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Moquet O, Faye I, Auffret N, Garin B, Brichler S, Césaire R. Human T-cell lymphotropic virus screening in France: Missed opportunities? A retrospective multicenter study of serological testing in hospital laboratories. IJID REGIONS 2024; 12:100387. [PMID: 39041060 PMCID: PMC11262194 DOI: 10.1016/j.ijregi.2024.100387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/07/2024] [Revised: 06/06/2024] [Accepted: 06/11/2024] [Indexed: 07/24/2024]
Abstract
Objectives Human T-lymphotropic virus 1 infection is endemic in the French Antilles, French Guiana, and sub-Saharan Africa, the origin of many immigrants currently living in France. There are no national screening recommendations outside of the regulatory obligations concerning donations of blood, tissue, gametes, or milk to a lactarium. This study aimed to investigate the screening and diagnostic practices for this infection in France. Methods Serological statistics for regulatory, antenatal, sexually transmitted infections (for CeGIDDs (Centre Gratuit d'Information, de Dépistage et de Diagnostic des Infections Sexuellement Transmissibles), which are public sexual health clinics), accidental exposure to blood screenings, and diagnosis since January 1, 2018 were collected from 23 hospital laboratories (two in the French Antilles, 21 in mainland France) associated with 55 hospitals and 22 maternity units. Results A total absence of antenatal screening was reported by 75% of the laboratories associated with maternity units in mainland France. All the laboratories in mainland France reported an absence of screening in the accidental exposure to blood context, as did all the laboratories in mainland France associated with a CeGIDD in the context of sexually transmitted infection screening. Conversely, screening in accordance with the existing regulations was generally systematically carried out. The most frequently reported diagnostic contexts were hematology and neurology. Conclusions This study reveals an underscreening of human T-lymphotropic virus 1 in the hospital laboratories of mainland France.
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Affiliation(s)
- Olivier Moquet
- Centre de biologie du Nivernais, centre hospitalier de l'agglomération de Nevers, Nevers, France
| | - Ibrahima Faye
- Centre de biologie du Nivernais, centre hospitalier de l'agglomération de Nevers, Nevers, France
| | - Nicolas Auffret
- Plateforme de Biologie Hospitalo-Universitaire, secteur virologie, centre hospitalo-universitaire de Dijon, Dijon, France
| | - Benoit Garin
- Laboratoire de Virologie, centre hospitalo-universitaire de la Guadeloupe, Pointe-à-Pitre, France
| | - Ségolène Brichler
- Service de microbiologie clinique, hôpital universitaire Avicenne, Bobigny, France
| | - Raymond Césaire
- Laboratoire de Virologie, centre hospitalo-universitaire de la Guadeloupe, Pointe-à-Pitre, France
- PCCEI, University of Montpellier, Inserm, EFS and University of Antilles, Pointe-à-Pitre, France
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2
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Maličev E, Železnik K, Jazbec K. An evaluation of a volumetric method for the flow cytometric determination of residual leukocytes in blood transfusion units. PLoS One 2022; 17:e0279244. [PMID: 36534689 PMCID: PMC9762584 DOI: 10.1371/journal.pone.0279244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 12/03/2022] [Indexed: 12/24/2022] Open
Abstract
The removal of leukocytes from blood components helps to prevent or reduce some adverse reactions that occur after blood transfusions. The implementation of the leukodepletion process in the preparation of blood units requires quality control, consisting of a reliable cell counting method to determine residual leukocytes in blood components. The most widely used methodology is a flow cytometric bead-based counting method. To avoid the need for commercial counting beads, we evaluated a volumetric counting method of leukocyte enumeration. A total of 160 specimens of leukodepleted plasma, red cell and platelet units, as well as 58 samples of commercially available controls containing different concentration levels of leukocytes, were included in the study. The conventional quality control method using the bead-based counting method performed with the FACSCalibur flow cytometer was compared to the bead-based counting method and the volumetric counting method performed with the MACSQuant 10 flow cytometer. Our results show that the MACSQuant bead-based method, as well as the volumetric MACSQuant method, meet the sensitivity requirements of residual leukocyte enumeration when compared to the gold standard, bead-based FACSCalibur method. We conclude that the volumetric method can be a substitute for the bead-based counting of residual leukocytes in a variety of blood components.
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Affiliation(s)
- Elvira Maličev
- Department of Immunohematology, Blood Transfusion Centre of Slovenia, Ljubljana, Slovenia
- Biotechnical Faculty, University of Ljubljana, Ljubljana, Slovenia
| | - Klara Železnik
- Department of Immunohematology, Blood Transfusion Centre of Slovenia, Ljubljana, Slovenia
| | - Katerina Jazbec
- Department of Immunohematology, Blood Transfusion Centre of Slovenia, Ljubljana, Slovenia
- * E-mail:
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3
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Odedra A, McCarthy JS. Safety Considerations for Malaria Volunteer Infection Studies: A Mini-Review. Am J Trop Med Hyg 2020; 102:934-939. [PMID: 32189610 DOI: 10.4269/ajtmh.19-0351] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Malaria clinical studies entailing the experimental infection of healthy volunteers with Plasmodium parasites by bites from infected mosquitos, injection of cryopreserved sporozoites, or injection of blood-stage parasites provide valuable information for vaccine and drug development. Success of these studies depends on maintaining safety. In this mini-review, we discuss the safety risks and associated mitigation strategies of these three types of experimental malaria infection. We aimed to inform researchers and regulators who are currently involved in or are planning to establish experimental malaria infection studies in endemic or non-endemic settings.
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Affiliation(s)
- Anand Odedra
- QIMR Berghofer Medical Research Institute, Herston, Australia.,Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - James S McCarthy
- The University of Queensland, St Lucia, Australia.,QIMR Berghofer Medical Research Institute, Herston, Australia
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Chen Y, Hu Y, Zhang J, Shen Y, Huang J, Yin J, Wang P, Fan Y, Wang J, Lu S, Yang Y, Yan L, Li K, Song Z, Tong C, Du S. Clinical characteristics, risk factors, immune status and prognosis of secondary infection of sepsis: a retrospective observational study. BMC Anesthesiol 2019; 19:185. [PMID: 31627725 PMCID: PMC6800505 DOI: 10.1186/s12871-019-0849-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2018] [Accepted: 09/13/2019] [Indexed: 12/29/2022] Open
Abstract
Background Secondary infection has a higher incidence in septic patients and affects clinical outcomes. This study aims to investigate the clinical characteristics, risk factors, immune status and prognosis of secondary infection of sepsis. Methods A four-year retrospective study was carried out in Zhongshan Hospital, Fudan University, enrolling septic patients admitted between January, 2014 and January, 2018. Clinical data were acquired from medical records. CD14+ monocyte human leukocyte antigen-D related (HLA-DR) expression and serum cytokines levels were measured by flow cytometry and enzyme-linked immunosorbent assay (ELISA) respectively. Results A total of 297 septic patients were enrolled, 92 of whom developed 150 cases of secondary infections. Respiratory tract was the most common site of secondary infection (n = 84, 56%) and Acinetobacter baumanii the most commonly isolated pathogen (n = 40, 31%). Urinary and deep venous catheterization increased the risk of secondary infection. Lower HLA-DR expression and elevated IL-10 level were found in secondary infection group. The expected prolonged in-hospital stay owing to secondary infection was 4.63 ± 1.87 days. Secondary infection was also associated with higher in-hospital, 30-day and 90-day mortality. Kaplan-Meier survival analysis and Log-rank test revealed that secondary infection group had worse survival between day 15 and day 90. Conclusions Urinary and deep venous catheterization increased the risk of secondary infection, in which underlying immunosuppression might also play a role. Secondary infection affected the prognosis of septic patients and prolonged in-hospital length of stay.
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Affiliation(s)
- Yao Chen
- Department of Emergency Medicine, Zhongshan Hospital, Fudan University, Shanghai, 200032, China
| | - Yanyan Hu
- Department of Emergency Medicine, Zhongshan Hospital, Fudan University, Shanghai, 200032, China
| | - Jin Zhang
- Department of Emergency Medicine, Zhongshan Hospital, Fudan University, Shanghai, 200032, China
| | - Yue Shen
- Department of Gastroenterology, Zhongshan Hospital, Fudan University, Shanghai, 200032, China
| | - Junling Huang
- Department of Emergency Medicine, Zhongshan Hospital, Fudan University, Shanghai, 200032, China
| | - Jun Yin
- Department of Emergency Medicine, Zhongshan Hospital, Fudan University, Shanghai, 200032, China
| | - Ping Wang
- Department of Emergency Medicine, Zhongshan Hospital, Fudan University, Shanghai, 200032, China
| | - Ying Fan
- Department of Emergency Medicine, Zhongshan Hospital, Fudan University, Shanghai, 200032, China
| | - Jianli Wang
- Department of Emergency Medicine, Zhongshan Hospital, Fudan University, Shanghai, 200032, China
| | - Su Lu
- Department of Emergency Medicine, Zhongshan Hospital, Fudan University, Shanghai, 200032, China
| | - Yilin Yang
- Department of Emergency Medicine, Zhongshan Hospital, Fudan University, Shanghai, 200032, China
| | - Lei Yan
- Department of Emergency Medicine, Zhongshan Hospital, Fudan University, Shanghai, 200032, China
| | - Keyong Li
- Department of Pharmacology, University of Virginia School of Medicine, Charlottesville, Virginia, 22908, USA
| | - Zhenju Song
- Department of Emergency Medicine, Zhongshan Hospital, Fudan University, Shanghai, 200032, China.
| | - Chaoyang Tong
- Department of Emergency Medicine, Zhongshan Hospital, Fudan University, Shanghai, 200032, China.
| | - Shilin Du
- Department of Emergency Medicine, Zhongshan Hospital, Fudan University, Shanghai, 200032, China.
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Handheld Microflow Cytometer Based on a Motorized Smart Pipette, a Microfluidic Cell Concentrator, and a Miniaturized Fluorescence Microscope. SENSORS 2019; 19:s19122761. [PMID: 31248214 PMCID: PMC6630933 DOI: 10.3390/s19122761] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Revised: 06/10/2019] [Accepted: 06/17/2019] [Indexed: 01/03/2023]
Abstract
Miniaturizing flow cytometry requires a comprehensive approach to redesigning the conventional fluidic and optical systems to have a small footprint and simple usage and to enable rapid cell analysis. Microfluidic methods have addressed some challenges in limiting the realization of microflow cytometry, but most microfluidics-based flow cytometry techniques still rely on bulky equipment (e.g., high-precision syringe pumps and bench-top microscopes). Here, we describe a comprehensive approach that achieves high-throughput white blood cell (WBC) counting in a portable and handheld manner, thereby allowing the complete miniaturization of flow cytometry. Our approach integrates three major components: a motorized smart pipette for accurate volume metering and controllable liquid pumping, a microfluidic cell concentrator for target cell enrichment, and a miniaturized fluorescence microscope for portable flow cytometric analysis. We first validated the capability of each component by precisely metering various fluid samples and controlling flow rates in a range from 219.5 to 840.5 μL/min, achieving high sample-volume reduction via on-chip WBC enrichment, and successfully counting single WBCs flowing through a region of interrogation. We synergistically combined the three major components to create a handheld, integrated microflow cytometer and operated it with a simple protocol of drawing up a blood sample via pipetting and injecting the sample into the microfluidic concentrator by powering the motorized smart pipette. We then demonstrated the utility of the microflow cytometer as a quality control means for leukoreduced blood products, quantitatively analyzing residual WBCs (rWBCs) in blood samples present at concentrations as low as 0.1 rWBCs/μL. These portable, controllable, high-throughput, and quantitative microflow cytometric technologies provide promising ways of miniaturizing flow cytometry.
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Impact of peri-operative blood transfusion on post-operative infections after radical gastrectomy for gastric cancer: a propensity score matching analysis focusing on the timing, amount of transfusion and role of leukocyte depletion. J Cancer Res Clin Oncol 2018; 144:1143-1154. [PMID: 29572591 PMCID: PMC5948291 DOI: 10.1007/s00432-018-2630-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Accepted: 03/20/2018] [Indexed: 01/26/2023]
Abstract
Purpose Allogeneic blood transfusions (BTF) are sometimes inevitable during radical gastrectomy with lymphadenectomy for advanced gastric cancer. The aim of this retrospective study was to investigate the association between BTF and post-operative infections, focusing on the impact of timing, amount of transfusion and the role of leukocyte depletion. Methods The study cohort was 2064 patients who underwent gastrectomy for gastric cancer from November 2010 to August 2017. The association between BTF and post-operative infections was estimated by univariate and multivariate analyses after propensity score matching. Subgroup analysis was performed according to the timing and amount of transfusion, and leukocyte depletion or not. Results Out of a total 2064 patients, 426 (20.6%) received peri-operative BTF. After one-to-one matching, 361 pairs of patients were included for further analysis, of who 68 (9.4%) developed infections. Multivariate analysis identified that an operation time ≥ 240 min, combined multi-organ resection, BTF and BMI ≥ 25 kg/m2 were independent risk factors for post-operative infection. Patients given a high-volume (> 7.5 U), intra-operatively of leukocyte-non-depleted BTF had the highest risk of developing infections clarified by subgroup analysis. Conclusion Infection was the most common complication following gastrectomy for gastric cancer and BTF was identified as an independent risk factor by propensity score matching and multivariate analyses. The timing, amount of transfusion and leukocyte depletion had an impact on the incidence of infection. To decrease infection, BTF should be avoided where possible, particularly during operation, with a large amount and leukocyte-not-depleted blood.
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Humanes Cytomegalievirus (HCMV). Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2018; 61:116-128. [DOI: 10.1007/s00103-017-2661-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Chang CC, Lee TC, Su MJ, Lin HC, Cheng FY, Chen YT, Yen TH, Chu FY. Transfusion-associated adverse reactions (TAARs) and cytokine accumulations in the stored blood components: the impact of prestorage versus poststorage leukoreduction. Oncotarget 2017; 9:4385-4394. [PMID: 29435110 PMCID: PMC5796981 DOI: 10.18632/oncotarget.23136] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Accepted: 11/13/2017] [Indexed: 01/08/2023] Open
Abstract
Leukoreduction in blood units could prevent patients undergoing transfusions from transfusion-associated adverse reactions (TAARs) such as febrile nonhemolytic transfusion reactions (FNHTRs). However, the effect of prestorage and poststorage leukoreduction on TAARs and its underlying mechanisms in stored blood components remains to be determined. Therefore, we investigated the impact of prestorage leukocyte-reduced (pre-LR) and poststorage leukocyte-reduced (post-LR) blood products, including red blood cells (RBCs) and apheresis platelets (PHs), on the incidence of FNHTRs and other TAARs in patients who received transfusions from 2009 to 2014 in a tertiary care center. We also investigated the difference of leukocyte-related bioactive mediators between pre- and post-LR blood components. The results indicated that prevalence of TAARs was significantly reduced in the transfusions of pre-LR blood components. Particularly, the prevalence of FNHTRs was significantly reduced in the pre-LR RBC transfusions and the prevalence of allergy reactions was markedly reduced in the pre-LR PH transfusions. Furthermore, in vitro evaluation of cytokines in the pre- and post-LR blood components revealed that IL-1β, IL-8 and RANTES levels were significantly elevated in the post-LR RBCs during the storage. In contrast, IL-1β, IL-6 and IL-8 levels were significantly elevated in the post-LR PHs during the storage. These findings suggested that prestorage leukoreduction had a diminishing effect on the development of TAARs, which could be associated with less accumulation of cytokines in the stored blood components.
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Affiliation(s)
- Chih-Chun Chang
- Department of Clinical Pathology, Far Eastern Memorial Hospital, New Taipei, Taiwan
| | - Tai-Chen Lee
- Department of Clinical Pathology, Far Eastern Memorial Hospital, New Taipei, Taiwan
| | - Ming-Jang Su
- Department of Clinical Pathology, Far Eastern Memorial Hospital, New Taipei, Taiwan
| | - Hsiu-Chen Lin
- Department of Clinical Pathology, Far Eastern Memorial Hospital, New Taipei, Taiwan
| | - Fang-Yi Cheng
- Department of Clinical Pathology, Far Eastern Memorial Hospital, New Taipei, Taiwan
| | - Yi-Ting Chen
- Department of Clinical Pathology, Far Eastern Memorial Hospital, New Taipei, Taiwan
| | - Tzung-Hai Yen
- Department of Nephrology and Division of Clinical Toxicology and Toxicology Laboratory, Chang Gung Memorial Hospital, Lin-Kou Medical Center, Taoyuan, Taiwan.,College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Fang-Yeh Chu
- Department of Clinical Pathology, Far Eastern Memorial Hospital, New Taipei, Taiwan.,School of Medical Laboratory Science and Biotechnology, Taipei Medical University, Taipei, Taiwan.,Graduate School of Biotechnology and Bioengineering, Yuan Ze University, Taoyuan, Taiwan.,Department of Medical Laboratory Science and Biotechnology, Yuanpei University, Hsinchu, Taiwan
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Balance Between the Proinflammatory and Anti-Inflammatory Immune Responses with Blood Transfusion in Sepsis. Crit Care Nurs Clin North Am 2017; 29:331-340. [PMID: 28778292 DOI: 10.1016/j.cnc.2017.04.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Blood product transfusion may exacerbate the initial immunosuppressive response of sepsis. Nurses and other patient care providers must be diligent in recognizing and managing a worsening immune status, using flow cytometry to monitor patients' immune status. This type of monitoring may be instrumental in reducing morbidity and mortality in persons with sepsis. This article discusses the recent literature on the associated inflammatory responses that occur with blood transfusion and provides an analysis of alterations in key inflammatory pathways in response to transfusion in a sepsis population.
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Abstract
A goal of platelet storage is to maintain the quality of platelets from the point of donation to the point of transfusion - to suspend the aging process. This effort is judged by clinical and laboratory measures with varying degrees of success. Recent work gives encouragement that platelets can be maintained ex vivo beyond the current 5 -7 day shelf life whilst maintaining their quality, as measured by posttransfusion recovery and survival. However, additional measures are needed to validate the development of technologies that may further reduce the aging of stored platelets, or enhance their hemostatic properties.
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Affiliation(s)
- Peter A Smethurst
- a Components Development Laboratory, NHS Blood and Transplant, Cambridge, UK, and Department of Haematology , University of Cambridge , Cambridge , UK
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11
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Elansary M, El Haddad HE, Eldin UAAS, Hamdy A, Sherif MM. Seroprevalence and real-time PCR study of Epstein—Barr virus and the value of screening in pretransplant patients. THE EGYPTIAN JOURNAL OF INTERNAL MEDICINE 2016. [DOI: 10.4103/1110-7782.182947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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12
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Leucoreduction of blood components: an effective way to increase blood safety? BLOOD TRANSFUSION = TRASFUSIONE DEL SANGUE 2015; 14:214-27. [PMID: 26710353 DOI: 10.2450/2015.0154-15] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 06/09/2015] [Accepted: 08/31/2015] [Indexed: 02/08/2023]
Abstract
Over the past 30 years, it has been demonstrated that removal of white blood cells from blood components is effective in preventing some adverse reactions such as febrile non-haemolytic transfusion reactions, immunisation against human leucocyte antigens and human platelet antigens, and transmission of cytomegalovirus. In this review we discuss indications for leucoreduction and classify them into three categories: evidence-based indications for which the clinical efficacy is proven, indications based on the analysis of observational clinical studies with very consistent results and indications for which the clinical efficacy is partial or unproven.
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Lopez Roa P, Perez-Granda MJ, Munoz P, Catalan P, Alonso R, Sanchez-Perez E, Novoa E, Bouza E. A Prospective Monitoring Study of Cytomegalovirus Infection in Non-Immunosuppressed Critical Heart Surgery Patients. PLoS One 2015; 10:e0129447. [PMID: 26070136 PMCID: PMC4466502 DOI: 10.1371/journal.pone.0129447] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2015] [Accepted: 05/09/2015] [Indexed: 01/22/2023] Open
Abstract
Background Reactivation of cytomegalovirus (CMV) has been reported occasionally in immnunocompetent patients in the intensive care unit (ICU). The epidemiology and association of CMV infection with adverse outcome is not well defined in this population. Patients undergoing major heart surgery (MHS) are at a particularly high risk of infection. CMV infection has not been systematically monitored in MSH-ICU patients. Methods We assessed CMV plasma viremia weekly using a quantitative polymerase chain reaction assay in a prospective cohort of immunocompetent adults admitted to the MHS-ICU for at least 72 hours between October 2012 and May 2013. Risk factors for CMV infection and its potential association with continued hospitalization or death by day 30 (composited endpoint) were assessed using univariate and multivariate logistic regression analyses. Results CMV viremia at any level was recorded in 16.5% of patients at a median of 17 days (range, 3-54 days) after admission to the MHS-ICU. Diabetes (adjusted OR, 5.6; 95% CI, 1.8-17.4; p=0.003) and transfusion requirement (>10 units) (adjusted OR, 13.7; 95% CI, 3.9-47.8; p<0.001) were independent risk factors associated with CMV reactivation. Reactivation of CMV at any level was independently associated with the composite endpoint (adjusted OR, 12.1; 95% CI, 2.3-64; p=0.003). Conclusion Reactivation of CMV is relatively frequent in immunocompetent patients undergoing MHS and is associated with prolonged hospitalization or death.
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Affiliation(s)
- Paula Lopez Roa
- Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain
- Instituto de Investigación Biomédica Gregorio Marañón, Madrid, Spain
- * E-mail:
| | - Maria Jesus Perez-Granda
- Instituto de Investigación Biomédica Gregorio Marañón, Madrid, Spain
- Medicine Department, School of Medicine, Universidad Complutense, Madrid, Spain
- Department of Anesthesiology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Patricia Munoz
- Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain
- Instituto de Investigación Biomédica Gregorio Marañón, Madrid, Spain
- Medicine Department, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Pilar Catalan
- Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Roberto Alonso
- Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain
- Instituto de Investigación Biomédica Gregorio Marañón, Madrid, Spain
| | - Eduardo Sanchez-Perez
- Department of Anesthesiology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Emma Novoa
- Department of Anesthesiology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Emilio Bouza
- Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain
- Instituto de Investigación Biomédica Gregorio Marañón, Madrid, Spain
- Medicine Department, School of Medicine, Universidad Complutense, Madrid, Spain
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14
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Rouka E, Kyriakou D. Molecular epidemiology of human Herpesviruses types 1-6 and 8 among Greek blood donors. Transfus Med 2015; 25:276-9. [PMID: 25940787 DOI: 10.1111/tme.12202] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2015] [Revised: 04/06/2015] [Accepted: 04/13/2015] [Indexed: 11/28/2022]
Abstract
BACKGROUND Human Herpesviruses (HHVs) maintain life-long latent persistence in the majority of the adult population including blood donors. The necessity for their study resides in the potential risk of transfusion-associated infection and the subsequent complications in the immunocompromised host. We aimed to assess the prevalence of HHVs types 1-6 and 8 among healthy blood donors of Thessaly prefecture in order to evaluate the frequency distribution of HHVs in Greek population and to ascertain possible correlations with demographic factors. MATERIALS AND METHODS Polymerase chain reaction (PCR) detection of HHVs DNA was determined in 401 randomly selected consecutive blood donors of Central Greece. Epidemiological data were recorded through a well structured questionnaire. RESULTS The overall PCR positivity for HHVs was 25·4%. HHVs types 1-3 were not detected in any donor sample. A specimen with high level of HHV-6 DNA (1,580,400 copies per mL) was recorded. HHV-4 DNA positivity was significantly associated with rural residency. CONCLUSION HHV-4 DNA is commonly detected in whole blood specimens of healthy individuals. HHVs types 5, 6 and 8 are rarely detected. However, the existence of a donor sample with high HHV-6 viral load raises questions regarding the potential risk of HHV-6 blood-borne infection and the safety of blood products.
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Affiliation(s)
- E Rouka
- Transfusion Medicine Department, University Hospital of Larisa, Larisa, Greece
| | - D Kyriakou
- Transfusion Medicine Department, University Hospital of Larisa, Larisa, Greece
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15
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Garraud O. La transfusion sanguine : une thérapie de paradoxes. Presse Med 2015; 44:160-4. [DOI: 10.1016/j.lpm.2014.06.041] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2014] [Accepted: 06/29/2014] [Indexed: 01/17/2023] Open
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16
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Ammann RA, Niggli FK, Leibundgut K, Teuffel O, Bodmer N. Exploring the association of hemoglobin level and adverse events in children with cancer presenting with fever in neutropenia. PLoS One 2014; 9:e101696. [PMID: 25020130 PMCID: PMC4096594 DOI: 10.1371/journal.pone.0101696] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2013] [Accepted: 06/10/2014] [Indexed: 11/25/2022] Open
Abstract
Background In children and adolescents with fever in neutropenia (FN) during chemotherapy for cancer, hemoglobin ≥90 g/L at presentation with FN had been associated with adverse events (AE). This analysis explored three hypothetical pathophysiological mechanisms potentially explaining this counterintuitive finding, and further analyzed the statistical association between hemoglobin and AE. Methods Two of 8 centers, reporting on 311 of 421 FN episodes in 138 of 215 patients participated in this retrospective analysis based on prospectively collected data from three databases (SPOG 2003 FN, transfusion and hematology laboratories). Associations with AE were analyzed using mixed logistic regression. Results Hemoglobin was ≥90 g/L in 141 (45%) of 311 FN episodes, specifically in 59/103 (57%) episodes with AE, and in 82/208 (39%) without (OR, 2.3; 99%CI, 1.1–4.9; P = 0.004). In FN with AE, hemoglobin was bimodally distributed with a dip around 85 g/L. There were no significant interactions for center, age and sex. In multivariate mixed logistic regression, AE was significantly and independently associated with leukopenia (leukocytes <0.3 G/L; OR, 3.3; 99%CI, 1.1–99; P = 0.004), dehydration (hemoglobinPresentation/hemoglobin8–72 hours ≥1.10 in untransfused patients; OR, 3.5; 99%CI, 1.1–11.4; P = 0.006) and non-moderate anemia (difference from 85 g/L; 1.6 per 10 g/L; 1.0–2.6; P = 0.005), but not with recent transfusion of packed red blood cells (pRBC), very recent transfusion of pRBC or platelets, or with hemoglobin ≥90 g/L as such. Conclusions Non-moderate anemia and dehydration were significantly and relevantly associated with the risk of AE in children with cancer and FN. These results need validation in prospective cohorts before clinical implementation.
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Affiliation(s)
- Roland A. Ammann
- Department of Pediatrics, University of Bern, Bern, Switzerland
- * E-mail:
| | - Felix K. Niggli
- Division of Oncology, Department of Pediatrics, University of Zurich, Zurich, Switzerland
| | - Kurt Leibundgut
- Department of Pediatrics, University of Bern, Bern, Switzerland
| | - Oliver Teuffel
- Department of Pediatrics, University of Bern, Bern, Switzerland
- Division of Oncology, Medical Services of the Statutory Health Insurance Baden-Württemberg, Tübingen, Germany
| | - Nicole Bodmer
- Division of Oncology, Department of Pediatrics, University of Zurich, Zurich, Switzerland
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Vossier L, Leon F, Bachelier C, Marchandin H, Lehmann S, Leonetti JP, Brodolin K, Coste J, Fournier-Wirth C. An innovative biologic recycling process of leukoreduction filters to produce active human antimicrobial peptides. Transfusion 2013; 54:1332-9. [PMID: 24117506 DOI: 10.1111/trf.12444] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2013] [Revised: 08/06/2013] [Accepted: 08/14/2013] [Indexed: 12/13/2022]
Abstract
BACKGROUND Human neutrophil peptides (HNPs) 1 to 3 are the major antimicrobial peptides of the azurophilic granules of neutrophils. They represent an important arm of the innate immune system. Their production by chemical synthesis and recombinant technologies is expensive and limited by technical constraints due to their composition and the presence of three disulfide bonds. STUDY DESIGN AND METHODS We have developed an original approach based on the purification of the natural human defensins HNPs 1 to 3 from neutrophils trapped on leukoreduction filters used in blood processing. The purification of HNPs 1 to 3 from these filters is performed in two steps: extraction of HNPs 1 to 3 retained in the filters followed by their immunoprecipitation. Studies were performed to determine the stability of defensins in the filters stored at room temperature. The activity of HNPs 1 to 3 obtained by our rapid protocol was validated by determining minimal inhibitory concentrations (MICs) against six reference bacterial strains and 12 clinical isolates. RESULTS The human defensins HNPs 1 to 3 extracted from leukoreduction filters displayed high antimicrobial activity against tested strains, with MIC values between 0.12 and 1 μg/mL. Kinetics assays showed the appearance of activity 15 minutes after peptide addition. Moreover, we found that the HNPs 1 to 3 purified from leukoreduction filters that had been stored for 45 days at room temperature remained active. CONCLUSION Leukoreduction filters provide a rich and safe source of active human defensins HNPs 1 to 3. Moreover, the stability of the peptides in filters stored at room temperature allows envisaging a large-scale development of the process.
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Affiliation(s)
- Ludivine Vossier
- Laboratoire TransDiag, Etablissement Français du Sang Pyrénées-Méditerranée, Montpellier, France
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Sheehy SH, Douglas AD, Draper SJ. Challenges of assessing the clinical efficacy of asexual blood-stage Plasmodium falciparum malaria vaccines. Hum Vaccin Immunother 2013; 9:1831-40. [PMID: 23778312 PMCID: PMC3906345 DOI: 10.4161/hv.25383] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
In the absence of any highly effective vaccine candidate against Plasmodium falciparum malaria, it remains imperative for the field to pursue all avenues that may lead to the successful development of such a formulation. The development of a subunit vaccine targeting the asexual blood-stage of Plasmodium falciparum malaria infection has proven particularly challenging with only limited success to date in clinical trials. However, only a fraction of potential blood-stage vaccine antigens have been evaluated as targets, and a number of new promising candidate antigen formulations and delivery platforms are approaching clinical development. It is therefore essential that reliable and sensitive methods of detecting, or ruling out, even modest efficacy of blood-stage vaccines in small clinical trials be established. In this article we evaluate the challenges facing blood-stage vaccine developers, assess the appropriateness and limitations of various in vivo approaches for efficacy assessment and suggest future directions for the field.
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Nagura Y, Tsuno NH, Tanaka M, Matsuhashi M, Takahashi K. The effect of pre-storage whole-blood leukocyte reduction on cytokines/chemokines levels in autologous CPDA-1 whole blood. Transfus Apher Sci 2013; 49:223-30. [PMID: 23462351 DOI: 10.1016/j.transci.2013.01.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2012] [Revised: 09/29/2012] [Accepted: 01/10/2013] [Indexed: 12/26/2022]
Abstract
BACKGROUND In this study, we aimed to investigate the effectiveness of pre-storage leukocyte filtration of autologous blood (AB), especially focusing on the cytokines/chemokines accumulation on blood products. MATERIALS AND METHODS After approval of the ethics committee of the University of Tokyo, a total of 26 orthopedic patients, who donated AB prior to surgery after informed consent, were enrolled. The effects of filtration on blood cell counts were analyzed, and the accumulation of cytokines and chemokines were measured on pre- and post-leukoreduced (LR) samples, using the Luminex system. The time-dependent changes of the cytokines/chemokines and the effect of the filtration on their concentration were analyzed, and compared with the normal plasma levels reported in the literature. RESULTS LR effectively reduced the number of leukocytes and platelets, without affecting that of red cells. The concentration of most of the cytokines/chemokines analyzed, except the EGF, sCD40-L and sFas-L, decreased time-dependently of storage or did not change in pre-LR samples. However, EGF, sCD40L and sFas-L were significantly reduced by LR. Some, such as IL-8 and RANTES, were also importantly decreased by LR, and others, such as IL-1β and TNF-α, were not significantly affected by LR. CONCLUSIONS Leukocyte filtration effectively removes platelets and leukocytes from AB, thus preventing the accumulation of cytokines/chemokines. Since adverse effects due to AB transfusion, although rare, are observed, there is need to consider the implementation of pre-storage leukocyte reduction (PSLR) for AB.
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Affiliation(s)
- Yutaka Nagura
- Department of Transfusion Medicine, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
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20
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Engwerda CR, Minigo G, Amante FH, McCarthy JS. Experimentally induced blood stage malaria infection as a tool for clinical research. Trends Parasitol 2012; 28:515-21. [PMID: 23041118 DOI: 10.1016/j.pt.2012.09.001] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2012] [Revised: 09/10/2012] [Accepted: 09/13/2012] [Indexed: 11/29/2022]
Abstract
A system for experimentally induced blood stage malaria infection (IBSM) with Plasmodium falciparum by direct intravenous inoculation of infected erythrocytes was developed at the Queensland Institute of Medical Research (QIMR) more than 15 years ago. Since that time, this system has been used in several studies to investigate the protective effect of vaccines, the clearance kinetics of parasites following drug treatment, and to improve understanding of the early events in blood stage infection. In this article, we will review the development of IBSM and the applications for which it is being employed. We will discuss the advantages and disadvantages of IBSM, and finish by describing some exciting new areas of research that have been made possible by this system.
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Guinet F, Carniel E, Leclercq A. Transfusion-Transmitted Yersinia enterocolitica Sepsis. Clin Infect Dis 2011; 53:583-91. [DOI: 10.1093/cid/cir452] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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22
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Collins TA. Packed red blood cell transfusions in critically ill patients. Crit Care Nurse 2011; 31:25-33; quiz 34. [PMID: 21285463 DOI: 10.4037/ccn2011200] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
Anemia, which is prevalent in critically ill patients, often requires frequent blood transfusions. These blood transfusions are not without risks. A critical review of 6 studies shows an association between red blood cell transfusion and increased mortality. However, when disease state was adjusted for in 2 studies, researchers found that red blood cell transfusion correlated with decreased mortality. Thus further research, particularly on leukoreduction and age of stored blood, must be done before a change in practice can be implemented. It is vital that nurses stay current on this research in order to improve patients' outcomes.
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Affiliation(s)
- Tara Ann Collins
- Hospital of University of Pennsylvania, Rhoads 5 SICU, 3400 Spruce Street, Philadelphia, PA 19104, USA.
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23
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Abstract
Au cours des 20 dernières années, la sécurité en transfusion sanguine a fait de très grands progrès vis-à-vis du risque infectieux et notamment de celui représenté par les rétrovirus (HIV et HTLV) et les virus des hépatites B et C. L’objet de cette revue est de répertorier les risques viraux résiduels ou émergents qui seraient susceptibles d’entraîner de nouvelles contaminations chez les receveurs. À côté de nombreux autres virus (HHV-8, erythrovirus B19, virus des hépatites A et E…), une place toute particulière est faite aux arboviroses émergentes (infections à West Nile virus, dengue et chikungunya) qui menacent de toucher le territoire métropolitain suite à l’implantation en Europe du moustique Aedes albopictus, principal vecteur de la dengue et du chikungunya dans les régions tempérées. Un autre risque sanguin émergent, particulièrement au Royaume-Uni et en France, est constitué par le prion à l’origine de la forme variante de la maladie de Creutzfeldt-Jakob. La revue se termine par un rapide panorama des mesures qui sont susceptibles de contrôler ces émergences : exclusion des donneurs à risque, tests diagnostiques spécifiques de tel ou tel agent, déleucocytation des produits sanguins labiles et traitements physiques ou chimiques capables d’inactiver de façon non spécifique les agents infectieux potentiellement contaminants sans trop altérer les propriétés des composants sanguins. La capacité à maîtriser de façon prospective les nouveaux risques viraux au niveau transfusionnel représente un vrai défi pour préserver la confiance retrouvée des prescripteurs et des receveurs vis-à-vis des produits sanguins.
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Schottstedt V, Blümel J, Burger R, Drosten C, Gröner A, Gürtler L, Heiden M, Hildebrandt M, Jansen B, Montag-Lessing T, Offergeld R, Pauli G, Seitz R, Schlenkrich U, Strobel J, Willkommen H, von König CHW. Human Cytomegalovirus (HCMV) - Revised. ACTA ACUST UNITED AC 2010; 37:365-375. [PMID: 21483467 DOI: 10.1159/000322141] [Citation(s) in RCA: 74] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2010] [Accepted: 07/13/2010] [Indexed: 02/05/2023]
Affiliation(s)
- Volkmar Schottstedt
- Arbeitskreis Blut, Untergruppe «Bewertung Blutassoziierter Krankheitserreger»
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25
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Olsen MA, Butler AM, Willers DM, Gross GA, Devkota P, Fraser VJ. Risk factors for endometritis after low transverse cesarean delivery. Infect Control Hosp Epidemiol 2010; 31:69-77. [PMID: 19951198 DOI: 10.1086/649018] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
OBJECTIVE To determine independent risk factors for endometritis after low transverse cesarean delivery. STUDY DESIGN We performed a retrospective case-control study during the period from July 1999 through June 2001 in a large tertiary care academic hospital. Endometritis was defined as fever beginning more than 24 hours or continuing for at least 24 hours after delivery plus fundal tenderness in the absence of other causes for fever. Independent risk factors for endometritis were determined by means of multivariable logistic regression. A fractional polynomial method was used to examine risk of endometritis associated with the continuous variable, duration of rupture of membranes. RESULTS Endometritis was identified in 124 (7.7%) of 1,605 women within 30 days after low transverse cesarean delivery. Independent risk factors for endometritis included age (odds ratio [OR] for each additional year, 0.93 [corrected] [95% confidence interval {CI}, 0.90-0.97]) and anemia or perioperative blood transfusion (OR, 2.18 [CI, 1.30-3.68]). Risk of endometritis was marginally associated with a proxy for low socioeconomic status, lack of private health insurance (OR, 1.72 [CI, 0.99-3.00]); with amniotomy (OR, 1.69 [CI, 0.97-2.95]); and with longer duration of rupture of membranes. CONCLUSION Risk of endometritis was independently associated with younger age and anemia and was marginally associated with lack of private health insurance and amniotomy. The odds of endometritis increased approximately 1.7-fold within 1 hour after rupture of membranes, but increased duration of rupture was only marginally associated with increased risk. Knowledge of these risk factors can guide selective use of prophylactic antibiotics during labor and heighten awareness of the risk in subgroups at highest risk of infection.
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Affiliation(s)
- Margaret A Olsen
- Division of Infectious Diseases, Washington University School of Medicine, St Louis, Missouri 63110, USA.
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Abstract
Allogeneic blood transfusions have been associated with several risks and complications and with worse outcomes in a substantial number of patient populations and clinical scenarios. Allogeneic blood is costly and difficult to procure, transport, and store. Global and local shortages are imminent. Alternatives to transfusion provide many advantages, and their use is likely to improve outcomes as safer and more effective agents are developed.
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Affiliation(s)
- Aryeh Shander
- Department of Anesthesiology, Critical Care and Hyperbaric Medicine, Englewood Hospital and Medical Center, Englewood, NJ 07631, USA.
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Transfusion-transmissible infections and transfusion-related immunomodulation. Best Pract Res Clin Anaesthesiol 2008; 22:503-17. [DOI: 10.1016/j.bpa.2008.05.003] [Citation(s) in RCA: 69] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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31
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HIV-1 Viral Load After Leukodepletion. J Acquir Immune Defic Syndr 2008; 48:224-5. [DOI: 10.1097/qai.0b013e318160a694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Blumberg N, Heal JM. Universal Leukocyte Reduction of Blood Transfusions. Clin Infect Dis 2007; 45:1014-5. [PMID: 17879917 DOI: 10.1086/521897] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2007] [Accepted: 07/02/2007] [Indexed: 11/04/2022] Open
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