[Transfusion management and immuno-hematological follow-up after allogeneic hematopoietic cell transplantation: Guidelines from the Francophone Society of Bone Marrow Transplantation and Cellular Therapy (SFGM-TC)]. / Prise en charge transfusionnelle et suivi immunohématologique après allogreffe de cellules souches hématopoïétiques : recommandations de la Société francophone de greffe de moelle et de thérapie cellulaire (SFGM-TC).

The French High Authority of Health (HAS) and National Drug Safety (ANSM) agencies recommendations issued in 2014, the French General Direction of Health (DGS) instruction published in November 2021, the French National Blood Bank (EFS) guidelines and the data available in the literature globally define "good transfusion practices" but provide little information about the immuno-hematological and transfusion management of patients who have received an allogeneic hematopoietic stem transplantation (allo-HCT). The aim of this workshop was to harmonize these practices in situations for which there are currently no recommendations. In order to anticipate possible transfusion issues after allo-HCT, we recommend performing, before the transplantation, an extended red blood cell phenotyping of the donor and a detection of HLA alloimmunization in the recipient. We recommend to systematically perform for minor ABO mismatches: a direct antiglobulin test between D8 and D20, and for major ABO mismatches; a titration of anti-A/anti-B antibodies and an erythrocyte chimerism at D100. At one-year post-transplant, we recommend carrying out an erythrocyte chimerism to allow, if necessary, the update of transfusion counselling (RH phenotype, irradiation of packed red blood cells).

Early prediction of unexplained syncope by support vector machines.

The goal of the present study was to develop and evaluate a new method for the prediction of unexplained syncope occurrences. Diagnosis of syncope is currently based on the reproduction of symptoms in combination with hypotension and bradycardia induced by a 45 min 60-70 degrees head-upright tilt test (HUTT). The main drawback of this widely used test concerns its duration that reaches 55 min if the patient does not faint. Our method is a first step in the avoidance of the HUTT. An electrocardiogram and a transthoracic impedance waveform were recorded for 10 min of supine rest of a HUTT in 128 patients with a history of unexplained recurrent syncope. Seven indices were computed on the transthoracic impedance and its first derivative. The prediction quality of every subset of these variables, mixed with age and sex, has been tested by a support vector machine in a retrospective group of 64 patients (100% of sensitivity and 100% of specificity was reached). The best subset obtained has been evaluated prospectively in a group of 64 patients (94% of sensitivity and 79% of specificity was reached). These results compare very favorably with published results for other unexplained syncope detectors.