ABSTRACT
BACKGROUND: Estimation of the amount of blood products required during liver transplantation can help provision of adequate blood supply, minimize transfusion-associated complications, and plan for preventive measures in high risk patients. OBJECTIVE: To investigate independent predictors of peri-operative blood product transfusion and its impact on short-term survival of liver transplant recipients. METHODS: In a cross-sectional study, old charts of patients who underwent liver transplantation between March 2003 and March 2013 at Namazi Hospital, Shiraz, Iran, were reviewed. The mean amount of blood product utilized during surgery and hospital stay and the related factors, including demographic characteristics, pre-transplant laboratory data, pre-transplant clinical data, operation data, and post-transplantation data were recorded. RESULTS: We studied 1198 patients who underwent liver transplantation. The mean±SD amounts of red blood cells, fresh frozen plasma, and platelet transfusion during surgery and hospital stay were 2.67±3.5, 2.06±3.8, and 1.6±3.8 units, respectively. The mortality rate was significantly higher in patients who received high amounts of blood products (p<0.001). The mean amount of blood products' utilized during operation was significantly (p<0.001) decreased from 2003 to 2013.The mean amount of packed cell usage during operation and hospital stay was significantly (p<0.001) correlated with age, technique of surgery, serum albumin level, cirrhosis, blood urea nitrogen, length of operation, and prothrombin time. CONCLUSION: Pre-operative factors may predict blood transfusion requirements in patients undergoing liver transplantation. Therefore, evaluation of patients before operation should be considered to provide adequate blood supply and minimize transfusion-associated complications. Understanding pre-operative factors associated with rate of transfusion may help us to best utilize the limited available blood resources.
ABSTRACT
Visceral leishmaniasis (VL) is a serious health problem in Iran. The disease is mainly transmitted by sand fly bites, but its transmission through transfusion in endemic areas may also occur. The current study aimed to determine the prevalence of Leishmania infection among blood donors in VL-endemic areas in south of Iran. A total of 2003 healthy blood donors from blood service centers in five VL-endemic districts in Fars province, southern Iran, were enrolled in the study. The blood samples were assessed for antibodies against Leishmania infantum by direct agglutination test (DAT). Seropositive subjects were tested for the presence of L. infantum DNA in their buffy coat by the molecular method. Socio-demographic features of the subjects were also documented during sample collecting. The mean age of participants was 36.3 (SD = 10.7 years). Male constituted 94.7 % of the subjects while only 5.3 % of donors were female. Twenty-eight blood donors (1.4 %) were positive for Leishmania infection by DAT. Only one of these seropositive donors was positive for Leishmania infection by polymerase chain reaction. A significant correlation was found between age, the place of residence and seropositivity to Leishmania (P < 0.05). Findings of this study revealed that the prevalence of Leishmania infection among blood donors in transfusion centers in the VL-endemic areas in Iran is relatively high. These asymptomatic blood donors may constitute a risk of transmitting of VL to susceptible recipients.
ABSTRACT
A number of studies have indicated that some blood donors may donate blood in order to obtain an HIV test. These particular donors pose a serious hazard to the health care system by increasing the risk of HIV being transmitted through the donated blood. The study was undertaken to discover the effectiveness of new measures introduced to reduce the number of donors using blood donation centres to obtain an HIV test. The measures included increased educational information regarding the hazards of HIV transmission through donated blood, and the availability of special HIV clinics offering free services and anonymity. A survey of blood donors was undertaken over a period of 3 years, from 2004 to 2007. The cross-sectional survey involved 14 752 volunteers and all the participants were asked to complete a questionnaire which covered areas such as demographic characteristics and their motivation for donating blood. During the first year of the survey, it was discovered that 14. 2% of donors donated blood in order to be tested for HIV, and in the following 2 years it was 11. 2 and 9. 3%, respectively. A significant decrease was shown during the survey (P < 0. 05). The majority of these particular donors were found to be young, single, men with poor educational backgrounds and first-time blood donors. Over the period of this study, a reduction in the number of donors using blood donation centres in order to be tested for HIV was clearly evident. This positive downward trend may be attributed to the success of the new measures introduced.
