Construction of blood quality monitoring indicator system in blood banks of Shandong / 中国输血杂志

【Objective】 To establish a blood quality monitoring indicator system, in order to continuously improve blood quality and standardized management. 【Methods】 Based on the research of literature and standards, and guided by the key control points of blood collection and supply process, the blood quality monitoring indicator system was developed. Through two rounds of Delphi expert consultation, the indicator content was further revised and improved according to expert opinions after six months of trial implementation. The indicator weight was calculated by questionnaire and analytic hierarchy process. 【Results】 A blood quality monitoring indicator system covering the whole process of blood collection and supply was constructed, including five primary indicators, namely blood donation service, blood component preparation, blood testing, blood supply and quality control, as well as 72 secondary indicators, including definitions, calculation formulas, etc. Two rounds of expert consultation and two rounds of feasibility study meeting were held to revise 17 items and the weight of each indicator was obtained through the analytic hierarchy process. After partial adjustments, a blood quality monitoring indicator system was formed. 【Conclusion】 A blood quality monitoring indicator system covering the whole process of blood collection and supply has been established for the first time, which can effectively evaluate the quality management level of blood banks and coordinate blood quality control activities of blood banks in Shandong like pieces in a chess game, thus improving the standardized management level

Application of quality monitoring indicators of blood testing in blood banks of Shandong province / 中国输血杂志

【Objective】 To objectively evaluate the quality control level of blood testing process in blood banks through quantitative monitoring and trend analysis, and to promote the homogenization level and standardized management of blood testing laboratories in blood banks. 【Methods】 A quality monitoring indicator system covering the whole process of blood collection and supply, including blood donation service, blood component preparation, blood testing, blood supply and quality control was established. The questionnaire Quality Monitoring Indicators for Blood Collection and Supply Process with clear definition of indicators and calculation formulas was distributed to 17 blood banks in Shandong province. Quality monitoring indicators of each blood bank from January to December 2022 were collected, and 31 indicators in terms of blood testing were analyzed using SPSS25.0 software. 【Results】 The proportion of unqualified serological tests in 17 blood bank laboratories was 55.84% for ALT, 13.63% for HBsAg, 5.08% for anti HCV, 5.62% for anti HIV, 18.18% for anti TP, and 1.65% for other factors (mainly sample quality). The detection unqualified rate and median were (1.23±0.57)% and 1.11%, respectively. The ALT unqualified rate and median were (0.74±0.53)% and 0.60%, respectively. The detection unqualified rate was positively correlated with ALT unqualified rate (r=0.974, P0.05), while the outrage rate was positively correlated with the usage rate (r=0.592, P<0.05). A total of 443 HBV DNA positive samples were detected in all blood banks, with an unqualified rate of 3.78/10 000; 15 HCV RNA positive samples were detected, with an unqualified rate of 0.13/10 000; 5 HIV RNA positive samples were detected, with an unqualified rate of 0.04/10 000. The unqualified rate of NAT was (0.72±0.04)‰, the single NAT reaction rate [(0.39±0.02)‰] was positively correlated with the single HBV DNA reaction rate [ (0.36±0.02) ‰] (r=0.886, P<0.05). There was a difference in the discriminated reactive rate by individual NAT among three blood bank laboratories (C, F, H) (P<0.05). The median resolution rate of 17 blood station laboratories by minipool test was 36.36%, the median rate of invalid batch of NAT was 0.67%, and the median rate of invalid result of NAT was 0.07‰. The consistency rate of ELISA dual reagent detection results was (99.63±0.24)%, and the median length of equipment failure was 14 days. The error rate of blood type testing in blood collection department was 0.14‰. 【Conclusion】 The quality monitoring indicator system for blood testing process in Shandong can monitor potential risks before, during and after the experiment, and has good applicability, feasibility, and effectiveness, and can facilitate the continuous improvement of laboratory quality control level. The application of blood testing quality monitoring indicators will promote the homogenization and standardization of blood quality management in Shandong, and lay the foundation for future comprehensive evaluations of blood banks.

Application of quality control indicator system in blood banks of Shandong / 中国输血杂志

【Objective】 To establish an effective quality monitoring indicator system for blood quality control in blood banks, in order to analyze the quality control indicators for blood collection and supply, and evaluate blood quality control process, thus promoting continuous improvement and standardizing management of blood quality control in blood banks. 【Methods】 A quality monitoring indicator system covering the whole process of blood collection and supply, including blood donation services, component preparation, blood testing, blood supply and quality control was established. The Questionnaire of Quality Monitoring Indicators for Blood Collection and Supply Process was distributed to 17 blood banks in Shandong, which clarified the definition and calculation formula of indicators. The quality monitoring indicator data from January to December 2022 in each blood bank were collected, and 20 quality control indicators data were analyzed by SPSS25.0 software. 【Results】 The average pass rate of key equipment monitoring, environment monitoring, key material monitoring, and blood testing item monitoring of 17 blood banks were 99.47%, 99.51%, 99.95% and 98.99%, respectively. Significant difference was noticed in the pass rate of environment monitoring among blood banks of varied scales(P<0.05), and the Pearson correlation coefficient (r) between the total number of blood quality testing items and the total amount of blood component preparation was 0.645 (P<0.05). The average discarding rates of blood testing or non-blood testing were 1.14% and 3.36% respectively, showing significant difference among blood banks of varied scales (P<0.05). The average discarding rate of lipemic blood was 3.07%, which had a positive correlation with the discarding rate of non testing (r=0.981 3, P<0.05). There was a statistically significant difference in the discarding rate of lipemic blood between blood banks with lipemic blood control measures and those without (P<0.05). The average discarding rate of abnormal color, non-standard volume, blood bag damage, hemolysis, blood protein precipitation and blood clotting were 0.20%, 0.14%, 0.06%, 0.06%, 0.02% and 0.02% respectively, showing statistically significant differences among large, medium and small blood banks(P<0.05).The average discarding rates of expired blood, other factors, confidential unit exclusion and unqualified samples were 0.02%, 0.05%, 0.003% and 0.004%, respectively. The discarding rate of blood with air bubbles was 0.015%, while that of blood with foreign body and unqualified label were 0. 【Conclusion】 The quality control indicator system of blood banks in Shandong can monitor weak points in process management, with good applicability, feasibility, and effectiveness. It is conducive to evaluate different blood banks, continuously improve the quality control level of blood collection and supply, promote the homogenization and standardization of blood quality management, and lay the foundation for comprehensive evaluation of blood banks in Shandong.

Quality monitoring indicator system in blood banks of Shandong: applied in blood donation services, component preparation and blood supply process / 中国输血杂志

【Objective】 To establish an effective quality indicator monitoring system, scientifically and objectively evaluate the quality management level of blood banks, and achieve continuous improvement of quality management in blood bank. 【Methods】 A quality monitoring indicator system that covers the whole process of blood collection and supply was established, the questionnaire of Quality Monitoring Indicators for Blood Collection and Supply Process with clear definition of indicators and calculation formulas was distributed to 17 blood banks in Shandong. Statistical analysis of 21 quality monitoring indicators in terms of blood donation service (10 indicators), blood component preparation (7 indicators ), and blood supply (4 indicators) from each blood bank from January to December 2022 were conducted using SPSS25.0 software The differences in quality monitoring indicators of blood banks of different scales were analyzed. 【Results】 The average values of quality monitoring indicators for blood donation service process of 17 blood banks were as follows: 44.66% (2 233/5 000) of regular donors proportion, 0.22% (11/50) of adverse reactions incidence, 0.46% (23/5 000) of non-standard whole blood collection rate, 0.052% (13/25 000) of missed HBsAg screening rate, 99.42% (4 971/5 000) of first, puncture successful rate, 86.49% (173/200) of double platelet collection rate, 66.50% (133/200) of 400 mL whole blood collection rate, 99.25% (397/400) of donor satisfaction rate, 82.68% (2 067/2 500) of use rate of whole blood collection bags with bypass system with sample tube, and 1 case of occupational exposure in blood collection.There was a strong positive correlation between the proportion of regular blood donors and the collection rate of 400 mL whole blood (P<0.05). The platelet collection rate, incidence of adverse reactions to blood donation, and non-standard whole blood collection rate in large blood banks were significantly lower than those in medium and small blood banks (P<0.05). The average quality monitoring indicators for blood component preparation process of 17 blood banks were as follows: the leakage rate of blood component preparation bags was 0.03% (3/10 000), the discarding rate of lipemic blood was 3.05% (61/2 000), the discarding rate of hemolysis blood was 0.13%(13/10 000). 0.06 case had labeling errors, 8 bags had blood catheter leaks, 2.76 bags had blood puncture/connection leaks, and 0.59 cases had non-conforming consumables. The discarding rate of hemolysis blood of large blood banks was significantly lower than that of medium and small blood banks (P<0.05), and the discarding rate of lipemic blood of large and medium blood banks was significantly lower than that of small blood banks (P<0.05). The average values of quality monitoring indicators for blood supply process of 17 blood banks were as follows: the discarding rate of expired blood was 0.023% (23/100 000), the leakage rate during storage and distribution was of 0.009%(9/100 000), the discarding rate of returned blood was 0.106% (53/50 000), the service satisfaction of hospitals was 99.16% (2 479/2 500). The leakage rate of blood components during storage and distribution was statistically different with that of blood component preparation bags between different blood banks (P<0.05). There were statistically significant differences in the proportion of regular blood donors, incidence of adverse reactions, non-standard whole blood collection rate, 400 mL whole blood collection rate, double platelet collection rate, the blood bag leakage rate during preparation process, the blood components leakage rate during storage and distribution as well as the discarding rate of lipemic blood, hemolysis blood, expired blood and returned blood among large, medium and small blood banks (all P<0.05). 【Conclusion】 The establishment of a quality monitoring indicator system for blood donation services, blood component preparation and blood supply processes in Shandong has good applicability, feasibility and effectiveness. It can objectively evaluate the quality management level, facilitate the continuous improvement of the quality management system, promote the homogenization of blood management in the province and lay the foundation for future comprehensive evaluation of blood banks.

Construction of a whole business process supervision and management system: based on management information system of blood banks / 中国输血杂志

【Objective】 To achieve supervision and management of the whole business process of blood center, raise productivity and ensure blood quality by enabling blood center managers comprehensively grasp the key business operation situation of the whole process at anytime and anywhere. 【Methods】 A whole business process supervision and management system was established covering background of preparation, business scope, content of position supervision and management, overall framework design, interface design of management and supervision management, physical database design, program development and online debugging, and was integrated with the blood bank management information system. The display and management were through a mobile APP to record key indicators of business process from blood collection to blood supply timely and comprehensively. Statistical analysis was conducted on total collection volume, total preparation volume and total supply volume, as well as discarding rate of test unqualified and of non-test unqualified (lipemic blood excluded) in 2023 and 2022. 【Results】 We established a mobile APP based on a blood bank management information system for business supervision and management of whole process, and achieved management by phones. After its implementation in 2023, the total collection volume, total preparation volume and total supply volume in 2023 were all higher than those in 2022, with growth rates of 5.88% (13 247/225 454 U), 4.73% (24 156/510 698 U), and 6.70% (34 814/519 914 U), respectively. The discarding rate in 2023 was lower than that in 2022 (0.54%, 2 868/534 854 U) vs (0.60%, 3 047/510 698 U) (P<0.01), and the non-test unqualified discarding rate (lipemic blood excluded) in 2023 was significantly lower than that in 2022(0.12%, 649/534 854 U) vs (0.19%, 991/510 698 U)(P<0.01). 【Conclusion】 The construction of supervision and management system of a whole business process based on blood bank management information system can meet the standardized service needs of managers at anytime and anywhere, continuously raise productivity and the standardization and scientific level of blood bank management, thus ensuring blood supply.

ABO and rhesus blood group frequency among donors and admitted patients at Zawia Medical Center, AzZawya City, Libya

The identification and categorization of blood groups play a crucial role in transfusion medicine as it allows for safe and compatible transfusions. Among the various blood group systems, the ABO and Rhesus blood grouping systems have special clinical significance. Understanding the distribution and frequency of ABO and Rhesus blood groups within a specific community is essential for healthcare planning, especially when it comes to blood supply management and organ transplantation. Additionally, studies have also shown a relationship between ABO blood groups and the onset and spread of diseases. Therefore, this study was conducted to detect the distribution and frequency of ABO and Rhesus blood groups in AzZawya City, Libya. In this retrospective study, data from the blood bank at Zawia Medical Center were collected over three years to detect the distribution of ABO and Rh blood groups among 5187 donors and admitted patients. The result shows that blood group O is the dominant among all study subjects (45%), as well as, among males (48.2%), and females (42.2%). Blood group A is the second most common at 34.6% among total, 33% among males, and 36% among females. For Rhesus antigens 89.4% of study subjects were Rhesus positive, 87.3% for males and 80% for females. In addition, the results show a statistically significant association between gender and blood group distribution p <0.001. Knowing the most common blood types helps maintain adequate blood bank supplies.

Determinantes externos de la disponibilidad de sangre / External Determinants of Blood Availability

El acceso universal a las transfusiones de sangre depende de diversos factores localizados dentro y fuera de los servicios de salud. Motivados por ser este un tema infrecuente, el trabajo tiene el objetivo de analizar desde una perspectiva multidimensional y holística los determinantes externos de la disponibilidad de sangre para las transfusiones. El desarrollo socioeconómico constituye un importante factor dinamizador porque condiciona, de cierta manera, la infraestructura del sistema sanitario e incide sobre los factores epidemiológicos, sociodemográficos y jurídicos. A su vez, estos influyen en la organización de las actividades y la complejidad de la asistencia sanitaria, factores que otorgan un sentido positivo o negativo a la disponibilidad de sangre. Tomarlos en consideración al diseñar las políticas de salud relacionadas con el uso de la sangre permite una mayor precisión en las intervenciones locales que contribuyan a mejorar la seguridad de las transfusiones(AU)

Universal access to blood transfusions depends on a number of localized factors both inside and outside health services. Motivated by being an infrequent topic, this work aims to analyze from a multidimensional and holistic perspective the external determinants of the availability of blood for transfusions. Socio-economic development is an important dynamic factor because it conditions, in a certain way, the infrastructure of the health system and affects epidemiological, sociodemographic and legal factors. In turn, these influence the organization of activities and the complexity of health care, factors that give a positive or negative meaning to the availability of blood. Taking them into consideration when designing health policies related to the use of blood allows greater precision in local interventions that contribute to improving the safety of transfusions(AU)

Analysis of the types and causes of invalid results in nucleic acid test for blood screening / 中国输血杂志

【Objective】 To analyze the reasons for the invalidity of blood nucleic acid test results, and to explore the countermeasures to reduce the invalidity of the test. 【Methods】 From 2019 to 2021, the number of tests performed in our laboratory for Cobas s201 blood nucleic acid screening system and the number of batches and tests with invalid results were counted, and the types and reasons of invalid results were analyzed. 【Results】 From 2019 to 2021, the Cobas s201 nucleic acid detection system detected a total of 5, 420 batches and 127, 950 pools, and the invalid rate of batches and pools were 1.83% and 1.97%, respectively. The types of invalid results can be summarized as improper operation, sample quality problems, invalid quality control (IQC), equipment failure and others. Among them, IQC and equipment failure were the main reasons for invalid results, accounting for 44.51% and 39.96%, respectively. IQC was mainly related to cross-contamination of samples and insufficient mixing of quality control products. Equipment failures mostly occurred in the robotic arm gripper of the nucleic acid extraction instrument and the TC module of the amplification instrument. 【Conclusion】 The laboratory should conduct quality monitoring for invalid results, and take targeted improvement measures, especially to reduce invalid results caused by invalid quality control and instrument failure.

Metaanálisis de la validez diagnóstica de las pruebas de tamización del virus de inmunodeficiencia humana en bancos de sangre, 2000-2020

Objetivo: Evaluar la validez diagnóstica del ensayo de inmunoabsorción ligado a enzima (Enzyme-Linked Immunosorbent Assay, ELISA) para el virus de inmunodeficiencia humana (VIH) en bancos de sangre, con base en estudios publicados entre 2000 y 2020. Metodología: Se realizó una revisión sistemática y metaanálisis de pruebas diagnósticas, mediante un modelo de efectos aleatorios para la sensibilidad, la especificidad, el cociente de probabilidad positivo y negativo, la razón de odds (OR) diagnóstica y la curva ROC, con sus intervalos de confianza del 95 %. La heterogeneidad se evaluó con el estadístico Q(χ2) DerSimonian-Laird y el I2 de inconsistencia, y la incertidumbre, con el porcentaje de peso de cada estudio. Resultados: Se incluyeron 15 investigaciones; la ELISA de tercera generación (detección de anticuerpos) se aplicó en 2992 infectados y 4076 sanos; las de cuarta generación (determinación simultánea de antígeno-anticuerpo), en 967 infectados y 154 264 sanos; ambas presentaron sensibilidad cercana al 100 %, pero la especificidad fue mejor en los ensayos de cuarta generación (98 vs. 100 %). Para ambas tecnologías, los cocientes de probabilidad, OR diagnóstica y curva ROC evidenciaron excelente discriminación de sanos e infectados. Conclusión: Se confirmó que las ELISA de tercera y cuarta generación presentan excelente validez y utilidad diagnóstica en donantes de sangre, lo que es importante para las políticas de sangre segura y control del VIH.

Objective: To evaluate the diagnostic validity of the enzyme-linked immunosorbent assay (ELISA) for human immunodeficiency virus (HIV) in blood banks, based on studies published between 2000 and 2020. Methodology: We performed a systematic review and meta-analysis of diagnostic tests, using a random-effects model for the sensitivity, specificity, positive and negative likelihood ratio, diagnostic odds ratio (DOR), and ROC curve, with 95% confidence intervals. Heterogeneity was assessed with the DerSimonianLaird Q(χ2) statistic and the I2 inconsistency statistic. Uncertainty was assessed using percentage study weights. Results: 15 studies were included. The third-generation ELISA (antibody detection) was applied for 2,992 infected and 4,076 healthy individuals, and the fourth-generation ELISA (simultaneous antigen-antibody detection) was used for 967 infected and 154,264 healthy individuals. Both showed close to 100% sensitivity, but there was an improved specificity in the fourth-generation assays (98% vs. 100%). Both technologies' likelihood ratios, DOR, and ROC curve aptly distinguished between healthy and infected individuals. Conclusion: The third and fourth-generation ELISA were confirmed to have excellent validity and diagnostic utility in blood donors, which is important for HIV control and blood safety policies.

Objetivo: Avaliar a validade diagnóstica do ensaio de imunoabsorção ligado à enzima (Enzyme-Linked Immunosorbent Assay, ELISA) para o vírus de imunodeficiência humana (VIH) em bancos de sangue, com base em estudos publicados entre 2000 e 2020. Medotologia: Realizou-se uma revisão sistemática e meta-análise de provas diagnósticas, por meio de um modelo de efeitos aleatórios para a sensibilidade, a especificidade, o cociente de probabilidade positivo e negativo, a razão de odds (OR) diagnóstica e a curva de ROC, com seus intervalos de confiança do 95%. A heterogeneidade foi avaliada com o estatístico Q(χ2) DerSimonian-Laird e o I2 de inconsistência, e a incerteza, com a porcentagem de peso de cada estudo. Resultados: Foram incluídas 15 pesquisas; a ELISA de terceira geração (detecção de anticorpos) aplicouse em 2992 infetados e 4076 sadios; as de quarta geração (determinação simultânea de antígeno-anticorpos), em 967 infetados e sadios; ambas as duas apresentaram sensibilidade próxima ao 100%, mas a especificidade foi melhor nos ensaios de quarta geração (98 vs. 100%). Para ambas as tecnologias, os cocientes de probabilidade, OR diagnóstica e curva ROC evidenciaram excelente discriminação de sadios e infetados. Conclusão: Confirmou-se que as ELISA de terceira e quarta geração apresentam excelente validade e utilidade diagnóstica em doadores de sangue, o que é importante para as políticas de sangue seguro e controle do VIH.

Rendimiento del Kit de Chagas V2.0 IICS-UNA para el tamizaje de la enfermedad

En Paraguay la enfermedad de Chagas es endémica, siendo el número de personas infectadas de aproximadamente 165.000 y la población expuesta del 30% según registros del 2012. El objetivo del trabajo fue evaluar el ELISA Chagas test IICS V2.0 para tamizaje de la enfermedad en muestras de donantes de sangre. Se realizó un estudio transversal de pruebas diagnósticas, para lo que se incluyeron 775 muestras de suero provenientes de dos bancos de sangre, a partir de cuyos resultados se calculó la sensibilidad, valores predictivos positivo, negativo y la curva ROC. También se determinó la concordancia y correlación entre el ELISA Chagas test IICS V2.0 y un ELISA comercial. De las 775 muestras de bancos de sangre analizadas se obtuvo una sensibilidad del 99%, especificidad de 96%, VPP 96%, VPN 99% y un índice kappa igual a 0,95 (0,93-0,97) Error Estándar (EE) 0.01 y p>00001 y el área ROC igual a 0,9835. Con respecto a la concordancia con el test comercial, el índice kappa fue de 0,926 IC95% (0,888-0,976), p=0,00001 y el coeficiente de correlación r=0,971 IC95% (0,962-0.978) p=0,0001. Las concordancias obtenidas fueron muy buenas con respecto a la serología de las muestras de banco de sangre como la comparada con el test comercial, pudiendo utilizarse el kit de Chagas IICS V2 para el tamizaje de la enfermedad.

In Paraguay, Chagas disease is endemic, with approximately 165,000 infected people and 30% of the exposed population according to 2012 records. The objective of this study was to evaluate the ELISA Chagas test IICS V2.0 for screening of the disease in blood donor samples. We carried out a cross-sectional study of diagnostic tests, including 775 serum samples from two blood banks, and then calculating sensitivity, positive and negative values and the ROC curve. We also determined the concordance and correlation between the ELISA Chagas test IICS V2.0 and commercial ELISA. In the 775 blood bank samples analyzed, the Chagas ELISA test IICS V2.0 obtained a sensitivity of 99%, specificity of 96%, PPV 96%, NPV 99% and a kappa index equal to 0.95 (0.93-0.97) Standard Error (SE) 0.01 and p>0.0001 and the ROC area equal to 0.9835. Regarding the concordance with the commercial test, the kappa index was 0.926 CI95% (0.888-0.976), p=0.00001 and the correlation coefficient r=0.971 CI95%(0.962-0.978) p=0.0001.The concordances obtained were very good with respect to the serology of the blood bank samples as compared to the commercial test, allowing the use of the Chagas IICS V2 kit for the disease screening.

Seropositivity of COVID-19 Among Healthy Voluntary Blood Donors and Its Association with Blood Groups: A Reflection of Burden of Asymptomatic COVID-19 Cases in The District of South Gujarat

Introduction: First case of COVID-19 in the district was reported on 19th March 2020, thereby increas-ing exponentially, presenting with various symptoms to having few or no symptoms, posing challenge to prevent disease transmission by being a significant source of infection. This study conducted to assess relationship between COVID-19 infection within blood groups and burden of reported cases in the dis-trict to seropositivity among donors. Methodology: This is a prospective observational study from second largest blood bank of south Guja-rat, catering to a population of seven million, 4916 donors from the month of August 2020 to May 2021 participated in the study. Observations: Seropositivity was found to be 54.6%, with higher prevalence (68.63%) among female compared to male (54.45%), there was no statistical difference among age groups & RH groups, blood group AB was found to have highest seropositivity followed by A, B and O group. First time donors sero-positivity was higher compared to frequent donors among the study participants. Seropositivity among donors was positively corelated with RTPCR Positivity rate reported in the district. Conclusions: Looking at similar trend of active surveillance and its correlation to blood bank positivity, we urge policy makers to strengthen hospital-based surveillance for real time insights.

Analysis of Donor Deferral in a Tertiary Health Institution in South-Western Nigeria

Aim:This study aimed at evaluating the deferral pattern among blood donors, in order to draw out lessons that will help canvass for a strengthened policy framework and encourage better outcomes in voluntary blood donation. Study Design:This was a retrospective study. Place and Duration of Study:All the data were sourced from the central database of donors, as recorded by the Haematology Department of Babcock University Teaching Hospital Ilisan-Remo, Ogun state, Nigeria. The data used spanned through a period of 5 years, from 2017 to 2021. Methodology:A total of 7,362voluntary and non-remunerated blood donors were included in this study. Their records were accessed and used for the study. Data were analysed using SPSS version 25. The level of statisticalsignificance was set at P < 0.05.Results:In this study, half (50.2%) of the entire population of volunteers were between the ages of 18 and 30 years while only 3.7% of them were between 51 and 60 years of age. There were more male volunteers for blood donation compared to the females who only represented 10.8% of the population. 61% of the voluntary donorswere accepted for blood donation while 39% were regarded as unfit and hence, deferred. The 3 main reasons for deferral in this study were inadequate hemoglobin (54.7% of deferral cases), unmatched blood group (30.9%) and transfusion transmissible infections (14.4%). Age and gender had a statistically significant (P < 0.05) relationship with the pattern of deferral of the volunteers. Conclusion:The high deferral rate observed in this study may reveal an urgent need for a community-based intervention and targeted efforts by necessary agencies to help improve the general health status of possible future voluntary blood donors.

Evaluation of Causes and Rate of Wastage of Blood and its Components – An Important Quality Indicator in Blood Banks.

Background: The evaluation of wastage of blood products represents an important element in the appropriate use of blood components, a critical control point in the system of blood administration. Discarding or wastage of blood can be attributed to several reasons namely time expiry, wasted import, non-usage of ordered blood, broken bags and seal with leakage, hemolytic reasons, clotted blood, returned after 30 min, and miscellaneous others.Wasting of blood and blood components are an inefficient use of resources and may be avoided. The present study was undertaken with aim of primarily to determine the frequency of blood products wasting and secondarily to determine the factors that affect blood products wastage at our institute. Methods: The present study is a retrospective cross sectional descriptive study conducted in a tertiary teaching hospital located in South Delhi catering to low socioeconomic population. Blood component wastage was defined as components that did not meet the required standards of hospitals or fractionation centres during collection, processing and storage. The main reasons included expiry date, inappropriate volume, haemolysis of red blood cells (RBCs), contamination of plasma or platelets with RBCs, blood bag leakage, reactive infectious disease tests and inappropriate temperature during storage or transportation. The required data from clinical units and blood bank were collected and analyzed for a period of 7 years. Results: A total of 13728 blood units were received during the specified period. Overall wasted factor was of 18.5% with maximum wastage of platelet concentrate units (53.7%). Analyzing the causes of blood and blood product wastage in the hospital for this study showed that blood and blood product wastage were associated with many causes of which the common causes, included the expiration of the usability period (69.2%), sero-reactivity for infectious diseases (13.7%) and Quality Control units (9.2%). Conclusion: Blood is an irreplaceable precious resource which needs to be properly utilized with minimal wastage. Although present study was limited due to its retrospective nature but it still outlines the importance to emphasize that measures should be taken into account for formulating guidelines, effective policies, and training efforts for personnel.

Metaanálisis de la validez del inmunodiagnóstico del virus linfotrópico de células T humanas i/ii en bancos de sangre, 2000-2018 / Meta-analysis regarding the validity of the immunodiagnosis of human T-cell lymphotropic virus I/II in blood banks, 2000-2018 / Meta-análise da validade do imunodiagnóstico do vírus linfotrópico de células t humanas I/II em bancos de sangue, 2000-2018

Resumen Objetivo: Evaluar la validez del inmunodiagnóstico del htlv i/ii en bancos de sangre, con base en estudios publicados en la literatura científica. Metodología: Se efectuó un metaanálisis de pruebas diagnósticas siguiendo la guía prisma y las recomendaciones de Cochrane. Se evaluó la calidad metodológica con quadas y se garantizó la reproducibilidad y la exhaustividad. Se realizó también un análisis de efectos aleatorios para la sensibilidad, la especificidad, los cocientes de probabilidad, la razón de momios diagnóstica y la curva característica operativa del receptor (roc) con sus intervalos de confianza (ic) del 95 %. Resultados: Se tamizaron 4604 estudios, de los cuales solo tres cumplieron el protocolo. Se evaluaron 548 infectados con htlv i/ii y 6643 sanos. El inmunodiagnóstico de htlv i/ii presentó una sensibilidad del 99 % (ic95 % = 98,0-99,0), especificidad del 100 % (ic95 % = 99,9-100), cocientes de probabilidad positivo de 315,8 (ic95 % = 128,2-778,5) y negativo de 0,02 (ic95 % = 0,01-0,04), razón de momios diagnóstica de 24373 (ic95 % = 6864-86545) y área bajo la curva roc del 99,9 %. Conclusión: Se dispone de pocos estudios en este campo del inmunodiagnóstico htlv i/ii. El elevado número de sujetos analizados evidenció alta validez del inmunodiagnóstico, lo que resulta determinante para garantizar la inocuidad de las unidades de sangre, la detección de portadores asintomáticos, la disminución de la transmisión y el inicio de tratamiento.

Abstract Objective: To evaluate the validity of the immunodiagnosis of htlv i/ii in blood banks, based on studies published in the scientific literature. Methodology: A meta-analysis of diagnostic tests was carried out following the PRISMA guidelines and Cochrane recommendations. The methodological quality was evaluated with QUADAS, and reproducibility and completeness were guaranteed. A random effects analysis was also performed with respect to sensitivity, specificity, likelihood ratios, diagnostic odds ratio, and receiver operating characteristic curve (ROC) with their 95 % confidence intervals (CI). Results: 4,604 studies were screened, of which only three complied with the protocol. 548 subjects infected with HTLV I/II and 6,643 healthy subjects were evaluated. The immunodiagnosis of HTLV I/II had a sensitivity of 99 % (95 % CI = 98.0-99.0), a specificity of 100 % (95 % CI = 99.9-100), a positive likelihood ratio of 315.8 (95 % CI = 128.2-778.5) and a negative likelihood ratio of 0.02 (95 % CI = 0.01-0.04), a diagnostic odds ratio of 24,373 (95 % CI = 6,864-86,545), and an area under the ROC curve of 99.9 %. Conclusion: Few studies are available in the field of HTLV I/II immunodiagnosis. The high number of subjects analyzed showed high validity of the immunodiagnosis, which is decisive to guarantee the safety of the blood units, the detection of asymptomatic carriers, the decrease in transmission, and the start of treatment.

Resumo Objetivo: Avaliar a validade do imunodiagnóstico do HTLV I/II nos bancos de sangue, baseados nos estudos publicados na literatura científica. Metodologia: Foi realizada uma meta-análise de testes diagnósticos seguindo a guia PRISMA e as recomendações de Cochrane. Foi avaliada a qualidade metodológica com QUADAS e garantiu-se a reprodutibilidade e a integridade. Realizou-se também uma análise de efeitos aleatórios para a sensibilidade, a especificidade, os quocientes de probabilidade, a razão de probabilidade diagnóstica e a Curva Característica de Operação do Receptor (Curva ROC) com seus Intervalos de Confiança (IC) de 95%. Resultados: Foram selecionados 4604 estudos, dos quais somente 3 cumpriram com o protocolo. Foram avaliados 548 infectados com o vírus HTLV I/II e 6.643 saudáveis. O imunodiagnóstico de HTLV I/II apresentou uma sensibilidade de 99% (IC95% = 98,0-99,0), especificidade de 100% (IC95%= 99,9-100), quocientes de probalidade positiva de 315,8 (IC95% = 128,2-778,5) e negativo de 0,02 (IC95% = 0,01-0,04), razão de probabilidade diagnóstica de 24373 (IC95% = 6864-86545) e área sob a curva ROC de 99,9%. Conclusão: São poucos os estudos disponíveis neste campo do imunodiagnóstico HTLV I/II. O elevado número de pessoas analisadas evidenciou alta validade do imunodiagnóstico, o que é decisivo para garantir a inocuidade das unidades de sangue, a detecção de portadores assintomáticos, a diminuição da transmissão e o início do tratamento.

Células madre mesenquimatosas y sus diferentes usos / Mesenchymal stem cells and their different uses

Introducción: las células madre mesenquimatosas (CMM) se diferencian de diversos tipos celulares para la regeneración de tejidos, esta característica sumada con la versatilidad del antígeno leucocitario humano (HLA) representan una eficaz alternativa para el tratamiento de enfermedades con tejidos deteriorados. Se pueden obtener a partir de médula ósea, cordón umbilical (CU) y sangre fetal. Objetivo: analizar los tipos de diferenciación de las CMM, sus métodos de extracción y su relación con bancos de sangre de cordón umbilical (BSCU), a fin de demostrar la eficacia de las CMM, en patologías que impliquen alteración de algún tejido u órgano. Metodología: se revisaron varias publicaciones en español e inglés en Pubmed, Clinicalkey y Science Direct; desde 2013 hasta 2020. Se usaron los términos sangre fetal, células madre mesenquimatosas, trasplante de Células Madre de Sangre del Cordón Umbilical y bancos de sangre. Con dicha información se redactó un panorama amplio sobre las células mesenquimales y como estas participan en diversas áreas de la salud, con un énfasis importante en sus usos terapéuticos y lo referente a de donde provienen. Conclusión: a través de la pluripotencialidad de las CMM, se han podido emplear en múltiples patologías pues reestablece tejidos o líneas celulares exitosamente. Así mismo, los recursos para su obtención son claves en la tolerancia de los pacientes, por lo cual una gran opción para su obtención es el CU, que actualmente cuenta con bancos exclusivos para esto. (AU)

Introduction: mesenchymal stem cells (MSC) differentiate into multiple cell types for tissue regeneration, this characteristic added with the versatility of human leukocyte antigen (HLA) represent an effective alternative for the treatment of diseases with damaged tissues. They can be obtained from bone marrow, umbilical cord (UC), and fetal blood. Objetive: analyze the types of differentiation of MSC, their extraction methods and their relationship with umbilical cord blood banks (UCBB), in order to demonstrate the efficacy of MSC, in pathologies that involve alteration of a tissue or organ. Methodology: several publications in Spanish and English in Pubmed, Clinicalkey and Science Direct were reviewed; from 2013 to 2020. The terms fetal blood, mesenchymal stem cells, Umbilical Cord Blood Stem Cell transplantation and blood banks were used. With this information, a broad overview of mesenchymal cells and how they participate in various areas of health was drawn up, with an important emphasis on their therapeutic uses and where they come from. Conclusion: through the pluripotentiality of MSC, they have been used in multiple pathologies as it successfully re-establishes tissues or cell lines. Also, the resources for obtaining it are key in the tolerance of patients, which is why a great option for obtaining it is the UC, which currently has exclusive banks for this.

Redução de doações de sangue: a importância da doação de campanha em Goiânia, Estado de Goiás, Brasil / Reduction in blood donations: the importance of campaing donation in Goiânia, Goiás, Brazil

Analisar as tendências das doações de sangue no Hemocentro do Estado de Goiás (HEMOGO), Brasil, considerando as campanhas de incentivo e as infecções transmissíveis por transfusão. Estudo retrospectivo das doações de sangue entre 2010-2016. Os doadores foram agrupados em categorias autóloga, voluntária, de reposição e de campanha. Houve 149.983 doações com redução de 29% (p <0,05). As doações por homens, com idade entre 18 e 29 anos e com menor escolaridade diminuíram (p <0,05) ao longo do tempo. Quase 50% das doações eram da categoria voluntária, 30% de campanha, 18% de reposição e 1% de outras categorias. As doações da campanha diminuíram 5,02% (p <0,05) entre 2010 a 2016. A prevalência de infecções transmitidas por transfusão (ITT) foi de 3,71% e a chance de doadores de campanha terem ITT foi menor (OR = 0,8628; IC: 0,8126 - 0,9161; p <0,0001). Os resultados mostraram uma redução nas doações de sangue, influenciadas principalmente por uma diminuição nas doações da campanha.

To analyze the trends of blood donations in a public blood center of Goias, Brazil (HEMOGO ­ Hemocentro do Estado de Goiás), considering incentive campaigns and transfusion transmissible infection. Retrospective study of the blood donations between 2010-2016. Donors were grouped into autologous, voluntary, replacement and campaign categories. There were 149,983 donations with a reduction of 29% (p<0.05) in the investigated period. Donations by males, aging between 18 and 29 years old, and those with a lower level of education decreased (p<0.05) over time. Almost 50% of donations were from the voluntary category, 30% from campaing, 18% from replacement and 1% from other categories. The campaign donations decreased 5.02% (p<0.05) during the 2010 to 2016. The prevalence of transfusion-transmitted infections (TTI) was 3.71% and the chance of campaign donors having TTI was lower (OR = 0.8628; CI: 0.8126 - 0.9161; p<0.0001). The results showed a significant reduction in the number of blood donations mainly influenced by a decrease in campaign donations.

Occupational exposure of blood bank staff: Cause analysis and risk prevention / 中国输血杂志

【Objective】 To explore the causes of occupational exposure, so as to prevent occupational exposure that endangering the physical and mental health of staff in blood centers. 【Methods】 Occupational exposure cases reported from May 1, 2014 to April 30, 2020 by Taizhou Blood Center were classified and analyzed in terms of the exposure mode, body parts, post distribution, seniority of operators and whether the operation was carried out as required. 【Results】 From May 1, 2014 to December 31, 2020, 23 cases of occupational exposure (6.66/100000) occurred in Taizhou Blood Center, and the incidence rate was roughly the same in each year. Among the occupational exposure modes, sharp device puncture, wound exposure and mucosal exposure accounted for 65.2% (15/23), 17.4% (4/23) and 17.4% (4/23), respectively. The exposed sites of body were mainly fingers, followed by eyes and mouth. The incidence of occupational exposure of phlebotomist post accounted for 65.2% (15/23), followed by apheresis platelet collection, component preparation and preliminary screening post [21.7% (5/23), 8.7% (2/23) and 4.3% (1/23), respectively, P<0.05]. The incidence of occupational exposure of new staff rotated within one year was 43.5% (10/23), followed by fixed-point staff within 1-5 years and over 5 years [34.8% (8/23) and 21.7% (5/23), respectively], P<0.05. 56.5% (13/23) of occupational exposure was due to employees′ failure to obey the operate as required. 【Conclusion】 Where there is needle contact there is exposure risk. the newer staff are more likely to suffer occupational exposure, and most exposure are caused by non-compliance with the regulations. The establishment of various preventive measures can effectively reduce the incidence of occupational exposure in blood banks and ensure occupational safety.

Unqualified rate of anti-HIV detection in the laboratories from blood banks in Beijing-Tianjin-Hebei region / 中国输血杂志

【Objective】 To investigate the unqualified rate of anti-HIV detection of blood screening laboratories in Beijing-Tianjin-Hebei region, and explore the differences in anti-HIV detection ability and influencing factors in each laboratory. 【Methods】 Through filling questionnaires via e-mail, the anti-HIV ELISA unqualified rate and confirmed (WB) positive results (data) from January to December 2018 from 15 blood screening laboratories in Beijing-Tianjin-Hebei region were collected. Our laboratory was responsible for data collection and confirmation, and statistics software SPSS22.0 was used for analysis. 【Results】 1) There was a statistically significant difference among the unqualified rate of anti-HIV ELISA(6.77‱~35.71‱) and confirmed positive rate(0.60‱~3.56‱) in 15 blood screening laboratories in Beijing-Tianjin-Hebei region (P<0.05); 2) There were significant differencse among the ELISA unqualified rate and the confirmed positive rate of 8 reagents for anti-HIV detection(P<0.01), and the sensitivity of the 4th generation detection reagent and the imported reagent was higher than that of the 3rd generation reagent and the domestic reagent. The anti-HIV ELISA unqualified rate of R5 was the highest (19.08‱). 3)There were significant differences in the anti-HIV ELISA unqualified rate of R1, R2, R3, R5 and R7 reagents among different blood station laboratories(P<0.05), and there were no significant differences in the anti-HIV ELISA unqualified rate of R4, R6 and R8 reagents among different blood station laboratories(P>0.05). 4)The unqualified rate of anti-HIV ELISA of laboratories using different regents showed significant differences(P<0.05), except H, J, M. The unqualified rate of imported reagent was significantly higher than that of domestic reagents of laboratories using imported and domestic reagents combinations(P<0.05), except O. 62.5% (5/8) laboratories using domestic 3rd and 4th generation reagent combination showed significant differences in the unqualified rates among different reagents(P<0.05); 5) The positive rate of single-reagent(62.02%~95.45%)in 15 blood screening laboratories showed significant difference(P<0.001), and A was the lowest (62.02%). 【Conclusion】 The anti-HIV detection ability among 15 blood screening laboratories in Beijing-Tianjin-Hebei region is quite different. The application of different reagents is the main factor for the difference, and other factors such as personnel, instruments and test strategies also has a great impact on the detection of anti-HIV. It is still necessary to promote the process of homogenization of blood testing quality among blood screening laboratories in Beijing-Tianjin-Hebei region.

Fairness of blood bank resources allocation in China / 中国输血杂志

【Objective】 To study the fairness of blood bank resources allocation in China, aimed at providing references for reasonable allocation of blood bank resources. 【Methods】 A questionnaire survey was conducted among 32 provincial blood centers and 321 regional central blood banks across China in August 1~25, 2018. Resource allocation of blood banks in China was analyzed using descriptive methods, and the fairness of resource allocation were analyzed using Lorenz curve, Gini coefficient and Theil index. 【Results】 Blood bank resources and services showed an overall upward trend from 2013 to 2017. The fairness of institutional coverage was optimal in 2017 according to the Lorenz curve and Gini coefficient, suggesting the allocation of blood bank resources according to the population was better than geographic area. The fairness of health technicians staffing was the worst from the perspective of geographic area. The total Theil index was 0.448 5~0.526 7, and the differences was contributed more by intra group comparison than that of inter group. 【Conclusion】 The unbalanced development underlying in the provincial and regional blood centers has been observed, and the service capacity needs to be further improved. The resource allocation varies greatly among regions, and it is recommended to optimize the regional planning of blood bank resources.

Motivos de diferimiento de potenciales donantes de un banco de sangre de medellín-colombia, 2012-2018

Introducción: en Colombia no se dispone de investigaciones sobre las causas de diferimiento de potenciales donantes de sangre. Objetivo: determinar la prevalencia de los motivos de diferimiento de donantes de un banco de sangre en Medellín, Colombia. Métodos: estudio transversal con 43.002 sujetos en quienes se estimó la prevalencia general de diferimientos y las específicas por sexo y edad. Para cada motivo de diferimiento se estimaron razones de odds crudas y ajustadas mediante modelos de regresión logística. Resultados: los principales motivos de diferimiento fueron el riesgo del compañero sexual (25,2 %), hemoglobina inadecuada (15,2 %) y procedencia de zonas endémicas de malaria o Chagas (8,2 %), la menor prevalencia se registró en la exposición o reactividad a infecciones trasmisibles por transfusión. En las mujeres la mayor prevalencia fue baja hemoglobina, reactividad en pruebas inmunohematológicas, riesgo con elementos cortopunzantes y tratamientos contraindicados para donar, y en los hombres fueron las enfermedades de base, reactividad en marcadores de infección del banco y riesgo sexual. Conclusión: El banco presentó una alta prevalencia de diferimientos por el comportamiento sexual y la hemoglobina, con diferencias estadísticas según la edad y el sexo. Esto constituye una evidencia relevante para mejorar procesos de captación, campañas educativas y acciones de salud pública, prevención y vigilancia epidemiológica de los diferimientos más prevalentes para garantizar un suministro suficiente de sangre.

Introduction: In Colombia, there is no research on the causes of blood donor deferral. Objective: To determine the prevalence of the reasons for donor deferral of a blood bank in Medellín, Colombia. Materials and methods: A cross-sectional study with 43,002 subjects to estimate the general and sex-/age-specific prevalence of deferrals. For each deferral reason, crude and adjusted odds ratios were calculated using logistic regression models. Results: The main reasons for deferral were the risk of the sexual partner (25.2 %), inadequate hemoglobin (15.2 %), and origin from endemic areas of malaria or Chagas (8.2 %); the lowest prevalence was reported in exposure or reactivity to transfusion-transmissible infections. In women, the highest prevalence was low hemoglobin, reactivity in immunohaematological tests, the risk of sharps, and contraindicated treatments for donating, and in men, underlying diseases, reactivity in bank infection markers, and sexual risk. Conclusion: The bank had a high prevalence of sexual behavior and hemoglobin deferrals, with statistical differences in age and sex. The preceding constitutes relevant evidence to improve recruitment processes, educational campaigns and public health actions, epidemiological prevention, and surveillance of the most prevalent deferrals to ensure sufficient blood supply.