[The possibility of applying historical concentration of thrombocytes in examination of donors.]

The historical concentration of thrombocytes is an average of three subsequent concentrations of thrombocytes before donation (during two years) in blood of donors. The evaluation was applied to characteristics of historical concentration of thrombocytes concerning concentration of thrombocytes in blood of 99 regular donors before every donation of apheresis thrombocytes. It is established that less than 20% dispersion between historical concentration of thrombocytes and value obtained in day of donation is observed in 96% of regular donors. The average concentration of thrombocytes before three subsequent donations of apparatus apheresis in males is statistically higher than in females: 235,2±6,7 and 222,1±11,0 (× 109 cells/l) correspondingly (p < 0,05). The concentration of thrombocytes has no relationship with intervals between donations. There is no statistically significant differences between historical concentration of thrombocytes and concentration of thrombocytes before fourth donation and in general and between separate donations both in males and females. It is appropriate to analyze quality of concentrates of thrombocytes received through program accounting historical concentration of thrombocytes.

POLYMORPHISM OF COLLECTION, TRANSFUSION AND EFFECTIVENESS OF DONOR PLATELETS CONCENTRATES.

There were compared the results of 520 platelets transfusions in 8 centers. In the surveyed organizations part of prophylactic platelet transfusions ranged from 10% to 91%. On average platelet transfusions for the prevention of bleeding in 3,6 times more often than to stop the bleeding. 67,5% ofrecipients ofplatelets have oncology diseases. Target platelet concentrations for preventive transfusions seems high compared to modern evidence-based value - 10 @. 10°/l. 25% ofprophylactic transfusions included in the study were performed in patients with platelet count of 30 @. 10°l or more. In 76,7% of transfusions used platelet concentrates prepared by apheresis. Single whole blood- derived-units are used at 3,7 times more often than pooled platelets.

[THE IMPLEMENTATION OF NAT-SCREENING OF INFECTIONS IN BLOOD DONORS OF THE REPUBLIC OF KAZAKHSTAN].

The article presents analysis of screening of markers of infections in donors using the nucleic amplification technique (NAT) within 4 years. The comparison is made with similar international indices and evaluation was applied to efficiency of the given technique in Kazakhstan. The study established that productivity of NAT technique in Kazakhstan significantly exceeds average international values. The implementation of the given technique permitted to prevent transfusion of infected blood.

[Prevalence and incidence of infections among blood donors in Astana].

The prevalence and incidence of infections among 28,248 blood donors in Astana in 2012 was determined. The estimated residual risk of the transfusion infection was as follows: for HIV--1,2, HCV--137,7, HBV--125,4 per 1 million donations. High risk of transfusion infection with HIV, hepatitis B, and C stimulates the active implementation of the measures for increasing the safety of blood: the selection of donors, increasing the sensitivity of infections screening methods, inactivation of pathogens in blood components and transfusion management appointment at the clinic.

[The organization of centralized testing of donor blood for infection in the Irkutskaia oblast].

The article presents the results of changes of concentration of DNA of viral hepatitis B under conservation in frozen conditions. The optimal scheme of preparing and delivering samples of donor blood stored up in institutions of blood service of the Irkutskaia oblast for molecular biological testing was elaborated.

[Prevalence and incidence of the infections among blood donors in Russia].

The prevalence and incidence of the infections among Russian blood donors in 2010-2012 was determined. The estimated residual risk of the transfusion infection was as follows: for HIV - 16.2, HCV - 33.7; HBV - 97.1 per 1 million donations. In the information system of the blood service AIST data should be divided based on the posi- tive results of screening and confirmatory tests for markers of the infection. High risk of the transfusion infection with HIV, hepatitis B and C stimulates the active implementation of the measures for increasing the safety of blood: the selection of donors, increasing the sensitivity of infections screening methods, inactivation of patho- gens in blood components, and transfusion management appointment at the clinic.

[The individual selection of erythrocytes for regional clinics].

The article deals with the results of work of Krasnoyarsk kray blood center immune hematologic laboratory concerning selection of erythrocytes in 2003-2010. In Krasnoyarsk kray, the portion of transfusions of individually selected erythrocytes increases and reached 31.9%. The setting up of register of donors typed by Ab0 and Rhesus systems makes it possible to implement effectively the individual selection of erythrocytes in optimal time-frame and in amount needed in clinics.

[Analysis of errors in transfusion of blood].

The authors studied materials of 17 complications due to transfusion of erythrocytes incompatible by AB0 phenotype, developed during 25 years in clinics of the Stavropol krai. All complications were associated with concrete defects in the work of blood service: wrong organization of blood service management in the clinic, poor special training of the personnel, low technological equipment of blood service, errors in laboratory investigations, laboratory investigations made not by specialists of laboratory diagnostics. In 40% of cases of posttransfusion complications transfusion was not indicated.

[Prescreening of the activity of alanine aminotransferase enhances the cost-effectiveness of blood storage].

The cost-effectiveness of prescreening for alanine aminotransferase (ALT) activity was evaluated in blood donors before donation. Since September 15, 2006, the Krasnodar Territory blood transfusion station has examined more than 32 thousand donors in this fashion. A Reflotron Plus biochemical analyzer (Roche Diagnostics, Switzerland) was used. In 2008, 1230 subjects with increased ALT activity were withdrawn from donation. A total of 17,096 persons were examined. Their examination cost 1,219,457.8 rubles. Non-productive outlays of 7,773,919.8 rubles were prevented. The savings amounted to 6,554,462.12 rubles. Prescreening for ALT was found to be cost-effective if the rate of positive results in the donor population was 1.13% or more.

[Quality of transfusion means and protocols of massive transfusions].

The authors have analyzed distinctions of transfusion correction of massive blood loss in Russia and abroad. National protocols of massive transfusions suppose using plasma volumes 3-4 times greater than similar protocols in other developed countries. Russian standards of quality of blood components do not correspond to the tasks of modem transfusion therapy.

[Introduction of regulations of administration of blood components into clinical practice].

The authors describe "The regulations of administration of blood components" taking into account the purposeful parameters of homeostasis, which must be obtained during transfusion of blood components. The volume of erythrocytes and plasma transfused in the Center during the first and second quarters of 2006 and 2007 years were compared with the main indicators of the medical activities. The introduction of the limiting strategy of hemotransfusions based on the advantages of the world conclusive medicine was not followed by worse results of treatment, but promoted economy of facilities and blood components for the country.

[Virus inactivation in a single unit of plasma for transfusion].

Transfusion-transmitted viral infection in Russia is most commonly due to plasma transfusion. Methylene blue treatment (Macotronic) is the most practical technology for plasma viral inactivation. It was shown to provide the maximal level of inactivation of both enveloped and non-enveloped viruses. It is preferable to perform inactivation of single plasma units, which can be done at any healthcare facility. The first experience in methylene blue plasma virus inactivation revealed good clinical results and social satisfaction.

[Occupational traumatism in blood service: improvement of the safety system].

An analysis of questionnaires used in the institutions of blood service has shown the absence of standards in maintenance of safety of the personnel storing up blood. Most frequent cases of contamination of the personnel with donors' blood was noted when venepunctions were being made, during filling the test-tubes from a tube, utilization of waste products, cutting the tubes and opening the test tubes. Introduction of a system of higher occupational safety of the personnel and successive action of using innovations, up-to-date configuration of hemocontainers with vacuum sampling of the first portion of blood for laboratory investigations and fixed closing the needle allows reduce occupational traumatism in blood service.

[Technologies and control of cleanness of the rooms in the blood center].

To prevent bacterial contamination of blood transfusion media, the following three types of rooms in blood service institutions should meet especially high requirements for cleanness: 1. Box and its foreroom (or room equipped with laminar cabinet) for open-air preparation of washed red blood cells or other blood components. 2. Box (laminar cabinet) in bacteriological laboratory. 3. Two areas of gene diagnosis laboratory: a) for RNA detection (HIV and HCV diagnosis) to prevent sample contamination with extraneous RNAases; b) for preparation of in-house test kits. Required cleanness of rooms in blood service institutions can be attained using the following equipment available from Laminarnye Sistemy, Ltd. (Miass, Chelyabinsk Region, Russia): clean chamber equipment; abacterial air environment box for working with agents and microorganisms; box for working with DNA samples.

[NAT screening of viral infections in donors enhances blood safety].

The first experience in introducing the nucleic acid amplification technique (NAT) in an Indian blood service as compared with the established European practice is analyzed. Examination of 12,224 donor blood samples revealed 217 (1.78%) persons with markers of infections, including 8 (0.065%) persons only with markers of viral genome, without serological signs of infections. In India, enzyme immunoassay-negative NAT-positive donations were tens of times more detectable than in the developed countries, which is associated with the epidemiological features and the large (more than 50%) proportion of paid donors. By taking into account the fact that 4.6% of the preserved blood doses are annually rejected as defective in the Russian Federation, as evidenced by the screening of markers of infections, the introduction of NAT may be expected to reveal a large proportion of donors in the period of both a "seronegative window" and chronic carriers of hepatitis B virus with its blood content. Both intralaboratory monitoring using the certified standards and the laboratory work quality system as a whole are a necessary condition for introducing NAT into a blood service.

[The verification of the results of screening antibodies to hepatitis C virus in blood donors].

6,744 persons were examined for the presence of antibodies to hepatitis C virus (HCV) before blood donation (4,219 persons in Moscow and 2,525 persons in St. Petersburg). The serum samples found to contain antibodies to HCV were additionally studied by the immunoblot techniques. The positive results of antibody screening were registered in 78 persons: 26 persons in Moscow (0.62%) and 52 in St. Petersburg (2.05%). In both cities the positive results of screening were confirmed in 62% of cases. Different occurrence of the profile with the presence of antibodies to all fragments of the virus: 52% in Moscow, 12% in St. Petersburg (chi2 = 12.11; p < 0.001). Considerable differences were also registered in the spread of individual antibodies.