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【Objective】 To observe and analyze the detection results of blood type unexpected antibody and its risk factors in inpatients, so as to provide reference for promoting the safety of clinical blood transfusion. 【Methods】 Clinical data of 22 800 inpatients were collected retrospectively and unexpected antibody screening was performed by microcolumn gel method and saline method. According to the screening results, the inpatients were divided into positive group (n = 62) and negative group (n = 22 738). Clinical data of the two groups were collected and analized by univariate analysis, and specificity identification of unexpected antibody was performed in the positive group. The specific distribution characteristics of antibody were statistically analyzed, and the risk factors of unexpected antibody were analyzed by binary logistic regression. 【Results】 Among the 22 800 inpatients, the yield rate of unexpected antibody was 0.27% (62/22 800), with Rh, MNS, Lewis, Kidd blood group antibody, mixed antibody, autoantibodies and others accounted for 40.32% (25/62), 14.52% (9/62), 6.45%(4/62), 1.61%(1/62), 20.97%(13/62), 6.45%(4/62) and 9.68%(6/62), respectively. Univariate analysis showed that there were significant differences in gender, age, pregnancy history, blood transfusion history, blood transfusion frequency and disease type between the positive group and the negative group by chi-square test (χ2 = 11.142, 6.994, 12.453, 4.762, 5.493, 92.381, all P<0.05), while there was no significant difference in nationality (χ2 = 3.719, P>0.05 ) . Binary logistic regression analysis showed that female, age >60 years old, with history of blood transfusion, number of blood transfusion >3 times, history of pregnancy, solid tumor and blood diseases, severe internal medical diseases were independent risk factors for unexpected antibody(P<0.05) . 【Conclusion】 For patients who need blood transfusion, especially those with the above risk factors, conducting unexpected antibodies screening and identification before transfusion, avoiding corresponding antibodies and selecting antigen-negative blood for cross-matching were suggested to ensure the effectiveness and safety of clinical blood transfusion.
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【Objective】 To establish a rare blood group information supply platform in Shaanxi Province. 【Methods】 The rare blood group information supply platform consists of sample registration, result registration, donor files and inventory blood. The blood donation codes of voluntary blood donors were recorded for blood typing, and the antigen identification results of each blood group system were registered, all stored in the rare blood type information supply platform. When receiving an application for unusual or rare blood type missing multiple conventional antigens or a certain high-frequency antigen, the corresponding antigen negative blood donors and their blood status (in stock or not) were queried from the donor profile module of the platform, and the inventory of blood of rare blood type was monitored dynamically. 【Results】 The results showed that 5.060% (273/5 398) of rare Rh phenotype donors, 1.540‰ (51/33 010) of donors lacking multiple regular antigens, and 13 O-type donors lacking high-frequency antigens were recorded in the rare blood type information supply platform. Among them, 0.019‰ (3/158 484) of Jk(a-b-) phenotype, 0.436‰ (2/4 586) of Di(a+b-) phenotype, and 4.030‰ (8/1 983) of Fy (a-b+) phenotype were stored in the blood bank for rare blood type. 【Conclusion】 The establishment of rare blood group information supply platform can meet the urgent demand for blood of rare blood types in clinical practice and ensure the safety of blood transfusion.
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【Objective】 To determine the value of quality assessment system in supervising standard clinical blood use and improving the quality of clinical blood transfusion medical records. 【Methods】 The clinical blood transfusion records of Children′s Hospital, Zhejiang University School of Medical every quarter from January 2019 to December 2022 were selected and extracted for evaluation by 5% to 10% for the current season. These blood transfusion medical records were scored and graded A(≥90 points)/B(80-89 points)/C(<80 points)according to the Evaluation Table of Clinical Science Rational Use of Blood in Children′s Hospital of Zhejiang University, and the annual A rate was statistically analyzed. After summarizing the deduction points, a rectification plan was submitted to the medical department and publicized on the hospital network. 【Results】 A total of 1 975 blood transfusion medical records were analyzed from January 2019 to December 2022, including 343 in 2019 (17.37%), 517 in 2020 (26.18%), 556 in 2021 (28.15%) and 559 in 2022 (28.30%), with Grade A rates at 67.06%, 92.07%, 93.17% and 91.06%, respectively. According to Pearson Chi-square test, the Grade A rates of blood transfusion records in 2020, 2021 and 2022 were significantly higher than those in 2019 (P<0.000 1). In the assessment, the main reasons for deduction of points were missed pre-transfusion immunization tests and missed blood transfusion course records. From 2019 to 2022, the missed rates of pre-transfusion immunization tests were 22.68%, 6.47%, 1.26% and 2.49%, and the missed rates of blood transfusion course records were 32.21%, 10.59%, 5.57% and 6.61%, respectively. 【Conclusion】 The regular and reasonable assessment and publicity system of blood transfusion medical records is conducive to improving the quality of blood transfusion medical records, promoting rational blood use and ensuring the safety of blood use for children.
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【Objective】 To analyze the safety of homotypic transfusion in military donors with negative unexpected antibody. 【Methods】 Blood samples (4 mL/person)of eligible military blood donors from November 2018 to October 2019 in our hospital (also working as forces blood station) were conducted for RBC antigen typing, unexpected antibody screening, direct antiglobulin test and cross-match test using microcolumn gel technology, and the compatibility of homotype blood samples was statistical analyzed. 【Results】 A total of 1 577 samples from eligible military blood donors were collected, including A RhD (+ ), B RhD (+ ), O RhD (+ ) and AB RhD (+ ), accounting for 31.39% (495/1 577), 34.37% (542/1 577), 24.10% (380/1 577) and 10.15% (160/1 577), respectively. Six samples presenting positive unexpected antibodies (0.38%, 6/1 577) were screened out, and a total of 7 141 cross-matching tests were performed on 1 571 unexpected antibody negative samples, including A RhD (+ ) [37.36% (2 668/7 141)], B RhD (+ ) [34.81% (2 486/7 141)], O RhD (+ ) [17.71% (1265/7 141)] and AB RhD (+ ) [10.11% (722/7 141)]. There was only 1 case of incompatible cross-matching presented between other donors and clinical patients, and the direct antiglobulin test was 1+ , therefore suspended red blood cells of the donor were scrapped. 【Conclusion】 There was high compatibility and good security of homotype transfusion of military blood donors with negative unexpected antibody.
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Platelets transfusion is one of the most important methods to prevent and treat hemorrhagic diseases.At present, the vitro storage of platelets with gentle agitation at (22±2)℃ is short and susceptible to bacterial contamination, which greatly affects the availability and safety of clinical platelets transfusion.Studies at home and abroad have shown that storage at 4°C could prolong the preservation period of platelets.However, refrigeration may aggravate platelets storage lesion (PSL) and accelerate the clearance mechanism after transfusion, which seriously restricts the clinical application of refrigerated platelets.This paper reviews the research advances in PSL caused by 4℃ storage and the clearance mechanism after transfusion.
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【Objective】 To observe the distribution of the unexpected antibodies in order to study the safety and strategies in 1 779 cases of clinical blood transfusion. 【Methods】 A total of 1 779 patients with unexpected antibodies were enrolled from transfusion candidates in various hospitals in Xi′an during a 10-year period(from 2012 to 2022.5). 【Results】 The unexpected antibodies were detected in 926(52.05%) of 1779 samples. The detected antibodies were mainly from 8 blood group systems and their distributions were as follows: Rh antibodies in 69.76%(646/926), Kidd in 2.59%(24/926), Lewis in 4.21%(39/926), MNS in 12.53%(116/926), P in 0.43%(4/926), Diego in 0.65%(6/926), Duffy in 0.54%(5/926), I in 0.97%(9/926), Rh+ MNS in 1.30%(12/926), Rh+ Lewis in 0.65%(6/926), Rh+ Kidd in 3.24%(30/926), Rh+ Diego in 1.51%(14/926), Rh+ Duffy in 0.86%(8/926), MNS+ Diego in 0.11%(1/926), Rh+ MNS+ Kidd in 0.22%(2/926), Rh+ Lewis+ Kidd in 0.22%(2/926), Rh+ Kidd+ P in 0.11%(1/926), Rh+ Kidd+ Diego in 0.11%(1/926). 【Conclusion】 According to the distribution of unexpected antibodies in Xi′an, antibodies from Rh system, were the most common ones.First, the production of unexpected antibodies can be effectively reduced by establishing Rh compatible blood transfusion. Secondly, antibody screen cells containing low-frequency antigens, such as Mur, Dia and Wra, should be reasonably selected to prevent missing detection of anti-low frequency antigen antibodies in Xi′an. Furthermore, the genotyping technology of rare blood group should be promoted and a rare blood group red blood cell bank be established to optimize the blood inventory and ensure the safety of blood transfusion.
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【Objective】 To evaluate the quality of platelet concentrates prepared by two different blood collection bags, so as to provide references for the development of high-quality platelet preparation. 【Methods】 Platelet concentrates were prepared using buffy coating from the whole blood collected by conventional and optimized single-use blood collection bags with leukoreduction filter, respectively. The volume of whole blood collected was 400 mL, and 60 bags in total. They were divided into group A (conventional collection bags, n=30), and the size of buffy coating pouch was 15 cm×12 cm; group B (optimized collection bags, n=30), and the size of buffy coating pouch was 11 cm×9 cm. 【Results】 There were significant differences between group A and group B in the amount of red blood cells contamination, platelet content, and platelet yielding rate (P<0.05), which were (2.62±0.57)×109/mL vs (1.37±0.35)×109/mL, (4.41±0.31)×1010/mL vs (6.21±0.63)×1010/mL, and (55.03±0.06)% vs (79.23±0.09)%, respectively. 【Conclusion】 The buffy coating pouch with the size of 11 cm×9 cm can produce better platelet concentrates, thus improves the safety and efficacy of clinical blood transfusion.
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Objective@#To evaluate the reduction of the residual risk of blood transfusion- transmitted hepatitis B virus (HBV), using nucleic acid detection(NAT)test for enzyme linked immunosorbent assay (ELISA) qualified volunteer-donor bloods in Quzhou area after NAT was developed.@*Methods@#Specimens were collected from March 2016 to March 2017, detected by ELISA twice with two different reagents and NAT only once. The residual risks of blood transfusion-transmitted HBV infection were calculated by mathematical model of risk evaluation.@*Results@#Totally 27 646 specimens were collected from March 2016 to March 2017, which included 76 specimens that were both ELISA and NAT positive, 31 specimens were ELISA negative but NAT positive.The total number of NAT positive specimens was 107.The residual risk of HBV by ELISA test was 28.2×10 -5and NAT test was 13.0×10-5.@*Conclusions@#NAT detection can greatly reduce the residual risk of blood transfusion-transmitted HBV infection, and provide effective value for bloods safety in practice.
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Objective Irregular antibody screening and identification are very important to reduce hemolytic reaction.The dis-tribution of irregular antibodies of blood group was analyzed in patients, to provide evidence for using Micro column gel test to detect and identify irregular antibodies transfusion safety. Methods Micro column gel anti-globulin technique was used to screen the irregular an-tibodies and cross-matching in 29770 patients.If the serum had irregular antibodies, the spectrum cells were used to identify the specific-ity of irregular antibodies. Results Among 29 770 patients, 120 cases had irregular antibodies of blood group.The positive rate was 0.4%.The irregular antibodies include Rh system(n=67),MNS system (n=7), Lewis system(n=5),cases of Kidd system(n=3) and undefined specified antibodies(n=38).Among the 120 antibody-positive patients, 70 were female patients and 50 were male patients. Further study showed that the pregnancy history was to the main factor causing irregular antibodies in women (46 positive cases among 70 female patients) . Conclusion The study showed that some patients had irregular antibodies of blood group, especially female patients with pregnancy history.These results suggested that irregular antibody screening and cross-matching by micro column gel method in pa-tients before transfusion had great significance for ensuring the blood transfusion safety.
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Objective To explore the method and effect of checklist tool implemented in the safety management of clinical blood transfusion in intensive care unit. Methods A checklist was specially designed according to the technical standard and check system of clinical blood transfusion. 379 patients prescribed a blood transfusion enrolled in ICU from January to May 2013 were conducted as the control group before the checklist was designed. After the application of checklist during the blood transfusion process, 846 patients prescribed a blood transfusion enrolled in ICU from June to December 2013 were conducted as the experimental group. The incidence of blood transfusion safety related adverse events between the two groups was compared. Results The incidence of adverse events was 1.32% (5 of 379 patients) in the control group, and there was no sign of adverse events occurred in the experimental group. The difference had statistical significance (χ2=11.21, P<0.05). Conclusion The application of checklist reduced the incidence of blood transfusion safety related adverse events,and effectively improved the quality of nursing safety and patient satisfaction.
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OBJECTIVE Through detecting hepatitis B virus markers and hepatitis B virus DNA,to probe into the significance of HBV-DNA detection in HBsAg negative blood donors for blood transfusion safety.METHODS ELISA was used for detecting hepatitis B virus markers,and real-time fluorescent quantitative PCR assay was introduced for measuring HBV-DNA.RESULTS Totally 1 698 samples from HBsAg negative blood donors were examined,the positive rate of HBV-DNA was 2.71%.The rate of the HBsAb positive and HBcAb positive group,the HBsAb positive,HBeAb positive and HBcAb positive group,the HBcAb positive group,the HBeAb positive and HBcAb positive group,the HBsAb positive group and the all hepatitis B virus markers negative group were 5.71%,3.60%,6.60%,2.77%,38.48% and 46.94%,respectively.The positive rate of HBV-DNA in these groups were 7.22%,8.20%,4.46%,8.51%,1.21% and 2.26%,respectively.CONCLUSIONS It′s very important for blood transfusion safety to detect HBV-DNA in HBsAg negative blood donors.The more economic,reasonable and effective detecting method should be developed for blood transfusion safety.
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The world health organization (WHO) considered the World health day as day of blood transfusion safety with slogan blood safety begins, blood cures the life to mobilize everyone over the world takes care the blood program through the humane blood donation and assurance of blood safety. WHO called for each country must have blood program under direct management of Ministry of health. The answer to this call, the institute of hematology and blood transfusion mobilize “blood safety year” organized in 11/03/2000.
Subject(s)
Blood Transfusion , SafetyABSTRACT
The Current safety measure based on Bio-Medicine model can't avoid the communicating disease or accidents. The only way to solve the problem is to establish a clinic blood transfusion safety system based on social medicine model. The first important work is to set up the ethics criteria on the clinic blood transfusion, train qualified blood transfusion officials, and improve the management of the use of blood based on social medicine model.