Variations in hemoglobin measurement and eligibility criteria across blood donation services are associated with differing low-hemoglobin deferral rates: a BEST Collaborative study.

BACKGROUND: Determination of blood donor hemoglobin (Hb) levels is a pre-requisite to ensure donor safety and blood product quality. We aimed to identify Hb measurement practices across blood donation services and to what extent differences associate with low-Hb deferral rates. METHODS: An online survey was performed among Biomedical Excellence for Safer Transfusion (BEST) Collaborative members, extended with published data. Multivariable negative-binomial regression models were built to estimate adjusted associations of minimum donation intervals, Hb cut-offs (high, ≥13.5 g/dL in men or ≥ 12.5 g/dL in women, vs. lower values), iron monitoring (yes/no), providing or prescribing iron supplementation (yes/no), post-versus pre-donation Hb measurement and geographical location (Asian vs. rest), with low-Hb deferral rates. RESULTS: Data were included from 38 blood services. Low-Hb deferral rates varied from 0.11% to 8.81% among men and 0.84% to 31.85% among women. Services with longer minimum donation intervals had significantly lower deferral rates among both women (rate ratio, RR 0.53, 95%CI 0.33-0.84) and men (RR 0.53, 95%CI 0.31-0.90). In women, iron supplementation was associated with lower Hb deferral rates (RR 0.47, 95%CI 0.23-0.94). Finally, being located in Asia was associated with higher low-Hb deferral rates; RR 9.10 (95%CI 3.89-21.27) for women and 6.76 (95%CI 2.45-18.68) for men. CONCLUSION: Differences in Hb measurement and eligibility criteria, particularly longer donation intervals and iron supplementation in women, are associated with variations in low-Hb deferral rates. These insights could help improve both blood donation service efficiency and donor care.

West Nile virus infection incidence based on donated blood samples and neuroinvasive disease reports, Northern Texas, USA, 2012.

During the 2012 outbreak of West Nile virus in the United States, approximately one third of the cases were in Texas. Of those, about half occurred in northern Texas. Models based on infected blood donors and persons with neuroinvasive disease showed, respectively, that ≈0.72% and 1.98% of persons in northern Texas became infected.

A case of masquerading alloantibodies: the value of a multitechnique approach.

In an immunohematology reference laboratory, samples received for antibody identification react in many different ways requiring a variety of approaches. Sometimes, the clues from initial testing can lead to faulty assumptions and misdirection. Fortunately, a well-supplied reference laboratory will have access to a variety of techniques and reagents that, when used together, can reveal the true identity of the antibodies involved. We present a case of a patient sample with an apparent group AB, D+ blood type showing strong reactivity with all cells tested in the forward and reverse ABO, in the D testing as well as in a three-cell antibody screen. The initial assumption was that the plasma contained a cold autoantibody. Subsequent testing, including the use of gel column technology, ficin-treated cells, and antisera for phenotyping, showed the apparent cold autoantibody to bea red herring. Additional tube testing at immediate spin, 37°C,and indirect antiglobulin test (IAT) revealed the presence of four alloantibodies: anti-M and anti-E reacting at immediate spin, 37°C, and IAT plus anti-Fy(a) and anti-Jk(b) reacting at lAT.

Low CD34 collection from a healthy blood progenitor cell donor: a case report.

BACKGROUND: Transplantation of hematopoietic progenitor cells is widely used to ameliorate the consequences of bone marrow failure. In allogeneic transplantation, peripheral blood progenitor cells (PBPCs) from an HLA-matched donor are collected by apheresis and then identified using flow cytometric methods as being CD34 marker positive cells. CASE REPORT: A 25-year-old healthy male was matched with an obese 106 kg 23-year-old female diagnosed with acute lymphoblastic lymphoma. After a routine course of G-CSF induction, a 2-day PBPC collection procedure with a collection volume of 12 L/day was planned. All samples for CD34 estimation were shipped, stored, and tested according to the laboratory standard regulations. Testing was performed per International Society for Hematotherapy and Graft protocol, and CD34+ cells were immunophenotyped using monoclonal antibody against CD34 and CD45 by multicolor flow cytometry. RESULTS: The cumulative yield of both collections was 70.6 x 10(6) CD34+ cells (0.67 x 10(6) CD34+ cells/kg), which fell short of the requested dose of 530 x 10(6) (5 x 10(6) CD34+ cells/kg). Surprisingly, the recipient engrafted successfully and 12 days posttransplant short tandem repeat testing demonstrated only T cells of donor origin in the peripheral blood. CONCLUSION: To our knowledge, no successful engraftment has been reported as yet with such a poor collection of PBPC. The amountof transfused CD34+ cells (0.67 x 10(6)/kg) was significantly less than the minimum required amount (5x 10(6)/kg).