Transfusion can cause transfusion-transmitted diseases and various transfusion reactions. Recent improvements in the safety of blood supply and the increasing costs associated with transfusion therapies have led to a re-evaluation of the clinical practices of blood transfusion and blood conservation, which need practical guidelines for the use of constituent parts of blood. The traditional threshold of the hemoglobin concentration at 10g /dL for RBC transfusion has moved down to 7g /dL, and that of the platelet count at 20 x 10(9)/L for platelet transfusion can also be lowered to 5 x 10(9)/L. To improve the transfusion practice, as recommended by the guidelines, a prospective audit allied to educational programs can be effective in modifying the clinicians' practices of requesting transfusions.
Blood Group Incompatibility ; Blood Transfusion ; Platelet Count ; Platelet Transfusion

OBJECTIVE: To explore the blood transfusion data of emergency hemorrhage patients, so as to provide the basis for improving the quality of emergency blood transfusion and guiding clinic rational blood transfusion. METHODS: one thousand emergency blood loss patients once transfused RBC suspension were collected by Recipient Epidemiology and Donor Evaluation Study-III internationals Site range from November 2012 to November 2015. The clinical data including age, sex, clinical diagnosis etc were analyzed retrospectively. According to the quantity of blood transfusion the 1 000 patients were divided into 3 groups: low transfusion volume group(834),moderate transfusion volume group(116) and high transfusion volume group(50), difference was compared among the 3 groups，the transfusion predicting index and risk factor were analyzed by unvariate and multivoriate analyses using SPSS 23.0 software. RESULTS: High volume transfusion group was different from moderate and low volume transfusion in sex, pathogenesis, systolic pressure, hemoglobin level, with or without surgical operation, infusion volume of blood products, the retention time of ICU, total hospitalzed stay and mortality(P＜0.05), but there were no differences in age, respiration frequency, temperature before transfusion and creatinine level. The multivarate analysis showed that with or without surgical operation(OR=7.515，95% CI: 3.289-17.174, P=0.000), bleeding volume in surgery(OR=2.626, 95% CI: 1.428-4.828, P=0.043), the amount of transfused red blood cells(OR=2.574, 95% CI: 1.306-5.073, P=0.015), plasma transfusion or no(OR=2.118, 95% CI: 1.184-3.789, P=0.011), cryoprecipitate transfusion or no(OR=5.296, 95% CI: 2.164-12.960, P=0.000) were the independent risk factors for death resulted from emergency blood loss. CONCLUSION The probability of massive transfusion in the trauma patients is higher，and the massive transfusion associates with increased mortality in the emergency blood loss patients. Surgery operation, bleeding volume in operation, amount of transfused red blood cells, plasma transfusion and cryoprecipitate transfusion may predict the mortality of patients with blood transfusion.
Blood Transfusion ; Erythrocyte Transfusion ; Hemorrhage ; Humans ; Platelet Transfusion ; Retrospective Studies

OBJECTIVETo explore the key technique for preparation of the frozen platelet and efficacy of its clinical application.

METHODSThe influences of the donators' peripheral platelet count, starting time of freeze, injection rate and evenness of the freeze-protective agent, storage mode, re-melting temperature and the capacity of water-bath etc. on the quality of the frozen platelets were analyzed retrospectively in 3 257 samples of frozen platelets before platelet pheresis. Then, the platelet counts were examined in 150 cases transfused with frozen platelets at the time-points of 1, 24, 48 and 72 hrs after transfusion, 90 cases suffered from the obstetrical bleeding were transfused with 200 parts of the re-melting frozen platelets, and then the peripheral blood platelet count, platelet increasing index(CCI), bleeding time and blood clot retraction rate etc. were observed for determining the clinical efficiency of the frozen platelets.

RESULTSThe floccule in the re-melting frozen platelets from the donators with (175-250)×10(9)/L platelets were decreased significantly(P<0.01). The quality of frozen platelets was influenced by the following factors, such as injection of DMSO at a too fast and heterogeneous rate, blood bags stored in a multilamminar space, and re-melting in a water-bath of small capacity etc. The routine storage for 0 and 3 days did not influence the quality of the frozen platelets. The recovery rate of one year-freezing platelets all was higher than 80%. The effects of the frozen platelets transfused into the patients with obstetrical bleeding displayed good haemostatic results, and the blood transfusion reaction did not occur. However, the frozen platelets immediately were exhausted and displayed their function, but the counting after 48 hrs could not display a good effect of raising platelet number.

CONCLUSIONSThe peripheral platelet count before platelet pheresis, the injection rate and evenness of the protective agent, the number of stratum for blood bags and the capacity of re-melting water-bath etc. all are the key factors influencing the quality of the frozen platelets. The frozen platelets prepared in this study shows a good efficacy of clinical application.

Blood Platelets ; Blood Preservation ; Blood Transfusion ; Freezing ; Hemostasis ; Humans ; Platelet Count ; Platelet Transfusion ; Plateletpheresis ; Transfusion Reaction

OBJECTIVE: To investigate the related factors of adverse reactions of blood transfusion, and clinical precautions so as to reduce the adverse reactions. METHODS: Data of 2108 patients with allogeneic transfusion in our hospital from January 2017 to June 2017 collected and analyzed. RESULTS: These patients received 15 244 time of blood transfusion, and 213 time of adverse reactions occurred in 178 patients in totality, the incidence is 1.4%, and there was no significant difference between the male (1.31%) and female (1.53%). The main type of transfusion reaction were allergy (73.23%), FNHTR (11.74%) and TACO (10.80%). Among all kinds of blood components, the incidence of adverse reactions of apheresis platelet transfusion was the highest (4.31%), significantly higher than that of cryoprecipitate and other blood components. The incidence rate of adverse reactions of blood transfusion in the hematopathy patients was 2.56%, significantly higher than that of immune diseases (1.48%), cancer diseases (1.28%) and other diseases (1.08%), (P＜0.01). The rate of transfusion history of apheresis platelets was 42.67% (the incidence of adverse reactions was 4.31%), significantly higher than other groups (P＜0.01); the rate of transfusion history of cryoprecipitate was 4.11% (the incidence of adverse reaction was 0.45%), significantly lower than other groups (P＜0.05). Among the disease types, the rate of transfusion history in the hematopathy patients was 48.79% (the incidence of adverse reaction was 2.56%), significantly higher than that of other groups (P＜0.01). The incidence of drug allergy in patients with the adverse reactions to blood transfusion was 11.25%, significantly higher than that of patients without adverse reactions (4.71%) (P＜0.01). CONCLUSION The main risk factors of adverse reactions of blood transfusion are as follows: blood varieties, disease type, transfusion history and drug allergy history. For the patients with transfusion, multiple factors should be controlled, so as to reduce the adverse reactions.
Blood Component Transfusion ; Blood Transfusion ; Female ; Humans ; Hypersensitivity ; Male ; Platelet Transfusion ; Transfusion Reaction

As allogeneic blood transfusion plays a role in clinical treatment effects, it also produces a number of immune-related side effects, such as the increased rate of postoperative infection, the rising relapse rate of malignant resection and so on. All those factors, such as CD200 surface molecule of allogeneic mononuclear cells, interleukin, sHLA and sFasL which are detached from the leukocyte surface during the period of storage, and serum bioactive molecules related to a certain degree with the occurrence of transfusion-related immunomodulation (TRIM). The clinical controlled trials, laboratory researches and animal models demonstrated that cloning deletion, induction of anergy and immune suppression are the three major mechanisms of TRIM. In this article, the research advances on mechanism of TRIM and the mediators inducing TRIM are reviewed.
Animals ; Humans ; Immunomodulation ; Immunosuppression ; Platelet Transfusion ; adverse effects ; Transfusion Reaction

In 2001-2002 period, at the Hospital of Hemotology and Blood Transfusion of Ho Chi Minh, a cross-sectioncal analytic descriptive study was carried out covering 92 cases thrombocyte transfusion for 67 patients with acute myoblastic and lymphoblastic leucemia. The results were analogue with those obstained by foreign authors concerning the indices of assessment of the efficacy of thrombocyte transfusion. The number of thrombocytes in a condensed unit of blood plaquettes obtained on the apparatus of extraction and isolation in comparing with body weight of Viet Nam subject had created optimal doses of thrombocyte transfusion in patients without associated factors increasing the consumption of blood plaquettes and these are the doses possibly attained in Vietnamese blood donor
Leukemia, Lymphocytic, Acute ; Platelet Transfusion ; Blood

OBJECTIVETo investigate the factors influencing platelet transfusion results so as to improve the platelet transfusion efficiency.

METHODSAccording to the clinical symptoms (bleeding condition is stopped or improved)and the corrected count of increment (CCI), the patients were divided into efficient transfusion and inefficient transfusion groups. A total of 20 671 patients' clinical data and main platelet transfusion parameters in 26 045 tranfusions including platelet count of per- and post- transfusion, platelet component sorts, storage time and transfusion number were analysed.

RESULTSThe comparison of platelet transfusion efficiency in age and sex between two groups did not showed statistical difference (P > 0.05), the platelet count before transfusion between two groups showed statistical difference (t = -5.59, P < 0.001) after converting to log, a significant linear correlation did not exist between storage time of the platelet and CCI (corrected count of increment), but there was statistical difference in transfusion efficiency of patients with different diseases. The patients with hematologic diseases showed lower efficiency of platelet transfusion. According to the results of Wilcocon test detection, there was difference between different times of transfusion and transfusion efficiency, that is to say, the transfusion frequency was higher, the transfusion efficency was lower. The Fisher test indicated that the transfusion efficiency of single platelet transfusion was lower than that of transfussed platelet with other blood components (P < 0.01).

CONCLUSIONPlatelet transfusion efficiency associates with many factors, including different diseases, whether being transfused with other blood components, the platelet count before transfusion, transfusion frequency, but the time of storage does not relate to the transfusion efficacy.

Blood Platelets ; Hematologic Diseases ; Humans ; Platelet Count ; Platelet Transfusion

BACKGROUND: In Korea, a platelet transfusion dose (TD) of 8 units of platelet concentrates (PC) is usually used. To minimize the shortage of blood products and transfusion-related adverse reactions, the TD has been changed from 8 to 6 units in 2006 in our hospital. Here, we analyzed the dose reduction effect on patients' platelet counts and transfusion frequency. METHODS: We compared the amount of issued PC, platelet counts before and after transfusion, post-transfusion platelet increments, and transfusion frequencies in patients who were transfused with 8 PC in 2006 and 6 PC in 2008. RESULTS: Despite an increase in the number of admitted patients by 20% in 2008 with a disease distribution similar to that in 2006, the number of issued PC in 2008 was decreased by 26.6% compared to that in 2006. In 2008, post-transfusion platelet counts, pre-transfusion platelet counts in patients transfused with 320 mL whole blood-derived PC, and platelet increments in patients transfused with 400 mL whole blood-derived PC were significantly decreased. However, the mean transfusion frequency per one month was not significantly different, 4.3 times in 2006 and 4.7 in 2008. CONCLUSIONS: By implementing a policy of platelet TD restriction, the amount of total issued PC was markedly decreased. Although post-transfusion platelet counts were decreased, the transfusion frequency in a month was not significantly increased. The restriction of platelet TD was helpful for increasing physicians' recognition of blood shortage while achieving similar transfusion effects. We conclude that 6 units of PC would be a better guideline for the platelet TD.
Evaluation Studies as Topic ; Humans ; Organizational Policy ; Platelet Count ; *Platelet Transfusion

OBJECTIVE: To investigate the changes of platelet count (PLT), plateletcrit (PCT), mean platelet volume (MPV) and platelet distribution width (PDW) before and after apheresis platelet transfusion, the correlation between the parameters and their clinical significance. METHODS: A total of 38 patients who received apheresis platelet transfusion were selected, their results of blood routine test closest to the time point of apheresis platelet transfusion were consulted from hospital information system and the changes of PLT, PCT, MPV and PDW were compared before and after transfusion. The correlation between above parameters was analyzed. The correlation of body mass index (BMI) with the increased multiple and increased value after platelet infusion was also analyzed. RESULTS: Compared with pre-infusion, PLT and PCT significantly increased (both P <0.001) while MPV and PDW showed no significant difference after apheresis platelet transfusion (P >0.05). The difference of PLT and PCT before and after apheresis platelet transfusion had no correlation with PLT and PCT before transfusion (r =0.002, r =0.001), while the difference of MPV and PDW was negatively correlated with MPV and PDW before transfusion (r =-0.462, r =-0.610). The PLT growth rate was positively correlated with PCT growth rate before and after apheresis platelet transfusion (r =0.819). BMI was positively correlated with the increased multiple of PLT after infusion (r =0.721), but not with the increased value of PLT after infusion (r =0.374). CONCLUSION Apheresis platelet transfusion can cause platelet parameters change and shows different characteristics. Characteristic changes of platelet parameters and their correlation can be used as reference indices to evaluate the efficacy of apheresis platelet transfusion.
Humans ; Mean Platelet Volume ; Platelet Transfusion ; Blood Platelets ; Platelet Count/methods* ; Blood Component Removal

OBJECTIVETo analyse the cases of platelet transfusion refractoriness after received HLA-matched unrelated donor hematopoietic stem cell transplantation, to analyze and identify the phenotype and genotype of CD36 in both the patient and stem cell donor, as well as the characteristic of antibody induced platelet transfusion refractoriness, and to analyse the efficacy of matched CD36-deficiency platelets transfusions.

METHODSThe CD36 expression on platelet and monocyte was analyzed by flow cytometry (FCM) in both patient and donor. Polymerase chain reaction sequence-based typing (PCR-SBT) was used to analyze the exons sequence of CD36 and HPA. Fast monoclonal antibody-specific immobilization of platelet antigen (F-MAIPA) and FCM were used to identify platelet antibodies in the patient. Short tandem repeat polymerase chain reaction (STR-PCR) was applied to monitor engraftment evidence. The platelet level was monitored. CD36- deficiency donor's platelets were selected from CD36- deficiency donor blood bank.

RESULTSThe donor was CD36 positive and the patient was typed I CD36 deficiency. The anti-CD36 antibody was identified in patient's serum (after transplantation), while the HLA and HPA-related antibodies were excluded. Sequence analysis of CD36 exon in the patient showed Exon 6 -1G>C(Change in splicing site) homozygote, which was a novel CD36 mutation. STR, HPA and CD36 of the patient (complete chimerism) were conversed to that of donor gene types on day 18 after allo-HSCT. The positive CD36 expression on platelet and monocyte in the patient was observed on day 96 after allo-HSCT. The patient showed the platelet transfusion refractoriness which was significantly improved after platelets transfusions from CD36 deficiency donors.

CONCLUSIONStem cell transplants resulted in anti-CD36 and caused platelet transfusion refractoriness, that was first reported in China. To ensure the efficacy of platelet transfusion, the CD36-deficiency patient should receive CD36 deficiency platelets for transfusion.

Antigens, Human Platelet ; Blood Platelet Disorders ; Blood Platelets ; CD36 Antigens ; China ; Humans ; Platelet Transfusion ; Thrombocytopenia