statistically significant difference in any of the PCs quality parameters between the two types of mixing methods at either day 1 or day 5 of storage (p > 0.05). Conclusion: Comparable PCs quality is achieved from both manual mixing and automated procedures.
ABSTRACT
@#The current focus of perioperative management of anaemia has shifted from allogeneic transfusion to optimising and conserving the patient’s blood through the implementation of patient blood management (PBM) strategies. We hereby report a case to illustrate the success of applying PBM strategies in managing a surgical patient with an extremely rare red blood cells (RBC) phenotype. An 80-year-old Malay man was planned for urgent major abdominal surgery following diagnosis of intestinal obstruction secondary to an advanced rectosigmoid tumour. A request of two units packed RBC was made given anticipated blood loss intraoperatively. His pre-operative haemoglobin was 135 g/L. His previous immunohaematological record showed that he had an extremely rare P2k (P1-, P-, Pk+) phenotype with clinically significant anti-P, anti-PX2, and anti-P1. The elements of PBM strategies were explored and applied. Eventually, the patient successfully underwent a surgical operation without any allogeneic RBC transfusion.