[Incidence rate of acute reactions in transfusion of blood and its products prepared by Urumia Blood Refinery Center]

"Blood transfusion is one of essential and important but dangerous parts of today's medicine in which if appropriate measures have not been done, fatal reactions may occur. Acute hemolytic reactions, febrile reactions, and allergic reactions are among the most important and most prevalent transfusion reactions that happen shortly after its beginning and can lead to considerable mortality and morbidity. The aim of this descriptive study was to investigate the prevalence of acute reactions of blood and its products prepared by Urumia Blood Refinery Center. 3880 blood product units transfused to 1261 patients were studied by convenience sampling method. Various instruments and methods such as sphygmomanometer, thermometer, urine analysis, interview and observation were used for data gathering. Collected data were documented in special forms designed for this purpose. Descriptive statistics were used for data analysis. Among the blood recipients, 604 were female and 657 were male. The most frequent complaints of patients were coldness [22.5%], pruritus [20.1%] and chills [18.1%]. The prevalence of acute hemolytic reaction, febrile reaction and allergic reactions were 0.52, 6.2 and 11.1 per 1000 transfusions respectively. In spite of improved blood refinement techniques, acute transfusion reactions can lead to significant morbidity and mortality. Therefore, physicians', nurses' and midwives' meticulous attention to early symptoms and signs of acute reactions to transfusion of blood and its products have an important role in preventing adverse outcomes of this life-saving remedy

Use of the gel-based DiaMed-ID microtyping system for crossmatching enhances sensitivity.

A host of newer techniques have been introduced over the past decade in blood bank serological testing. One such technology which has been in vogue in the west since early 1990s is the gel test. The procedures used are standardized and they provide clear and stable reactions that improve result interpretation. The principle involves the differential passage of red cell agglutinates and free red blood cells through a dextran acrylamide gel. The results are stable and may be read even after many hours. The test is easy to perform, sensitive and reproducible. We report our experience in compatibility testing with use of the DiaMed micro typing system which is based on the gel technology. Over a one year period since this technology was introduced in our blood bank, we noticed a startling 65 fold rise (p<0.0001) in the reported number of incompatible units in one year which rose from a paltry 4 (0.02%) to 260 (1.6%). We found the DiaMed system easy to use and as our findings suggest it proved to be more sensitive than the conventional tube agglutination technique.

Efficacy of leucocyte filters during transfusions in preventing the development of anti-HLA antibodies.

The study was planned to investigate the effectiveness of using leucocyte filters in neonates during exchange and erythrocyte transfusion in preventing the development of anti-HLA antibodies. Twenty-four newborn infants who were admitted to the Neonatology Unit and received either exchange or at least two erythrocyte transfusions were recruited. The study group comprised of 12 infants on whom leucocyte filters were used during transfusions. Control group included the remaining 12 infants who were transfused without using a leucocyte filter. Anti-HLA antibodies in the serum samples were studied using modified Amos technique. Presence of anti-HLA antibodies in post-transfusion sera was detected in 3 (25%) of 12 infants in the study (filter) group, while in 10 (83.33%) of 12 infants in the control (no-filter) group. The difference between two groups was statistically significant (p < 0.05). The study demonstrated that term and preterm neonates were capable of developing anti-HLA antibodies following exchange and erythrocyte transfusions, and use of leucocyte filters could efficiently prevent the formation of anti-HLA antibodies.

Fenobarbital, fototerapia e incompatibilidade ABO / Phenobarbital, phototherapy and incompatibility ABO

O presente trabalho tem como objetivo avaliar a eficácia do fenobarbital no controle da icterícia de crianças com possibilidade de incompatibilidade sangüínea materno fetal pelo sistema ABO, (ISMF ABO) como terapêutica coadjuvante à fototerapia. Participaram do estudo 93 crianças de termo, tipo A ou B, com mäe tipo O e que ficaram ictéricas, necessitando de fototerapia. Alternadamente, por ordem de entrada no estudo, as crianças receberam fenobarbital ou näo. A droga foi administrada na dosagem de 3mg/Kg/dia, divididos em duas tomadas diárias. Näo foram demonstradas diferenças estatisticamente significativas entre os dois grupos quanto ao número de dosagens de bilirrubina por criança, tempo de fototerapia, tempo de internaçäo, número de exsangüíneo-transfusöes realizadas, o valor máximo de bilirrubina detectado e ritmo de evoluçäo de bilirrubina plasmática em períodos de 24 horas após o início do tratamento. Conclui-se que näo se encontra suporte para o uso de rotina do fenobarbital, na terapêutica da hiperbilirrubinemia em crianças com possibilidade de ISMF-ABO

Estado actual de la incompatibilidad al factor Rh / Actual status of the incompatibility to Rh factor

Se estudia una población de 1.352 embarazadas Rh negativas en el Centro, que para tal efecto funciona en el Hospital Paula Jaraquemada, asistidas entre 1981 y 1984. Se hace notar que 107 de ellas (7,92%) estaban sensibilizadas, correspondiendo 46 (43%) a títulos de anticuerpos anti-Rh hasta 1 x 16, que no presentaron mayores problemas para sus productos. La frecuencia de sensibilización severa y la mortalidad perinatal descendieron, comparadas con un estudio anterior (1978-1980) del mismo centro, de 6,25% a 3,1% y de 14,28% a 5,55%, respectivamente, lo que es reflejo de la disminución de las formas clínicas graves y el aumento de las benignas. Se describe el método de estudio del problema Rh, se analiza la correlación, título anticuerpo materno, curva espectrofotométrica del líquido amniótico y estado del recién nacido. Un total de siete transfusiones intraperitoneales se realizó en cuatro pacientes altamento sensibilizadas, lográndose éxito con dos recién nacidos. Se plantean las limitaciones, con nuestros actuales, de mejorar los resultados perinatales en los casos de severidad extrema. Se sugiere el grado de sensibilización, con título 1 x 16, como punto inicial para estudio espectrofotométrico de líquido amniótico. Finalmente, se revisa con espíritu crítico el manejo de la profilaxis con Gama Globulina Anti-D