Desafíos en el manejo del sarcoma de Ewing en una paciente testigo de Jehová / Challenges in the care of Ewing's sarcoma in a Jehovah's Witness patient

El sarcoma de Ewing es una neoplasia de hueso y tejidos blandos, cuyo manejo se relaciona con toxicidad hematológica. Este aspecto representa un desafío médico y ético en los pacientes testigos de Jehová quienes, por sus creencias religiosas, rechazan la aplicación de hemoderivados, con riesgo de que se descontinúe la quimioterapia o de que se utilicen dosis subóptimas. Se presenta el caso de una mujer colombiana de 34 años, testigo de Jehová, con diagnóstico de sarcoma de Ewing con estadificación clínica IIB (T1N0M0) en las regiones maxilar y mandibular izquierdas, tratada con quimioterapia, quien presentó un valor mínimo de hemoglobina de hasta 4,5 g/dl y tuvo indicación quirúrgica como parte del tratamiento. En estos pacientes, la decisión de practicar una transfusión comprende implicaciones éticas que requieren alternativas terapéuticas y un abordaje multidisciplinario.

Ewing's sarcoma is a bone and soft tissue neoplasm, whose management is related to hematological toxicity. This aspect represents a medical and ethical challenge in Jehovah's Witnesses patients, who, due to their religious beliefs, reject the blood component transfusion, with the risk of discontinuing chemotherapy or using suboptimal doses. We present the case of a 34-year-old Colombian woman, Jehovah's Witness, diagnosed with Ewing's sarcoma with clinical stage IIB (T1N0M0) in the left maxillary and mandibular regions, treated with chemotherapy, who presented a hemoglobin nadir of up to 4.5 g/dL, and surgical indication as part of the treatment. In these patients, the transfusion decision has ethical implications that require therapeutic alternatives and a multidisciplinary approach.

Evaluation of hierarchical teaching model in advanced training of therapeutic blood component apheresis / 中国输血杂志

【Objective】 To explore the efficiency of hierarchical teaching model in advanced training of therapeutic blood component apheresis. 【Methods】 A total of 76 students who participated in the advanced training(≥3 months) of therapeutic blood component apheresis in Blood Transfusion Department of our hospital from January 2016 to December 2021 were taken as subjects. They were divided into observation group(hierarchical teaching mode, n=46) and control group (traditional teaching mode, n=30) using random number table method. The assessment scores of the two groups in terms of theoretical knowledge and experimental operation ability before and after the advanced traning were compared, and the satisfaction of students for the teaching models were collected by questionnaires. 【Results】 After training, the average score of the observation group and control group in terms of theoretical knowledge and experimental operation ability were 52.57±2.17 vs 51.00±2.73, 34.74±1.99 vs 33.40±2.42, respectively (P<0.05), and the training satisfaction was 95.35% (41/43) vs 78.57% (22/28) (P<0.05). 【Conclusion】 Compared to traditional teaching mode, hierarchical teaching mode in advanced training of therapeutic blood component apheresis has better effect on the trainees to master relevant theoretical knowledge and operational skills.

Establishment and application of performance appraisal system oriented to improve blood collection and supply / 中国输血杂志

【Objective】 To establish a comprehensive performance appraisal system, in order to promote blood collection, preparation and supply. 【Methods】 The performance reform leading group headed by the central leader was set up to manage the overall work, with performance reform office set up to formulate the central performance reform plan and the target assessment plan. The operation effectiveness was evaluated by comparing the index changes in blood collection, preparation and supply. 【Results】 Compared with before the implementation of performance (from 2018 to 2019, a total of 24 months), except for the total monthly collection of street whole blood, the per person of street monthly blood collection and the total and per person monthly collection of apheresis platelets were significantly increased (P<0.05) during the process of blood collection. The total and per person monthly preparation of cryoprecipitates and virus inactivates plasma were significantly increased (P<0.05) during the process of blood preparation. The total and per person monthly supply of apheresis platelets, cryoprecipitates and virus inactivates plasma were significantly increased (P<0.05) during the process of blood supply. 【Conclusion】 The adjustment and implementation of performance reform program optimized the performance salary distribution system, and the formulation and implementation of target assessment program significantly promoted blood collection, preparation and supply.

Analysis of blood component transfusion and some adverse reactions in myelodysplastic syndroms patients / 中国输血杂志

【Objective】 To analyze the blood transfusion and adverse reactions in myelodysplastic syndroms (MDS) patients, so as to improve transfusion management in MDS patients. 【Methods】 The diagnosis and treatment information of MDS patients with blood transfusion in our hospital from January 2003 to December 2022 were collected, and the component transfusion and adverse reactions were investigated. 【Results】 The average infusion volume of red blood cells(RBCs) and platelets were respectively (27.46±43.11 ) and (16.41±24.81 ) in 799 MDS patients, which had no correlation with gender and blood type. The incidence of adverse reactions was 18.27% (146/799), with the most common adverse reactions as delayed serologic transfusion reaction (DSTR) (9.01%, 72/799), followed by non hemolytic fever reaction (4.76%, 38/799) and allergic reaction (4.38%, 35/799). Compared with all patients with transfusion, DSTR was more common in females (P<0.05), with elder age and had more RBCs consumption (all P<0.01). 86.11%(62/72) were Rh system, and 40.28% (29/72) had 2 or more antibodies. The occurrence time of DSTR in some patients was not related to the volume of RBCs trans infusion. 【Conclusion】 MDS patients, with more average transfusion volume and higher incidence of adverse reactions especially DSTR, were recommended a strictly limited transfusion schedule and Rh phenotype matching RBC products. The investigation of immune status of MDS patients at different periods is helpful to provide new aspects and therapeutic measures for the pathogenesis of DSTR, and the antibody screening time may adjusted appropriately.

Statistical process control methods for quality inspection of blood component samples: a case study / 中国输血杂志

【Objective】 To explore the analytical methods for detecting data in the process of quality inspection of blood component samples. 【Methods】 The quality inspection data of blood component samples from 2018 to 2022 in our center were collected. Based on the principles of statistical process control, control charts were created using Minitab software to analyze key test items. 【Results】 The P control chart was used to analyze the pass rate of platelet content and revealed one out-of-control point. The normality test was performed on plasma protein content to analyze the causes of data fluctuations for further improvement. The mean and range control chart was utilized for hematocrit measurement, with abnormal data trends detected. Further analysis of the normality test and process capability analysis was conducted, resulting in a Cpk value of 0.67. 【Conclusion】 By applying statistical process control methods, the study employed P control charts to analyze count data in the quality inspection of blood component samples, conducted normality tests for measurement data, and utilized mean and range control charts to identify abnormal data trends. For data conforming to a normal distribution, the process capability index (Cpk) was calculated to explore effective monitoring methods for ensuring stability in the blood supply process.

A software for blood product information management: development and application / 中国输血杂志

【Objective】 To develop a mobile software application named " Component Assistant" and test for its performance in practical work, so as to address the difficulties and problems encountered during the management process of blood component preparation, such as communication and coordination in the workflow, personnel scheduling and workload arrangements. 【Methods】 The software was developed based on the daily work requirements and processes using Java language, and foreground-background separation technologies were employed to provide secure and reliable data support. 【Results】 The results of practical work verification showed that through this software, component preparation managers were able to real-time monitor blood collection situations, blood transfusion details, manage inventory levels, and summarize and review the details of the preparation process. Comparison of the usage sequence of this software, the average amount of blood prepared of employees has increased(198 bloodbag, /M), the workload of employees has increased(3.5, /M) and the rest time has been shortened(1 h, /M). 【Conclusion】 The innovation of this software lies in providing effective data support for matching the workload and personnel in component preparation operations, meeting the needs of blood component preparation management, and greatly improving work efficiency in this field.

Predicting donor-related factors for high platelet yield donations by classification and regression tree analysis

Introduction Collecting high-dose (HD) or double-dose (DD) apheresis platelets units from a single collection offers significant benefit by improving inventory logistics and minimizing the cost per unit produced. Platelet collection yield by apheresis is primarily influenced by donor factors, but the cell separator used also affects the collection yield. Objectives To predict the cutoff in donor factors resulting in HD and DD platelet collections between Trima/Spectra Optia and MCS+ apheresis equipment using Classification and Regression Trees (CART) analysis. Methods High platelet yield collections (target ≥ 4.5 × 1011 platelets) using MCS+, Trima Accel and Spectra Optia were included. Endpoints were ≥ 6 × 1011 platelets for DD and ≥ 4.5 to < 6 × 1011 for HD collections. The CART, a tree building technique, was used to predict the donor factors resulting in high-yield platelet collections in Trima/Spectra Optia and MCS+ equipment by R programming. Results Out of 1,102 donations, the DDs represented 60% and the HDs, 31%. The Trima/Spectra Optia predicted higher success rates when the donor platelet count was set at ≥ 205 × 103/µl and ≥ 237 × 103/µl for HD and DD collections. The MCS+ predicted better success when the donor platelet count was ≥ 286 × 103/µl for HD and ≥ 384 × 103/µl for DD collections. Increased donor weight helped counter the effects of lower donor platelet counts only for HD collections in both the equipment. Conclusions The donor platelet count and weight formed the strongest criteria for predicting high platelet yield donations. Success rates for collecting DD and HD products were higher in the Trima/Spectra Optia, as they require lower donor platelet count and body weight than the MCS+.

Construction and validity of checklist for patient safety during the transfusion process / Construcción y validación de una lista de verificación para la seguridad del paciente durante el proceso de transfusión / Construção e validação de checklist para segurança do paciente no ato transfusional

ABSTRACT Objective: to construct and validate a checklist for patient safety during transfusion. Method: this is a methodological study whose development took place, between February 2020 and January 2021, at a teaching hospital in Santa Maria, RS, Brazil. The design was based on the survey of items in an integrative literature review, and validity, with 17 health specialists and 8 hemotherapy experts. Pre-test was carried out with 36 professionals from the target population. For data analysis, the Content Validity Index was calculated. Results: the checklist was composed of 29 items and 90 sub-items, distributed in three domains, corresponding to the transfusion act stages: Pre-transfusion (Medical prescription, Compatibility and Bedside identification); Transfusion (Blood component installation); and Post-transfusion (Monitoring). The items obtained a Content Validity Index predominantly > 0.80 in all stages. After reformulations suggested by participants, a Content Validity Index of 0.98 was obtained in its final version. Conclusion: the checklist demonstrated evidence of content validity and can be a reliable instrument to promote patient safety during transfusion.

RESUMEN Objetivo: construir y validar una lista de verificación para la seguridad del paciente durante la transfusión. Método: estudio metodológico cuyo desarrollo tuvo lugar entre febrero de 2020 y enero de 2021 en un hospital universitario de Santa María, RS, Brasil. El diseño se basó en el levantamiento de ítems en una revisión integrativa de la literatura, validación con 17 especialistas de la salud y 8 expertos en hemoterapia. La preprueba se realizó con 36 profesionales de la población objetivo. Para el análisis de los datos, se calculó el Índice de Validez de Contenido. Resultados: la lista de verificación estuvo compuesta por 29 ítems y 90 subítems, distribuidos en tres dominios, correspondientes a las etapas del acto transfusional: Pre-transfusión (Prescripción médica, Compatibilidad e Identificación al pie de la cama); Transfusión (Instalación del componente sanguíneo); y Post-transfusión (Monitoreo). Los ítems obtuvieron un Índice de Validez de Contenido predominantemente > 0,80 en todas las etapas. Luego de reformulaciones sugeridas por los participantes, se obtuvo un Índice de Validez de Contenido de 0,98 en su versión final. Conclusión: la lista de verificación demostró evidencia de validez de contenido y puede ser una herramienta confiable para promover la seguridad del paciente durante la transfusión.

RESUMO Objetivo: construir e validar um checklist para segurança do paciente no ato transfusional. Método: estudo metodológico cujo desenvolvimento ocorreu entre fevereiro de 2020 e janeiro de 2021, em um hospital de ensino de Santa Maria, RS, Brasil. A concepção se deu pelo levantamento dos itens em revisão integrativa da literatura, validação com 17 especialistas da saúde e 8 experts em hemoterapia. O pré-teste foi realizado com 36 profissionais da população-alvo. Para análise dos dados, procedeu-se ao cálculo do Índice de Validade de Conteúdo. Resultados: o checklist ficou composto de 29 itens e 90 subitens, distribuídos em três domínios, correspondentes às etapas do ato transfusional: Pré-transfusão (Prescrição médica, Compatibilização e Identificação Beira-leito); Transfusão (Instalação do hemocomponente); e Pós-transfusão (Monitoramento). Os itens obtiveram Índice de Validade de Conteúdo predominantemente >0,80 em todas as etapas. Após realizadas reformulações sugeridas pelos participantes, obteve-se Índice de Validade de Conteúdo de 0,98 na sua versão final. Conclusão: o checklist demonstrou evidências de validade de conteúdo, podendo ser uma ferramenta confiável para promover a segurança do paciente no ato transfusional.

Evaluación de la eficacia en la colecta de plaquetas por un separador celular / Evaluation of the efficacy in the collection of platelets by a cell separator / Avaliação da eficiência da coleta de plaquetas por um separador de células separador de células

La aféresis es el procedimiento más utilizado para la obtención de concentrados plaquetarios de alto rendimiento, calidad y para mejorar las terapias transfusionales en pacientes trombocitopénicos, oncohematológicos,cirugias e incluso, en pacientes con factores clínicos adversos a la refractariedad. Objetivo. Determinar la eficacia de un separador celular en la colecta de plaquetas en un Instituto Nacional de Salud de Lima. Material y métodos. Estudio descriptivo; la muestra fue de 80 concentrados plaquetarios, obtenidos por plaquetoaferesis y utilizando el equipo de separador celular americano. La colecta de plaquetas se realizó en un servicio de Hemoterapia y Banco de Sangre de una institución de salud de Lima, durante los meses de febrero a julio de 2018. La eficacia se realizó evaluando el rendimiento, la eficiencia y el cumplimiento de estándares de calidad aprobados. Uno de los parámetros utilizados fue el recuento de plaquetas y leucocitos residuales, procesados en el analizador hematológico. Resultados. Las evaluaciones fueron: concentración promedio de plaquetas por concentrado plaquetario (rendimiento)= 3,4 x 1011 plaquetas /ml, recuento de leucocitos residuales = 0,07 x 10 6 leucocitos/ml, volumen promedio de sangre procesado = 2480 ml, volumen final promedio = 217,5 ml, eficiencia en la colecta = 56,9 a 63,9 %, el tiempo medio por procedimiento de colecta = 72 minutos. Conclusiones. Los concentrados plaquetarios obtenidos con el procedimiento de plaquetoaferesis cumplen con los estándares de calidad nacional e internacionales, por lo que, se concluye que este procedimiento es eficaz en la colecta de productos de alta calidad que logran la eficacia en la transfusión.

Apheresis is the most widely used procedure to obtain high yield and quality platelet concentrates and to improve transfusion therapies in thrombocytopenic patients, oncohematological patients, surgical patients and even patients with adverse clinical factors to refractoriness. Objective. To determine the efficacy of a cell separator in the collection of platelets in a National Health Institute in Lima. Material and methods. Descriptive study; the sample consisted of 80 platelet concentrates, obtained by plateletpheresis and using American cell separator equipment. The platelet collection was performed in a Hemotherapy and Blood Bank service of a health institution in Lima, during the months of February to July 2018. Effectiveness was performed by evaluating performance, efficiency and compliance with approved quality standards. One of the parameters used was the residual platelet and leukocyte count, processed in the hematological analyzer. Results. The evaluations were: average platelet concentration per platelet concentrate (yield)= 3.4 x 1011 platelets/ml, residual leukocyte count = 0.07 x 10 6 leukocytes/ml, average volume of blood processed = 2480 ml, average final volume = 217.5 ml, collection efficiency = 56.9 to 63.9 %, average time per collection procedure = 72 minutes. Conclusions. The platelet concentrates obtained with the plateletpheresis procedure comply with national and international quality standards, therefore, it is concluded that this procedure is effective in the collection of high quality products that achieve transfusion efficiency.

A aférese é o procedimento mais utilizado para obter concentrados plaquetários de alto rendimento e alta qualidade e para melhorar as terapias transfusionais em pacientes trombocitopênicos, oncohematológicos, cirúrgicos e até mesmo pacientes com fatores clínicos adversos à refratariedade. Objetivo. Para determinar a eficácia de um separador de células na coleta de plaquetas em um Instituto Nacional de Saúde em Lima. Material e métodos. Estudo descritivo; a amostra consistiu de 80 concentrados de plaquetas, obtidos por plaquetaferese e utilizando equipamento separador de células americano. A coleta de plaquetas foi realizada em um serviço de Hemoterapia e Banco de Sangue de uma instituição de saúde em Lima, durante os meses de fevereiro a julho de 2018. A eficácia foi avaliada através da avaliação do desempenho, eficiência e conformidade com os padrões de qualidade aprovados. Um dos parâmetros utilizados foi a contagem residual de plaquetas e leucócitos, processada no analisador hematológico. Resultados. As avaliações foram: concentração média de plaquetas por concentrado de plaquetas (rendimento) = 3,4 x 1011 plaquetas/ml, contagem de leucócitos residuais = 0,07 x 10 6 leucócitos/ml, volume médio de sangue processado = 2480 ml, volume final médio = 217,5 ml, eficiência da coleta = 56,9 a 63,9%, tempo médio por procedimento de coleta = 72 minutos. Conclusões. Os concentrados de plaquetas obtidos com o procedimento de plaquetférese atendem aos padrões de qualidade nacionais e internacionais, portanto, conclui-se que este procedimento é eficaz na coleta de produtos de alta qualidade que alcançam eficiência transfusional.

Validation of blood components transport through a pneumatic tube system

ABSTRACT Introduction: Urgent blood component transfusions may be life-saving for patients in hemorrhagic shock. Measures to reduce the time taken to provide these transfusions, such as uncrossmatched transfusion or abbreviated testing, are available. However, transport time is still an additional delay and the use of a pneumatic tube system (PTS) may be an alternative to shorten the transport time of blood components. Objectives: To assess pneumatic tube system transportation of blood components based on a validation protocol. Methods: Pre- and post-transport quality control laboratory parameters, visual appearance, transport time and temperature of the packed red blood cells (RBCs), thawed fresh plasma (TFP), cryoprecipitate (CR), and platelet concentrate (PC) were evaluated. Parameters were compared between transport via pneumatic tube and courier. Results: A total of 23 units of RBCs, 50 units of TFP, 30 units of CR and ten units of PC were evaluated. No statistically significant differences were found between pre- and post-transport laboratory results. There was also no difference in laboratory parameters between transport modalities (PTS versus courier). All blood components transported matched regulatory requirements for quality criteria. The temperature during transport remained stable and the transport time via PTS was significantly shorter than the courier's transport time (p < 0.05). Conclusion: The PTS was considered a fast, safe and reliable means of transportation for blood components, also securing quality prerequisites.

An observational study on utilization of blood and blood components in a tertiary care hospital of Kolkata, West Bengal

Background: Blood is essential for human survival though it is a scarce and precious resource. Blood Transfusions also have some risks, like immunomodulation in the recipients, transmission of infectious agents, and may lead to serious adverse reaction. Hence, it is necessary to make an efficient use of blood and blood products. Aims and Objectives: With this background, the present study was carried out at the blood bank of Medical College and Hospital, a tertiary care hospital of West Bengal, India to evaluate the utilization pattern of blood and blood components. Materials and Methods: Facility based, observational, descriptive, and cross-sectional epidemiological study was conducted on the basis of secondary data collected from records of blood bank, medical college, Kolkata, regarding blood and blood component transfusion pattern of patients who were admitted in medical college and hospital and received blood and blood components from blood bank medical college, Kolkata during period from September 1, 2021, to September 15, 2021. Results: Total number of transfusion recipients during the study period was 1339. Total 2621 no of blood and blood components were issued. About 66.84% (895) of all recipients were transfused with single unit of blood or blood component. Packed red blood cells were the maximum utilized blood component. The most common diagnosis for patients requiring blood and blood components was anemia. Conclusion: A large proportion of patients were transfused with single unit of blood or blood component, which might not be beneficial. Training, regular meeting with clinicians and periodic assessment of blood usage are recommended to prevent inappropriate transfusion.

Profile of hemotherapy care and the safety of the transfusion process

SUMMARY OBJECTIVE: This study aimed to evaluate the safety of the transfusion process in a public teaching hospital and to outline the profile of the hemotherapy care provided. METHODS: This was an exploratory, descriptive, and prospective study with a quantitative approach and grounded in field research. Data were obtained from medical and nursing records and active search. RESULTS: Concentrated red blood cells were the most transfused blood component. Inadequate indications of blood components were detected in 15% of Concentrated red blood cells transfusions, 20% of fresh plasma, 29.2% of platelet concentrates, and 36.4% of cryoprecipitates. Filling out the blood component request forms, the nursing checklist and the entry book were inadequate in 88.3, 92.8, and 69.5% of the procedures, respectively. CONCLUSIONS: Faults were identified throughout the transfusion process, revealing inadequate compliance with current standards and legislation, essential in minimizing the occurrence of errors and maximizing the safety of transfusion. Studies of this nature reinforce the need for continued research in this field.

Development and implementation of a COVID-19 convalescent plasma program in a middle-income economy

Abstract Introduction Convalescent Plasma therapy is one of the therapeutic strategies that has been used for patients with the Covid-19 disease. Implementing a program with national extension to supply hospitals with this blood component is a great challenge mainly in a middle-income economy. Objectives Our objective was to develop and implement a Covid-19 Convalescent Plasma Program which met established quality standards and was adapted to a reality of limited resources. Methods A multicentric convalescent plasma collection program was developed and implemented, based on four main sequential procedures: selective donor recruitment, pre-donation antibody screening (Anti-SARS-CoV-2- Chemiluminescence IgG Abbott), convalescent plasma collection by apheresis or whole-blood processing and distribution to the hospitals according to local demand. Results From the 572 candidates submitted to the pre-donation antibody screening, only 270 (47%) were considered eligible for plasma donation according to the established criteria. Higher levels of total antibody were associated with the donor age being above 45 years old (p= 0.002), hospital admission (p= 0.018), and a shorter interval between the diagnosis of the SARS-CoV-2 infection and plasma donation (p < 0.001). There was no association between the ABO and Rh blood groups and their antibody levels. Of the 468 donations made, 61% were from the collection of whole-blood and 39%, from apheresis. The Covid-19 Convalescent Plasma units obtained were distributed to 21 different cities throughout the country by air or ground transportation. Conclusion The implementation of a Covid-19 Convalescent Plasma program in a continental country with relatively scarce resources is feasible with alternative strategies to promote lower cost procedures, while complying with local regulations and meeting quality standards.

Intercambio plasmático terapéutico por plasmafiltración: experiencia de 11 años de un centro / Therapeutic plasma exchange: experience in 102 patients

BACKGROUND: Therapeutic Plasma Exchange (TPE) is a procedure in which plasma and harmful macromolecules are separated from the rest of the blood components by centrifugation or filtration through membranes and are replaced with solutions with albumin and/or plasma. AIM: To communicate our experience using TPE by filtration. MATERIAL AND METHODS: Review of records of 655 TPE sessions performed in 102 patients aged 50 ± 18 years (64% women). The requirement of renal replacement therapy (RRT) and seven days and one year mortality were recorded. RESULTS: Forty five percent of patients had hypertension or diabetes. The main indications for TPE were pulmonary-renal syndrome (PRS) (62%) and antibody mediated graft rejection (29%), followed by neurological diseases (36%). Fifteen percent of patients required RRT for one year. Mortality at seven days and one year was 20 and 30%, respectively. Out of the total of deaths associated with kidney diseases, 88% corresponded to PRS and ANCA vasculitis. The main complications were thrombocytopenia in 41%, hypocalcemia in 18%, and hypotension in 16%. CONCLUSIONS: In our experience, TPE by filtration is a safe technique, with mild and preventable complications. Despite this, the reported mortality is high, which reflects the severity of the diseases that motivated the indication for TPE.

Current status and trend analysis of clinical use of low-dose blood components, from 2015 to 2020 in Dongguan / 中国输血杂志

【Objective】 To retrospectively analyze the clinical use of low-dose blood components in Dongguan and the trend of clinical pediatric blood use, so as to provide reference for better preparation and inventory management of low-dose blood components in blood centers. 【Methods】 The clinical consumption of RBCs, platelets and plasma of Dongguan Blood Center from 2015 to 2020 was counted. The compositions and changes of low-dose blood components by specifications (0.25 U, 0.5 U), years and hospitals (public grade A general hospital, public grade A specialized hospital, private grade A hospital, private hospital equivalent to grade A, regional central hospital, public township hospital, small private hospital) were analyzed. 【Results】 The cumulative growth rates of low-dose RBCs, platelets, and plasma in 6 years were 10.78%, 1 098.55% and -29.41%, respectively, and the compound annual growth rates were 2.07%, 64.34% and -6.73%, respectively. The composition of low-dose blood components in RBCs, platelets and plasma was different (P<0.05) in different levels of hospitals, among which RBCs and plasma were the mostly used in public grade A specialized hospital, accounting for 45.08% (7 272 /16 133) and 53.18% (7 199/13 373) respectively, while platelets were the mostly used in private grade A management hospitals, accounting for 77.38% (3 393/4 385), dominated by apheresis platelets 53.84% (1 144/2 125) and irradiated apheresis platelets 99.51% (2 249/2 260). The composition ratios of 0.25 U and 0.5 U RBCs used in different hospitals were significantly different (P<0.05). The 0.25 U RBCs were used mostly in public grade A hospitals (62.60%, 3 502/5 594) and 0.5 U RBCs in public grade A specialized hospitals (62.09%, 6 544/10 539). 【Conclusion】 The total consumption of low-dose blood components in clinical pediatrics from 2015 to 2020 were as follows: platelets had increased significantly year by year, RBCs had increased steadily and with fluctuation, plasma had a downward trend year by year. The consumption volume and varieties used in different levels of hospitals were uneven, which may be related to the development of pediatrics departments in hospitals and their capabilities to conduct new business. Regular monitoring of the trend of low-dose blood component consumption is of great significance to guarantee the pediatric clinical blood supply.

Current situation and main problems of blood quality control in Hebei province / 中国输血杂志

【Objective】 To investigate the status quo and existing problems of quality control laboratory of blood stations in Hebei province, and to provide reference for the capacity building of quality control laboratory in the future. 【Methods】 The data of routine blood collection and supply, blood component preparation, blood sampling ratio/frequency, and sampling results among 12 blood stations in Hebei in 2020 were collected. The monitoring effect of blood component quality in Hebei province, combined with the indicator changes of main blood components, were analyzed. 【Results】 Blood component preparation from blood stations in Hebei are different. The requirements for the number and frequency of routine sampling in each apartment are not standardized, and retrospective analysis was not conducted basically. Although the frequency and sampling of blood component quality monitoring can meet the minimum requirements of the Quality Monitoring Guidelines of Whole Blood and Blood Components 2017 and Technical Operating Regulations of Blood Stations (2019 Edition), but does not match the actual collection and preparation units. The qualification rate and reliability are unstable due to the small sample size. Monthly quality inspection can result in judgment errors, which is not conducive to systematic analysis and continuous improvement of blood collection and supply process. 【Conclusion】 In the context of continuous enhancement of blood collection and supply standardization in Hebei Province, the blood quality monitoring mechanism based on intra-province consistency can be further studied to standardize intra-province homogenization of blood quality monitoring in multiple links including sampling rules, statistical analysis and data comparison calibers.

Efficacy of autologous platelet-rich plasma in the treatment of refractory wounds after breast cancer surgery / 中国输血杂志

【Objective】 To explore the effect of autologous platelet-rich plasma (PRP) in the treatment of refractory wounds after radical breast cancer resection. 【Methods】 The clinical data of 8 patients with refractory wound healing after radical resection of breast cancer, who received autologous PRP treatment at the South District Wound Treatment Center from November 2020 to May 2021, were collected, including age, sex, wound location, wound area/depth, TNM staging, surgical method, postoperative pathology, chemotherapy conditions, PRP treatment, etc. Wound healing time and scar hyperplasia (vascular distribution, color, softness, thickness, itching, pain, etc.) were observed after PRP treatment. The efficacy of autologous PRP was analyzed and evaluated retrospectively based on the above data. 【Results】 The wounds of 8 patients healed smoothly, and the granulation tissue of the wound was relatively matured and completely covered by the crawling epidermis. The wound healing time was 14 to 26 (20.6±3.6) days, and all patients had not developed scar hyperplasia. 【Conclusion】 The efficacy of autologous PRP treatment of refractory wounds after radical breast cancer resection is fast and effective, and can eliminate scar hyperplasia, which is worthy of clinical promotion.

Extracellular vesicles in the blood components and their roles in transfusion-related immunomodulation / 中国输血杂志

Extracellular vesicles (EVs) with a variety of bioactive molecules can be continuously secreted during the storage of blood components, which can promote cell-cell interaction and mediate cell-to-cell signal transmission. EVs are widely involved in inflammation, metabolism and immunization. In recent years, studies have reported that EVs in the blood components can not only cause transfusion-related lung injury through activating neutrophils, but also act on monocytes to stimulate inflammatory response. EVs can play different regulatory effects on the immune system of patients. In this review, the role and mechanism in transfusion-related immunomodulation (TRIM) of EVs in different blood components have been summarized.

Retrospective analysis of quality data of different blood components in Chongqing / 中国输血杂志

【Objective】 To provide reference for formulating relatively unified quality control strategies and meeting the requirements of homogenization construction of blood banks across Chongqing area by retrospectively analyzing sampling results of different blood components during the past two years in all levels of blood banks in Chongqing area. 【Methods】 The key quality data of blood components prepared by 6 blood banks in Chongqing were analyzed retrospectively. According to the issuing units to the clinical during the past two years, the research objects were selected as leukocyte-depleted suspended RBCs, cryoprecipitate, pathogen inactivated fresh frozen plasma(FFP) and apheresis platelets. The quality data of the above-mentioned blood components from January 2019 to June 2021 were collected and analyzed. 【Results】 For leukocyte-depleted suspended RBCs(1U)prepared by 5 blood banks, statistically significant differences in Hb, residual white blood cells and hemolysis rate at the end of storage, except for Hct, were noticed(P<0.05). For cryoprecipitate, the content of blood coagulation factor Ⅷ and fibrinogen were statistically different among 3 blood banks in 1U specification(P<0.05) and among 5 blood banks in 2U specification(P<0.05). For pathogen inactivated FFP, the content of blood coagulation factor Ⅷ, plasma proteins, and residual methylene blue were statistically different among 3 blood banks(P<0.05). For apheresis platelets, Plt, white/red blood cells contamination and pH at the end of storage were statistically different among 3 blood banks(P<0.05). 【Conclusion】 The quality data of blood components, prepared by different blood banks, meet the requirements of national standard, however, certain differences are existing among blood banks.Key points during the process of collection, preparation, storage and transportation need to be cleared and unified, so as to reduce the differences between each other, and determine the direction and basis for homogeneity construction in the next step.

Adverse reactions to blood transfusion: A retrospective analysis of 814 cases in Qingdao area from 2020 to 2021 / 中国输血杂志

【Objective】 To investigate the incidence and composition of adverse reactions to blood transfusion(ARBT) in Qingdao hospitals in recent years. 【Methods】 The "Statistical Table of Adverse Reactions to Blood Transfusion in Medical Institutions" issued by Qingdao Quality Control Center of Blood Transfusion throughout 2020 to 2021, involving 96 hospitals in the region, were collected and analyzed, including the number, proportion and types of ARBT, as well as the types of blood components transfused. 【Results】 From 2020 to 2021, 296 676 cases of blood transfusion in 96 hospitals occurred, and the incidence of ARBT was 0.27% (814/296 676), of which the incidence of ARBT involving plasma transfusion was 0.17% [accounting for 39.07% (318/814) of all transfusion reactions], involving platelet transfusion was 0.68% [31.08% (259/814)], involving erythrocyte transfusion was 0.11% [27.64% (225/814)] and cryoprecipitation transfusion 0.03% [1.47% (12/814)]. The types of ARBT were anaphylaxis 77.64% (632/814), fever 19.78% (161/814), transfusion-related dyspnea 1.47% (12/814), transfusion-related circulatory overload 0.37% (3/814), purpura 0.25% (2/814) and transfusion-related hypotension 0.25% (2/814), delayed hemolysis 0.12%(1/814) and acute hemolysis 0.12%(1/814), respectively. 【Conclusion】 In recent years, the incidence of ARBT in local medical institutions is lower than that of domestic general level, and the main reactions are anaphylaxis and fever following the transfusion of plasma or (and) platelets.The monitoring and control of ARBT should be strengthened in each hospital with accurate and timely report, and active preventive measures should be taken to control or reduce the incidence of ARBT effectively.