Evaluation of erythrocytapheresis compared to phlebotomy in polycythaemia vera patients.

Introduction: Polycythaemia vera patients can present with arterial or venous vascular occlusive events such as thrombosis or cardiovascular disease; disease-related symptoms may significantly impact on the quality of life. The aim of this study was to evaluate the efficacy and safety of erythrocytapheresis compared to phlebotomy in the treatment of polycythaemia patients.

Methods: This study reports the findings of a retrospective analysis of 40 polycythaemia vera patients diagnosed according to published guidelines and treated either with erythrocytapheresis or phlebotomy over a four-year period.

Efficacy of Replacement and Anti-Platelet Therapies in a Patient with Severe Haemophilia A Undergoing Percutaneous Coronary Stent Implantation.

Introduction: Severe haemophilia A is characterized by serious factor VIII deficiency (biological activity <1%) resulting in frequent spontaneous haemorrhage and abnormal bleeding after minor injury, surgery or tooth extraction.

Patient And Methods: We report the case of a 58-year-old patient with severe haemophilia A without inhibitors but with other comorbidities (HCV and HIV seroconversion), who underwent coronary angioplasty and stent implantation after acute myocardial infarction.

Results: Compared with previous therapy, Nuwiq led to a reduction of about 20% in drug consumption (360,000 IU vs 540,000 IU per year) and in the annualized bleeding rate (ABR) (5 vs 15).

The prevention of adverse reactions to transfusions in patients with haemoglobinopathies: a proposed algorithm.

Background: Transfusion therapy remains the main treatment for patients with severe haemoglobinopathies, but can cause adverse reactions which may be classified as immediate or delayed. The use of targeted prevention with drugs and treatments of blood components in selected patients can contribute to reducing the development of some reactions.The aim of our study was to develop an algorithm capable of guiding behaviours to adopt in order to reduce the incidence of immediate transfusion reactions.

Use of an identification system based on biometric data for patients requiring transfusions guarantees transfusion safety and traceability.

Background: One of the most serious risks of blood transfusions is an error in ABO blood group compatibility, which can cause a haemolytic transfusion reaction and, in the most severe cases, the death of the patient. The frequency and type of errors observed suggest that these are inevitable, in that mistakes are inherent to human nature, unless significant changes, including the use of computerised instruments, are made to procedures.

Methods: In order to identify patients who are candidates for the transfusion of blood components and to guarantee the traceability of the transfusion, the Securblood system (BBS srl) was introduced.

Continuous improvement of our autologous blood donation program carried out during 10 years in 1198 orthopaedic patients.

Background: We analysed the relationship between baseline haemoglobin levels and the need for post-operative blood transfusion in our patients. The aim of this study was to evaluate and optimize the pre-operative autologous blood donation (PABD) program at our hospital through a constant audit.

Materials And Methods: Between January 1997 and December 2006 we evaluated 1198 consecutive patients who underwent elective, unilateral, primary total hip or knee arthroplasty and who met our inclusion criteria.

Chronic red blood cell exchange to prevent clinical complications in sickle cell disease.

We tracked the results of 394 manual or automatic red blood cell exchanges done with a cell separator in 20 sickle cell patients at high risk for recurrent complications. Over an average of 6 years, none of the patients developed complications related to the procedure or to the increased blood use. It was safe and effective in preventing complications of sickle cell disease, and if done automatically, reduced iron overload.