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Prevention of ABO Incompatible Blood Transfusion: '2-2-2 Safe Blood Transfusion Campaign'.

Duck CHO ; Jungwon HYUN ; Dong Wook RYANG

Korean Journal of Blood Transfusion.2013;24(1):79-81.

No abstract available.
Blood Transfusion

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High-Resolution Melting Analysis for Genotyping Duffy Blood Group Antigens.

Chae Seung LIM ; Kyung Hee KIM ; Soyoung CHUNG ; Yoon Ho KIM ; Jae Yeol CHOI ; Il Tae KIM

Korean Journal of Blood Transfusion.2013;24(1):71-78.

BACKGROUND: Accurate typing of Duffy blood group is important because anti-Duffy antibodies cause hemolytic transfusion reaction and hemolytic disease of the newborn. The aim of this study was to evaluate a new genotyping method using high resolution melting (HRM) analysis, a rapid and inexpensive approach for high-throughput Duffy genotyping. METHODS: A total of 20 unrelated Korean blood samples were obtained and an African-black sample was used for GATA control. Phenotyping was performed by hemagglutination (DiaMed AG, Switzerland). GATA and FYA/B PCR products were obtained by PCR-restriction fragment length polymorphism (RFLP) using Taq DNA polymerase (Promega, WI) and enzymes BanI and StyI (New England Biolab, UK). For HRM, PCR amplification was performed using LightCycler 480 ResoLight Dye (Roche, USA) and Lightcycer 480 (Roche, USA). RESULTS: Phenotyping and genotyping data using PCR-RFLP and HRM analysis were compared. Different types of HRM curves were obtained according to genotypes, FYA/FYA, FYB/FYB, and FYA/FYB, and to GATA mutations, homozygote FYB-33T (T/T), heterozygote FYB-33T/33C (T/C), and homozygote FYB-33C (C/C). Phenotypes 18 Fy(a+b-), 1 Fy(a+b+), 1 Fy(a-b+), and 1 Fy(a-b-) showed complete concordance with genotyping methods. Fy(a-b-) sample was found to be a FYB-33C homozygote by both genotyping methods. CONCLUSION: Phenotyping and genotyping showed concordant results and both genotyping methods using PCR-RFLP and HRM analysis showed good agreement in finding mutation in GATA and FY gene coding regions. HRM analysis is suitable and reliable for high-throughput screening for Duffy genotyping.
Antibodies ; Blood Group Antigens ; Blood Group Incompatibility ; Clinical Coding ; England ; Freezing ; Genotype ; Hemagglutination ; Heterozygote ; Homozygote ; Humans ; Infant, Newborn ; Mass Screening ; Phenotype ; Polymerase Chain Reaction ; Taq Polymerase

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Eleven Years' Experience with Unexpected Antibody Screening Tests Including a Di(a) Cell in Transfusion Candidates.

Soon Jung OK ; Shine Young KIM ; In Suk KIM ; Eun Yup LEE ; Hyung Hoi KIM

Korean Journal of Blood Transfusion.2013;24(1):64-70.

BACKGROUND: The Di(a) antigen has been detected with a relatively higher incidence among the Korean and Southeast Asian population. A 'Type and Screen' procedure is recommended for efficient transfusion, therefore, we perform antibody screening tests using antibody screening panels containing a Di(a) cell. The purpose of this study was to report on the experience of unexpected antibody screening test including a Di(a) cell in the Korean population. METHODS: We analyzed the results of antibody screening testing and identification performed during the recent 11-year period from January 2002 to December 2012. A commercially available three-cell antigen panel (Diacell I, II, Di(a); DiaMed, Murten, Switzerland) was used for antibody screening. Antibodies were identified using a LISS/Coombs gel card and NaCl/Enzyme card, using the DiaMed-ID system (DiaMed, Murten, Switzerland). RESULTS: The frequency of unexpected antibodies was 1.23% (1,918/156,161); the most frequently detected antibodies were anti-E (292 samples), followed by anti-E,c (127 samples), anti-Le(a) (103 samples), and anti-Di(a) (91 samples). CONCLUSION: Results of this study showed that the most identified unexpected antibodies were clinically significant, and, in particular, anti-Di(a) antibodies are detected frequently in the Korean population. Thus, unexpected antibody screening test including a Di(a) cell is thought to be helpful in Korea for safe transfusion.
Antibodies ; Asian Continental Ancestry Group ; Humans ; Incidence ; Korea ; Mass Screening

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Transfusion Therapy in the Emergency Department.

Young Duck CHO ; Sung Hyunk CHOI ; Young Hoon YOON ; Jung Youn KIM ; Sang Min PARK ; Chae Seung LIM

Korean Journal of Blood Transfusion.2013;24(1):58-63.

BACKGROUND: Most patients requiring transfusion are admitted to the general ward; however, the number of patients visiting the emergency department for transfusion is increasing. In this study, we reviewed the transfusion therapies that are performed in the emergency department and analyzed their status. METHODS: We conducted a retrospective review of the charts of patients who visited the emergency department in our hospital for transfusion therapy from October 1, 2008 to October 30, 2012. We collected and analyzed general information on the patients and divided them into groups according to the number and kind of blood products they received. RESULTS: A total of 4,497 patients visited the emergency department for transfusion therapy during the study period. Among 4,497 patients, 2,925 patients were enrolled in the study and 1,572 patients were excluded. Out of 2,925 patients, there were 1,745 male patients (59.66%) and 1,180 female patients (40.34%), mean age was 61.24 (+/-17.49); 2,340 patients (80.00%) were admitted, 364 (12.45%) discharged, 44 (1.50%) expired, and 177 (6.05%) were transferred. The most common cause for transfusion was upper and lower gastrointestinal bleeding (928, 32%), followed by trauma (548, 19%), malignancy (376, 13%), anemia (294, 10%), infection (281, 10%), and gynecologic (137, 5%) respectively. CONCLUSION: Performance of transfusion therapy in the emergency department is not uncommon; therefore, proper protocols by cause of bleeding will be required for prevention of unnecessary complication that may occur during transfusion therapy.
Anemia ; Emergencies ; Female ; Hemorrhage ; Humans ; Male ; Retrospective Studies

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Effect of the Least Incompatible Blood Transfusion in Patients with Panagglutination (Least Incompatible Blood Transfusion).

Woonhyoung LEE ; Youkyung SEO ; June Won CHEONG ; Sinyoung KIM ; Hyun Ok KIM

Korean Journal of Blood Transfusion.2013;24(1):48-57.

BACKGROUND: In patients who had serum autoantibody that reacted with all screening red blood cells (panagglutination), waiting for compatible blood is likely to delay a needed transfusion. In some cases of severely diminished hemoglobin counts, the least incompatible blood may be transfused. However, the least incompatible transfusion therapy is challenged by the presence of unexpected antibody in patient's serum, which may cause a transfusion reaction. The aim of this study was to evaluate the effect of the least incompatible transfusion on clinical outcomes in patients with panagglutination. METHODS: We conducted a retrospective study of 49 patients with panagglutination on an unexpected antibody screening test between January 2006 and July 2010. In 36 patients having the least incompatible blood transfusion, changes in hemoglobin and lactate dehydrogenase (LD) values before and after transfusion were analyzed. One year mortality after initial need for transfusion was documented. RESULTS: In all 36 patients who underwent transfusion, hemoglobin values showed an increase of 1.2 (0.0~3.0) g/dL per unit without occurrence of acute transfusion reactions indicated by an increase in the LD level. The least incompatible transfusion did not show an association with increased all-cause mortality. CONCLUSION: As an alternative to the time consuming process of alloantibody detection, patients with severe anemia can be effectively transfused with "least incompatible units" in an emergency clinical setting without experiencing acute transfusion reactions.
Anemia ; Blood Group Incompatibility ; Blood Transfusion ; Emergencies ; Erythrocytes ; Hemoglobins ; Humans ; L-Lactate Dehydrogenase ; Mass Screening ; Retrospective Studies

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Evaluation of the VITROS 3600 Analyzer for HBsAg.

Yu Soek JUNG ; Young Ae LIM

Korean Journal of Blood Transfusion.2013;24(1):41-47.

BACKGROUND: The VITROS 3600 (Ortho Clinical Diagnostics, Johnson & Johnson, Buckinghamshire, UK), which uses the enhanced chemiluminescence immunoassay, has recently been introduced; however, it has not been evaluated for detection of HBsAg in Korea. We evaluated the ability of the VITROS 3600 for detection of HBsAg, compared with the ARCHITECT i2000 (Abbott Laboratories, Abbott Park, IL, USA), which is used widely in Korea to help in selection of an analyzer for detection of HBsAg. METHODS: A total of 800 samples were tested randomly for HBsAg and 150 samples with positive HBV DNA detected by real-time PCR were used in this study. Precision, agreement, and Pearson correlations between two analyzers were evaluated. RESULTS: The total standard deviations (SD) were 0.016 and 0.183 for the negative and positive HBsAg controls, respectively; the precision met the criteria suggested by the manufacturer. There were 100% agreements for the 800 random samples (positive 33, negative 767) and 150 samples with HBV DNA (positive 148, negative 2) between two analyzers. In addition, good correlation was observed between two analyzers for the 767 HBsAg negative samples (r=0.691, P=0.004), and 148 HBV DNA positive samples (r=0.763, P<0.001). CONCLUSION: The VITROS 3600 showed good precision and agreement. And, correlation between the VITROS 3600 and the ARCHITECT i2000 was excellent. Therefore, this result will be helpful in selection of an analyzer for detection of HBsAg.
DNA ; Enzyme-Linked Immunosorbent Assay ; Hepatitis B Surface Antigens ; Hepatitis B virus ; Immunoassay ; Korea ; Luminescence ; Real-Time Polymerase Chain Reaction

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The Status of the Korea Blood Inventory Monitoring System, 2009~2012.

Jin A OH ; Jee Yeon SHIN ; Kyoung Yul LEE ; Kyeong Eun JEONG ; Cho Rong SEO ; Young Sill CHOI ; Dong Han LEE

Korean Journal of Blood Transfusion.2013;24(1):33-40.

BACKGROUND: In the Republic of Korea, due to the low birth rate, blood donation is expected to decrease. However, the demand for blood is increasing as the proportion of elderly has increased. Korea Centers for Disease Control and Prevention operate the Korea Blood Inventory Monitoring System (KBIMs) for detection and response to the shortage of blood. The aim of this study was to show the trend of blood supply monitored by KBIMs. METHODS: This study analyzed the red blood cell inventory ratio, average daily usage, time-lag from blood donation to transfusion and from receipt to transfusion in blood banks monitored by KBIMs from 2009 to 2012. RESULTS: A total of 25 hospitals have participated in KBIMs since 2009. The average inventory ratio of blood banks was 5.3 days. By month, the inventory ratio was highest between November and February; and by week, highest on Fridays. Daily amount of RBC utilized in hospitals peaked on Thursday by week. Time-lag from blood donation to transfusion and from receipt to transfusion in blood banks was 12.2 and 6.4 days, respectively. The inventory ratio of type-A RBC was the lowest, because of the highest level of demand. In addition, time-lags from blood donation to transfusion and from receipt to transfusion were shortest in type-A RBC. CONCLUSION: The inventory ratio in blood banks monitored by KBIMs was stable throughout the years. However, due to higher level of demand, there is a risk of shortage of type-A RBC.
Aged ; Birth Rate ; Blood Banks ; Blood Donors ; Centers for Disease Control and Prevention (U.S.) ; Erythrocytes ; Humans ; Korea ; Republic of Korea

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Functional Interaction of HIF-1 and NF-kappaB Increasing the Transcriptional Activation of TNF-alpha Gene in Monocytes.

Min Jeong PARK ; Sun Min LEE ; Soon Jung OK ; Hye Rim KIM ; Hyung Hoi KIM ; Jae Hun CHEONG

Korean Journal of Blood Transfusion.2013;24(1):21-32.

BACKGROUND: Tumor necrosis factor alpha (TNF-alpha) is a pleiotropic cytokine fulfilling a broad variety of immunoregulatory functions. Monocytes and macrophages play a pivotal role in inflammation and immune regulation. NF-kappaB and HIF-1 are known to increase expression of the TNF-alpha gene in a separate way. METHODS: Human monocytic leukemia, U937 cells, were transfected using the standard electroporation method for intracellular expression of NF-kappaB and HIF-1. We performed analysis using the mammalian two-hybrid assay and co-immunoprecipitation assay for detection of protein interaction of both proteins. In addition, chromatin immunoprecipitation analysis was performed for examination of NF-kappaB and HIF-1 binding on the TNF-alpha gene promoter. RESULTS: Here we show that NF-kappaB and HIF-1 cooperatively induced an increase in expression of the TNF-alpha gene dependent on promoter activity by the direct protein interaction of these two transcription factors. Hypoxia signaling induced marked enhancement of the transactivation of TNF-alpha promoter by HIF-1 and NF-kappaB. A tandem NF-kappaB/HIF-1 binding site was identified within the TNF-alpha promoter, which acted as a strong enhancer element. Physical association of the Rel domain of NF-kappaB and the N-TD domain of HIF-1 was required. Hypoxia treatment also resulted in a significant increase in the protein interaction of NF-kappaB and HIF-1 in vivo. Both transcription factors were recruited on the chromatin TNF-alpha promoter dependent on hypoxia stimuli. CONCLUSION: The results of this study indicate that a variety of extracellular signals for activation of TNF-alpha gene expression might converge on the transcriptional regulation through the NF-kappaB/HIF-1 signaling pathway.
Anoxia ; Binding Sites ; Chromatin ; Chromatin Immunoprecipitation ; Electroporation ; Enhancer Elements, Genetic ; Gene Expression ; Humans ; Immunoprecipitation ; Inflammation ; Leukemia ; Macrophages ; Monocytes ; NF-kappa B ; Proteins ; Transcription Factors ; Transcriptional Activation ; Tumor Necrosis Factor-alpha ; Two-Hybrid System Techniques ; U937 Cells

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Characteristics of Duffy Blood Group Antigens and Their Global Distribution.

Chae Seung LIM ; Kyung Hee KIM

Korean Journal of Blood Transfusion.2013;24(1):13-20.

The Duffy antigen was discovered in 1950, in a multiply transfused hemophiliac. Important progress has since been made in understanding the Duffy blood group system and its complexity. The Duffy blood group antigen (gp-Fy) is present primarily in erythrocytes, and also in endothelial cells of capillary and postcapillary venules, Purkinje cells of cerebellum, kidney, and pulmonary alveoli. The gp-Fy serves not only as a blood group antigen, but also as a receptor for chemokines, and as a receptor for Plasmodium vivax malaria parasites. The Duffy antigen is encoded by the DARC gene, its approved name is Duffy blood group chemokine receptor. Investigation of the DARC gene can help us in understanding the relationship of infectious disease to race or population. In addition, the allelic frequency of DARC varies according to the geographic area, which appears to reflect the history that mankind had adapted to environments and diseases, emigrating. As a result, further study of Duffy antigens can provide us with an integral and sound understanding of the human race.
Blood Group Antigens ; Capillaries ; Cerebellum ; Chemokines ; Communicable Diseases ; Continental Population Groups ; Duffy Blood-Group System ; Endothelial Cells ; Erythrocytes ; Humans ; Kidney ; Malaria, Vivax ; Parasites ; Plasmodium vivax ; Pulmonary Alveoli ; Purkinje Cells ; Venules

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Repeat Blood Donors and Iron Deficiency Anemia.

Deokja OH ; Jayoung LEE

Korean Journal of Blood Transfusion.2013;24(1):1-12.

Recently, there is a growing concern for loss of iron among repeat blood donors. We evaluated the effects of blood donation to iron deficiency in several studies and propose following measures to prevent iron depletion among repeat blood donors. We reviewed and analyzed comprehensively results of several domestic and foreign studies and cited Korean blood donor's statistics data. There is a high prevalence of iron depletion in repeat blood donors. Predictors of iron depletion (serum ferritin <12~15 ng/mL) included a high frequency of blood donation, short donation interval, and female gender regardless of blood donation type. Taking iron supplements reduced the risk of iron depletion for repeat blood donors. We would like to propose the following preventive measures for repeat blood donors. 1) Test for serum ferritin for repeat donors who donate at least three times per year. If the donors show low serum ferritin level which is below 15 ng/mL, 2) Increase the donation interval or limit of blood donation frequency and 3) Recommend iron supplement for a certain period.
Anemia, Iron-Deficiency ; Blood Donors ; Female ; Ferritins ; Humans ; Iron ; Prevalence ; Tissue Donors

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