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1.
Transfusion ; 64(4): 656-664, 2024 Apr.
Article in English | MEDLINE | ID: mdl-38385641

ABSTRACT

BACKGROUND: Special Forces (SF) teams operate in remote environments with limited medical support. As a result, they may need to rely on buddy transfusions to treat bleeding teammates. Considering that 450 mL has no direct impact on their combat performances, it might be tempting to take more blood from a compatible donor to save a hemorrhaging teammate. This study investigates the effect of a 900 mL blood donation on SF operator performance and recovery time following this donation. STUDY DESIGN AND METHODS: Participants underwent a multifactorial assessment including measures of physiological parameters, vigilance, and physical performance. Results from the day of blood donation were compared with baseline values obtained 1 week earlier (i.e., immediate effect), as well as repeated testing at 7, 14, and approximately 30 days after blood donation (i.e., recovery period). RESULTS: Hemoglobin levels and heart rate were affected by giving blood. The participants also experienced a significant decrease in physical performance of more than 50% immediately after blood donation. Recovery was slow over the following weeks, remaining significantly different from baseline until full recovery around day 30. However, participants were still able to respond to a simple stimulus and adjust their response, if necessary, even immediately after donating blood. DISCUSSION: A 900 mL blood donation greatly affects the physical fitness of SF operators. A donation may be worthwhile if it is the only life-saving procedure available and does not endanger the donor's life. The donor would then become a patient and unable to complete the mission.


Subject(s)
Blood Donation , Blood Donors , Humans , Blood Transfusion
2.
Immunohematology ; 39(1): 35-42, 2023 Apr 01.
Article in English | MEDLINE | ID: mdl-37017596

ABSTRACT

To date, 43 blood group systems with 349 red blood cell (RBC) antigens have been recognized. The study of their distribution is useful for blood services to improve their supply strategies for providing blood of rare phenotypes, but also to design indigenous RBC panels for alloantibody screening and identification. In Burkina Faso, the distribution of extended blood group antigens is not known. This study aimed to investigate the extended profiles of blood group antigens and phenotypes of this population and to raise limitations and potential strategies for the design of local RBC panels. We conducted a cross-sectional study that included group O blood donors. Extended phenotyping for antigens in the Rh, Kell, Kidd, Duffy, Lewis, MNS, and P1PK systems was performed using the conventional serologic tube technique. The prevalence of each antigen and phenotype combination was determined. A total of 763 blood donors were included. The majority were positive for D, c, e, and k and negative for Fya and Fyb. The prevalence of K, Fya, Fyb, and Cw was less than 5 percent. The most frequent Rh phenotype was Dce, and the most common probable haplotype was R0R0 (69.5%). For the other blood group systems, the K-k+ (99.4%), M+N+S+s- (43.4%), and Fy(a-b-) (98.8%) phenotypes were the most frequent. Antigenic polymorphism of blood group systems by ethnicity and geography argues for the design and evaluation of population-sourced RBC panels to meet specific antibody profiles. However, some of the specificities identified in our study, such as the rarity of double-dose antigen profiles for certain antigens and the cost of antigen phenotyping tests, are major challenges to overcome.


Subject(s)
Blood Group Antigens , Humans , Burkina Faso , Cross-Sectional Studies , Erythrocytes , Antigens , ABO Blood-Group System , Phenotype
3.
Immunohematology ; 39(4): 172-180, 2023 Dec 01.
Article in English | MEDLINE | ID: mdl-38179780

ABSTRACT

In sub-Saharan Africa, antibody detection tests remain inaccessible because of the high cost and limited shelf life of red blood cell (RBC) reagents. This study aimed at investigating the feasibility and performance of locally prepared RBC reagents for antibody detection in Burkina Faso. We conducted an experimental study comparing commercial RBC panels and a local panel prepared from phenotyped blood donors in Ouagadougou, Burkina Faso. Antibody detection testing was performed by the indirect antiglobulin test using a gel card filtration column in a low-ionic-strength solution. Judgment criteria were the concordance rate and the kappa agreement coefficient of results generated by the two panels. A total of 302 blood donors were phenotyped for the major antigens of the RH, KEL, MNS, FY, JK, LE, and P1PK blood group systems. From this pool of donors, we designed an RBC detection panel that was used to screen for unexpected antibodies in 1096 plasma samples from 832 patients with a history of transfusion and 264 recently delivered or pregnant women with no history of blood transfusion. A positive antibody detection test was observed in 8.1 percent of the samples using the local panel versus 6.4 percent with the commercial panels. A total of 23 samples were negative with the commercial panels and positive with the local panel, while the findings were reversed for four samples. The concordance rate was 97.5 percent, and the kappa agreement coefficient was 0.815. Our results suggest that the development of local RBC panels can be an alternative to commercial panels in countries with limited resources. It could also be a cost-effective intervention, mainly for children under 5 years of age, women of childbearing age, and pregnant women, all of whom are most at risk for malaria and sickle cell disease complications. Blood services could develop and implement appropriate strategies to make phenotyped donor pools available for the design of suitable RBC panels.


Subject(s)
Antibodies , Erythrocytes , Child , Humans , Female , Pregnancy , Child, Preschool , Indicators and Reagents , Burkina Faso , Feasibility Studies
4.
Transfus Clin Biol ; 28(4): 414-419, 2021 Nov.
Article in English | MEDLINE | ID: mdl-34111506

ABSTRACT

In this unprecedented crisis of severe acute respiratory syndrome coronavirus 2 and its associated coronavirus disease 2019 (COVID-19), polymerase chain reaction and then serological testing platforms have been massively developed to face the important screening demand. Polymerase chain reaction and serological testing platforms are not the only actors impacted by the crisis, transfusion services are facing important difficulties. A positive direct antiglobulin test is frequently observed for patients encountering COVID-19. Patients with severe symptoms may develop anaemia and become good candidates for blood transfusions. The interpretation of a positive direct antiglobulin test for patients recently transfused and suffering from COVID-19 is complex. The differentiation between COVID-19 induced antibodies and possible associated transfusion alloantibodies is therefore crucial. In this context, the elution technique incorporated in an appropriate decision-making process plays its full role. This intricate topic is presented through a case report followed by literature review and finally decision-making process for COVID-19 patients necessitating red blood cells administration.


Subject(s)
COVID-19 , Blood Transfusion , Coombs Test , Humans , SARS-CoV-2
7.
Transfus Clin Biol ; 25(1): 2-7, 2018 Feb.
Article in English | MEDLINE | ID: mdl-29336950

ABSTRACT

OBJECTIVES: Recently, daratumumab has been included in the therapeutic strategies for myeloma patients. This molecule is an antibody directed against CD38, strongly expressed on plasma cells. Nevertheless, as CD38 is also present on erythrocyte membrane, daratumumab interferes with immunohaematological tests, complicating the selection of compatible blood. METHODS: A total of 14 patients treated by daratumumab have been followed in our transfusion laboratory. Among them, 11 have been transfused. Dithiotreitol (DTT) has been used to inhibit the daratumumab's interference, in the pre-transfusion tests (irregular antibody screening and cross-match). RESULTS: The red blood cell treatment with DTT has been very efficacious to inhibit the daratumumab's interference in 13 patients out of 14. Some precautionary measures had to be taken into account, especially the pH and the storage conditions. An extended pheno/genotype was an additional security element in the selection of compatible blood. To simplify and to optimize the laboratory practices, a decisional flow chart has been written. CONCLUSION: DTT red blood cell treatment is very useful and efficacious in the pre-transfusion tests of patients treated with daratumumab. It allows to avoid the selection of blood bags only on the basis of an extended pheno/genotype, what is more secure and more ethical with respect to other at higher risk patients. A clear decisional flow chart allows a quality assurance gait. Collaboration with physicians is essential.


Subject(s)
ADP-ribosyl Cyclase 1/antagonists & inhibitors , Antibodies, Monoclonal/pharmacology , Antigen-Antibody Reactions/drug effects , Blood Grouping and Crossmatching/methods , Coombs Test , Membrane Glycoproteins/antagonists & inhibitors , Molecular Targeted Therapy , Multiple Myeloma/drug therapy , ADP-ribosyl Cyclase 1/immunology , Adult , Aged , Aged, 80 and over , Antibodies, Monoclonal/therapeutic use , Blood Group Incompatibility/prevention & control , Blood Preservation , Blood Transfusion , Decision Trees , Dithiothreitol/pharmacology , Erythrocyte Membrane/drug effects , Erythrocyte Membrane/immunology , False Positive Reactions , Female , Humans , Hydrogen-Ion Concentration , Isoantibodies/blood , Male , Membrane Glycoproteins/immunology , Middle Aged , Multiple Myeloma/blood , Multiple Myeloma/therapy , Plasma Cells/immunology , Specimen Handling , Transfusion Reaction/etiology , Transfusion Reaction/prevention & control
8.
Transfus Clin Biol ; 24(4): 440-448, 2017 Nov.
Article in French | MEDLINE | ID: mdl-28571691

ABSTRACT

BACKGROUND: The National Blood Transfusion Centre, unique operator of blood transfusion in Burkina Faso is engaged into the quality process according to ISO 9001. Therefore, the assessment of customer satisfaction is a main part of its system. Our study conceives "customer satisfaction" as dependant to the perceived service quality based on SERVQUAL model. OBJECTIVES: To identify factors associated with the satisfaction of blood products prescribers in order to help decision-makers for continuous improvement of services. MATERIAL AND METHODS: We conducted a cross-sectional survey among prescribers of blood components in Ouagadougou, between February 27 and April 30, 2015. We used an anonymous self-administered questionnaire, including 13 items associated to the 5 dimensions of SERVQUAL model. The different satisfaction gaps were calculated and linear regression was used to determine statistical associations with a significance level of 5%. RESULTS: The return rate was 94.5% about the 256 questionnaires distributed. A total of 30% of respondents were satisfied to very satisfied. The overall global gap of satisfaction was -5.74. The product delivery time, the efficacy and safety of blood products, the medical and clinical support, the pro-activity of the communication, the management of blood products reservation and the satisfaction of needs in blood products were the factors associated with the prescribers' satisfaction. CONCLUSION: This first study in blood transfusion services in our context was been useful to assess customer satisfaction and identify the main axes on which targeting priority actions in order to effectively use available resources.


Subject(s)
Attitude of Health Personnel , Blood Banks , Blood Transfusion/psychology , Consumer Behavior , Physicians/psychology , Prescriptions , Adult , Burkina Faso , Cross-Sectional Studies , Female , Health Care Surveys , Humans , Male , Medicine , Middle Aged , Models, Psychological , Quality of Health Care
9.
B-ENT ; Suppl 26(1): 67-85, 2016.
Article in English | MEDLINE | ID: mdl-29461735

ABSTRACT

Facing coagulation disorders after acute trauma. PROBLEMS/OBJECTIVES: Trauma is the leading cause of mortality for persons between one and 44 years of age, essentially due to bleeding complications. METHODOLOGY: We screened the PubMed, Scopus and Cochrane Library databases, using specific keywords. Only publications in English were considered. MAIN RESULTS: The pathophysiology of trauma-induced coagulopathy (TIC) is complex and includes the classic "lethal triad" (i.e., haemodilution, acidosis, hypothermia) but may also include activation of protein C, endothelial and platelet dysfunction, and fibrinogen depletion. The time between trauma and treatment of the resultant massive bleeding should be as short as possible using techniques for rapid control of bleeding and avoiding aggravating factors (hypothermia, metabolic acidosis and hypocalcaemia). If given within three hours of injury, tranexamic acid (TXA) reduces all causes of mortality in trauma patients and reduces transfusion requirements. In a bleeding patient, crystalloids are preferred to colloids and the ratio of fresh frozen plasma to packed red blood cells should be at least 1:2. Damage control surgery (DCS) should be considered for patients who present with, or are at risk for developing, the "lethal triad", multiple life-threatening injuries or shock, and in mass casualty situations. DCS can also aid in the evaluation of the extent of tissue injuries and the control of haemorrhage and infection. Finally, there is currently no evidence of the added value of laboratory assays in the management of TIC. CONCLUSIONS: TIC appears quickly after trauma and should be anticipated and detected as soon as possible. TXA plays a central role in the management of such patients. Each institution should establish a local algorithm for the management of bleeding patients.


Subject(s)
Blood Coagulation Disorders/physiopathology , Blood Platelet Disorders/physiopathology , Endothelium, Vascular/physiopathology , Hemorrhage/physiopathology , Wounds and Injuries/physiopathology , Acidosis/blood , Acidosis/etiology , Acidosis/physiopathology , Blood Coagulation Disorders/blood , Blood Coagulation Disorders/etiology , Blood Coagulation Disorders/therapy , Blood Transfusion , Hemodilution , Hemorrhage/blood , Hemorrhage/etiology , Hemorrhage/therapy , Humans , Hypothermia/blood , Hypothermia/etiology , Hypothermia/physiopathology , Wounds and Injuries/blood , Wounds and Injuries/complications
11.
Acta Clin Belg ; 67(3): 201-8, 2012.
Article in English | MEDLINE | ID: mdl-22897069

ABSTRACT

The following recommendations, which aim at improving the clinical diagnosis ofTRALI and the laboratory investigations that can support it, were drawn up by a working group of the Superior Health Council. TRALI is a complication of blood transfusion that is both serious and underreported. Systematic reporting may help to develop preventive actions. Therefore, the Superior Health Council recommends that there should be a more stringent surveillance of patients who receive a blood component transfusion. The clinician should pay very close attention to any change in the patient's respiratory status (cf. dyspnoea and arterial desaturation), which should be notified systematically to the haemovigilance contact person in the hospital.


Subject(s)
Acute Lung Injury/diagnosis , Acute Lung Injury/therapy , Respiratory Distress Syndrome/diagnosis , Respiratory Distress Syndrome/therapy , Transfusion Reaction , Acute Lung Injury/etiology , Antibodies, Antineutrophil Cytoplasmic/blood , Autoantibodies/blood , Belgium , Blood Donors , Diagnosis, Differential , HLA Antigens/immunology , Humans , Oxygen Inhalation Therapy , Positive-Pressure Respiration , Respiratory Distress Syndrome/etiology
13.
Acta Clin Belg ; 66(5): 346-60, 2011.
Article in English | MEDLINE | ID: mdl-22145269

ABSTRACT

The following recommendations, which aim at standardising and rationalising the clinical indications for administering polyclonal immunoglobulins in Belgium, were drawn up by a working group of the Superior Health Council. To this end, the Superior Health Council organised an expert meeting devoted to"Guidelines for the use of immunoglobulins". The experts discussed the indications for immunoglobulin use, the'ideal'immunoglobulin preparation, its mechanisms of action, the practical issues involved in administering immunoglobulins and their potential side effects. The recommendations formulated by the experts were validated by the Superior Health Council working group with the purpose of harmonising immunoglobulin use in Belgium


Subject(s)
Immune System Diseases/drug therapy , Immunoglobulins, Intravenous/therapeutic use , Immunologic Factors/therapeutic use , Belgium , Evidence-Based Medicine , Humans , Immunoglobulins, Intravenous/administration & dosage , Immunoglobulins, Intravenous/adverse effects , Immunologic Deficiency Syndromes/drug therapy , Immunologic Factors/administration & dosage , Immunologic Factors/adverse effects , Nervous System Diseases/drug therapy , Treatment Outcome
14.
Transfus Clin Biol ; 18(5-6): 536-41, 2011 Dec.
Article in French | MEDLINE | ID: mdl-21676637

ABSTRACT

PURPOSE OF THE STUDY: To evaluate the needs in staff training in transfusion centres of Sub-Saharan Africa. MATERIAL AND METHODS: This preliminary study analyzed the training level of each personnel of four blood banks of Sub-Saharan Africa, their training fields, duration and training structures. RESULTS: The needs remain high in all the fields and are critical regarding the administration of blood transfusion services, equipment maintenance and clinical use of blood.


Subject(s)
Blood Banks , Health Personnel/education , Africa South of the Sahara , Blood Banks/statistics & numerical data , Blood Safety , Blood Transfusion/statistics & numerical data , Education, Professional/statistics & numerical data , Health Personnel/statistics & numerical data , Health Services Needs and Demand , Humans , Workforce
16.
Acta Anaesthesiol Belg ; 61(3): 147-50, 2010.
Article in English | MEDLINE | ID: mdl-21268570

ABSTRACT

The combination of Pleth Variability Index (PVI) and passive leg raising (PLR)-induced pulse pressure variation may help to diagnose hypovolemia in spontaneously breathing patients. In 44 subjects, PVI and Pulse Pressure (PP) variation after PLR were measured before and after induced hypovolemia (blood gift or hemodialysis session). PVI values were significantly greater after hemodialysis session or blood gift (22% vs 18%, P = 0.03); in contrast PP variation did not change significantly (7% vs 4%, P = 0.49). The accuracy of these parameters or of their combination to identify the "after hypovolemia induction" period was weak. In spontaneous ventilation, PVI value is greater after induced hypovolemia, whereas PP variation does not change significantly. The combination of PVI and PLR does not improve the accuracy of the detection of induced hypovolemia.


Subject(s)
Blood Pressure , Hypovolemia/diagnosis , Respiration , Aged , Algorithms , Female , Humans , Leg , Male , Middle Aged , Renal Dialysis
17.
Transfus Med ; 20(1): 1-10, 2010 Feb.
Article in English | MEDLINE | ID: mdl-19725906

ABSTRACT

The high prevalence of numerous endemic and epidemic diseases such as malaria, HIV infection and viral hepatitis in some areas of sub-Saharan Africa (SSA) affects the health status of blood donors. Considering the difficulties in ensuring sufficient and safe blood supply, analysing epidemiological factors that impact blood donors in this community may further bring light on issues of supply and safety, and help in planning for its rational use. This review does not aim to propose new strategies but describes the main characteristics of blood donors in SSA as collected from different reports. Data were mainly obtained from the reports of the World Health Organization and national blood transfusion programmes and also from relevant literature and conference reports. Several characteristics are common in blood donors, such as the predominance of young adult males, the high frequency of Transmission-transmitted Infections (TTIs) and some erythrocytic phenotypes. The data indicate variations in the level of improvement of blood collection and blood safety from one area to another, particularly in the field of donor motivation or screening strategies for TTIs. These data could be useful to supplement previous reports and to provide updates for governments and international organizations' programs involved in the improvement of blood safety in Africa.


Subject(s)
Blood Donors , Adolescent , Adult , Africa South of the Sahara , Black People/genetics , Blood Banks/economics , Blood Banks/organization & administration , Blood Banks/standards , Blood Donors/psychology , Blood Donors/statistics & numerical data , Blood Group Antigens/analysis , Blood Group Antigens/genetics , Blood Transfusion/economics , Blood Transfusion/standards , Directed Tissue Donation/statistics & numerical data , Donor Selection/methods , Donor Selection/standards , Endemic Diseases/prevention & control , Female , HIV Infections/blood , HIV Infections/epidemiology , HIV Infections/prevention & control , HIV Infections/transmission , HIV Seroprevalence , Hepatitis, Viral, Human/blood , Hepatitis, Viral, Human/epidemiology , Hepatitis, Viral, Human/prevention & control , Hepatitis, Viral, Human/transmission , Humans , Infection Control/methods , Leukocyte Reduction Procedures , Malaria, Falciparum/blood , Malaria, Falciparum/epidemiology , Malaria, Falciparum/prevention & control , Malaria, Falciparum/transmission , Male , Middle Aged , Motivation , Transfusion Reaction , Volunteers , World Health Organization , Young Adult
19.
Vox Sang ; 96(3): 213-8, 2009 Apr.
Article in English | MEDLINE | ID: mdl-19207170

ABSTRACT

BACKGROUND AND OBJECTIVES: Photochemical treatment (PCT) based on amotosalen and ultraviolet A light (UVA) demonstrated a wide range of pathogen inactivation. However, coagulation proteins are affected by this treatment. The aim of this study was to evaluate the coagulation parameters in apheresis plasma units after thawing and processing by PCT. MATERIALS AND METHODS: Thirty apheresis plasma units were rapidly frozen at

Subject(s)
Blood Coagulation , Blood Component Removal/methods , Blood Preservation/methods , Furocoumarins/pharmacology , Photosensitizing Agents/pharmacology , Plasma/radiation effects , Ultraviolet Rays , Humans , Plasma/drug effects
20.
Leukemia ; 21(8): 1715-22, 2007 Aug.
Article in English | MEDLINE | ID: mdl-17541398

ABSTRACT

Chromosomal translocations represent an important prognostic indicator in B-cell chronic lymphocytic leukemia (B-CLL). However, their value had been neither determined in homogeneously treated patients nor compared to that of IgV(H) mutational status. Sixty-five B-CLL patients were investigated using cytogenetics, interphase fluorescence in situ hybridization (FISH), analysis of IgV(H) and of TP53 mutational status before treatment with 2-chloro-2'-deoxyadenosine (CdA). Translocations (n=45) were detected in 42% of the patients, including both balanced (n=12) and unbalanced (n=33) types. IgV(H) was mutated in 43% of the patients. Patients with translocations were more heavily pretreated (P=0.05), presented with more complex karyotypes (P<0.001), 17p abnormalities and TP53 mutations, and had a higher failure rate (59 vs 21% in patients without translocations, P=0.004). Patients with unbalanced translocations displayed a shorter median treatment-free survival (TFS, 6.9 vs 35.9 months, log rank 22.72, P<0.001) and overall survival (OS, 13.0 vs 68.0 months, log rank 16.51, P<0.001), as compared to patients without translocation. In multivariate analysis, unbalanced translocations were independently associated with therapeutic failure, short TFS and short OS. IgV(H) mutational status was independently associated with risk of failure and TFS, but not OS. In B-CLL patients treated with CdA, translocations are strong predictors of outcome.


Subject(s)
Antineoplastic Agents/therapeutic use , Cladribine/therapeutic use , Leukemia, Lymphocytic, Chronic, B-Cell/genetics , Leukemia, Lymphocytic, Chronic, B-Cell/mortality , Translocation, Genetic , Adult , Aged , Aged, 80 and over , Chromosome Aberrations , Chromosomes, Human, Pair 11/genetics , Chromosomes, Human, Pair 13/genetics , Chromosomes, Human, Pair 17/genetics , Female , Humans , In Situ Hybridization, Fluorescence , Interphase , Karyotyping , Leukemia, Lymphocytic, Chronic, B-Cell/drug therapy , Male , Middle Aged , Mutation/genetics , Prognosis , Risk Factors , Survival Rate , Treatment Failure , Tumor Suppressor Protein p53/genetics , Tumor Suppressor Protein p53/metabolism
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