فصلنامه خون
سال بیستم شماره 4 (پیاپی 82، زمستان 1402)

β-thalassemia patients need regular blood. Regular blood transfusion has side effects. The most common of which is FNHTR. One of the causes of FNHTR is the antibody production against HLA-II antigens. HLA polymorphism vary in different communities and may affect the susceptibility or resistance to FNHTR. In this study, the relationship between HLA-DR polymorphisms and development of FNHTR in multi-transfused thalassemia patients in Tehran province was investigated.

In this cross-sectional study, 88 ß-thalassemia major and intermediate patients with average age 38.63 ± 11.28 with 35 being male (39.8%) and 53 female (60.2%) were enrolled and for better results, 70 thalassemia patients with FNHTR were compared with 18 thalassemia patients without FNHTR. HLA-DR genotype was investigated by PCR-SSP method. Data were analyzed by chi-squared and pearson test.

The results of PCR-SSP showed that HLA-DRB1*11 allele had the highest prevalence (26.7%) in the total study population. No statistically significant correlation between HLA-DR alleles and development of FNHTR was observed. Although HLA-DRB1*10 as a possible genetic marker may play a role in protecting against FNHTR (p = 0.049).

Conclusions :

In this study, no significant association between HLA-DR allele frequency and FNHTR was found. Although alleles HLA-DRB1*03, HLA-DRB1*10, HLA-DRB1*13 and HLA-DRB1*16 have higher prevalence in the no FNHTR group, but only in the case of HLA-DRB1*10 this relationship was significant and was considered as possible genetic markers against development of FNHTR. Further studies investigating HLA-II allelic levels in larger populations may provide more deep data on this association.

Nowadays, it is necessary to evaluate the prevalence of HBV and HCV viruses all around the world due to the importance of preventing infections transmitted through transfusion of blood products. In this study, we investigated the prevalence of these two viruses that cause viral hepatitis among blood donors in Sistan and Baluchestan province.

This retrospective study is conducted on blood donors in Sistan and Baluchestan province in order to evaluate the prevalence rate and trend of Hepatitis B and C during the years 2011-2022. The data were analyzed using Mann–Whitney U test, chi-square (χ2), and SPSS 22.

The prevalence rates of hepatitis B and C infections among blood donors were 0.329% and 0.05%, in Sistan and Baluchestan province respectively. During the years 2011 to 2022, the prevalence of hepatitis B infection decreased from 818 cases per hundred thousand people in 2011 to 109 cases in 2022. Similarly, the prevalence of hepatitis C decreased from 102 cases in 2011 to 27 cases in 2022.

Conclusions :

The results of the present study indicated a decrease in the prevalence of hepatitis B and C infections over a decade, which can show the effective trend of health indicators and prevention programs of HBV and HCV.

Blood transfusion is a major challenge in treating trauma patients. This study investigated blood transfusion rates and related factors in trauma patients.

This retrospective cross-sectional study analyzed 849 trauma patients admitted to a trauma center in Shiraz, Iran during 2019-2021. Blood components usage and its relation to demographics, clinical status, lab values, and ABC score were assessed. The frequency of massive blood transfusion and the average number of blood units and blood components  consumed in these patients were surveyed. Data were analyzed by T-test, Chi-squared test, and logistic regression with SPSS-23.

The mean age was 38.6 ± 19.40 years and 80.9% were male. The mean blood units, platelets, and plasma used were 5.74 ± 4.57, 1.21 ± 4.87, 2.73 ± 4.32, respectively. 62.01% received massive transfusion with mean blood, platelets, and plasma units used being 8.17 ± 5.21, 3.92 ± 4.88 and 1.85 ± 6.01, respectively. Blood use correlated with systolic/diastolic pressures, blood sugar, lymphocyte count, pH, bicarbonate, base deficit, and hematocrit. 13.3% had positive ABC score and received more blood products (p < 0.001).

Conclusions :

Blood transfusion in trauma patients depends on various clinical and lab factors. Identifying high-risk patients requiring urgent blood transfusion and rapid preparation of blood products is vital for optimizing trauma patient management and outcome.

Despite the success of CAR-T cells in the treatment of hematologic malignancies, the use of allogeneic sources of T lymphocytes to produce these cells is associated with risk of GvHD. Cytokine induced killer (CIK) cells are a population with a lower risk of GvHD. Therefore, CAR-CIK cells can be evaluated as a potential alternative for CAR-T cells.

In this experimental study, after isolation and culture of mononuclear cells isolated from the peripheral blood of two healthy donors, T and CIK cells are transduced with CD19 gene containing lentiviral vector. On the 16th day of culture, to compare the cytotoxicity of CAR-T and CAR-CIK cells, these cells were co-cultured with CD19+ K562 target cells, and the death rate among the target cells was measured using a lactate dehydrogenase release assay kit. Student T-test, Anova and post-hoc Tukey were used for statistical analysis using Graph Pad prism software 8. A p-value less than 0.05 was considered statistically significant.

In both CAR-CIK and CAR-T cell, CAR receptor caused a significant increase in cytotoxicity. So that no significant difference was observed between the cytotoxicity of CAR-T cells (67.8% ± 1.7) and CAR-CIK (65.1% ± 1.8).

Conclusions :

CAR-CIK cells show a suitable in vitro cytotoxicity, so they can be considered as a potential alternative for CAR-T cells. However, more preclinical and clinical studies are needed to compare other effective dimensions in the function of these two cell types.

Constant control of electrical panels is effective in ensuring the safety of users. This study was conducted during the years 2022-2023 to evaluate their structure in blood transfusion centers by ETBA method.

In this descriptive-analytical study with the ETBA method, the performance and quality of the grounding system, capacitor bank, connections, the location of the panels, the arrangement structure of the components, and their cleanliness and safety in the centers of Kermanshah, Hamadan, Ilam, Sanandaj, Arak, Karaj, Semnan, Bandar Abbas, Sari and Yazd were investigated. The obtained information was analyzed statistically with SPSS 25 software.

The results showed 74.3% electrical panels with unprincipled volume and distribution of connections, 72.4% due to the selection of inappropriate location and distance from tools and devices, deployment in users' traffic area without provision of fence and safety devices, 70.5% not equipped with warning devices, 43.3% non-standard arrangement, 51.4% insufficient cleaning, 66.3% not having an active earth connection, and 60.3% not having a capacitor bank did not have reliable electrical safety.

Based on these results, the regular and continuous establishment and implementation of the medical equipment maintenance management system can be a fundamental and effective factor in identifying risks and the pertinent degree of risks and damages in the process of activity.

Lead, mercury and cadmium are a serious threat to people. Since blood products are considered as hidden and potential sources of exposure to these heavy metals, systematic review of their concentration in blood donors helps make a decision about the necessity of such a blood donor screening. Therefore, the current protocol has been prepared with the aim of describing the method and steps of such a relevant systematic review.

English keywords "blood donor", Lead, Mercury, Cadmium, Pb, Hg, Cd will be searched online in PubMed, Scopus, Web of Science and ProQuest databases. After screening and selection of relevant articles by two referees, the necessary information will be extracted. If more than 5 primary studies are obtained, meta-analysis will be performed. The heterogeneity among studies will be evaluated by Cochran Q and I2 statistics. Fixed effects model or random effects model will be used to pool the means. Statistical analysis will be performed by meta package in R software.

This systematic review is ongoing and will be completed by March 19, 2024.

Conclusions :

This protocol has been prepared to describe the steps of conducting a systematic review of studies that have measured the blood concentration of lead, mercury and cadmium in blood donors with the aim of making a decision about the necessity of such a blood donor screening to obtain safer products and prevent the exposure of recipients.

In the 80s, cord blood stem cells were used for the first time to treat diseases in humans, and contrary to the opinion of the opponents of using this new cell source, the result was satisfactory, and since then, cord blood has been an important source for cell therapy in humans. Considering the dominant approach to increase the clinical use of umbilical cord blood and the expansion of experimental and research studies in this field, this review article has discussed the current applications and future perspectives while examining the biology of cord blood stem cells.

To conduct this review, the key words “cell bank, umbilical cord blood, Wharton's jelly, stem cell and mesenchymal stem cell” were searched in PubMed and Google scholar databases in the period from 1990 to 2022.

Cord blood cells have significant biological differences compared to other sources (bone marrow and peripheral blood).The absolute number of lymphocytes in cord blood is higher than the peripheral blood and the relative number of natural killer cells in cord blood is higher. Also, cells derived from umbilical cord blood have longer telomeres and more self-renewal capacity than peripheral blood and bone marrow, which makes them very potent.

Conclusions :

This source is of interest not only because of its high immunomodulatory properties in the treatment of inflammatory, autoimmune and systemic diseases, but also because of its anti-inflammatory properties, high differentiation ability and high proliferation capacity, as an ideal option for cell therapy in diseases in addition to hematological disorders. In addition, the preparation, processing, maintenance and storage of cells derived from umbilical cord blood are easy and inexpensive, which is an important point for treatment systems worldwide.

Blood transfusion is one of the vital components of modern health care, but adverse reactions following the injection of this life-giving fluid may occur and cause more than 1% of irreversible complications. The use of blood transfusion checklists is one of the ways to prevent this issue in recent years. The aim of this study was to summarize the experiences of using blood transfusion checklists and their effectiveness to improve patient safety.

This study was conducted as a review. Databases including PubMed, Science Direct, MEDLINE, Proquest, SID, Scopus, Google scholar, and library resources were searched using keywords checklist, blood transfusion, complications of blood transfusion, clinical outcomes, effectiveness between the years 2000 to 2022.

A total of 25,000 articles were initially reviewed and 11 relevant articles were used to prepare this article. There are many differences in the types and items that make up blood transfusion checklists in the health systems of different countries, but what is essential is the commonality of all these checklists, which is to reduce complications related to blood transfusion and increase patient safety.

Conclusions :

Blood transfusion checklists are relatively simple and are shown to be promising tools that have been able to place a positive impact on enhancing patient safety by ensuring the delivery of evidence-based best practices and high-quality safe care.