A Review of the Use of Metallic Nanoparticles as a Novel Approach for Overcoming the Stability Challenges of Blood Products: A Narrative Review from 2011-2021.

PURPOSE: To obtain safe and qualified blood products (e.g., platelets, plasma, and red blood cells), various limitations such as limited shelf life (especially for platelets) and stability must be addressed. In this review study, the most commonly used metal nanomaterials (e.g., gold, silver, iron, and magnetic) reported in the literature from 2011 to 2021 were discussed owing to their unique properties, which provide exciting approaches to overcome these limitations and improve the stability, safety, and quality of blood products. Novelty: This study reviews for the first time the results of studies (from 2011 to 2021) that consider the effects of various metallic nanoparticles on the different blood products. RESULTS: The results of this review study showed that some metallic nanoparticles are effective in improving the stability of plasma proteins. For this purpose, modified Fe3O4 magnetic nanoparticles and citrate-AuNPs protect albumin products against stressful situations. Also, SiO2 microspheres and silicacoated magnetite nanoparticles are highly capable of improving IgG stability. ZnO nanoparticles also reduced thrombin production, and protein-coated GMNP nanoparticles prevented unwanted leakage of factor VIII through blood vessels. Furthermore, the stability and longevity of erythrocytes can be improved by AuNP nanoparticles and Zr-based organic nanoparticles. In addition, platelet storage time can be improved using PEGylated Au and functionalized iron oxide nanoparticles. SUGGESTION: According to the results of this study, it is suggested that further research should be conducted on metal nanoparticles as the most promising candidates to prepare metal nanoparticles with improved properties to increase the stability of various blood products.

Effects and treatment applications of polymeric nanoparticles on improving platelets' storage time: a review of the literature from 2010 to 2020.

Maintaining the quality of platelet products and increasing their storage time are priorities for treatment applications. The formation of platelet storage lesions that limit the storage period and preservation temperature, which can prepare a decent environment for bacterial growth, are the most important challenges that researchers are dealing with in platelet preservation. Nanotechnology is an emerging field of science that has introduced novel solutions to resolve these problems. Here, we reviewed the reported effects of polymeric nanoparticles-including chitosan, dendrimers, polyethylene glycol (PEG), and liposome-on platelets in articles from 2010 to 2020. As a result, we concluded that the presence of dendrimer nanoparticles with a smaller size, negative charge, low molecular weight, and low concentration along with PEGylation can increase the stability and survival of platelets during storage. In addition, PEGylation of platelets can also be a promising approach to improve the quality of platelet bags during storage.

Spatio-Temporal Analysis of the Hepatitis B Prevalence in Iranian Blood Donors from 2000 to 2016 at National and Provincial Level.

BACKGROUND: High risk blood transfusions can cause a lot of financial and psychological burden to the community. The prevalence of Hepatitis B is useful for evaluating the blood products' safety and donor selection methods. We aimed to predict the prevalence of hepatitis B in Iranian blood donors from 2000-2016. METHODS: Positive cases of hepatitis B from 2006 to 2014 were collected from Iranian Blood Transfusion Organization. This database was classified according to the age, provinces, and type of donation. Data was not existed in all subnational levels and all years, therefore, for predicting the hepatitis B prevalence, two separate, Spatio-temporal and mixed model (GLMM) were developed. RESULTS: At the national level, the hepatitis B prevalence declined from 0.69 (0.51 to 0.90) in 2000 to 0.27 (0.21 to 0.33) in 2016. In first-time, regular, and repeated donors, this prevalence declined from 2.31 (1.74 to 2.31), 0.26 (0.19 to 0.34), and 0.51 (0.38 to 0.68) in 2000 to 0.87 (0.69 to 1.09), 0.09 (0.07 to 0.12), and 0.19 (0.14 to 0.24) in 2016. At the provincial level, the highest and lowest prevalence in 2016 was observed in North Khorasan and Gilan. With increasing age, the average prevalence of hepatitis B, increased. CONCLUSION: Prevalence of hepatitis B in Iranian blood donors has been reduced significantly over 17 years, but still new cases of hepatitis B are reported. By precise monitoring the donor selection process and implementing more sensitive laboratory screening, we can reduce the risk of new infectious agents.

Analysis of blood donors' characteristics and deferrals related to COVID-19 in Iran.

BACKGROUND: With the outbreak of the coronavirus disease in 2019, called COVID-19, Iranian Blood Transfusion Organization (IBTO) implemented the new deferrals. This study analyzed the COVID-19 deferrals of blood volunteers and compared the demographics, deferrals, and the donor status during the COVID-19 outbreak in 2019. STUDY DESIGN AND METHODS: Data were collected from the integrated blood donor database between Feb-Apr 2019 and 2020. Deferral reasons of COVID-19 were categorized as: those who have symptoms or live with a symptomatic family member, have direct exposure with a confirmed case, have travelled from the outbreak affected areas, and have fully recovered from confirmed COVID-19. The z-test analysis was used, and 95 % confidence intervals were calculated to compare the sample proportions. RESULTS: The blood donations dropped to 26.09 % in 2020. The percent change of first-time blood donors, female donors, and donors within the age group of 45-54 years old was significantly greater in 2020 than the same time frame in 2019 (p < 0.05). The results showed that 0.58 % of volunteers were deferred from blood donation to avoid transmission of SARS-CoV-2. The rate of COVID-19 deferrals in all types except travelling to affected areas has increased in the second 30-day of the study (p < 0.05). CONCLUSION: The blood shortage that occurred during the COVID-19 outbreak was not due to increased deferral for COVID-19, but it was mostly due to a decrease in the number of volunteers who referred to BTCs.

The incidence of hepatitis C in patients with thalassemia after screening in blood transfusion centers: a fourteen-year study.

BACKGROUND: Blood safety is important in all transfusion centers. The aim has always been to try to guarantee the recipient's safety through careful screening and examination of donors' blood samples. In Iran the hepatitis C virus (HCV) screening test became mandatory for blood donations from 1996. We decided to determine the incidence of new cases of HCV in patients with thalassemia, after screening of blood bags was initiated. STUDY DESIGN AND METHODS: The study was done on patients with complete files for anti-HCV test results. Only cases that had a confirmed positive anti-HCV result after a negative result were considered as new cases. The incidence rate was estimated and expressed in person-years (PY). Also, for increased accuracy and comparison of incidence in recent years, the incidence rate was calculated at two 7-year intervals (1996-2002 and 2003-2009). RESULTS: A total of 395 files were studied with a mean age of 27.5 years (SD ± 7.99 years). We had 109 (27.5%) anti-HCV positive, of which 21 (19.2% of positive cases) were exposed after 1996 and considered as new cases. The incidence of HCV cases in 14 years (1996-2009) was 4.2/1000 PY. The incidence in the first 7-year period (1996-2002) was 6.2/1000 PY and 1.3/1000 PY in the second 7-year period (2003-2009). CONCLUSION: The incidence of HCV is on the decline in Iran, both in blood donors and in recipients. We owe this to the improved blood safety in our transfusion center that has taken up better strategies. Even though the residual risk will never reach zero and we may still have new cases of HCV, it will definitely be with a lower rate. The fact that we have had no new cases among our patients with thalassemia since 2005 bears witness to this matter.

Frequency of hepatitis B virus DNA in anti-HBc positive, HBsAg negative blood donors in Rasht, northern Iran.

BACKGROUND: One of the important factors in the ensuing safety of blood transfusion is to use a sensitive screening assay for detection of blood-born infective agents such as HBV which transmits through transfusion. To improve the detection rate of HBV infection in blood donors, a cross-sectional study was conducted in Rasht, which is the largest city in the north of Iran to explore the possibility of using anti-HBc as a screening test. STUDY DESIGN AND METHODS: A total of 2041 blood samples negative for HBsAg, Anti-HCV, Anti-HIV I, II and RPR were tested to detect anti-HBc and then the positive anti-HBc samples were further checked for the presence of HBV DNA. RESULTS: The prevalence of anti-HBc positive samples was 3.8% and HBV DNA was detected in only one sample. CONCLUSIONS: This study showed that anti-HBc positive blood donors may be a source of HBV transmission and further study for evaluation of HBV DNA in anti-HBc positive blood units is needed.

Evaluation of new cases of HCV infection in thalassaemia patients for source of infection.

BACKGROUND: Screening tests on blood bags is important step for blood safety. In Iran, screening for HCV started from 1996. We decided to determine the new cases of hepatitis C in our thalassemic patients, after screening of blood bags was initiated and trace backing from recipients to find their donors. MATERIALS AND METHODS: The study was done on patients with complete files for HCVAb test results. Only cases that had a positive HCVAb result following a negative result were considered as new cases. For trace backing, we recorded the blood transfusions' date and the blood bags' number from last negative test results (HCVAb) to the first positive test result. These data were sent to the transfusion center. The suspected donors were contacted and asked to be tested again in the transfusion center. RESULTS: A total of 395 patients were studied; 229 (58%) males and 166 (42%) females. Mean age was 27.5 years. We had 109 HCV (27.5%) positive cases of whom 21 were infected after 1996. We traced the last five cases contaminated during 2003 and 2004. These five patients had 13, 10, 13, 12, and 6 donors, respectively (totally 54 donors were found). We proved the healthy state in 68.5% (37 of 54) of our donors population. Of them, 81% were repeated donors and 17 of 54 donors (31.5%) could not be traced (because of change in addresses). We did not have any HCV new cases after 2004. CONCLUSION: We could not prove HCV transmission from donors as the source of infection. Although parenteral transmission is always on top of the list in HCV infection, the possibility of hospital and/or nursing personnel transmission and/or patient-to-patient transmission such as use of common instruments like subcutaneous Desferal(®) infusion pumps; which the patients used for iron chelation therapy, should also be kept in mind.