Are we missing reverse TRALI? - A real world experience from a tertiary care oncology centre in India.

Transfusion related acute lung injury (TRALI) is a rare but potentially fatal pulmonary complication of transfusion that presents as acute hypoxemia and non-cardiogenic pulmonary oedema, developing during or within six hours of transfusion. Majority of the cases reported are due to transfusion of plasma rich blood components containing antibodies to human leukocyte antigen (anti-HLA) or human neutrophil antigen (anti-HNA). Rarely, anti-HLA or anti-HNA in recipients against transfused donor leukocyte antigens, cause TRALI by a reverse mechanism.

Importance and results of sterility testing of various products in a microbiology laboratory of eastern India.

Components of blood products from Blood bank, stem cells products from Haemotapoietic Stem Cell Transplant unit, CSSD (Central Sterile Supply Department) items, and pharrrmaceutical products, were sterility tested by liquid culture. 2.91% of the total 3122 samples sent for sterility testing from various departments were positive (i.

Challenges in transfusion and the role of Thalidomide in E-β-Thalassemia-A case report.

Hemoglobin E-β-thalassemia is a common β-thalassemia that has a variable presentation from mild to severe life-threatening anemia. We describe such a case, who presented with severe anemia and multiple allo-antibodies. Our case illustrates the role of thalidomide in transfusion-sparing therapies in patients with transfusion-dependent thalassemia and challenges in the blood bank.

Fresh Frozen Plasma and Platelet Transfusion Practices in Neonatal Intensive Care Unit of a Tertiary Care Hospital.

Blood transfusion is an indispensable part of modern medical and surgical practices. More than 35% of critically ill patients receive transfusion of blood components during their intensive care unit stay. The aim of study is to obtain an information regarding the relationship of platelet concentrate (PC) and fresh frozen plasma (FFP) transfusion on clinical outcome of neonates admitted in neonatal ICU (NICU).

Incompatible crossmatch: First sign of a hemolytic transfusion reaction due to out-of-group platelet transfusion.

Platelet (PLT) transfusion is undertaken in a variety of clinical settings with thrombocytopenia, with or without bleeding. Since PLTs are most often stored in donor plasma, group-specific PLT transfusions are preferred to out-of-group transfusions. PLTs adsorb ABO antigens over their surface from the plasma.

Red Cell Transfusion Practices in Neonatal Intensive Care Unit: An Experience from Tertiary Care Centre.

Red cells are the most often transfused blood components during the neonatal period. The aim of the present study was to obtain information regarding the relationship of red cell transfusion with clinical outcomes and to evaluate red cell transfusion practices in neonatal centre of a tertiary care centre. The clinical history, blood component details and laboratory parameters were evaluated with clinical outcomes.

Clinical and laboratory profile of anti-M.

Anti-M is a frequently detected naturally occurring antibody that has been reported in various clinical settings and also in voluntary donors. We describe here the clinical and laboratory findings of 11 cases with anti-M detected at our center. This report is a retrospective study in which we reviewed our immunohematology laboratory records for cases involving anti-M.

Comparison of micro column technology with conventional tube methods for antibody detection.

Background And Objectives: Conventional tube technique (CTT) has been the mainstay for antibody detection in pretransfusion testing. There have been rapid technological advances in blood banking and methodology of crossmatch has been modified to improve the sensitivity of these tests and to enable automation. This study was done to compare the efficacy of three crossmatch techniques: CTT, tube low-ionic-strength-saline indirect antiglobulin test (tube LISS-IAT), and micro column technology (MCT) used in the blood bank serology laboratory.

Resolution of Serologic Problems Due to Cold Agglutinins in Chronic Lymphocytic Leukemia.

Introduction: Autoimmune hemolytic anemia can be classified depending on presence of warm, cold or mixed type of autoantibodies that are directed against antigens on the red blood cell surface. Here we report a case of pathological cold agglutinin disease which was eventually detected due to blood group discrepancy.

Case Details: A request was sent to the blood bank for two units of packed red cells in a diagnosed case of CLL which showed type IV discrepancy during blood grouping.

Blood Group Discrepancy-First Sign of Autoimmune Hemolytic Anemia after Hematopoietic Stem Cell Transplantation in a Child.

A 12-year-old male child was presented in the emergency with features of anemia and mild icterus on day+67 of HSCT. The child was suffering from Fanconi anemia and undergone HSCT from ABO-matched, fully HLA matched sibling donor. The diagnosis of mixed type AIHA due to cytomegalovirus reactivation was made in the immunohematology laboratory and blood group discrepancy was the first sign of AIHA in this patient.

Importance of Clinically Significant Anti-M Antibody in Hematopoietic Stem Cell Transplantation.

Naturally occurring anti-M antibodies are mostly of the IgM class, however, an IgG component can also be present along with IgM. The IgM anti-M antibodies can be ignored if they are not reactive at 37 °C, but the patient should receive M antigen-negative red blood cells if the antibody is reactive at 37 °C or if it is of IgG class. Here we discuss a case of clinically significant naturally occurring anti-M antibody had both IgM and IgG components in a 3 years old child who was a hematopoietic stem cell donor for her 6 years old sister suffering from beta-thalassemia major.

Evaluation of the pneumatic tube system for transportation of packed red cell units.

Background: Pneumatic tube system (PTS) is commonly used in hospital settings to transport blood samples to diagnostic laboratories. At our blood center, we receive blood requisitions via the PTS, but units are carried to the ward by human courier. Recently we considered using the PTS for transporting blood units.

Clinico-serologic co-relation in bi-directional ABO incompatible hemopoietic stem cell transplantation.

Background: The ABO blood group system is of prime significance in red cell transfusion and organ transplantation. However, ABO compatibility is not critical in allogenic hemopoietic stem cell transplantation (HSCT) and approximately 40-50% of hemopoietic stem cell transplants are ABO incompatible. This incompatibility may be major, minor or bi-directional.

An analysis of transfusion support in haematopoietic stem cell transplantation--report from a centre in India.

Background: Transfusion support in haematopoietic stem cell transplantation (HSCT) can be very demanding and challenging. The conditioning regimen, stem cell dose, donor type, presence of GvHD, infection all influence transfusion therapy in haematopoietic stem cell transplantation (HSCT). We retrospectively analysed the first 100 days transfusion requirements among HSCT recipients with haematological as well as non-haematological malignancies in our centre.

Warm autoimmune hemolytic anemia with mimicking anti-e specificity causing intravascular hemolysis in a chronic ITP patient.

A 12-year-old male child presented to the emergency room with three days history of cola-colored urine, mild icterus, dyspnea, palpitation and fatigue. He had a history of chronic ITP two years ago and had since been on steroid for maintenance of platelet count. He was subsequently diagnosed as a case of warm autoimmune hemolytic anemia.

Red cell alloimmunisation in oncology patients: A study from eastern India.

Background: Red cell alloimmunisation is an important complication in multi-transfused patients with haematologic and surgical malignancies. Antibody screening with identification is necessary to ensure transfusion safety. Data on the prevalence of alloimmunisation in oncology patients is limited.

Assessment of changes in plasma hemoglobin and potassium levels in red cell units during processing and storage.

Red cell units undergo changes during storage and processing. The study was planned to assess plasma potassium, plasma hemoglobin, percentage hemolysis during storage and to determine the effects of outdoor blood collection and processing on those parameters. Blood collection in three types of blood storage bags was done - single CPDA bag (40 outdoor and 40 in-house collection), triple CPD + SAGM bag (40 in-house collection) and quadruple CPD + SAGM bag with integral leukoreduction filter (40 in-house collection).

Anti N antibody in a patient of renal failure on hemodialysis.

Anti N is a rare antibody. It has been reported in renal failure patients on hemodialysis using formaldehyde sterilized equipment. Although anti N is usually clinically insignificant, rarely it can cause hemolytic transfusion reaction.