Donor transmitted malignancy is a real disastrous risk when dealing with expanded criteria donors. As donor age is increasing, guidelines for cancer screening of the elderly brain dead organ donors must be evidence-based but systematic review of such is sparse. Based on a review of published literature and our 20 years' experience, we propose a new series of guidelines concerning screening for the four most common malignancies: breast colon, lung and prostate cancer. Prospective testing of the efficacy of such protocol will then follow.
Kazerouni, Abbas; Burgess, James; Burns, Laura J; Wein, Lawrence M
Fecal microbiota transplantation is an effective treatment for recurrent Clostridium difficile infection and is being investigated as a treatment for other microbiota-associated diseases. To facilitate these activities, an international public stool bank has been created, which screens donors and processes stools in a standardized manner. The goal of this research is to use mathematical modeling and analysis to optimize screening and donor management at the stool bank. Compared to the current policy of screening active donors every 60 days before releasing their quarantined stools for sale, costs can be reduced by 10.3 % by increasing the screening frequency to every 36 days. In addition, the stool production rate varies widely across donors, and using donor-specific screening, where higher producers are screened more frequently, also reduces costs, as does introducing an interim (i.e., between consecutive regular tests) stool test for just rotavirus and C. difficile. We also derive a donor release (i.e., into the system) policy that allows the supply to approximately match an exponentially increasing deterministic demand. More frequent screening, interim screening for rotavirus and C. difficile, and donor-specific screening, where higher stool producers are screened more frequently, are all cost-reducing measures. If screening costs decrease in the future (e.g., as a result of bringing screening in house), a bottleneck for implementing some of these recommendations may be the reluctance of donors to undergo serum screening more frequently than monthly.
Fishman, J A
Viral, bacterial, parasitic, prion, and fungal infections, although uncommon, have been transmitted via organ and tissue allografts. Improved screening techniques for infectious diseases in organ donors have helped to reduce disease transmission. Reports of clusters of donor-derived infections illustrate the need to improve the screening of tissue and organ donors. Available microbiologic assays, including molecular tests, are generally designed for use as diagnostic tools in individuals believed to have a specific infection based on clinical or epidemiological criteria. These assays are frequently unsuitable in the screening of deceased organ donors. Nucleic acid testing may reduce the risk of disease transmission by detecting early-stage infection, including those from human immunodeficiency virus, hepatitis B virus, and hepatitis C virus in the "window" period before antibody seroconversion can be documented. Screening of organ donors for potential pathogens cannot completely exclude the risk of disease transmission. The process of donor screening must continue to evolve with advances in diagnostic technologies for infectious diseases.
Kitchen, A D; Newham, J A; Gillan, H L
A comprehensive and effective screening programme is essential to support the banking of tissues from deceased donors. However, the overall quality of the samples obtained from deceased donors, quantity and condition, is often not ideal, and this may lead to problems in achieving accurate and reliable results. Additionally a significant percentage of referrals are still rejected upon receipt as unsuitable for screening. We are actively involved in improving the overall quality of deceased donor screening outcomes, and have specifically evaluated and validated both serological and molecular assays for this purpose, as well as developing a specific screening strategy to minimise the specificity issues associated with serological screening. Here we review the nature and effectiveness of the deceased donor screening programme implemented by National Health Service Blood and Transplant (NHSBT), the organisation with overall responsibility for the supply of tissue products within England. Deceased donor screening data, serological and molecular, from August 2007 until May 2012 have been collated and analysed. Of 10,225 samples referred for serology screening, 5.5 % were reported as reactive; of 2,862 samples referred for molecular screening, 0.1 % were reported as reactive/inhibitory. Overall 20 % of the serological and 100 % of the molecular screen reactivity was confirmed as reflecting true infection. The use of a sequential serology screening algorithm has resulted in a marked reduction of tissues lost unnecessarily due to non-specific screen reactivity. The approach taken by NHSBT has resulted in the development of an effective and specific approach to the screening of deceased tissue donors.
Li, Ling; Li, Ka Yi; Yan, Ke; Ou, Guojin; Li, Wenhui; Wang, Jue; Song, Ning; Tian, Li; Ji, Xin; Chen, Yongjun; Liang, Xiaohua; Liu, Zhong; Wu, Yanyun
Since the establishment of People's Republic of China in 1949, the Chinese government has encountered several catastrophes related to transfusion transmitted diseases. The government's increasing attention to blood safety has prompted the initiation of a series of policies and measures that have enhanced the level of safety for the blood supply and met the basic clinical demands of blood for 1.3 billion people in the country. Blood donation screening strategies in China predominantly comprise donor screening and donor testing. Donor screening includes selection of low-risk blood donors by the use of a donor history questionnaire, predonation physical examination, and initial rapid donor testing. Donor testing includes direct pathogen detection and serology tests. The year 1998 marked the most transformative change in blood donor selection and screening policies in China. Before 1998, paid donation was the predominant mode of blood donation. Donor screening and donor testing were conducted before donation, and only those who were eligible were allowed to donate. To ensure the safety of blood, donor testing was performed again after donation. After the implementation of the Blood Donation Law in 1998, to promote voluntary and unpaid donation, predonation donor testing was eliminated to reduce the amount of waiting time and to provide a more convenient donation experience for blood donors. However, it is the national requirement that donated blood should undergo 2 rounds of testing using different equipment or reagents, conducted by different personnel. Donor selection has transitioned from paid donation and obligatory donation to voluntary donation with fixed volunteer groups, as the latter mode of donation provides the lowest risks. Donations are currently screened for syphilis, hepatitis C virus, HIV, and hepatitis B virus (HBV). Units, previously typed only for ABO, are now routinely tested for both ABO and Rh(D). Innovations in testing technologies and methods
Terry, M A; Ousley, P J
Current methods of screening donor eyes for corneal transplantation are not always effective in excluding corneas with abnormal topography. We used the Orbscan to determine whether corneal-thickness maps could be used as a technique for donor tissue screening. Forty eye-bank eyes were measured with the Orbscan, and a corneal-thickness map was generated. Average central pachymetry measurements from each map were compared with the thinnest midperipheral thickness reading. Two eyes from a donor who had photorefractive keratectomy (PRK) and two eyes from a donor with keratoconus were then compared with the normal donor eye results. The average difference between the thinnest midperipheral pachymetry and the central pachymetry in the control group was 0.040 +/- 0.026 mm. The eyes from the donor with PRK showed larger disparities between the central and midperipheral thicknesses because of the thinned central cornea, with differences of 0.154 mm in the right eye and 0.106 mm in the left eye. The eyes from the donor with keratoconus had midperipheral corneas that were thinner than the center, indicating eccentric, ectatic cones. The differences in thickness between the center and midperiphery in the eyes from the donor with PRK and the donor with keratoconus differed from the control group by >2 SD. Diseases or surgery that affect the relationship between the central and midperipheral corneal thickness may be screened through Orbscan pachymetry mapping with comparison with a normal range.
Assal, A; Pelletier, B; David, B; Tiberghien, P
In May 2007, the French Blood Service (Etablissement français du sang, EFS) introduced systematic screening of at-risk blood donors for anti-Trypanosoma cruzi antibodies. This concerned donors originating from an endemic area, donors with mothers originating from such an area and individuals who had lived in or travelled to endemic areas, whatever the length of their stay. Five samples out of 163,740 were positive, all from individuals originating from an endemic area. One thousand three hundred seventy-four blood donations were considered as equivocal because they had discordant results on the two Elisa tests used in screening. The authors discuss difficulties presented by routine screening of travellers and residents as well as the advantages and drawbacks of the strategy used. They present arguments in favour of its simplification.
Grabarczyk, Piotr; Kopacz, Aneta; Sulkowska, Ewa; Kubicka-Russel, Dorota; Mikulska, Maria; Brojer, Ewa; Łętowska, Magdalena
Blood donor screening of viral markers in Poland is based on serologic testing for anti-HCV, HBsAg, anti-HIV1/2 (chemiluminescence tests) and on nucleic acid testing (NAT) for RNA HCV, RNA HIV-1 and DNA HBV performed in minipools of 6 with real-time PCR (MPX 2.0 test on cobas s201) or with TMA in individual donations (Ultrio Plus or Ultrio Elite). Donors of plasma for anti-D and anti-HBs production are tested for parvovirus B19 DNA. Before implementation tests and equipment are evaluated at the Institute of Hematology and Transfusion Medicine (IHTM). The last 20 years witnessed a decreasing trend for HBsAg in both first time and repeat donors (1%-0.3% and 0.1%-0.02% respectively). Prevalence of anti-HCV repeat reactive results was stable and oscillated around 0.8% for first time donors and 0.2% for repeat donors. Elevated prevalence of seropositive HIV infected donors was recently observed (7.5-9 cases/100,000 donors). Since respective molecular markers implementation HCV RNA was detected on average in 1/119,235 seronegative donations, HIV RNA in 1/783,821 and HBV DNA in 1/61,047. HBV NAT yields were mostly occult hepatitis B (1/80,248); window period cases were less frequent (1/255,146). The efficiency of HBV DNA detection depends on the sensitivity of the HBV DNA screening system.
Niederwieser, D; Gentilini, C; Hegenbart, U; Lange, T; Moosmann, P; Pönisch, W; Al-Ali, H; Raida, M; Ljungman, P; Tyndall, A; Urbano-Ispizua, A; Lazarus, H M; Gratwohl, A
With increasing donor age, the potential of transmitting diseases from donor to recipient reaches new dimensions. Potentially transmittable diseases from donors include infections, congenital disorders, and acquired illnesses like autoimmune diseases or malignancies of hematological or nonhematological origin. While established nonmalignant or malignant diseases might be easy to discover, early-stage hematological diseases like CML, light-chain multiple myelomas, aleukemic leukemias, occult myelodysplastic syndromes and other malignant and nonmalignant diseases might not be detectable by routine screening but only by invasive, new and/or expensive diagnostic tests. In the following article, we propose recommendations for donor work-up, taking into consideration the age of the donors. In contrast to blood transfusions, stem cells from donors with abnormal findings might still be acceptable for HCT, when no other options are available and life expectancy is limited. This issue is discussed in detail in relation to the available donor and stem cell source. Finally, the recommendations presented here aim at harmonized worldwide work-up for donors to insure high standard quality.
Huang, Robert C; Fishman, Jay A
Transmission of infection to recipients of solid organs is uncommon but well documented. Improved technologies for the diagnosis of infectious diseases suggest possible changes to paradigms used in the screening of organ donors to prevent disease transmission with transplantation. Available microbiologic assays, including molecular tests, are generally designed for use as diagnostic tools in individuals believed to have a specific infection based on clinical or epidemiological criteria. By contrast, these assays often lack the performance characteristics required for screening of deceased organ donors. This challenge is apparent with the analysis of assays for human T-cell lymphotropic virus-I and -II in low-risk populations. Changing epidemiologic patterns associated with the spread of novel pathogens or altered patterns of immigration will necessitate flexibility in the "list" of potential pathogens. Individual benefits from transplantation generally outweigh the risk of transmission of infection. However, this favorable experience will not obviate the need to continuously improve screening practices.
Rosen, Amanda; Ison, Michael G
Living organ donor candidates are screened for medical and psychosocial contraindications to donation. One important goal of this process is to prevent donor-derived infectious diseases transmissions. These transmissions are exceptionally rare, but have the potential to cause significant morbidity and mortality. The Organ Procurement and Transplantation Network now requires each recovery hospital to develop a protocol for evaluating living donors for tuberculosis and other geographically-defined endemic pathogens, including Trypanosoma cruzi (the causative pathogen of Chagas' disease), Strongyloides stercoralis, and West Nile Virus (WNV), in addition to universal screening for blood-borne pathogens. Enhanced screening requirements were developed in response to the changing epidemiology and endemicity of these diseases, as well as recent case reports of donor-derived disease transmission. Living organ donor disease screening presents a number of unique challenges to clinicians and policy-makers, including deciding which donors to test, which testing modality to use, when to test, and appropriate interpretation of results. This review will analyze the epidemiology of T. cruzi, S. stercoralis, and WNV, the assays available for screening for these diseases, and the subsequent impact on the living organ donor process . This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
...The Food and Drug Administration (FDA) is announcing the availability of a draft document entitled ``Guidance for Industry: Use of Donor Screening Tests to Test Donors of Human Cells, Tissues, and Cellular and Tissue-Based Products (HCT/Ps) for Infection with Treponema pallidum (Syphilis),'' dated October 2013. The draft guidance document provides establishments that make donor eligibility......
Cai, Li-Na; Chen, Bao-An
With increasing application of blood transfusion, the research of side-effects such as transfusion-transmitted infections (TTIs) became more and more important. Up to the 90's of the 20th century, the first blood donor screening for pathogens transfected from blood transfusion entirely depended on serological test. At this time, the detection of virus were performed mainly by using method of detecting antibody, except hepatitis B virus (HBV) can be detected by hepatitis B surface antigen (HBsAg). Now, the molecular technologies, such as the polymerase chain reaction (PCR), have been used in clinic. These technologic methods can provide capability of detection for blood donor screening and reduced possibility of infection from blood transfusion. This review summarises the development of nucleic acid amplification technology and describes its current state.
Schwartz, B S; Paster, M; Ison, M G; Chin-Hong, P V
Donor-derived Trypanosoma cruzi infection in solid organ transplant recipients is associated with significant morbidity and mortality. Little is known about T. cruzi screening practices among U.S. organ procurement organizations (OPOs). We distributed a questionnaire to all U.S. OPO directors, requesting data on T. cruzi screening strategies, laboratory methods, number of donors screened, disposition of organs from positive donors and attitudes toward screening. Fifty-eight (100%) U.S. OPOs responded to the survey. Donor screening began in 2002 and is presently performed by 11 (19%) OPOs. Among screening OPOs, four screen all donors and seven use a risk-based strategy. Three different T. cruzi serology tests are used for donor screening. During 2008, 9/993 (0.9%) donors screened positive by a T. cruzi screening test, 6/9 (66%) had confirmatory tests performed and 4/6 (66%) had positive confirmatory tests. These results led to the nonuse of five donors and 17 organs. Five organs from three seropositive donors were transplanted in 2008 without recognized disease transmission. Variability of T. cruzi donor screening strategies, laboratory methods and disposition of organs from positive donors currently exists. Further research is needed to identify the risk of donor-derived T. cruzi infections to help inform the best screening strategy.
Dondorp, W; De Wert, G; Pennings, G; Shenfield, F; Devroey, P; Tarlatzis, B; Barri, P; Diedrich, K; Eichenlaub-Ritter, U; Tüttelmann, F; Provoost, V
This Task Force document explores the ethical issues involved in the debate about the scope of genetic screening of gamete donors. Calls for expanded donor screening arise against the background of both occasional findings of serious but rare genetic conditions in donors or donor offspring that were not detected through present screening procedures and the advent of new genomic technologies promising affordable testing of donors for a wide range of conditions. Ethical principles require that all stakeholders' interests are taken into account, including those of candidate donors. The message of the profession should be that avoiding all risks is impossible and that testing should remain proportional.
Garcia, M N; Woc-Colburn, L; Rossmann, S N; Townsend, R L; Stramer, S L; Bravo, M; Kamel, H; Beddard, R; Townsend, M; Oldham, R; Bottazzi, M E; Hotez, P J; Murray, K O
Chagas disease is an important emerging disease in Texas that results in cardiomyopathy in about 30% of those infected with the parasite Trypanosoma cruzi. Between the years 2008 and 2012, about 1/6500 blood donors were T. cruzi antibody-confirmed positive. We found older persons and minority populations, particularly Hispanic, at highest risk for screening positive for T. cruzi antibodies during routine blood donation. Zip code analysis determined that T. cruzi is associated with poverty. Chagas disease has a significant disease burden and is a cause of substantial economic losses in Texas.
Reine, Nyssa J
In recent years, blood-component therapy has become more accessible in veterinary practice. As with human medicine, care must be taken to minimize the risk of disease transmission from donor to recipient. Determining the appropriate diseases to screen for is complicated by regional variations in disease incidence, the existence of chronic carrier states for some diseases, the difficulty in screening-test selection, and testing cost. The feline diseases considered include retroviral infections, feline coronaviruses, ehrlichiosis (Ehrlichia canis-like), anaplasmosis (Anaplasma phagocytophilum), neorickettsiosis (Neorickettsia risticii), hemoplasmosis (Mycoplasma hemofelis and M. hemominutum, previously feline hemobartonellosis), and cytauxzoonosis (Cytauxzoon felis). The canine diseases considered in this paper include babesiosis (Babesia canis and B. gibsonii,) ehrlichiosis (E. canis and E. ewingii), anaplasmosis (A. phagocytophilum), neorickettsiosis (N. risticii var. atypicalis), leishmaniasis (Leishmania donovani complex), brucellosis (Brucella canis), hemoplasmosis (M. hemocanis, previously canine hemobartonellosis), and bartonellosis (Bartonella vinsonii).
Belardinelli, A; Benni, M; Tazzari, P L; Pagliaro, P
The haemoglobin level of prospective blood donors is usually performed on blood obtained by from the finger pulp by fingerstick with a lancet and filling a capillary tube with a sample. New noninvasive methods are now available for rapid, noninvasive predonation haemoglobin screening. Prospective blood donors at our blood centre were tested, in two different trials, as follows: by the NBM 200 (OrSense) test (n = 445 donors) and by the Pronto-7 (Masimo) test (n = 463 donors). The haemoglobin values of each trial and the haemoglobin of finger pulp blood obtained by fingerstick with a lancet (HemoCue) were compared with the haemoglobin values obtained from a venous sample on a Cell Counter (Beckman Coulter). Comparison of Beckman Coulter Cell Counter and OrSense and results showed a bias of 0.29 g/dl, the standard deviation of the differences (SDD) of 0.98 and 95% limits of agreement from -1.64 to 2.21, using Bland and Altman statistical methodology. Comparison of Masimo and Beckman Coulter Cell Counter results showed a bias of -0.53 g/dl, SDD of 1.04 and 95% limits of agreement from -2.57 to 1.51. Cumulative analysis of all 908 donors, as tested by the usual fingerstick test showed a bias of 0.83 g/dl, SDD of 0.70 and 95% limits of agreement from -0.54 to 2.20 compared with the Coulter Cell Counter. Compared with the Coulter Counter, the specificity of the methods was 99.5% for fingerstick, 97% for OrSense and 83% for Massimo, and the sensitivity was 99, 98 and 93%, respectively. Analysis of finger pulp blood by either direct sampling by fingerstick and Hemocue, or by noninvasive haemoglobin tests does not replicate the results of cell counter analysis of venous samples. Compared with fingerstick, noninvasive haemoglobin tests eliminate pain and reduce stress, but have a lower level of specificity and sensitivity. © 2013 International Society of Blood Transfusion.
Pérez, M M; Marina, S; Egozcue, J
Cytogenetic studies were carried out in 100 potential semen donors for artificial insemination (AI) before they underwent the routine procedures for acceptance or rejection into the programme, namely medical history, physical examination and blood and semen analyses. Results were only compared at the end of the study. In 80 cases, the karyotype was normal; 12 males showed polymorphic chromosome variants; seven had pericentric inversions of heterochromatic regions; one had a short inversion of chromosome 2; and in one case centromere fragility was observed. Six of the 12 males with normal variants were accepted into the programme and four of them had fathered from one to 13 normal children at the end of the study; the other six had been rejected, four of them because of abnormal seminograms, and another two because the motility control of the frozen semen was negative. Of the seven males with pericentric inversions, one dropped out of the programme; four were accepted and three of them had produced from two to five normal children at the end of the study; two had been rejected due to abnormal seminograms. The individual with centromere fragility was accepted and had produced four normal children at the end of the series. Our conclusion is that although cytogenetic studies of potential donors for AI would be desirable, routine screening for chromosome anomalies is not justified at present.
Kwan, Candice K; Al-Samarrai, Teeb; Smith, Lou C; Sabharwal, Charulata J; Valente, Kim A; Torian, Lucia V; McMurdo, Lisa M; Shepard, Colin W; Brooks, John T; Kuehnert, Matthew J
Our survey of kidney and liver transplant centers in New York State found a wide variation among transplant centers in evaluation and screening for HIV risk and infection among prospective living donors. Survey results underscore the need to standardize practices. A recent transmission of human immunodeficiency virus (HIV) from a living donor to a kidney recipient revealed a possible limitation in existing screening protocols for HIV infection in living donors. We surveyed kidney and liver transplant centers (N = 18) in New York State to assess HIV screening protocols for living donors. Although most transplant centers evaluated HIV risk behaviors in living donors, evaluation practices varied widely, as did the extent of HIV testing and prevention counseling. All centers screened living donors for serologic evidence of HIV infection, either during initial evaluation or ≥1 month before surgery; however, only 50% of transplant centers repeated HIV testing within 14 days before surgery for all donors or donors with specific risk behaviors. Forty-four percent of transplant centers used HIV nucleic acid testing (NAT) to screen either all donors or donors with recognized risk behaviors, and 55% never performed HIV NAT. Results suggest the need to standardize evaluation of HIV risk behaviors and prevention counseling in New York State to prevent acquisition of HIV by prospective living organ donors, and to conduct HIV antibody testing and NAT as close to the time of donation as possible to prevent HIV transmission to recipients.
...) REGULATIONS UNDER CERTAIN OTHER ACTS ADMINISTERED BY THE FOOD AND DRUG ADMINISTRATION HUMAN CELLS, TISSUES..., you must screen a donor of cells or tissue by reviewing the donor's relevant medical records for: (1...) Communicable disease risks associated with xenotransplantation. (b) Donors of viable, leukocyte-rich cells...
...) REGULATIONS UNDER CERTAIN OTHER ACTS ADMINISTERED BY THE FOOD AND DRUG ADMINISTRATION HUMAN CELLS, TISSUES..., you must screen a donor of cells or tissue by reviewing the donor's relevant medical records for: (1...) Communicable disease risks associated with xenotransplantation. (b) Donors of viable, leukocyte-rich cells...
Moussa, Hajer; Ghommen, Néjiba; Romdhane, Houda; Abdelkefi, Saadia; Chakroun, Taher; Houissa, Batoul; Jemni, Saloua Yacoub
Background The (C)ces haplotype, mainly found in black individuals, contains two altered genes: a hybrid RHD-CE-Ds gene segregated with a ces allele of RHCE with two single nucleotide polymorphisms, c. 733C>G (p.Leu245Val) in exon 5 and c. 1006G>T (Gly336Cys) in exon 7. This haplotype could be responsible for false positive genotyping results in RhD-negative individuals and at a homozygous level lead to the loss of a high incidence antigen RH34. The aim of this study was to screen for the (C)ces haplotype in Tunisian blood donors, given its clinico-biological importance. Material and methods Blood samples were randomly collected from blood donors in the blood transfusion centre of Sousse (Tunisia). A total of 356 RhD-positive and 44 RhD-negative samples were tested for the (C)ces haplotype using two allele-specific primer polymerase chain reactions that detect c. 733C>G (p.Leu245Val) and c. 1006G>T (p. Gly336Cys) substitutions in exon 5 and 7 of the RHCE gene. In addition, the presence of the D-CE hybrid exon 3 was evaluated using a sequence-specific primer polymerase chain reaction. Results Among the 400 individuals only five exhibited the (C)ces haplotype in heterozygosity, for a frequency of 0.625%. On the basis of the allele-specific primer polymerase chain reaction results, the difference in (C)ces haplotype frequency was not statistically significant between RhD-positive and RhD-negative blood donors. Discussion These data showed the presence of the (C)ces haplotype at a low frequency (0.625%) compared to that among Africans in whom it is common. Nevertheless, the presence of RHD-CE-Ds in Tunisians, even at a lower frequency, should be considered in the development of a molecular genotyping strategy for Rh genes, to ensure better management of the prevention of alloimmunisation. PMID:24333089
Suryaprasad, A; Basavaraju, S V; Hocevar, S N; Theodoropoulos, N; Zuckerman, R A; Hayden, T; Forbi, J C; Pegues, D; Levine, M; Martin, S I; Kuehnert, M J; Blumberg, E A
Nucleic acid testing (NAT) for hepatitis C virus (HCV) is recommended for screening of organ donors, yet not all donor infections may be detected. We describe three US clusters of HCV transmission from donors at increased risk for HCV infection. Donor's and recipients' medical records were reviewed. Newly infected recipients were interviewed. Donor-derived HCV infection was considered when infection was newly detected after transplantation in recipients of organs from increased risk donors. Stored donor sera and tissue samples were tested for HCV RNA with high-sensitivity quantitative PCR. Posttransplant and pretransplant recipient sera were tested for HCV RNA. Quasispecies analysis of hypervariable region-1 was used to establish genetic relatedness of recipient HCV variants. Each donor had evidence of injection drug use preceding death. Of 12 recipients, 8 were HCV-infected-6 were newly diagnosed posttransplant. HCV RNA was retrospectively detected in stored samples from donor immunologic tissue collected at organ procurement. Phylogenetic analysis showed two clusters of closely related HCV variants from recipients. These investigations identified the first known HCV transmissions from increased risk organ donors with negative NAT screening, indicating very recent donor infection. Recipient informed consent and posttransplant screening for blood-borne pathogens are essential when considering increased risk donors.
O'Brien, S F; Ram, S S; Yi, Q-L; Goldman, M
Predonation screening questions about sexual risk factors should provide an extra layer of safety from recently acquired infections that may be too early to be detected by testing. Donors are required to read a definition of sex as it applies to predonation screening questions each time they come to donate, but how well donors apply such definitions has not been evaluated. We aimed to determine how donors define sex when answering screening questions. In total, 1297 whole blood donors were asked in a private interview to select from a list of sexual activities which ones they believed were being asked about in sexual background questions. Donors' definitions were coded as under-inclusive, correct or over-inclusive in relation to the blood services' definition. Qualitative interviews were carried out with 21 donors to understand reasoning behind definitions. Most donors had an over-inclusive definition (58.7%) or the correct definition (31.9%). Of the 9.4% of donors who had an under-inclusive definition, 95% included both vaginal and anal sex, but not oral sex. About 9% in each group were first-time donors (P > 0.05) who had never read the definition. The qualitative interviews indicated that donors reason their definition based on their own concept of transmissible disease risk. Donors apply a range of definitions of sex when answering questions about their sexual background. This may be due to different concepts of risk activities, and required reading of the definition has little impact.
Kitchen, A D; Hewitt, P E
We report two instances of human immunodeficiency virus (HIV) serological screening reactivity in blood donations which were subsequently determined to be due to donor participation in HIV vaccine trials. Both donations were screen reactive with atypical patterns on confirmation; no definitive conclusion could be given for either donor. Subsequent questioning identified that both donors had been involved in HIV vaccine trials. In both cases the screening and confirmation identified the presence of HIV antibodies, although vaccine induced. While clinical trials of vaccines are important, the implications of some need careful consideration if they are not to adversely impact other areas of healthcare.
Marcusa, Daniel P; Schaubel, Douglas E; Woodside, Kenneth J; Sung, Randall S
We report our experience with metabolic syndrome screening for obese living kidney donor candidates to mitigate the long-term risk of CKD. We retrospectively reviewed 814 obese (BMI≥30) and 993 nonobese living kidney donor evaluations over 12 years. Using logistic regression, we explored interactions between social/clinical variables and candidate acceptance before and after policy implementation. Obese donor candidate acceptance decreased after metabolic syndrome screening began (56.3%, 46.3%, p < 0.01), while nonobese candidate acceptance remained similar (59.6%, 59.2%, p = 0.59). Adjusting for age, gender, race, BMI, and number of prior evaluations, acceptance of obese candidates decreased significantly more than nonobese (p = 0.025). In candidates without metabolic syndrome, there was no significant change in how age, sex, race, or BMI affected a donor candidate's probability of acceptance. Metabolic syndrome screening is a simple stratification tool for centers with liberal absolute BMI cut-offs to exclude potentially higher-risk obese candidates. Our center screens obese living kidney donor candidates for metabolic syndrome to maximize donation opportunities while excluding a potentially higher-risk population of mild and moderately obese donor candidates. Retrospective review of 814 obese (BMI≥30) and 993 nonobese living kidney donor evaluations over 12 years found this policy decreased donor acceptance rate without introducing new age, gender or racial biases. Copyright © 2017 Elsevier Inc. All rights reserved.
Holt, P D; Tandy, N P; Anstee, D J
Altogether 29 745 English blood donors were screened for IgA deficiency by double diffusion analysis; 57 had apparent absence of IgA, a frequency of 1:522. Further examination by the more sensitive haemagglutination inhibition assay revealed 34 samples having no detectable IgA, a frequency of 1:875. All donors negative by double diffusion analysis were tested for the presence of antibodies to IgA. Six class specific anti IgA antibodies and four anti IgA antibodies of limited specificity were detected. Three of these had the specificity anti alpha2 and one anti A2m(2). The 34 IgA deficient donors detected provide a source of IgA deficient blood for transfusion to patients with anti IgA antibodies. PMID:304071
Mattern, R M; Cavanagh, H D
A review of the literature on transfusion-transmitted infectious diseases shows that antibody to hepatitis B core antigen (anti-HBc) is not presently viewed as helpful for hepatitis C or hepatitis non-ABC screening of blood donors. Its utility as a screen for hepatitis B or human immunodeficiency virus-1 (HIV-1) is controversial among experts. We compare relevant aspects of the screening of blood donations and the screening of cornea transplant donors to assess implications for the screening of donor corneas. We conclude that there is not sufficient evidence to warrant introducing anti-HBc as a routine screening test for cornea donors.
Levi, M E; Kumar, D; Green, M; Ison, M G; Kaul, D; Michaels, M G; Morris, M I; Schwartz, B S; Echenique, I A; Blumberg, E A
In February 2013, the Organ Procurement and Transplantation Network mandated that transplant centers perform screening of living kidney donors prior to transplantation for Strongyloides, Trypanosoma cruzi and West Nile virus (WNV) infection if the donor is from an endemic area. However, specific guidelines for screening were not provided, such as the optimal testing modalities, timing of screening prior to donation and the appropriate selection of donors. In this regard, the American Society of Transplantation Infectious Diseases Community of Practice, together with disease-specific experts, has developed this viewpoint document to provide guidance for the testing of live donors for Strongyloides, T. cruzi and WNV infection, specifically identifying at-risk populations and testing algorithms, including advantages, limitations and interpretation of results.
Gilner, Jennifer B.; Hernandez, Jose; Kurtzberg, Joanne; Heine, R. Phillips
To assess patterns of Chagas disease, we reviewed results of screening umbilical cord blood from a US public cord blood bank during 2007–2014. Nineteen maternal donors tested positive for Trypanosoma cruzi parasites (0.04%). Because perinatal transmission of Chagas disease is associated with substantial illness, targeted prenatal programs should screen for this disease. PMID:27433974
Nett, R J; Kuehnert, M J; Ison, M G; Orlowski, J P; Fischer, M; Staples, J E
The first cases of West Nile virus (WNV) transmitted through solid organ transplantation (SOT) were identified in 2002. Subsequently, 5 additional clusters have been reported to public health officials in the United States. Based upon a limited number of known cases, patients who acquire WNV from infected donor organs might be at higher risk for severe neurologic disease and death, compared with patients infected through mosquito bites. In response, some organ procurement organizations (OPOs) have instituted pre-transplant screening of organ donors for WNV infection. We evaluated the current practices, concerns, and challenges related to screening organ donors for WNV in the United States by reviewing the relevant medical literature and interviewing key stakeholders. Screening organ donors for WNV is not required by national policy. In 2008, 11 (19%) of 58 OPOs performed WNV screening using nucleic acid amplification testing (NAT). These OPOs differ in their screening strategies, NAT performed, and logistical challenges. Concerns of delays in receiving NAT results before transplant and potential false-positive results leading to organ wasting are limitations to more widespread screening. Furthermore, it is unknown if WNV screening practices decrease SOT-related morbidity and mortality, or if screening is cost-effective. Additional data are needed to assess and improve transplant outcomes related to WNV.
Kitchen, A D; Newham, J A
Whilst some of the assays used for serological screening of post-mortem blood samples from deceased tissue donors in some countries have been specifically validated by the manufacturer for this purpose, a significant number of those currently in use globally have not. Although specificity has previously been considered a problem in the screening of such samples, we believe that ensuring sensitivity is more important. The aim of this study was to validate a broader range of assays for the screening of post-mortem blood samples from deceased tissue donors. Six microplate immunoassays currently in use within National Health Service Blood and Transplant (NHSBT) for the screening of blood, tissue and stem cell donations were included. Representative samples from confirmed positive donors were titrated in screen negative post-mortem samples in parallel with normal pooled negative serum to determine if there was any inhibition with the post-mortem samples. There were no significant differences seen (P < 0.005) between the dilution curves obtained for the positive samples diluted in post-mortem samples and normal pooled sera. Although small numbers of samples were studied, it can be surmised that the post-mortem blood samples from deceased tissue donors, collected according to United Kingdom guidelines, are a suitable substrate for the assays evaluated. No diminution of reactivity was seen when dilution with sera from deceased donors was compared to dilution using pooled serum from live donors. In the absence of genuine low titre positive post-mortem samples, the use of samples spiked with various levels of target material provides a means of qualifying serological screening assays used by NHSBT for the screening of post-mortem blood samples from deceased tissue donors.
In't Veld, Peter; Lievens, Dirk; De Grijse, Joeri; Ling, Zhidong; Van der Auwera, Bart; Pipeleers-Marichal, Miriam; Gorus, Frans; Pipeleers, Daniel
Antibodies against islet cell antigens are used as predictive markers of type 1 diabetes, but it is unknown whether they reflect an ongoing autoimmune process in islet tissue. We investigated whether organs from adult donors that are positive for autoantibodies (aAbs) against islet cell antigens exhibit insulitis and/or a reduced beta-cell mass. Serum from 1,507 organ donors (age 25-60 years) was analyzed for islet cell antibodies (ICAs), glutamate decarboxylase aAbs (GADAs), insulinoma-associated protein 2 aAbs (IA-2As), and insulin aAbs. Tissue from the 62 aAb+ donors (4.1%) and from matched controls was examined for the presence of insulitis and for the relative area of insulin+ cells. Insulitis was detected in two cases; it was found in 3 and 9% of the islets and consisted of CD3+/CD8+ T-cells and CD68+ macrophages; in one case, it was associated with insulin+ cells that expressed the proliferation marker Ki67. Both subjects belonged to the subgroup of three donors with positivity for ICA, GADA, and IA-2-Ab and for the susceptible HLA-DQ genotype. Comparison of relative beta-cell area in aAb+ and aAb- donors did not show a significant difference. Insulitis was found in two of the three cases that presented at least three aAbs but in none of the other 59 antibody+ subjects or 62 matched controls. It was only detected in <10% of the islets, some of which presented signs of beta-cell proliferation. No decrease in beta-cell mass was detected in cases with insulitis or in the group of antibody+ subjects.
Moore, D R; Feurer, I D; Zavala, E Y; Shaffer, D; Karp, S; Hoy, H; Moore, D E
Most centers utilize phone or written surveys to screen candidates who self-refer to be living kidney donors. To increase efficiency and reduce resource utilization, we developed a web-based application to screen kidney donor candidates. The aim of this study was to evaluate the use of this web-based application. Method and time of referral were tabulated and descriptive statistics summarized demographic characteristics. Time series analyses evaluated use over time. Between January 1, 2011 and March 31, 2012, 1200 candidates self-referred to be living kidney donors at our center. Eight hundred one candidates (67%) completed the web-based survey and 399 (33%) completed a phone survey. Thirty-nine percent of donors accessed the application on nights and weekends. Postimplementation of the web-based application, there was a statistically significant increase (p < 0.001) in the number of self-referrals via the web-based application as opposed to telephone contact. Also, there was a significant increase (p = 0.025) in the total number of self-referrals post-implementation from 61 to 116 per month. An interactive web-based application is an effective strategy for the initial screening of donor candidates. The web-based application increased the ability to interface with donors, process them efficiently and ultimately increased donor self-referral at our center.
Miédougé, M; Rostaing, L; Mansuy, J M; Sandres-Sauné, K; Boudet, F; Izopet, J
In order to determine the impact of screening potential organ donors for hepatitis B virus DNA using a standardized test, the serum of 145 donor candidates was tested. All of the candidates were negative for hepatitis B virus DNA, but the status of one donor was doubtful for hepatitis B virus surface antigen and seven donors tested positive for hepatitis B virus core antibody without hepatitis B virus surface antigen. Nine transplant recipients tested positive for hepatitis B virus surface antibody; they were given kidneys from the donor with a doubtful hepatitis B virus surface antigen result and from four of the seven donors who tested positive for hepatitis B core antibody. Follow-up revealed no case of hepatitis B transmission. In this study, screening for hepatitis B virus DNA was useful and did not lead to donor organ shortage. Patients with hepatitis B virus surface antibodies can safely be given kidneys from donors who are positive for hepatitis B core antibody but negative for hepatitis B virus DNA.
Solves, P; Mirabet, V; Alvarez, M; Vila, E; Quiles, F; Villalba, J V; Montoro, J A; Soler, M A; Roig, R J
Hepatitis B virus (HBV) has been transmitted by tissue transplantation. In order to reduce the risk of HBV transmission, testing for antibody to HBV core antigen (anti-HBc) is used in addition to testing for hepatitis B surface antigen (HBsAg) in many blood centers and tissue banks. We retrospectively analyzed the results of HBV assays in tissue donors. All tissue donors were tested for HBsAg and anti-HBc. All anti-HBc positive sera were tested for the antibody to HBsAg (anti-HBs). From July 2006, an HBV nucleic acid testing (NAT) assay was also performed. A total of 6855 tissue donors from January 1999 till July 2007 were tested for HBV assays: 4756 women and 2099 men. Positive HBsAg was found in 23 (0.36%) living donors, while no multiorgan or cord blood (CB) donor was found to be positive for HBsAg. Positive anti-HBc was found in 80 multiorgan donors (12.94%), 599 living donors (17.84%), and 103 CB donors (3.57%) (P<0.005), while isolated anti-HBc was found in 12 multiorgan (1.94%), in 126 living tissue donors (3.75%), and in 8 CB donors (0.28%). A total of 1310 donors were analyzed for single-sample DNA HBV NAT assay. We consider that anti-HBc and NAT assays must both still be performed in addition to HBsAg assay for HBV screening in tissue donors. All these tests will be useful in order to define an algorithm for safe and efficient management of the tissue bank.
Niazi, Saifullah Khan; Bhatti, Farhat Abbas; Salamat, Nuzhat; Ghani, Eijaz; Tayyab, Muhammad
The Armed Forces Institute of Transfusion located in Rawalpindi, Northern Pakistan, acts as a regional blood center with more than 50,000 donations collected annually. Nucleic acid amplification testing (NAT) was introduced in our institution in September 2012 for screening all seronegative blood donors. The study was conducted from September 21, 2012, to September 20, 2013. Samples from the seronegative donors were run on cobas s 201 platform (Roche) in pools of six. Reactive donors were followed up for further confirmatory testing to rule out false-positive results. Viral load estimation was done for all NAT-reactive donors. After serologic screening of 56,772 blood donors, 2334 were found to be reactive; 719 (1.27%) were reactive for hepatitis B surface antigen, 1046 (1.84%) for antibody to hepatitis C virus (anti-HCV), 12 (0.02%) for antibody to human immunodeficiency virus, and 557 (0.98%) for syphilis antibodies. A total of 27 NAT-reactive donors were confirmed after testing 54,438 seronegative donors, with an overall NAT yield of one in 2016 donors: 23 for hepatitis B virus (HBV) DNA (HBV NAT yield, 1:2367) and four for HCV RNA (HCV NAT yield, 1:13,609). The residual risk after NAT implementation, calculated for the first-time blood donors, was 62.5 and 4.4 per million donors for HBV and HCV, respectively. NAT has improved the safety of blood products at our transfusion institution. Confirmation of NAT results must always be done either on follow-up samples or on samples from the retrieved frozen plasma bag. © 2015 AABB.
Fishman, Jay A; Greenwald, Melissa A; Grossi, Paolo A
Transmission of infection via transplantation of allografts including solid organs, eyes, and tissues are uncommon but potentially life-threatening events. Donor-derived infections have been documented following organ, tissue, and ocular transplants. Each year, more than 70 000 organs, 100 000 corneas, and 2 million human tissue allografts are implanted worldwide. Single donors may provide allografts for >100 organ and tissue recipients; each allograft carries some, largely unquantifiable, risk of disease transmission. Protocols for screening of organ or tissue donors for infectious risk are nonuniform, varying with the type of allograft, national standards, and availability of screening assays. In the absence of routine, active surveillance, coupled with the common failure to recognize or report transmission events, few data are available on the incidence of allograft-associated disease transmission. Research is needed to define the optimal screening assays and the transmissibility of infection with allografts. Approaches are reviewed that may contribute to safety in allograft transplantation.
Tynell, Elsa; Norda, Rut; Ekermo, Bengt; Sanner, Margareta; Andersson, Sören; Björkman, Anders
Screening of blood donors for markers of transfusion-transmissible infectious agents leads to a varying number of false-reactive test results and sometimes thereby temporary or permanent deferral of donors and also to loss of collected units. Data on false-reactive screening test results in 2002 and 2003 were collected from 19 blood centers in Sweden. A questionnaire was sent to donors deferred because of false-reactive screening test results to investigate their perception of the information and their reaction to the deferral. Testing of 21,189 samples from new donors and 423,543 donations from regular and/or repeat donors produced 1,059 false-reactive test results, mostly from hepatitis C virus antibody testing, and 299 deferrals. Six different human immunodeficiency virus tests led to between 0.02 and 0.2 percent false-reactive results. The deferral rate varied considerably between different counties. Of 204 deferred donors contacted, 180 (88%) answered the questionnaire. More than 80 percent were worried about their test results and worry was more common among those who did not feel sufficiently informed. The results imply that there is a need for a more standardized approach to the screening of blood donors and donations with the aim of minimizing the number of false-reactive screening test results. They also emphasize the importance of appropriate information and support to deferred donors.
Hâţu, Giorgiana; Brumboiu, Maria Irina; Gorgan, Iuliana Nela; Bocşan, I S
Blood services are required to provide the safest possible products, but no transfusion can ever be totally free of the risk of transfusion transmissible infections (TTI). Over the past decade, the risk of TTI through transfusion has been reduced (e.g. 1 in 300 000 for HBV to 1 in 2 million for HIV). With the introduction in 1999 of sensitive and expensive nucleic acid testing (NAT) technology in some countries, the disease transmission rate and the window period have been significantly reduced, but a remaining concern is the chance that a blood donor will be infected and not detected by such tests. To obtain safe blood and blood components it is important to ensure that the donors are healthy and free from TTI by using a donor selection procedure meticulously made, using a donor questionnaire to assess donor health and safety and for reducing the risk of transmission of infection, in particular for infections for which no suitable screening tests are available. In Romania the prevalence of TTI among donor population is high in comparison with other European Union (EU) countries. This may require significant improvements in the screening process of both donors and donations to minimize the infectious risk.
Barad, David H; Darmon, Sarah K; Kushnir, Vitaly A; Albertini, David F; Gleicher, Norbert
Our objective was to estimate the contribution of preimplantation genetic screening to in vitro fertilization pregnancy outcomes in donor oocyte-recipient cycles. This was a retrospective cross-sectional study of US national data from the Society for Assisted Reproductive Technology Clinic Outcome Reporting System between 2005 and 2013. Society for Assisted Reproductive Technology Clinic Outcome Reporting relies on voluntarily annual reports by more than 90% of US in vitro fertilization centers. We evaluated pregnancy and live birth rates in donor oocyte-recipient cycles after the first embryo transfer with day 5/6 embryos. Statistical models, adjusted for patient and donor ages, number of embryos transferred, race, infertility diagnosis, and cycle year were created to compare live birth rates in 392 preimplantation genetic screening and 20,616 control cycles. Overall, pregnancy and live birth rates were significantly lower in preimplantation genetic screening cycles than in control cycles. Adjusted odds of live birth for preimplantation genetic screening cycles were reduced by 35% (odds ratio, 0.65, 95% confidence interval, 0.53-0.80; P < .001). Preimplantation genetic screening, as practiced in donor oocyte-recipient cycles over the past 9 years, has not been associated with improved odds of live birth or reduction in miscarriage rates. Copyright © 2017 Elsevier Inc. All rights reserved.
Lenhard, M James; Maser, Raelene E; Kolm, Paul; Healy, Michael J; Seshadri, Prakash
The objective was to determine if a free, voluntary diabetes screening program as a part of the blood donation process might be cost-effective. During the first 6 months of the program, 26,415 donors were screened using a single random plasma glucose (RPG) level. All donors were asked to eat before donation. Low-, moderate-, and high-risk groups were formed based on RPG levels (<140, 140-200, and >200 mg/dL). Contact with a telephone questionnaire was made with 139 of 178 (78%) of the persons in the high-risk group with 33 new cases of diabetes diagnosed by the donor's physician and 26 donors indicating that they were not diagnosed with diabetes. Sex- and age-matched donors in the low- and moderate-risk groups were contacted and administered the same questionnaire. The three risk groups were similar, except for body mass index (28.1 ± 5.4 kg/m2 vs. 29.9 ± 5.5 kg/m2 vs. 32.7 ± 5.6 kg/m2 , p < 0.001). The discriminative effectiveness of screening was evaluated by the area under the receiver operating characteristics (AROC) curve. The AROC curve was 0.950 (95% confidence interval, 0.920-0.979) for the identification of diabetes. Using a RPG cutoff of 200 mg/dL, sensitivity was 100%, specificity was 82%, and positive predictive value was 56%. Cost analyses showed that the mean cost to screen, per donor, was less than $1. Cost per case identified was estimated to be less than $500 for a RPG cutoff of 200 mg/dL. Screening during the blood donation process appears to be accurate, convenient, and inexpensive. © 2013 American Association of Blood Banks.
Jimenez, Alexandra; Shaz, Beth H; Kessler, Debra; Bloch, Evan M
Zika virus (ZIKV) is a mosquito-borne flavivirus that is the focus of an ongoing pandemic. ZIKV is notable for its severe neurologic sequelae in babies born to infected mothers. High rates of subclinical infection, as evidenced by the finding of ZIKV RNA in asymptomatic donors, raise concerns of risk to the blood supply. To date, a total of four suspected cases of transfusion-transmitted ZIKV have been reported (all in Brazil), none of which were associated with clinical infection in the transfusion recipients. In 2016, the US Food and Drug Administration issued a guidance mandating national blood donor screening for ZIKV in the United States. Five days after implementation of donor screening at our facility, we encountered a ZIKV-positive donor. We provide a practical approach to donor, recipient, and blood product management in the setting of a positive donor ZIKV result. Such has been informed by the challenges we faced in the workup of a ZIKV-reactive donation and recipient lookback. © 2017 AABB.
Vo, Michelle T.; Bruhn, Roberta; Kaidarova, Zhanna; Custer, Brian S.; Murphy, Edward L.; Bloch, Evan M.
BACKGROUND False-positive infectious transfusion screening results remain a challenge with continued loss of both donors and blood products. We sought to identify associations between donor demographic characteristics (age, race, sex, education, first-time donor status) and testing false positive for viruses during routine blood donation screening. In addition the study assessed the prevalence of high-risk behaviors in false-positive donors. STUDY DESIGN AND METHODS Blood Systems, Inc. donors with allogeneic donations between January 1, 2011, and December 31, 2012, were compared in a case-control study. Those with a false-positive donation for one of four viruses (human immunodeficiency virus [HIV], human T-lymphotropic virus [HTLV], hepatitis B virus [HBV], and hepatitis C virus [HCV]) were included as cases. Those with negative test results were controls. For a subset of cases, infectious risk factors were evaluated. RESULTS Black race and Hispanic ethnicity were associated with HCV and HTLV false-positive results. Male sex and lower education were associated with HCV false positivity, and age 25 to 44 was associated with HTLV false positivity. First-time donors were more likely to be HCV false positive although less likely to be HBV and HTLV false positive. No significant associations between donor demographics and HIV false positivity were observed. A questionnaire for false-positive donors showed low levels of high-risk behaviors. CONCLUSION Demographic associations with HCV and HTLV false-positive results overlap with those of true infection. While true infection is unlikely given current testing algorithms and risk factor evaluation, the findings suggest nonrandom association. Further investigation into biologic mechanisms is warranted. PMID:26509432
da Silva, Michel Alves; de Souza, Renata Andréia Volpe; Carlos, Aline Meneses; Soares, Sheila; Moraes-Souza, Helio; Pereira, Gilberto de Araujo
Objective: Iron deficiency is the most common cause of anemia and one of the main factors in the clinical deferral of blood donors. This fact prompted the current study that aimed to determine the prevalence and etiology of anemia in blood donor candidates and to evaluate the hematological screening technique used for the exclusion of these donors. Methods: This was a prospective study that compared two groups (Anemic and Non-anemic). Initially screening for anemia was performed by manually measuring hemoglobin (Bioclin® Kit); the results were subsequently compared with an automated screening method (Coulter T-890). The etiology was investigated by hemoglobin electrophoresis in alkaline and acid pH, Hb A2 dosage and measurement of the ferritin concentration by immunoagglutination. Differences and associations of interest were analyzed using the Yates and McNemar's Chi-square tests and the Fisher, Mann-Whitney, Wilcoxon and Kruskal-Wallis tests. Results: The deferral rate due to anemia was 4.2%; iron deficiency was identified in 37.5% and beta thalassemia in 9.3% of the excluded candidates. There was a significant discrepancy between the two techniques used to measure hemoglobin with 38.1% of initially deferred donors presenting normal hemoglobin levels by the automated method. Conclusion: The results show a high rate of blood donors being deferred for anemia and confirm that iron deficiency is the most prevalent cause. The discrepancies found by comparing screening methods suggest that hemoglobin and hematocrit levels should be confirmed before deferring a donor due to anemia; this may increase supplies in blood banks. PMID:23125544
Niazi, Saifullah Khan; Bhatti, Farhat Abbas; Salamat, Nuzhat
To determine the seroprevalence of Human T-cell Lymphotropic Virus-1/2 (HTLV-1/2) in blood donors in Northern Pakistan. Descriptive study. Armed Forces Institute of Transfusion, Rawalpindi, from July to August 2013. A total of 2100 blood donors were screened for anti-HTLV-1/2 antibodies during the study period, in a pool of six, on a highly sensitive, Chemiluminiscent Microparticle Immunoassay (CMIA) based system. The screening test-reactive donors were recalled, counseled and interviewed, and a fresh sample was obtained for confirmatory testing. Confirmation was performed using additional immunoassays including Line Immunoassay (LIA); with additional testing for HTLV-1 pvDNAPCR. Frequency and percentages were determined. Four donors (0.19%) were repeatedly screening test-reactive and were subsequently confirmed to be HTLV-1 infected by line immunoassay and HTLV-1 pvDNAPCR. All four donors were male with mean age of 27 ± 6.27 years. Two (50%) of the positive donors gave history of Multiple Sexual Partners (MSP). HTLV-1 seroprevalence in Northern Pakistan blood donors was determined to be 0.19%. Large scale studies, including the cost effectiveness of screening blood donations for anti-HTLV-1/2 in Pakistan, are recommended.
Vollmer, T; Knabbe, C; Dreier, J
Acute primary cytomegalovirus (CMV) infections, which commonly occur asymptomatically among blood donors, represent a significant risk for serious morbidity in immunocompromised patients (a major group of transfusion recipients). We implemented a routine CMV pool screening procedure for plasma for the identification of CMV DNA-positive donors, and we evaluated the sensitivities and performance of different CMV DNA amplification systems. Minipools (MPs) of samples from 18,405 individual donors (54,451 donations) were screened for CMV DNA using the RealStar CMV PCR assay (Altona Diagnostic Technologies), with a minimum detection limit of 11.14 IU/ml. DNA was extracted with a high-volume protocol (4.8 ml, Chemagic Viral 5K kit; PerkinElmer) for blood donor pool screening (MP-nucleic acid testing [NAT]) and with the Nuclisens easyMAG system (0.5 ml; bioMérieux) for individual donation (ID)-NAT. In total, six CMV DNA-positive donors (0.03%) were identified by routine CMV screening, with DNA concentrations ranging from 4.35 × 10(2) to 4.30 × 10(3) IU/ml. Five donors already showed seroconversion and detectable IgA, IgM, and/or IgG antibody titers (IgA(+)/IgM(+)/IgG(-) or IgA(+)/IgM(+)/IgG(+)), and one donor showed no CMV-specific antibodies. Comparison of three commercial assays, i.e., the RealStar CMV PCR kit, the Sentosa SA CMV quantitative PCR kit (Vela Diagnostics), and the CMV R-gene PCR kit (bioMérieux), for MP-NAT and ID-NAT showed comparably good analytical sensitivities, ranging from 10.23 to 11.14 IU/ml (MP-NAT) or from 37.66 to 57.94 IU/ml (ID-NAT). The clinical relevance of transfusion-associated CMV infections requires further investigation, and the evaluated methods present powerful basic tools providing sensitive possibilities for viral testing. The application of CMV MP-NAT facilitated the identification of one donor with a window-phase donation during acute primary CMV infection.
Tyrrell, A; Worrall, E; Que, T N; Bates, I
To compare the cost and effectiveness of Copper Sulphate (CS) and HemoCue (HC) methods for screening blood donors for anaemia. Robust information from developing countries about cost and effectiveness of anaemia screening methods for blood donors is scarce. In such countries there are widespread shortages of blood, so the most cost-effective method should maximise blood supply without compromising donor safety. Economic data (e.g. staff time, equipment and buildings) were collected from direct observation of procedures and purchase data from Hanoi's Central Blood Bank administrative department. A framework for comparing the cost and effectiveness of anaemia screening methods was developed and a cost per effective (i.e. usable and accurate) test was generated for each method. Samples from 100 potential donors from the Hanoi Central Blood Bank (static) and 198 from two mobile units were tested. The mean probability of an ineffective anaemia test was 0·1 (0·05-0·2). The average cost of an HC test was $0·75 (static $0·61 and mobile $0·89) and a CS test was $0·31 (static $0·17 and mobile $0·45). The difference between static and mobile units was predominantly due to transport costs; the difference between the two methods was predominantly due to the HC microcuvettes. In this setting the CS yields greater value for money than the HC method for screening blood donors. The relative cost and effectiveness of CS and HC may be different in places with higher staff turnover, lower test accuracy, higher anaemia prevalence or lower workload than in Vietnam. © 2010 Liverpool School of Tropical Medicine. Transfusion Medicine © 2010 British Blood Transfusion Society.
Simon, Matthew S; Leff, Jared A; Pandya, Ankur; Cushing, Melissa; Shaz, Beth H; Calfee, David P; Schackman, Bruce R; Mushlin, Alvin I
Babesia microti is the leading reported cause of red blood cell (RBC) transfusion-transmitted infection in the United States. Donor screening assays are in development. A decision analytic model estimated the cost-effectiveness of screening strategies for preventing transfusion-transmitted babesiosis (TTB) in a hypothetical cohort of transfusion recipients in Babesia-endemic areas of the United States. Strategies included: 1) no screening; 2) Uniform Donor Health History Questionnaire (UDHQ), "status quo"; 3) recipient risk targeting using donor antibody and polymerase chain reaction (PCR) screening; 4) universal endemic donor antibody screening; and 5) universal endemic donor antibody and PCR screening. Outcome measures were TTB cases averted, costs, quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratios (ICERs; $/QALY). We assumed a societal willingness to pay of $1 million/QALY based on screening for other transfusion-transmitted infections. Compared to no screening, the UDHQ avoids 0.02 TTB cases per 100,000 RBC transfusions at an ICER of $160,000/QALY whereas recipient risk-targeted strategy using antibody/PCR avoids 1.62 TTB cases per 100,000 RBC transfusions at an ICER of $713,000/QALY compared to the UDHQ. Universal endemic antibody screening avoids 3.39 cases at an ICER of $760,000/QALY compared to the recipient risk-targeted strategy. Universal endemic antibody/PCR screening avoids 3.60 cases and has an ICER of $8.8 million/QALY compared to universal endemic antibody screening. Results are sensitive to blood donor Babesia prevalence, TTB transmission probability, screening test costs, risk and severity of TTB complications, and impact of babesiosis diagnosis on donor quality of life. Antibody screening for Babesia in endemic regions is appropriate from an economic perspective based on the societal willingness to pay for preventing infectious threats to blood safety. © 2013 American Association of Blood Banks.
Simon, Matthew S.; Leff, Jared A.; Pandya, Ankur; Cushing, Melissa; Shaz, Beth H.; Calfee, David P.; Schackman, Bruce R.; Mushlin, Alvin I.
Background Babesia microti is the leading reported cause of red blood cell (RBC) transfusion-transmitted infection in the United States (US). Donor screening assays are in development. Study Design and Methods A decision analytic model estimated the cost-effectiveness of screening strategies for preventing transfusion-transmitted babesiosis (TTB) in a hypothetical cohort of transfusion recipients in Babesia-endemic areas of the US. Strategies included: (1) No screening, (2) Uniform Donor Health History Questionnaire (UDHQ), “status quo”, (3) Recipient risk-targeting using donor antibody (Ab) and polymerase chain reaction (PCR) screening, (4) Universal endemic donor Ab screening, (5) Universal endemic donor Ab and PCR screening. Outcome measures were TTB cases averted, costs, quality-adjusted life years (QALYs) and incremental cost-effectiveness ratios ($/QALY). We assumed a societal willingness to pay of $1 million/QALY based on screening for other transfusion-transmitted infections. Results Compared to no screening, the UDHQ avoids 0.02 TTB cases per 100,000 RBC transfusions at an incremental cost effectiveness ratio (ICER) of $160,000/QALY whereas recipient risk-targeted strategy using Ab/PCR avoids 1.62 TTB cases per 100,000 RBC transfusions at an ICER of $713,000/QALY compared to the UDHQ. Universal endemic Ab screening avoids 3.39 cases at an ICER of $760,000/QALY compared to the recipient-risk targeted strategy. Universal endemic Ab/PCR screening avoids 3.60 cases and has an ICER of $8.8 million/QALY compared to universal endemic Ab screening. Results are sensitive to blood donor Babesia prevalence, TTB transmission probability, screening test costs, risk and severity of TTB complications, and impact of babesiosis diagnosis on donor quality of life. Conclusion Antibody screening for Babesia in endemic regions is appropriate from an economic perspective based on the societal willingness to pay for preventing infectious threats to blood safety. PMID
Guan, Huang-Tao; Wan, Zhao; Zhang, Li; Meng, Tian-qing; Xiong, Cheng-liang; Li, Cu-Ling
To determine the reasons for the elimination of student sperm donors after semen analysis, physical examination, and laboratory tests in the Hubei Provincial Human Sperm Bank. Understanding the status of student sperm donors can provide a valid reference for the screening work of sperm banks. The screening data from 3,564 student sperm donors in Hubei Provincial Human Sperm Bank from January 1, 2010-April 30, 2013, were retrospectively analyzed. A total of 733 students (20.57%) qualified for semen analysis in the human sperm bank, whereas 602 students (16.89%) completed the sperm donation procedure. The main reasons for elimination were as follows: unqualified semen parameters (2,748 cases), failed semen extraction (83 cases), sexually transmitted diseases (44 cases), hereditary or chromosomal disorders (44 cases), and hepatitis B infection (25 cases). Education level and temperature/climate possibly affect semen quality. Unqualified semen parameters were the main reason for elimination among student sperm donors. Human sperm banks should promote reproductive health knowledge and information on improving semen quality among students when promoting sperm donation.
Baleriola, C; Tu, E; Johal, H; Gillis, J; Ison, M G; Law, M; Coghlan, P; Rawlinson, W D
Expansion of the donor pool may lead to utilization of donors with risk factors for viral infections. Donor laboratory screening relies on serological and nucleic acid testing (NAT). The increased sensitivity of NAT in low prevalence populations may result in false-positive results (FPR) and may cause unnecessary discard of organs.We developed a screening algorithm to deal, in real time, with potential FPR. Three NAT assays: COBAS AmpliScreen assay (CAS), AmpliPrep Total Nucleic Acid Isolation/CAS, and AmpliPrep/TaqMan assays, were validated and used in parallel for prospective screening of increased-risk donors (IRD), and the probability of FPR was calculated. The lower limit of detection of this algorithm was 9.79, 21.02, and 4.31 IU/mL for human immunodeficiency virus-1, hepatitis C virus, and hepatitis B virus, respectively, with an average turn-around-time of 7.67 h from sample receipt to result reporting. The probability that a donor is potentially infectious with two NAT concordant results was >90%. NAT screening of 35 IRD within 18 months resulted in transplantation of 102 additional organs that without screening would either not be used or used with restrictions in Australia. Using a parallel testing algorithm, real-time confirmation of seropositive donors allows use of organs from IRD and safer expansion of the donor pool.
Sommese, Linda; Paolillo, Rossella; Sabia, Chiara; Costa, Dario; De Pascale, Maria Rosaria; Iannone, Carmela; Esposito, Antonella; Schiano, Concetta; Napoli, Claudio
Serological assays are still considered the most useful tests in the diagnosis of syphilis. Since no single serological assay is able to provide a satisfactory result, in our laboratory we have evaluated the usefulness of a commercially-available immunoblot to diagnose syphilis infection among blood donors. From October 2012 to June 2013, 4572 blood donors were screened for syphilis with an automated chemiluminescent microparticle immunoassay (CMIA). To confirm the presence of treponemal antibodies, CMIA-reactive sera were tested by standard Treponema pallidum haemagglutination assay (TPHA). In addition, an alternative confirmatory test - the immunoblot INNO-LIA assay was introduced in our laboratory. Since two additional positives among CMIA-reactive-TPHA-negative samples were found, we concluded that the INNO-LIA immunoblot allowed a better detection of syphilis compared to TPHA. A confirmatory strategy based on the use of two treponemal assays could meet the screening requirements for blood donors as well as in our centre. © The Author(s) 2015.
Kitchen, Alan D; Hewitt, Patricia E; Chiodini, Peter L
Trypanosoma cruzi is a parasitic infection endemic in Central and Southern America, but is spreading into nonendemic countries with migration of infected individuals from endemic countries. The parasite is transmitted by transfusion or transplantation and donation screening is performed routinely in endemic countries to prevent transmission. In situations where migrants from endemic countries have settled in nonendemic countries and present as donors (blood or other cellular products), intervention is required to prevent transfusion or transplantation transmission. A screening program for T. cruzi was developed and has been used successfully for over 10 years that includes donor selection and donation screening. Donor selection criteria to identify specific risk of T. cruzi infection were developed together with laboratory screening of donations for T. cruzi antibodies and the subsequent confirmation of screen reactivity. Since the introduction of T. cruzi screening in England in 1998, a total of 38,585 donors and donations have been screened for T. cruzi antibodies, of which 223 were repeat reactive on screening and referred for confirmation: 206 confirmed negative, 14 inconclusive, and three positive. Since the move in 2005 from donor qualification to donation release testing, 15,536 donations were collected and screened, of which 15,499 (99.8%) were T. cruzi antibody negative and released to inventory. An effective program to minimize risk of the transmission of T. cruzi infection via donations has been developed and implemented. Not only does the program minimize risk of transmission, it also minimizes the cumulative, and needless, loss of donors and donations that would ensue if permanent donor deferral alone was adopted. © 2012 American Association of Blood Banks.
Silver, Ari J.; Larson, Jessica L.; Silver, Maxwell J.; Lim, Regine M.; Borroto, Carlos; Spurrier, Brett; Morriss, Anne
Aims: DNA-based carrier screening is a standard component of donor eligibility protocols practiced by U.S. sperm banks. Applicants who test positive for carrying a recessive disease mutation are typically disqualified. The aim of our study was to examine the utility of a range of screening panels adopted by the industry and the effectiveness of the screening paradigm in reducing a future child's risk of inheriting disease. Methods: A cohort of 27 donor applicants, who tested negative on an initial cystic fibrosis carrier test, was further screened with three expanded commercial carrier testing panels. These results were then compared to a systematic analysis of the applicants' DNA using next-generation sequencing (NGS) data. Results: The carrier panels detected serious pediatric disease mutations in one, four, or six donor applicants. Because each panel screens distinct regions of the genome, no single donor was uniformly identified as carrier positive by all three panels. In contrast, systematic NGS analysis identified all donors as carriers of one or more mutations associated with severe monogenic pediatric disease. These included 30 variants classified as “pathogenic” based on clinical observation and 66 with a high likelihood of causing gene dysfunction. Conclusion: Despite tremendous advances in variant identification, understanding, and analysis, the vast majority of disease-causing mutation combinations remain undetected by commercial carrier screening panels, which cover a narrow, and often distinct, subset of genes and mutations. The biological reality is that all donors and recipients carry serious recessive disease mutations. This challenges the utility of any screening protocol that anchors donor eligibility to carrier status. A more effective approach to reducing recessive disease risk would consider joint comprehensive analysis of both donor and recipient disease mutations. This type of high-resolution recessive disease risk analysis is now
Bouma, Jennifer L; Aronson, Lillian R; Keith, Dennis G; Saunders, H Mark
Preoperative knowledge of the renal vascular anatomy is important for selection of the appropriate feline renal donor. Intravenous urograms (IVUs) have been performed routinely to screen potential donors at the Veterinary Hospital of the University of Pennsylvania (VHUP), but the vascular phase views lack sufficient detail of the renal vascular anatomy. Computed tomography angiography (CTA), which requires a helical computed tomography (CT) scanner, has been found to provide superior renal vascular anatomic information of prospective human renal donors. The specific aims of this study were as follows: 1) develop the CTA technique for the feline patient; and 2) obtain preliminary information on feline renal vessel anatomy in potential renal donors. Ten healthy, potential feline renal donors were anesthetized and imaged using a third-generation helical CT scanner. The time delay between i.v. contrast medium injection and image acquisition, and other parameters of slice collimation, slice interval, pitch, exposure settings, and reconstruction algorithms were varied to maximize contrast medium opacification of the renal vascular anatomy. Optimal CTA acquisition parameters were determined to be: 1) 10-sec delay post-i.v. bolus of iodinated contrast medium; 2) two serially acquired (corresponding to arterial and venous phases) helical scans through the renal vasculature; 3) pitch of 2 (4 mm/sec patient translation, 2 mm slice collimation); and 4) 120-kVp, 160-mA, and 1-sec exposure settings. Retrospective reconstructed CTA transverse images obtained at a 2-mm slice width and a 1-mm slice interval in combination with two-dimensional reformatted images and three-dimensional reconstructed images were qualitatively evaluated for vascular anatomy; vascular anatomy was confirmed at surgery. Four cats had single renal arteries and veins bilaterally; four cats had double renal veins. One cat had a small accessory artery supplying the caudal pole of the left kidney. One cat had a
Fridey, Joy L; Townsend, Mary J; Kessler, Debra A; Gregory, Kay R
A new donor history questionnaire, introduced by the American Association of Blood Banks in 2004 and approved by Food and Drug Administration in 2006, is now in widespread use in the United States. The development of this questionnaire involved an in-depth look at the entire system of donor screening questions, and is notable for its use of survey design experts as well as blood banking experts, government agencies, and an ethicist who represented the public interest in developing the actual questions. The end result is a questionnaire that uses capture questions in a time bounded format, donor educational materials, and a medication deferral list. Detailed instructions for donor screeners include follow-up questions in easy-to-follow flow-charts. Most importantly, for the first time in the history of developing donor history questions, all materials were tested for donor comprehension using cognitive interview evaluation. This article discusses the development of the questionnaire, explains the methodology, and describes the thinking and rationale for decisions made during redesign of the questionnaire.
Kaul, D R; Taranto, S; Alexander, C; Covington, S; Marvin, M; Nowicki, M; Orlowski, J; Pancoska, C; Pruett, T L; Ison, M G
Organ Procurement and Transplant Network (OPTN) policy currently requires the testing of all potential organ donors for human T-cell lymphotrophic virus (HTLV)-1/2. Most Organ Procurement Organizations (OPO) use the Abbott HTLV-I/HTLV-II Enzyme Immunoassay (EIA). This assay will no longer be manufactured after December 31, 2009; the only commercially available FDA-licensed assay will be the Abbott PRISM HTLV-I/II assay which poses many challenges to OPO use for organ donor screening. As a result, screening donors for HTLV-1/2 in a timely manner pretransplant after December 31, 2009 will be challenging. The true incidence of HTLV-1 in United States (U.S.) organ donors is not well described but appears to be low ( approximately 0.03-0.5%). HTLV-1 is associated with malignancy and neurological disease; HTLV-2 has not been convincingly associated with disease in humans. Donors that are HTLV-1/2 seropositive are infrequently used despite most results being either false positive or resulting from HTLV-2 infection. There is urgent need to encourage the development of assays, instruments and platforms optimized for organ donors that can be used to screen for transmissible disease in donors; these must have appropriate sensitivity and specificity to identify all infections while minimizing organ loss through false positive testing.
Theodoropoulos, N; Jaramillo, A; Ladner, D P; Ison, M G
Although Organ Procurement and Transplantation Network (OPTN) policy requires that all potential deceased organ donors are screened for human immunodeficiency (HIV), hepatitis B (HBV) and hepatitis C (HCV) viruses by serology, no current policy requires the use of nucleic acid testing (NAT) for organ donor screening. An electronic survey was sent to 58 organ procurement organizations (OPO) in the United States to assess current screening practices of potential deceased organ donors. Fifty-seven responses were collected for data analysis; not all respondents answered all questions. All OPOs performed required HIV, HBV and HCV serology screening and 48 (84%) performed confirmatory testing for seropositive donors. Ninety-eight percent, 75% and 97% of OPOs performed prospective HIV, HBV and HCV NAT, respectively. Fifty-two percent and 47% used a transcription-mediated amplification assay for HIV and HCV NAT, respectively. Of the 56 respondents that performed HIV NAT and 55 respondents that performed HCV NAT, 39 tested all donors. Seventeen (32%) OPOs performed confirmatory testing for all HIV-positive NAT results, and 15 (27%) OPOs performed confirmatory testing for all HCV-positive NAT results. Since 2008, the number of OPOs performing NAT has increased and more OPOs are testing all donors.
Livingstone, Scott M.; Andres, Axel; Shapiro, A.M. James; Kneteman, Norman N.; Bigam, David L.
Background Living donor hepatectomy (LDH) is increasingly being used to improve access to liver transplantation for those with end-stage liver disease. Although recipient outcomes are equivalent, donor complication rates range from 10% to 41%. A rare, but potentially serious complication is occurrence of a diaphragmatic hernia (DH), of which 9 cases have been reported so far in the literature. The purpose of this work was to review the clinical impact of DH post-LDH, including risk factors (RF) in hope of mitigating impact. Methods A literature review was performed identifying all previous reports of post-operative DH in living liver donors. Demographic and outcome data were gathered to help identify RF. We also report 2 cases from our own institution. Results Reported incidences range from 0.6% to 2.3%, of which the majority are delayed (≥19 months). Obstruction or intestinal strangulation was present in 45%, 60% of whom required an intestinal resection. The most common RF was right lobe donation. Conclusions Postoperative DH is a rare but serious complication of LDH. The major RFs are right lobe donation and potentially conditions resulting in increased intraabdominal pressure. Diaphragmatic hernia frequently lead to intestinal obstruction and strangulation and should be repaired when identified. The implementation of a screening protocol for early identification could lead to repair before the development of complications. We propose the addition of screening chest x-ray to follow-up protocols to aid in the identification and subsequent repair of postoperative DH. Such a practice could hopefully reduce the clinical impact of this complication. PMID:27830178
Len, O; Garzoni, C; Lumbreras, C; Molina, I; Meije, Y; Pahissa, A; Grossi, P
In the context of solid organ transplantation, screening of recipients and organ donors is crucial, and should be performed with great rigour to minimize the reactivation or the risk of transmission of certain infectious processes. This review aims to update understanding of the possible pathologies involved, as well as of emerging infections that, as a result of globalization, are gaining increasing prominence on a daily basis.
Walsh, A P H; Omar, A B; Collins, G S; Murray, G U; Walsh, D J; Salma, U; Sills, E Scott
Anonymous oocyte donation in the EU proceeds only after rigorous screening designed to ensure gamete safety. If anonymous donor gametes originating from outside EU territory are used by EU patients, donor testing must conform to the same standards as if gamete procurement had occurred in the EU. In Ireland, IVF recipients can be matched to anonymous donors in the Ukraine (a non-EU country). This investigation describes the evolution of anonymous oocyte donor screening methods during this period and associated results. Data were reviewed for all participants in an anonymous donor oocyte IVF programme from 2006 to 2009, when testing consistent with contemporary EU screening requirements was performed on all Ukrainian oocyte donors. HIV and hepatitis tests were aggregated from 314 anonymous oocyte donors and 265 recipients. The results included 5,524 Ukrainian women who were interviewed and 314 of these entered the programme (5.7% accession rate). Mean age of anonymous oocyte donors was 27.9 years; all had achieved at least one delivery. No case of hepatitis or HIV was detected at initial screening or at oocyte procurement. This is the first study of HIV and hepatitis incidence specifically among Ukrainian oocyte donors. We find anonymous oocyte donors to be a low-risk group, despite a high background HIV rate. Following full disclosure of the donation process, most Ukrainian women wishing to volunteer as anonymous oocyte donors do not participate. Current EU screening requirements appear adequate to maintain patient safety in the context of anonymous donor oocyte IVF.
Background After the largest outbreaks of Q fever ever recorded in history occurred in the Netherlands, concern arose that Coxiella may be transmitted via donated tissues of latent or chronically infected donors. The Dutch Health Council recently advised to screen tissue donors, donating high risk tissues, for Coxiella infection. Methods After validation of an enzyme immunoassay (EIA) test for IgG antibodies against phase 2 of C. burnetii for use on post-mortem samples, serum samples of 1033 consecutive Dutch post-mortem tissue donors were tested for IgG antibodies against phase 2 of C. burnetii. Confirmation of reactive results was done by immunofluorescence assay (IFA). All available tissues (corneas, heart valves, skin and bone marrow) from donors with IgG reactivity were tested for presence of Coxiella DNA by PCR. Risk factors for IgG reactivity were investigated. Results After validation of the tests for use on post-mortem samples, 50/1033 donors (4.8%) screened positive for phase 2 anti-Coxiella IgG by EIA, and 31 were confirmed by IFA (3.0%). One donor showed a serological profile compatible with chronic infection. All tested tissues (25 corneas, 6 heart valves, 4 skin and 3 bone marrow) from donors with IgG reactivity tested negative for the presence of Coxiella DNA. Except for living in a postal code area with a high number of Q fever notifications, no risk factors for IgG reactivity were found. Conclusions The strong correlation between notifications and seroprevalence confirms that the used assays are sufficiently specific for use on post-mortem samples, although one has to be aware of differences between batches. Thus, this study provides a validated method for screening tissue donors for infection with Coxiella burnetii that can be used in future outbreaks. PMID:24393298
Cadar, Daniel; Maier, Philipp; Müller, Susanne; Kress, Julia; Chudy, Michael; Bialonski, Alexandra; Schlaphof, Alexander; Jansen, Stephanie; Jöst, Hanna; Tannich, Egbert; Runkel, Stefan; Hitzler, Walter E; Hutschenreuter, Gabriele; Wessiepe, Martina; Schmidt-Chanasit, Jonas
Between 1 June and 31 December 2016, 13,023 blood donations from the University Hospital Aachen in Germany were routinely screened for West Nile virus (WNV) RNA using the cobas TaqScreen WNV Test. On 28 September 2016, one blood donor was tested positive. Subsequent analysis revealed an acute Usutu virus (USUV) infection. During the ongoing USUV epizootics in Germany, blood transfusion services, public health authorities and clinicians should be aware of increased human USUV infections. PMID:28422005
Custer, Brian; Kamel, Hany; Kiely, Nancy E; Murphy, Edward L; Busch, Michael P
Blood collected in the United States and Canada is screened for West Nile virus (WNV) using nucleic acid testing (NAT). The role that donor-reported symptoms of infection disclosed at or shortly after donation may play in enhancing blood safety has been debated. Little data are available on subsequent manifestations of WNV-specific disease outcomes in viremic donors. Donors with initially reactive NAT results were informed by telephone and asked to complete symptom interviews. The questionnaires are focused on three time periods: the week before, the day of, and the 2 weeks after donation. Symptoms and risk factors were compared between confirmed-positive and false-positive donors (classified based on confirmatory NAT and serology). Additional analyses comparing confirmed-positive symptomatic and asymptomatic donors were conducted. A total of 423 of 536 initially reactive donors were interviewed between 2003 and 2006: 292 confirmed-positive for WNV and 131 false-positive. Individual symptoms were not significant predictors of WNV infection, except skin rash in the week before donation (odds ratio [OR], 3.0; 95% confidence interval [CI], 1.2-7.9) and body aches in the period after donation (OR, 2.8; 95% CI, 1.1-7.4). Specific combinations of symptoms were not good predictors of infection, but donors with three or more concurrent symptoms before donation were more likely to have WNV infection (OR, 2.5; 95% CI, 1.2-5.1). Demographic characteristics, predonation symptoms, and serology profiles in confirmed-positive donors did not predict postdonation symptom severity. Thirty-five confirmed-positive donors (12%) sought medical care for WNV infection, with two hospitalizations, but no cases of neuroinvasive disease. The number rather than type of symptoms is associated with confirmed WNV infection, but the overall predictive value is low. Very few infected donors develop clinically significant disease.
El Ghouzzi, Marie-Hélène; Boiret, Elisabeth; Wind, Françoise; Brochard, Claudine; Fittere, Sébastien; Paris, Luc; Mazier, Dominique; Sansonetti, Nicole; Bierling, Philippe
Chagas disease is endemic in Latin America (LA). Currently 10 million people are infected despite World Health Organization efforts aimed at preventing domestic transmission. However, with the migration of infected asymptomatic individuals to nonendemic countries, transmission of Chagas disease by transfusion may become a worldwide problem. The observation that the number of cases of Chagas disease has increased over the past 10 years in French Guiana, together with the results of a previous hospital-based study in the Paris area, confirms the transmission of Chagas disease from patients coming from LA. For these reasons, the French authorities stopped the collection of blood in French Guiana in 2005 and began screening blood donors in the French Caribbean islands and, in 2007, in continental France. Data on birth place, mother's birth place, and travel in LA were recorded for at-risk donors. These subjects were tested using two enzyme-linked immunosorbent assays (ELISAs). Of the 312,458 individuals who gave blood in the Paris area during an 18-month period, 30,837 were tested. Of these, 972 were born in LA, three of whom were positive for the two ELISAs and immunofluorescence tests. The prevalence of Trypanosoma cruzi-positive donors was 9.7 in 100,000 tested donors, but 0.31% among donors born in LA. Serology tests gave discrepant results in 1.02% of the samples. The efficiency of blood donor screening programs could be improved by screening only blood donors who were born in LA or who have traveled in LA for extended periods, using a single enzyme immunoassay.
Vogler, Ingridt Hildegard; Saito, Mariza; Spinosa, Adriana Aparecida; da Silva, Marilza Celina; Munhoz, Egberto; Reiche, Edna Maria Vissoci
Background For transfusion purposes, blood donors must be accepted both in clinical and serological evaluations and must not have excluded their own donation using the confidential unit exclusion. Aim The objective of this study was to verify whether blood donors who choose self exclusion are more likely to be positive in serological tests than donors who do not. Methods A cross-sectional analysis was carried out of 51,861 consecutive whole blood donations from January 2004 to December 2008 at a public blood bank in Londrina, Southern Brazil. Results Self exclusion was chosen in 1672 (3.2%) donations, most frequently by first-time blood donors (p-value < 0.0001), by blood donors from external collections (p-value < 0.0001), by men (p value < 0.0001) and by under 30-year-old donors (p-value < 0.0001). The frequency of positive serology was 5.3% in the group that chose self exclusion and 3.5% in the group that did not choose self exclusion (p-value < 0.0001). Conclusions These results show that confidential unit exclusion used in this blood bank is effective and is inexpensive. However, the diagnostic power to detect blood-borne infections was low and resulted in the discard of a high number of blood bags without any direct or indirect serologic markers of pathogens. The use of confidential unit exclusion could be replaced with molecular tests to screen blood donors. PMID:23049338
Vermeulen, Marion; Swanevelder, Ronel; Chowdhury, Dhuly; Ingram, Charlotte; Reddy, Ravi; Bloch, Evan M; Custer, Brian S; Murphy, Edward L
Among 397,640 first-time blood donors screened in South Africa during 2012-2015, HIV prevalence was 1.13%, hepatitis B virus prevalence 0.66%, and hepatitis C virus prevalence 0.03%. Findings of note were a high HIV prevalence in Mpumalanga Province and the near absence of hepatitis C virus nationwide.
Gómez-Simón, A; Plaza, E M; Torregrosa, J M; Ferrer-Marín, F; Sánchez-Guiu, I; Vicente, V; Lozano, M L; Rivera, J
Inaccuracy of fingerstick haemoglobin compromises donor's health and losses blood donations. We evaluated the benefit of double haemoglobin screening with HemoCue. Blood donors underwent fingerstick screening by HemoCue and were driven for donation if capillary haemoglobin was within the regulatory range. Those failing were drawn venous blood and donated if their venous haemoglobin determined with HemoCue was acceptable. Of 276 605 donor clinic visits, 10 011 (3·6%) were assessed by two-step haemoglobin screening using HemoCue, because of low (n = 9444) or high (n = 567) capillary haemoglobin. Among these, 2561 (25·6%) were deemed eligible [recovered donations]. The recovery rate was 23·8% and 55·0% among donors presenting with low and high capillary haemoglobin, respectively. In both categories of attempted donations, capillary and venous haemoglobin with HemoCue correlated significantly in recovered donors (R(2) ≈ 0·5-0·7) but not in deferred visits (R(2) < 0·15). Venous haemoglobin with HemoCue and by haematological analyzer significantly correlated in all donations attempts (R(2) ≈ 0·7). Donors presenting with low capillary haemoglobin showed small bias between capillary and venous haemoglobin by HemoCue (-2·4 ± 6·2 g/l), fingerstick haemoglobin and venous haemoglobin with counter (1·3 ± 7·3 g/l), and venous haemoglobin with HemoCue and counter (3·7 ± 3·9 g/l). This bias was slightly greater in donors with high capillary haemoglobin (-7·5 ± 7·8, 13·7 ± 7·5, and 6·2 ± 7·5, respectively). Double haemoglobin screening by HemoCue reached an accuracy of 87·3% for qualifying donors presenting with low fingerstick haemoglobin. Double haemoglobin measurement with HemoCue [fingerstick and venous blood if required] is feasible and allows a significant recovery of blood donations. © 2014 International Society of Blood Transfusion.
Kleinman, Steven H; Kuhns, Mary C; Todd, Deborah S; Glynn, Simone A; McNamara, Anne; DiMarco, Anthony; Busch, Michael P
An estimate of the rate of HBV DNA-positive, anti-HBc-positive units is important for evaluating the need for anti-HBc donor screening, especially in the context of HBV NAT. HBsAg EIA-nonreactive, anti-HBc-reactive (Corzyme, Abbott Laboratories) specimens were retrieved from a repository and were retested for anti-HBc (with PRISM HBcore, Abbott Laboratories, currently under FDA review) and anti-HBs (with PRISM Ausab, Abbott Laboratories, research assay). HBV DNA testing using a PCR assay with a greater than 95 percent detection rate of less than 50 copies per mL was performed on a subset of specimens that were PRISM HBcore-reactive and were anti-HBs- negative or reactive at less than 100 IU per L. A total of 395 of 1231 specimens eligible by our serologic criteria were tested by PCR. Four anti-HBs-negative specimens were PCR-positive with estimated HBV DNA copy numbers of 10 per 30 copies per mL in two specimens and 50 to 100 copies per mL in two others. The HBV DNA detection rate in anti-HBs-negative specimens was 3.7 percent, and the projected rate among all Corzyme-reactive specimens was 0.24 percent, leading to an estimated yield of 1 HBV DNA-positive, anti-HBc-positive unit in 49,000 units that were otherwise eligible for transfusion (95% CI, 1 in 16,600-1 in 152,600). Anti-HBc screening detects HBsAg EIA-negative, HBV-infected donors at a rate comparable to the estimated residual risk for HBV window-period infections. The low viral load in the HBV DNA-positive samples suggests that minipool NAT will not detect most potentially infectious units from anti-HBc-positive donors.
Wasserfall, C; Montgomery, E; Yu, L; Michels, A; Gianani, R; Pugliese, A; Nierras, C; Kaddis, J S; Schatz, D A; Bonifacio, E; Atkinson, M A
The Network for Pancreatic Organ donors with Diabetes (nPOD) programme was developed in response to an unmet research need for human pancreatic tissue obtained from individuals with type 1 diabetes mellitus and people at increased risk [i.e. autoantibody (AAb)-positive] for the disease. This necessitated the establishment of a type 1 diabetes-specific AAb screening platform for organ procurement organizations (OPOs). Assay protocols for commercially available enzyme-linked immunosorbent assays (elisas) determining AAb against glutamic acid decarboxylase (GADA), insulinoma-associated protein-2 (IA-2A) and zinc transporter-8 (ZnT8A) were modified to identify AAb-positive donors within strict time requirements associated with organ donation programmes. These rapid elisas were evaluated by the international islet AAb standardization programme (IASP) and used by OPO laboratories as an adjunct to routine serological tests evaluating donors for organ transplantation. The rapid elisas performed well in three IASPs (2011, 2013, 2015) with 98-100% specificity for all three assays, including sensitivities of 64-82% (GADA), 60-64% (IA-2A) and 62-68% (ZnT8A). Since 2009, nPOD has screened 4442 organ donors by rapid elisa; 250 (5·6%) were identified as positive for one AAb and 14 (0.3%) for multiple AAb with 20 of these cases received by nPOD for follow-up studies (14 GADA+, two IA-2A(+) , four multiple AAb-positive). Rapid screening for type 1 diabetes-associated AAb in organ donors is feasible, allowing for identification of non-diabetic, high-risk individuals and procurement of valuable tissues for natural history studies of this disease. © 2016 British Society for Immunology.
Moon, Song Mi; Park, In-Ah; Kim, Sun-Mi; Park, Su-Jin; Jung, Joo Hee; Kim, Young Hoon; Park, Jae Berm; Hong, Bumsik; Lee, Sang-Oh; Choi, Sang-Ho; Kim, Yang Soo; Woo, Jun Hee; Park, Su-Kil; Lee, Sang Koo; Park, Jung Sik; Han, Duck Jong; Kim, Sung-Han
There are few data on donor screening for latent tuberculosis infection (LTBI) using the tuberculin skin test (TST) and interferon-gamma releasing assay (IGRA). In South Korea, most renal allografts involve living donors (average, 80%). Hence, we have an opportunity to evaluate donor and recipient screening for LTBI by TST and IGRA. All donors and recipients admitted for kidney transplantation during a 20-month period were evaluated prospectively by using TST and Mycobacterium tuberculosis-specific enzyme-linked immunosorbent spot (ELISPOT) assay. The study population consisted of 205 living donor-recipient pairs (≥16 years) including 15 (7%) who yielded indeterminate donor or recipient ELISPOT results. Of the 205 donors, 63 (31%) gave a positive TST ≥5 mm, 33 (16%) a positive TST ≥10 mm, and 96 (47%) a positive ELISPOT. Of the 205 recipients, 9 (5%) gave a positive TST ≥5 mm, 3 (2%) a positive TST ≥10 mm, and 79 (39%) had a positive ELISPOT. Of the 205 donor-recipient pairs, only 59 (29%) gave negative donor and recipient ELISPOT results and 139 (68%) negative donor and recipient TSTs (<5 mm) (P < 0.001). One third of donor-recipient pairs tends to be positive in the TST, and two thirds of the donor-recipient pairs tends to be positive in the ELISPOT. Given the high positive rate of LTBI obtained by screening donors, further studies on the clinical value of solid organ transplant donors with positive TST or ELISPOT and health economics analysis in countries with intermediate burden of TB are needed for policy decisions on isoniazid (INH) prophylaxis.
The performance of the multiplex Procleix Ultrio Elite assay as individual donor nucleic acid test (ID-NAT) for the detection of HIV-1, HIV-2, HCV, and HBV was evaluated in a retrospective, single center study. ID-NAT results of 21,181 blood donors, 984 tissue donors, 293 hematopoietic stem cell donors and 4 organ donors were reviewed in synopsis with results of serological screening and additional discriminatory and repetitive NAT in case of positive donors. Specificity of the initial Procleix Ultrio Elite assay was 99.98% and after discriminatory testing 100.00%. Initially invalid results were observed in 75 of 21,181 blood donors (0.35%) but 16 of 984 tissue donors (1.62%, p < 0.001) which included non-heart-beating ('cadaveric') donors. All these had valid negative ID-NAT results after repeated testing or testing of 1:5 diluted specimens in case of tissue donors. Occult hepatitis B (defined here as HBV DNAemia without HBsAg detection) was demonstrated by ID-NAT in two anti-HBc-positive tissue donors and suspected in two other tissue donors, where a definite diagnosis was not achieved due to the insufficient sample volumes available. The Procleix Ultrio Elite assay proved to be specific, robust and rapid. Therefore, routine ID-NAT may also be feasible for organ and granulocyte donors.
Summary Background The performance of the multiplex Procleix Ultrio Elite assay as individual donor nucleic acid test (ID-NAT) for the detection of HIV-1, HIV-2, HCV, and HBV was evaluated in a retrospective, single center study. Methods ID-NAT results of 21,181 blood donors, 984 tissue donors, 293 hematopoietic stem cell donors and 4 organ donors were reviewed in synopsis with results of serological screening and additional discriminatory and repetitive NAT in case of positive donors. Results Specificity of the initial Procleix Ultrio Elite assay was 99.98% and after discriminatory testing 100.00%. Initially invalid results were observed in 75 of 21,181 blood donors (0.35%) but 16 of 984 tissue donors (1.62%, p < 0.001) which included non-heart-beating (‘cadaveric’) donors. All these had valid negative ID-NAT results after repeated testing or testing of 1:5 diluted specimens in case of tissue donors. Occult hepatitis B (defined here as HBV DNAemia without HBsAg detection) was demonstrated by ID-NAT in two anti-HBc-positive tissue donors and suspected in two other tissue donors, where a definite diagnosis was not achieved due to the insufficient sample volumes available. Conclusion The Procleix Ultrio Elite assay proved to be specific, robust and rapid. Therefore, routine ID-NAT may also be feasible for organ and granulocyte donors. PMID:27403089
Mast, Alan E.; Steele, Whitney R.; Johnson, Bryce; Wright, David J.; Cable, Ritchard G.; Carey, Patricia; Gottschall, Jerome L.; Kiss, Joseph E.; Simon, Toby L.; Murphy, Edward L.
Background Anemia is an important public health concern. Data from population-based surveys such as the National Health and Nutrition Examination Survey (NHANES) are the gold standard, but are obtained infrequently and include only small samples from certain minority groups. Objectives We assessed whether readily available databases of blood donor hemoglobin values could be used as a surrogate for population hemoglobin values from NHANES. Design Blood donor venous and fingerstick hemoglobin values were compared to 10,254 NHANES 2005-2008 venous hemoglobin values using demographically stratified analyses and ANOVA. Fingerstick hemoglobins or hematocrits were converted to venous hemoglobin estimates using regression analysis. Results Venous hemoglobin values from 1,609 first time donors correlated extremely well with NHANES data across different age, gender and demographic groups. Cigarette smoking increased hemoglobin by 0.26 to 0.59 g/dL depending on intensity. Converted fingerstick hemoglobin from 36,793 first time donors agreed well with NHANES hemoglobin (weighted mean hemoglobin of 15.53 g/dL for donors and 15.73 g/dL for NHANES) with similar variation in mean hemoglobin by age. However, compared to NHANES, the larger donor dataset showed reduced differences in mean hemoglobin between Blacks and other races/ethnicities. Conclusions Overall, first-time donor fingerstick hemoglobins approximate U.S. population data and represent a readily available public health resource for ongoing anemia surveillance. PMID:22460662
Sarkodie, Francis; Owusu-Dabo, Ellis; Hassall, Oliver; Bates, Imelda; Bygbjerg, Ib C; Ullum, Henrik
To describe the recalled medical history, clinical manifestations, and treatment of yaws and syphilis by syphilis seroreactive blood donors in Kumasi, Ghana. Of the blood donors at Komfo Anokye Teaching Hospital, Kumasi, Ghana tested with the syphilis rapid diagnostic test (RDT) and later by rapid plasma reagin (RPR) test, 526 were seroreactive. Four hundred and seventy-one (89.5%) of these subjects were confirmed with the Ortho-Vitros Syphilis TP test as the gold standard and were interviewed to determine past or present clinical manifestations of yaws and syphilis. Of the 471 respondent donors, 28 (5.9%) gave a history of skin lesions and sores; four (14.3%) of these subjects, who were all male and RPR-positive, recalled a diagnosis of syphilis. All four reported having had skin lesions/bumps with slow-healing sores, but only one of them had had these symptoms before the age of 15 years. A small proportion of confirmed seroreactive donors in this sample had any recall of symptoms or treatment for yaws or syphilis. These data suggest that clinical questioning adds little further information to the current screening algorithm. The relative contribution of yaws and syphilis to frequent positive tests in endemic areas remains speculative. Copyright © 2016 The Author(s). Published by Elsevier Ltd.. All rights reserved.
Veldhuisen, B; van der Schoot, C E; de Haas, M
Blood group antigens, present on the cell membrane of red blood cells and platelets, can be defined either serologically or predicted based on the genotypes of genes encoding for blood group antigens. At present, the molecular basis of many antigens of the 30 blood group systems and 17 human platelet antigens is known. In many laboratories, blood group genotyping assays are routinely used for diagnostics in cases where patient red cells cannot be used for serological typing due to the presence of auto-antibodies or after recent transfusions. In addition, DNA genotyping is used to support (un)-expected serological findings. Fetal genotyping is routinely performed when there is a risk of alloimmune-mediated red cell or platelet destruction. In case of patient blood group antigen typing, it is important that a genotyping result is quickly available to support the selection of donor blood, and high-throughput of the genotyping method is not a prerequisite. In addition, genotyping of blood donors will be extremely useful to obtain donor blood with rare phenotypes, for example lacking a high-frequency antigen, and to obtain a fully typed donor database to be used for a better matching between recipient and donor to prevent adverse transfusion reactions. Serological typing of large cohorts of donors is a labour-intensive and expensive exercise and hampered by the lack of sufficient amounts of approved typing reagents for all blood group systems of interest. Currently, high-throughput genotyping based on DNA micro-arrays is a very feasible method to obtain a large pool of well-typed blood donors. Several systems for high-throughput blood group genotyping are developed and will be discussed in this review.
Lin, K T; Chang, C L; Tsai, M H; Lin, K S; Saldanha, J; Hung, C M
The ability of a new generation commercial, multiplex, multi-dye test from Roche, the cobas TaqScreen MPX test, version 2.0, to detect and identify occult HBV infections was evaluated using routine donor samples from Kaohsiung Blood Bank, Taiwan. A total of 5973 samples were tested by nucleic acid amplification technology (NAT); 5898 in pools of six, 66 in pools of less than six and nine samples individually. NAT-reactive samples were retested with alternative NAT tests, and follow-up samples from the donors were tested individually by NAT and for all the HBV serological markers. Eight NAT-only-reactive donors were identified, and follow-up samples were obtained from six of the donors. The results indicated that all eight donors had an occult HBV infection with viral loads <12 IU/ml. The cobas(®) TaqScreen MPX test, version 2.0, has an advantage over the current Roche blood screening test, the cobas TaqScreen MPX test, for screening donations in countries with a high prevalence of occult HBV infections since the uncertainty associated with identifying samples with very low viremia is removed by the ability of the test to identify the viral target in samples that are reactive with the cobas TaqScreen MPX test, version 2.0. © 2013 International Society of Blood Transfusion.
Goldman, Mindy; Uzicanin, Samra; Yi, Qi-Long; Acker, Jason; Ramirez-Arcos, Sandra
Hemoglobin (Hgb) determination is an essential part of donor qualification. We assessed and implemented a new spectrophotometer for donor Hgb determination. Precision, accuracy, and ease of use were assessed on a prototype DiaSpect analyzer (DiaSpect Medical, GmBH, Sailauf, Germany). A protocol to qualify the analyzer was developed and executed preimplementation. Samples were developed for periodic quality control (QC). Postimplementation performance was assessed based on QC results and trending of deferral rates. Precision was excellent, with a coefficient of variation of 0.53%-1.14% per sample. The correlation coefficient between capillary DiaSpect and venous laboratory autoanalyzer measurements was 0.736. After 169 out of 223 analyzers failed to qualify on our initial protocol, all were successfully qualified with the use of a modified protocol, adjusted to avoid sources of variability. Because commercial controls proved inadequate, in-house samples were developed for periodic QC. Postimplementation, all analyzers had adequate QC results. Deferral rates decreased from 10.1 to 8.1% (p < 0.0001) for female donors and from 0.8 to 0.6% for male donors (p < 0.0001). The system was faster and easier to use compared with our previous two-step process. We successfully implemented a new spectrophotometer, which resulted in greater efficiency, improved ease of use, and decreased deferrals. © 2012 American Association of Blood Banks.
Zou, Shimian; Foster, Gregory A; Dodd, Roger Y; Petersen, Lyle R; Stramer, Susan L
Nucleic acid testing (NAT) of blood donors provides opportunities for identifying West Nile virus (WNV)-infected persons before symptoms develop and for characterizing subsequent illness. From June 2003 through 2008, the American Red Cross performed follow‐up interviews with and additional laboratory testing for 1436 donors whose donations had initial test results that were reactive for WNV RNA; 821 of the donors were subsequently confirmed to have WNV infection, and the remainder were unconfirmed or determined to have false‐positive results. Symptoms attributed to WNV infection were determined by comparing symptom frequency among 576 donors identified with early WNV infection (immunoglobulin M antibody negative) and those with unconfirmed infection. We estimate that 26% of WNV‐infected persons become symptomatic, defined by the presence of at least 3 of 8 indicator symptoms. Nearly one‐half of symptomatic persons sought medical care; only 5% received a diagnosis of WNV infection. Female subjects and persons with higher viral loads detected in the index donation were more likely than other subjects to develop symptoms.
Fouelifack Ymele, Florent; Keugoung, Basile; Fouedjio, Jeanne Hortense; Kouam, Nadege; Mendibi, Sandrine; Dongtsa Mabou, Jacqueline
Background. Infections with human immunodeficiency virus (HIV), hepatitis B (HBV), and hepatitis C virus (HCV) are currently major public health problems. Methods. A retrospective study was conducted from January to June 2008 at the Blood Bank of the Central Hospital, Yaoundé (Cameroon). The objective was to study the prevalence of HIV, HBV, and HCV and their coinfections among blood donors. Results. A total of 4650 donors were identified, and the sex ratio (male/female) was 14/1. The median age of donors was 28 years (range: 16 to 69 years). Among blood donors, HBV, HIV, and HCV infection prevalences were 12.14% (n = 565) , 4.44% (n = 206), and 1.44% (n = 67), respectively. Coinfection with HIV and HBV was observed among 0.77% donors, followed by hepatitis B and C co-infection (0.21%) and HIV and HCV coinfection (0.06%). Co-infection with HIV-HBV-HCV was encountered in 2 donors. The HIV, HBV, and HCV infections lead to a destruction of one out of six sets of blood collected. Conclusion. There is a need to review policies for blood collection from donors, by modifying the algorithm of blood donors testing. Pretesting potential donors using rapid tests could help to avoid collection and destruction of (infected) blood. PMID:24066258
Tilley, Peter A G; Fox, Julie D; Lee, Bonita; Chui, Linda; Preiksaitis, Jutta
West Nile Virus (WNV)-specific nucleic acid amplification testing (NAAT) of organ and tissue donors remains controversial. We report three years of WNV donor screening in Alberta Canada using NAAT. Between 2003 and 2005, 1549 initial specimens were received. A valid negative result was issued within the specified turnaround time on 1531 (98.8%). The initial NAAT was successful for 1393 samples (90%), while repeat testing using an alternate NAAT resolved a further 126 samples. For 12 of 14 donors, a second specimen provided a valid negative result. Failure to generate a valid negative result in time resulted in rescheduling of one living related organ transplant, and surgery proceeded in the absence of a final result in one multi-organ donation after risk assessment. For 11 tissue donors, tissues were discarded due to lack of a WNV result. Invalid results usually occurred on postmortem haemolyzed tissue donor samples due to inhibitory reactions. There were no confirmed positive donors, no false-positive results and no solid organs lost due to WNV testing. We conclude that WNV NAAT of organ and tissue donors can be implemented without compromising availability of donors but requires committed laboratory support.
Green, Anthony P; Turner, Nicholas J; O'Reilly, Elaine
The widespread application of ω-transaminases as biocatalysts for chiral amine synthesis has been hampered by fundamental challenges, including unfavorable equilibrium positions and product inhibition. Herein, an efficient process that allows reactions to proceed in high conversion in the absence of by-product removal using only one equivalent of a diamine donor (ortho-xylylenediamine) is reported. This operationally simple method is compatible with the most widely used (R)- and (S)-selective ω-TAs and is particularly suitable for the conversion of substrates with unfavorable equilibrium positions (e.g., 1-indanone). Significantly, spontaneous polymerization of the isoindole by-product generates colored derivatives, providing a high-throughput screening platform to identify desired ω-TA activity. PMID:25138082
Ismail, Sohal Y; Duerinckx, Nathalie; van der Knoop, Marieke M; Timmerman, Lotte; Weimar, Willem; Dobbels, Fabienne; Massey, Emma K; Busschbach, Jan J J V
Across Europe, transplant centers vary in the content of the psychosocial evaluation for eligible living organ donors. To identify whether a common framework underlies this variation in this evaluation, we studied which psychosocial screening items are most commonly used and considered as most important in current psychosocial screening programs of living organ donors. A multivariate analytic method, concept mapping, was used to generate a visual representation of the "psychosocial" screening items of living kidney and liver donors. A list of 75 potential screening items was derived from a systematic literature review and sorted and rated for their importance and commonness by multidisciplinary affiliated health care professionals from across Europe. Results were discussed and fine-tuned during a consensus meeting. The analyses resulted in a 6-cluster solution. The following clusters on psychosocial screening items were identified, listed from most to least important: (1) personal resources, (2) motivation and decision making, (3) psychopathology, (4) social resources, (5) ethical and legal factors, and (6) information and risk processing. We provided a conceptual framework of the essential elements in psychosocial evaluation of living donors which can serve as a uniform basis for the selection of relevant psychosocial evaluation tools, which can be further tested in prospective studies.
Sarkodie, F; Hassall, O; Owusu-Dabo, E; Owusu-Ofori, S; Bates, I; Bygbjerg, I C; Owusu-Ofori, A; Harritshøj, L H; Ullum, H
Syphilis testing conventionally relies on a combination of non-treponemal and treponemal tests. The primary objective of this study was to describe the positive predictive value (PPV) of a screening algorithm in a combination of a treponemal rapid diagnostic test (RDT) and rapid plasma reagin (RPR) test at Komfo Anokye Teaching Hospital (KATH), Ghana. From February 2014 to January 2015, 5 mL of venous blood samples were taken from 16 016 blood donors and tested with a treponemal RDT; 5 mL of venous blood was taken from 526 consenting initial syphilis sero-reactive blood donors. These RDT reactive samples were confirmed with an algorithm, applying the Vitros(®) /Abbott-Architect(®) algorithm as gold standard. A total of 478 of 526 RDT reactive donors were confirmed positive for syphilis, making a PPV of 90·9%. Of the 172 (32·7%) donors who were also RPR positive, 167 were confirmed, resulting in a PPV of 97·1%. The PPV of the combined RDT and RPR (suspected active syphilis) testing algorithm was highest among donors at an enhanced risk of syphilis, family/replacement donors (99·9%), and among voluntary donors above 25 years (98·6%). Screening of blood donors by combining syphilis RDT and RPR with relatively good PPV may provide a reasonable technology for LMIC that has a limited capacity for testing and can contribute to the improvement of blood safety with a minimal loss of donors. © 2016 British Blood Transfusion Society.
Tong, Allison; Chapman, Jeremy R; Wong, Germaine; de Bruijn, Jeanine; Craig, Jonathan C
To minimize the health risks faced by living kidney donors, multiple clinical practice guidelines have been developed on the assessment and care of potential donors. This study aims to compare the quality, scope, and consistency of these guidelines. We searched for guidelines on living kidney donation in electronic databases, guideline registries, and relevant Web sites to February 21, 2011. Methodological quality was assessed using the Appraisal of Guidelines for Research and Education (AGREE) instrument. Textual synthesis was used to compare guideline recommendations. Ten guidelines, published from 1996 to 2010, were identified. Although generally comprehensive, scope varied considerably and mostly appeared to lack methodological rigor. Many recommendations were consistent, but important differences were evident, particularly for thresholds for comorbidities which precluded donation; obesity/overweight (body mass index, 30-35 kg/m), diabetes/prediabetes (fasting blood glucose level, 6.1-7.0 mmol/L and oral glucose tolerance test, 7.8-11.1 mmol/L), hypertension (130/85 to 140/90 mm Hg), cardiovascular disease, malignancy, and nephrolithiasis. The importance of informed voluntary consent, genuine motivation, support, and psychological health were recognized but difficult to implement as specific tools for conducting psychosocial assessments were not recommended. Multiple major guidelines for living kidney donation have been published recently, resulting in unnecessary duplicative efforts. Most do not meet standard processes for development, and important recommendations about thresholds for exclusion based on comorbidities are contradictory. There is an urgent need for international collaboration and coordination to ensure, where possible, that guidelines for living donation are consistent, evidence based, and comprehensive to promote best outcomes for a precious resource.
Jahan, Munira; Islam, Md Asadul; Akbar, Sheikh Mohammad Fazle; Takahashi, Kazuaki; Tabassum, Shahina; Rahman, Atiar; Haque, Md Atiqul; Biswas, Joly; Mishiro, Shunji; Al-Mahtab, Mamun
To avoid further transmission of hepatitis B virus (HBV) infection, blood is tested for hepatitis B surface antigen (HBsAg) before transfusion. However, post-transfusion hepatitis B has been detected in clinics after transfusion of HBsAg-negative blood. The study presented here was undertaken to assess if HBsAg-negative blood is free from HBV or not. Sera were collected from 398 blood donors who were negative for HBsAg. Out of 398 blood samples, antibody to hepatitis B core antigen (ant-HBc) was detected in 82 sera samples. HBV DNA was evaluated in HBsAg-negative, anti-HBc-positive sera. HBsAg, hepatitis B e antigen (HBeAg), antibody to HBeAg (anti-HBe), and anti-HBc in the sera were measured by an enzyme-linked immunosorbent assay (ELISA). HBV DNA was quantified by a real time polymerase chain reaction (PCR). Out of 82 HBsAg-negative, anti-HBc-positive sera samples, HBV DNA were detected in the sera of 7 voluntary blood donors. Out of these 7 subjects, all were negative for HBeAg. The levels of ALT were more than 30 IU/L in 6 of 7 HBVDNA-positive subjects and it was above upper limit of normal (>42 IU/ml) in one subject. The present recommendation about blood transfusion of HBsAg-negative blood system is not capable of blocking HBV transmission to blood recipients. Although advanced countries have adopted nucleic acid testing (NAT) for preventing HBV transmission, developing countries may apply anti-HBc testing and ALT estimation before blood transmission.
Sindhi, R; Landmark, J; Stratta, R J; Cushing, K; Taylor, R J
Severe hemolysis and graft ischemia complicating solitary pancreas transplantation with an ABO-compatible, Rh-negative, anti-D-positive donor to Rh-positive recipient is described in this article. A brief review of the literature is presented. A rationale for preoperative screening for red cell antibodies during solid organ transplantation in this special setting is discussed.
Olotu, Amadin A; Oyelese, Adesola O; Salawu, Lateef; Audu, Rosemary A; Okwuraiwe, Azuka P; Aboderin, Aaron O
Hepatitis B virus (HBV) transmission through blood transfusion is reduced by screening for hepatitis B surface antigen (HBsAg). However this method cannot detect the presence of occult hepatitis B virus infection. This study sought to determine the prevalence of occult hepatitis B virus infection among blood donors in Ile-Ife, Nigeria. For the first time in Nigeria we employed an automated real-time PCR- method to investigate the prevalence of occult HBV in blood donors. Blood donors screened with HBsAg immunochromatographic rapid test kits at the blood transfusion units of two hospitals and found to be negative were recruited into the study. Questionnaires to elicit risk factors for HBV infection were administered and then 10 ml of blood was collected from each donor. Plasma samples obtained from these HBsAg negative blood donors were screened again for HBsAg using an enzyme-linked immunosorbent assay (ELISA) method, and those found negative were screened for the presence of total antibody to the HBV core antigen (anti-HBc) using ELISA method. Those positive to anti-HBc were then tested for HBV DNA, using an automated real-time PCR method. Five hundred and seven blood donors found HBsAg negative by immunochromatographic rapid test kits at both blood transfusion units, were tested for HBsAg using ELISA and 5 (1 %) were HBsAg positive. The 502 found negative were tested for anti-HBc and 354 (70.5 %) were found positive implying previous exposure to HBV and 19 (5.4 %) of the 354 anti-HBc positive had HBV DNA signifying occult HBV infection. No risk factors were found to be associated with the presence of HBV DNA among those who tested positive. Occult HBV infection exists in blood donors in Ile-Ife, Nigeria and the use of HBsAg alone for screening prospective donors will not eliminate the risk of HBV transmission in blood transfusion or stem cell transplantation.
Kelley, Walter E; Bradley, Kristy; Duncan, Ashten; Smith, James
Upon recognition that West Nile virus (WNV) was transmissible by transfusion, universal testing of blood donors by nucleic acid testing (NAT) was initiated in 2003. A retrospective review of 2003-2013 blood donor records and public health surveillance data in Oklahoma was undertaken to determine the percentage of WNV-positive blood donors who developed clinical symptoms post-donation and to examine the incidence and timing of WNV viremic donors in the context of WNV disease reported statewide. Among all WNV NAT-positive blood donors, 19% had self-described symptoms consistent with WNV disease. A viremic blood donor was the seasonal index case of WNV transmission in Oklahoma during one year  of the study period. Blood donors remain an important surveillance component for epidemiologic monitoring of WNV in Oklahoma.
Stone, Mars; Lanteri, Marion C; Bakkour, Sonia; Deng, Xutao; Galel, Susan A; Linnen, Jeffrey M; Muñoz-Jordán, Jorge L; Lanciotti, Robert S; Rios, Maria; Gallian, Pierre; Musso, Didier; Levi, José E; Sabino, Ester C; Coffey, Lark L; Busch, Michael P
Zika virus (ZIKV) has spread rapidly in the Pacific and throughout the Americas and is associated with severe congenital and adult neurologic outcomes. Nucleic acid amplification technology (NAT) assays were developed for diagnostic applications and for blood donor screening on high-throughput NAT systems. We distributed blinded panels to compare the analytical performance of blood screening relative to diagnostic NAT assays. A 25-member, coded panel (11 half-log dilutions of a 2013 French Polynesia ZIKV isolate and 2015 Brazilian donor plasma implicated in transfusion transmission, and 3 negative controls) was sent to 11 laboratories that performed 17 assays with 2 to 12 replicates per panel member. Results were analyzed for the percentage reactivity at each dilution and by probit analysis to estimate the 50% and 95% limits of detection (LOD50 and LOD95 , respectively). Donor-screening NAT assays that process approximately 500 µL of plasma into amplification reactions were comparable in sensitivity (LOD50 and LOD95 , 2.5 and 15-18 copies/mL) and were approximately 10-fold to 100-fold more sensitive than research laboratory-developed and diagnostic reverse transcriptase-polymerase chain reaction tests that process from 10 to 30 µL of plasma per amplification. Increasing sample input volume assayed with the Centers for Disease Control and Prevention reverse transcriptase-polymerase chain reaction assays increased the LODs by 10-fold to 30-fold. Blood donor-screening ZIKV NAT assays demonstrate similar excellent sensitivities to assays currently used for screening for transfusion-transmitted viruses and are substantially more sensitive than most other laboratory-developed and diagnostic ZIKV reverse transcriptase-polymerase chain reaction assays. Enhancing sensitivities of laboratory-developed and diagnostic assays may be achievable by increasing sample input. © 2017 AABB.
Khan, Najib U; Ali, Ijaz; Ahmad, Naeem U; Iqbal, Aqib; Rehman, Latif U; Munir, Iqbal; Rehman, Muti U; Khan, Sanaullah; Ali, Sajid; Siddique, Lubna; Swati, Zahoor A
Hepatitis C is a fatal liver disease caused by the hepatitis C virus. In this study, blood donors, from various districts of the KPK province and the federally administered tribal area (FATA) of Pakistan were tested for anti-HCV antibodies and HCV RNA by ICT (Immuno-chromatographic test), ELISA and RT-PCR. Out of the 7148 blood donors, 224 (3.13%) were positive for anti-HCV antibodies by ICT, 135 (1.89%) by ELISA while 118 (1.65%) blood donors had active HCV infection as detected by RT-PCR. We suggest that ELISA should be used for anti-HCV screening in public sector hospitals and health care units.
Perreault, J; Lavoie, J; Painchaud, P; Côté, M; Constanzo-Yanez, J; Côté, R; Delage, G; Gendron, F; Dubuc, S; Caron, B; Lemieux, R; St-Louis, M
Large-scale genotyping of blood donors for red blood cell and platelet antigens has been predicted to replace phenotyping assays in the screening of compatible blood components for alloimmunized patients. Although several genotyping platforms have been described, novel procedures and processes are needed to perform genotyping efficiently and to maximize its benefits for blood banks. Here we describe the processes and procedures developed to introduce large-scale genotyping in our routine operations. Preliminary cost-benefit analysis indicated that genotyping must target frequent blood donors (> 3 donations/year) to be efficiently used. A custom-designed computer application was developed to manage the whole project. It selects frequent donors among recent donations, prints coded labels to identify blood samples sent to the external genotyping laboratory, and stores genotyping results. It can search for donors compatible for any combination of the 22 genotyped antigens as well as consult the current inventory for the presence of the corresponding blood components. The phenotype of recovered components is confirmed by standard serology techniques prior to shipment to hospitals. Since October 2007, 10 555 blood donors have been genotyped. The database is used on a regular basis to find compatible blood components with a genotype-phenotype concordance of 99.6%.
Mohamud, Hanat S; Mohamed, Deqa H; Alqahtani, Farjah H; Almajid, Fahad M; Alswat, Khalid; Somily, Ali M
Molecular screening technologies have improved blood safety by reducing the number of window-period transmissions relative to serological screening. In the two years following the introduction of molecular testing in King Khalid University Hospital, Saudi Arabia, 25,920 donor samples were screened in parallel by both serological and molecular techniques for hepatitis B virus (HBV), hepatitis C virus (HCV) and human immunodeficiency virus (HIV). No HCV or HIV NAT yields were detected. However, molecular screening enabled the interdiction of two confirmed HBV NAT yields. This is only the second report of confirmed HBV NAT yield in the Kingdom of Saudi Arabia, and amongst the few reports in the wider Middle East and North Africa region.
Sabino, Ester C.; Salles, Nanci A; de Almeida-Neto, Cesar; Barreto, Angela M.; Basques, Fernando; Barros, Emanuelle A.; Mendrone, Alfredo; Busch, Michael P
Background In Brazil it is mandatory to screen donors for HIV antibodies using two immunoassays (IAs) in parallel. Confirmatory testing is performed only on reactive donors who return for counseling. The goal of this analysis was to determine if concordant IA reactivity accurately predicts infection and can be used for HIV incidence/prevalence analyses. Methods We reviewed HIV screening and confirmatory results obtained for 307,407 donations in the first year of the REDS-II study in Brazil (2007), and for 2,304,755 donations collected from 1996 to 2006 in one of the REDS-II sites (Sao Paulo). Results In the Sao Paulo site, 11,410 (0.50%) HIV-IA-reactive donations were discarded, but only 2,095 (0.09%) were reactive to both IAs. Western blot was positive on 1,002 (48%) dual-IA-reactive donors who returned for counseling. Only 4 HIV-infected donors were detected who had been missed at screening by one of the IAs; all occurred prior to 2002. The positive predictive value (PPVs) of dual-IA-reactivity varied from 45.8 to 100%, with 80–90% PPVs when using IAs from different manufacturers. If both assays yielded signal-to-cutoff (S/C) values ≥3.0, PPVs ranged from 91–99%, with ~99% sensitivity for true HIV seropositivity. Conclusion Parallel testing of all donations has limited efficacy when highly sensitive IAs are used. Reactivity by two sequential IAs is useful for prevalence studies if the assays are from different manufacturers and especially if high S/C values are considered. PMID:20633245
Eccher, Albino; Cima, Luca; Ciangherotti, Andrea; Montin, Umberto; Violi, Paola; Carraro, Amedeo; Tedeschi, Umberto; Nacchia, Francesco; Fior, Francesca; Rostand, Momo; Boschiero, Luigino; D'Errico, Antonietta; Scarpa, Aldo; Casartelli-Liviero, Marilena; Ferrari, Giuseppe; Rodini, Viviana; Tomaselli, Elisabetta; Zampicinini, Laura; Vanzo, Francesca; Bovo, Chiara; Feltrin, Giuseppe; Neil, Desley; Brunelli, Matteo
Prevention of transmission of malignancy from donors to recipients is an aim of donor assessment. We report the most stringent interpretation of the Italian National Guidelines. A two-step ALERT process was used: ALERT1 consisting of clinical, radiological, and laboratory tests; ALERT2, consisting of intraoperative assessment in suspicious lesions. Four hundred of 506 potential deceased donors entered the ALERT system. Forty-one of 400 (10%) donors were excluded due to unacceptable risk of transmission. Of the remaining 359 193 required histopathology, which excluded malignancy or determined acceptable risk in 161/193 (83%). Thirty-five malignancies were identified: 19 (54%) at ALERT1, four (11%) at ALERT2, nine (26%) picked up at ALERT1 and confirmed by ALERT2. Three (9%) were missed by ALERT and diagnosed at postmortem examination. Prostate (n=12%, 34%) and renal cell (n=7%, 20%) were the most frequent carcinomas. The majority (92%) of prostate adenocarcinomas were of low risk and donation proceeded compared to 43% of renal carcinomas. Four renal carcinomas, two breast carcinomas, and a single case of nine different malignancies excluded donation. Positive ALERT donors had statistically more malignant reports than negative ALERT donors (P=<.05). Histopathology is an essential component of the multidisciplinary assessment of donors. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Kitchen, A D; Gillan, H L
The overall effectiveness of the NHSBT screening programme for infectious agents in deceased tissue donors is examined and evaluated in terms of current outcomes and how to improve upon these outcomes. The screening results and any subsequent confirmatory results from a total of 1659 samples from NHSBT deceased donors referred to NTMRL for screening for infectious agents were included in the analysis. Overall 1566/1659 (94.4%) of the samples were screen negative. A total of 93 were repeat reactive on screening for one or more of the mandatory markers screened for, of which only 12 (13%) were subsequently confirmed to be positive on confirmatory testing. The majority of the repeat reactive samples were demonstrating non-specific reactivity with the screening assays in use. Overall, the NHSBT screening programme for infectious agents in deceased tissue donors is very effective with a relatively low overall loss of donors because of non-specific reactivity. However, unnecessary loss of tissue products is not acceptable, and although this programme compares favourably with the outcomes of other such programmes, the confirmatory results obtained demonstrate both the need and the potential for improving the outcomes. This is particularly important as one donor may donate more than one product, and can be achieved very easily with a change to the screening algorithm followed, using the confirmatory data obtained to support and validate this change. CONTENTS SUMMARY: Critical analysis of the NHSBT screening programme for infectious agents in deceased tissue donors and a strategy involving the design and use of a different screening algorithm to improve these outcomes.
Zeng, P; Liu, J; Wang, J; Dong, X; Li, J; Bi, X; Ma, H; Wen, X; He, M; Liu, Y; Ness, P; Shan, H
To evaluate the strategy of parallel screening with different enzyme-linked immunosorbent assays (ELISA) among Chinese blood donors. Parallel screening with ELISA has been the main strategy to detect human immunodeficiency virus (HIV) in blood donations in China for more than a decade. The performance of the strategy should be analysed. A total of 821,927 donations collected from five Chinese blood centres in 2008-2010 were tested using two third-generation ELISAs by different manufacturers licenced and confirmed by the Western blot (WB) in this study. The confirmatory positive predictive values (PPV), false positive rates (FPR), false negative rates (FNR) and potential risks for transfusion resulting from single or sequential ELISA screening were evaluated. A total of 5318 (0·647%) of donations screened HIV reactive and were discarded. WB confirmatory results on 1668 available samples suggested that PPVs for dual ELISA, one round ELISA reactive and grey zone samples were 75·1, 0·7 and 0·5%, respectively. Eight out of 1124 one round ELISA reactive and 1 out of 195 grey zone samples were WB confirmed positive. All but one ELISA assay displayed comparable PPVs but variable FPRs and FNRs that differed by blood centre. In the absence of nucleic acid testing (NAT), parallel ELISA screening prevented a substantial number of HIV infected donations from entering the Chinese blood supply. However, the loss of false positive donors should be re-evaluated especially given the frequently reported blood supply shortage in China. © 2015 British Blood Transfusion Society.
Drosten, C; Seifried, E; Roth, W K
Screening of blood donors for human immunodeficiency virus type 1 (HIV-1) infection by PCR permits the earlier diagnosis of HIV-1 infection compared with that by serologic assays. We have established a high-throughput reverse transcription (RT)-PCR assay based on 5'-nuclease PCR. By in-tube detection of HIV-1 RNA with a fluorogenic probe, the 5'-nuclease PCR technology (TaqMan PCR) eliminates the risk of carryover contamination, a major problem in PCR testing. We outline the development and evaluation of the PCR assay from a technical point of view. A one-step RT-PCR that targets the gag genes of all known HIV-1 group M isolates was developed. An internal control RNA detectable with a heterologous 5'-nuclease probe was derived from the viral target cDNA and was packaged into MS2 coliphages (Armored RNA). Because the RNA was protected against digestion with RNase, it could be spiked into patient plasma to control the complete sample preparation and amplification process. The assay detected 831 HIV-1 type B genome equivalents per ml of native plasma (95% confidence interval [CI], 759 to 936 HIV-1 B genome equivalents per ml) with a >or=95% probability of a positive result, as determined by probit regression analysis. A detection limit of 1,195 genome equivalents per ml of (individual) donor plasma (95% CI, 1,014 to 1,470 genome equivalents per ml of plasma pooled from individuals) was achieved when 96 samples were pooled and enriched by centrifugation. Up to 4,000 plasma samples per PCR run were tested in a 3-month trial period. Although data from the present pilot feasibility study will have to be complemented by a large clinical validation study, the assay is a promising approach to the high-throughput screening of blood donors and is the first noncommercial test for high-throughput screening for HIV-1.
Yang, Yonglin; Nan, Yuchen; Cai, Jie; Xu, Jiling; Huang, Zuhu; Cai, Xubing
Hepatitis B surface antigen (HBsAg) is the main diagnosis marker for hepatitis B virus (HBV) infection. In this study, a novel HBV mutant from an HBV-positive blood donor with false-negative results during HBsAg screening was identified. DNA sequencing discovered two mutations at nt 353 (A to T) and nt 349 (T to A), leading to Thr to Met and Ser to Thr substitutions at aa 118 and 117 of HBsAg, respectively. Further analysis showed that eight of ten HBsAg ELISA kits failed to detect this HBsAg mutant. A mutagenesis assay indicated that the Thr to Met substitution at aa 118 was the determinant for escape from HBsAg ELISA detection. A small-scale screening of blood donors identified two individuals infected by this unique HBV mutant, suggesting a certain level of prevalence among the general population. In conclusion, our study identified the aa 118 mutation in HBV surface antigen and provided information for improvement of HBV diagnosis products.
Levi, José Eduardo; Pereira, Ricardo Antonio D'Almeida; Polite, Márcia Bernardino de Carvalho; Mota, Mariza Aparecida; Nunez, Silvia Patricia; Pinho, João Renato Rebello; Kutner, José Mauro
Objective To describe general data on nucleic acid/serology testing and report the first hepatitis B-nucleic acid testing yield case of an immunized donor in Brazil. Methods A total of 24,441 donations collected in 2010 and 2011 were submitted to individual nucleic acid testing for hepatitis B, hepatitis C and human immunodeficiency virus using the TaqMan(r) MPX kit (Roche) on the Cobas s201 platform, in addition to routine screening for serological markers. Nucleic acid testing-reactive donations were further evaluated by real-time polymerase chain reaction using Cobas AmpliPrep/Cobas TaqMan hepatitis B virus, hepatitis C virus and human immunodeficiency virus tests. Results Thirty-two donations were reactive by nucleic acid testing, 31 were also serologically reactive and one first-time donor was identified as having hepatitis B in the window period. Follow-up samples showed increasing titers of anti-HBs rising from 19 UI/mL in the index donation to 109 IU/mL seven months later attributable to his vaccination history. Curiously, this donor was never reactive for HbsAg nor for anti-HBc. In the yield donation, he was concomitantly reactive for syphilis (enzyme immunoassay and fluorescent treponemal antibody-absorption; venereal disease research laboratory non-reactive). Overall, six donors (0.02%) were characterized as occult hepatitis B. A total of 35% of the confirmed (recombinant immunoblot assay positive) hepatitis C donations were nucleic acid testing non-reactive and no human immunodeficiency virus "elite controller" was identified. Conclusion The yield rate (1:24,441; 95% confidence interval: 1:9,537 - 1:89,717) contrasts to the North American rate (1:410,540 donations) and strongly advocates the adoption of nucleic acid testing for hepatitis B in Brazil despite the increasing rate of anti-HBs reactive subjects due to the successful immunization program. PMID:23904804
Kim, Moon Jung; Park, Quehn; Kim, Myung Hee; Shin, Jeong Won
Background The Hb levels of prospective blood donors are usually determined using a finger prick test. A new noninvasive Hb device has the advantage of not causing any sampling pain. The purpose of this study was to evaluate the accuracy of the noninvasive Hb sensor and to compare its measurements with those of a currently used portable hemoglobinometer. Methods Hb was measured using a noninvasive Hb sensor (NBM-200; OrSense, Israel), a portable hemoglobinometer (HemoCue; HemoCue AB, Sweden), and an automated hematology analyzer (LH500; Beckman Coulter, USA). The correlations between Hb measurements taken by the NBM-200 and HemoCue with those by an automated hematology analyzer were assessed using intraclass correlation coefficients (ICCs). Hb measurements were compared among 3 different Hb level groups. Results The mean Hb values of 506 blood donors were 14.1 g/dL by the NBM-200, 14.0 g/dL by the LH500, and 14.3 g/dL by the HemoCue. The correlation between the LH500 and the NBM-200 was substantial (ICC=0.69), while that between the LH500 and the HemoCue agreed almost perfectly (ICC=0.86). Conclusions The possibility to judge to be eligible for donors who are ineligible to donate was substantial when using NBM-200. Even though the NBM-200 has the apparent advantage of noninvasiveness, its use in pre-screening should be given meticulous attention. Since pre-donation testing is crucial to protecting donors' health, complete evaluation of the instrument should be performed prior to use. PMID:23826562
González, Rocio; Torres, Pilar; Castro, Emma; Barbolla, Luz; Candotti, Daniel; Koppelman, Marco; Zaaijer, Hans L; Lelie, Nico; Allain, Jean-Pierre; Echevarría, Jose-Manuel
Screening of blood units for hepatitis B virus (HBV) DNA identifies donations collected during the window period (WP) of the acute infection and may improve viral safety of the blood supply. It also leads to the detection of occult hepatitis B infection (OBI). From January 2005 to December 2006, a total of 383,267 blood units were screened for hepatitis B surface antigen (HBsAg) and HBV DNA in two transfusion centers in Madrid, using either individual-donation nucleic acid testing (ID-NAT) or minipool (MP-NAT) of eight donations (MP8). Samples positive for HBV DNA and negative for HBsAg were confirmed by a second molecular test, the viral DNA was quantified, and a genome fragment including the region encoding the major hydrophilic region (MHR) of HBsAg was sequenced. The overall yield of HBV DNA-positive, HBsAg-negative units was 1 in 21,282 (18 cases), higher when using ID-NAT than MP8-NAT (1:9862 vs. 1:51,011; p < 0.01). Four donations (1/95,817) were collected during the infectious pre-HBsAg WP, one during an early recovery stage, and the remaining 13 (1/29,482) were OBIs, six of whom had no detectable antibody to HBsAg. Low-level Genotype D HBV DNA was detected in all OBI cases; the frequencies of this genotype and MHR amino acid substitutions were significantly higher than reported from unselected Spanish HBsAg carriers. Donors with OBI had normal aminotransferase levels and were significantly older than donors carrying HBsAg. Blood donors in the WP and with OBI are not uncommon in Madrid and are detected at a higher frequency with ID-NAT than MP-NAT.
Utility of the clinical practice of administering thrombophilic screening and antithrombotic prophylaxis with low-molecular-weight heparin to healthy donors treated with G-CSF for mobilization of peripheral blood stem cells.
Martino, Massimo; Luise, Francesca; Oriana, Vincenzo; Console, Giuseppe; Moscato, Tiziana; Mammì, Corrado; Messina, Giuseppe; Massara, Elisabetta; Irrera, Giuseppe; Piromalli, Angela; Lombardo, Vincenzo Trapani; Laganà, Carmelo; Iacopino, Pasquale
The aim of the study was to verify the utility of the clinical practice of administering thrombophilic screening and antithrombotic prophylaxis with low-molecular-weight heparin to healthy donors receiving granulocyte colony-stimulating factor to mobilize peripheral blood stem cells. Thrombophilia screening comprised of testing for factor V Leiden G1691A, prothrombin G20210A, the thermolabile variant (C677T) of the methylene tetrahydrofolate reductase gene, protein C, protein S, factor VIII and homocysteine plasmatic levels, antithrombin III activity, and acquired activated protein C resistance. We investigated prospectively 72 white Italian healthy donors, 39 men and 33 women, with a median age of 42 years (range, 18-65). Five donors (6.9%) were heterozygous carriers of Factor V Leiden G1691A; two healthy donors had the heterozygous prothrombin G20210A gene mutation; C677T mutation in the methylene tetrahydrofolate reductase gene was present in 34 (47.2%) donors in heterozygous and in 7 donors (9.7%) in homozygous. Acquired activated protein C resistance was revealed in 8 donors of the study (11.1%). The protein C plasmatic level was decreased in 3 donors (4.2%); the protein S level was decreased in 7 donors (9.7%). An elevated factor VIII dosage was shown in 10 donors (13.9%) and hyperhomocysteinemia in 9 donors (12.5%). Concentration of antithrombin III was in the normal range for all study group donors. The factor V Leiden mutation was combined with the heterozygous prothrombin G20210A in 2 cases and with protein S deficiency in one case; 2 healthy donors presented an associated deficiency of protein C and protein S. Although none of these healthy subjects had a previous history of thrombosis, low-molecular-weight heparin was administered to all donors during granulocyte colony-stimulating factor administration to prevent thrombotic events. No donor experienced short or long-term thrombotic diseases after a median follow-up of 29.2 months. Our data do not
Sharon, R; Frutkoff, I; Kidroni, G; Menczel, J
Salicylate concentrations in 3819 sera of apparently healthy voluntary blood donors were determined in view of the significance of this drug in the induction of allergic reactions and its possible interference in platelet function. Two hundred and ninety-five sera were found by a modified colorimetric determination to contain salicylates. The colorimetric determination was compared with a high performance liquid chromatography (HPLC) analysis of salicylate-containing sera. Drug concentrations detected were mostly in the range of 20-100 mg/l. Such concentrations have been reported to evoke allergic reactions and to affect the haemostatic action of platelets. PMID:7061719
Dim, Cyril C; Onyedum, Cajetan C; Dim, Ngozi R; Chukwuka, Judith C
The sustainability of donor-supported cervical cancer screening for HIV-positive women in underresourced setting is a concern. The authors aimed to determine the willingness of HIV-positive women for out-of-pocket payment for the cancer screening, if necessary. Questionnaires were administered to 400 HIV-positive women at the Adult HIV clinic, University of Nigeria Teaching Hospital (UNTH), Enugu, Nigeria. In all 11 (2.8%) respondents were aware of Pap smear, but only 1 (9.1%) of them had used it. After cervical cancer screening counseling, 378 (94.5%) respondents were willing to pay for Pap smear, irrespective of the cost. This willingness showed no trend across marital or educational groups. Younger age of respondents was not associated with willingness to pay for Pap smear (odds ratio = 1.24; confidence interval 95%: 0.52, 2.94). Willingness to pay for Pap smear by HIV-positive women in Enugu, Nigeria, is high. This has implication for the program sustainability. © The Author(s) 2013.
Biggerstaff, Brad J.; Basavaraju, Sridhar V.; Ocfemia, M. Cheryl Bañez; Alsina, Jose O.; Climent-Peris, Consuelo; Moseley, Robin R.; Chung, Koo-Whang; Rivera-García, Brenda; Bello-Pagán, Melissa; Pate, Lisa L.; Galel, Susan A.; Williamson, Phillip; Kuehnert, Matthew J.
Puerto Rico has been heavily impacted by Zika virus, a mosquitoborne flavivirus that emerged in the Americas during 2015. Although most persons with Zika virus show no symptoms, the virus can cause neurologic and other complications, including fetal microcephaly. Local Zika virus transmission in Puerto Rico has been reported since December 2015. To prevent transfusion-associated transmission, local blood collection ceased in March 2016 but resumed in April 2016 after Zika virus screening of blood donations became available. Using data from screening of blood donations collected by the 2 largest blood centers in Puerto Rico during April 3–August 12, 2016, and assuming a 9.9-day duration of viremia, we estimated that 469,321 persons in Puerto Rico were infected during this period, for an estimated cumulative incidence of 12.9%. Results from blood donation screening during arboviral outbreaks can supplement routine clinical and surveillance data for improved targeting of prevention efforts. PMID:28263141
Chevalier, Michelle S; Biggerstaff, Brad J; Basavaraju, Sridhar V; Ocfemia, M Cheryl Bañez; Alsina, Jose O; Climent-Peris, Consuelo; Moseley, Robin R; Chung, Koo-Whang; Rivera-García, Brenda; Bello-Pagán, Melissa; Pate, Lisa L; Galel, Susan A; Williamson, Phillip; Kuehnert, Matthew J
Puerto Rico has been heavily impacted by Zika virus, a mosquitoborne flavivirus that emerged in the Americas during 2015. Although most persons with Zika virus show no symptoms, the virus can cause neurologic and other complications, including fetal microcephaly. Local Zika virus transmission in Puerto Rico has been reported since December 2015. To prevent transfusion-associated transmission, local blood collection ceased in March 2016 but resumed in April 2016 after Zika virus screening of blood donations became available. Using data from screening of blood donations collected by the 2 largest blood centers in Puerto Rico during April 3-August 12, 2016, and assuming a 9.9-day duration of viremia, we estimated that 469,321 persons in Puerto Rico were infected during this period, for an estimated cumulative incidence of 12.9%. Results from blood donation screening during arboviral outbreaks can supplement routine clinical and surveillance data for improved targeting of prevention efforts.
Sommese, Linda; Sabia, Chiara; Paolillo, Rossella; Parente, Delia; Capuano, Maria; Iannone, Carmela; Cavalca, Francesco; Schiano, Concetta; Vasco, Maria; De Pascale, Maria Rosaria; Casamassimi, Amelia; Napoli, Claudio
Automated chemiluminescent immunoassays (CLIAs) are useful for the detection of hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus 1/2 antigen/antibodies (HIV 1/2 Ag/Ab) in blood donor screening. Eight hundred and forty serum samples were tested for hepatitis B surface antigen (HBsAg), HCV antibodies (anti-HCV), and HIV1/2 Ag/Ab in parallel using 2 different CLIAs (Abbott Architect i2000SR and Roche Cobas e411). The concordance between the 2 systems was high (Cohen's kappa 0.97 for HBsAg, 0.77 for anti-HCV, 0.92 for HIV1/2 Ag/Ab) and the specificity and the positive predictive value were comparable. Among the 12 discrepant results, 11 were false-positive and 1 (reactive by Architect) was true-positive for anti-HCV. Positivity for HBV DNA, HCV RNA, and HIV RNA was recorded in 90.9%, 38.9%, and 100% of true-positive samples, respectively. This study represents the first stringent comparison between Architect i2000SR and Cobas e411 in blood donors. We observed a good correlation and high agreement among HBV, HCV, and HIV with the 2 automated systems.
Information Report • Added additional tests: Chagas (screening) and Chagas (confirmatory), along with their results and test dates performed • Revisions...Disease Marker screen and Cord Information (Detailed and Summary) and Cord Lab Summary Reports o The Chagas EIA test text was changed to Chagas (screening...o The RIPA (confirmatory) test was changed to Chagas (confirmatory) National Marrow Donor Program® N000014-08-1-0058 QUARTER PROGRESS REPORT
Torres, Kátia Luz; Dos Santos Moresco, Mônica Nascimento; Sales, Luciane Rodrigues; da Silva Abranches, Josilene; Araújo Alexandre, Márcia Almeida; Malheiro, Adriana
With 99% of the cases in Brazil, malaria is endemic in the Amazon region. Transfusion-transmitted malaria, an important risk in endemic areas, has been reported. The aim of this study was to describe the epidemiological profile of blood donor candidates at the Fundação de Hematologia e Hemoterapia do Amazonas and evaluate the efficacy of rapid diagnostic tests used for malaria screening of blood donors within endemic regions. Between May 2008 and May 2009, 407 blood donor candidates were selected and grouped based on the Malaria Annual Parasite Index of the geographic area in which they originated: Group 1 (eligible donors - n=265) originated from areas of low to medium risk of exposure to malaria and Group 2 (ineligible donors - n=142) originated from high-risk areas. All samples were concurrently screened using two immunochromatic antigen-based rapid tests and by the thick smear test. All samples were negative by all three methods. The demographic profile indicated that the majority of participants were male, ages ranged from 18 to 39 years and less than half the candidates had only elementary schooling. Two issues need to be addressed: one is the ineligibility of donors and its impact on blood donor centers as, in this study, 22.7% of the donors were considered ineligible. The other is the limited sensitivity of the parasitological tests used, allowing a risk of false-negative results. New methods are needed to ensure transfusion safety without rejecting potential donors, which would ensure safe transfusion without harming the blood supply. Copyright © 2014 Associação Brasileira de Hematologia, Hemoterapia e Terapia Celular. Published by Elsevier Editora Ltda. All rights reserved.
Haer-Wigman, Lonneke; Ait Soussan, Aïcha; Ligthart, Peter; de Haas, Masja; van der Schoot, C Ellen
Individuals with anti-Jr(a) or anti-Lan are ideally transfused with rare Jr(a-) or Lan- red blood cells. We characterized mutations in Dutch Jr(a-) and Lan- individuals and developed a high-throughput genotyping assay to detect Jr(a-) and Lan- donors. Six Jr(a-) and seven Lan- persons, who all made anti-Jr(a) or anti-Lan, were sequenced for ABCG2 or ABCB6 and the copy number of ABCG2 and ABCB6 was determined. A total of 3366 Caucasian, 621 black, and 333 Chinese donors were screened with a high-throughput screening assay targeting frequently occurring mutations causing the Jr(a-) or Lan- phenotype. In the six tested Jr(a-) individuals previously described, c.376C > T, c.706C > T, and c.736C > T nonsense mutations in ABCG2 were detected. In the seven Lan- individuals 12 different mutations, of which 10 underlie the Lan- phenotype, were detected. No copy number variation was detected for ABCG2 and ABCB6. The high-throughput screening assay detected five Caucasian donors heterozygous for the c.706C > T or 736C > T mutation in ABCG2 and nine Caucasian donors heterozygous for the 574C > T mutation in ABCB6. No black or Chinese donors were found positive for a mutation. We describe eight new mutations in ABCB6 of which seven, including three missense mutations, underlie the Lan- phenotype and determine that a complete gene deletion of ABCG2 or ABCB6 is not responsible for the Jr(a-) or Lan- phenotype, respectively. The extended heterogeneity of mutations causing the Jr(a-) or Lan- phenotype in most populations makes genetic screening for the Jr(a-) and Lan- phenotype inefficient in those populations. © 2014 AABB.
Allison, Kirsty M; Faddy, Helen M; Margaritis, Angelo; Ismay, Susan; Marks, Denese C
Blood services are required to maintain repositories of frozen samples for confirmation of results and/or retrospective testing. The Australian Red Cross Blood Service archives donor samples in plasma preparation tubes (PPTs). This study aims to evaluate the effect of freeze-thawing and extended frozen storage on the ability to detect human immunodeficiency virus (HIV), hepatitis C virus (HCV), and hepatitis B virus (HBV) using blood donation screening assays in samples stored in PPTs. Whole blood was spiked with HIV-, HCV-, or HBV-reactive plasma at high and low viral loads and stored in PPTs or as plasma aliquots. All samples were frozen and stored at not more than -30°C. At 0, 3, 6, 12, 18, and 36 months, samples were tested for HIV and HCV antibodies, HBV surface antigen, and viral nucleic acid. Additional samples were thawed and refrozen either once or twice before testing to simulate up to three freeze-thaw cycles. All PPT and plasma aliquots retained appropriate viral reactivity, including those with multiple freeze-thaw cycles, on both nucleic acid testing and serology platforms. Frozen storage of biologicals in PPTs, as opposed to plasma aliquots, does not affect the ability to detect HIV, HCV, and HBV using viral nucleic acid or serology donation screening systems for up to 36 months. Freezing and thawing PPT samples did not impact the ability to detect these viruses. Our study demonstrates that PPTs appear to be an appropriate receptacle for frozen plasma sample archiving for up to 3 years. © 2015 AABB.
... determine whether a donor is eligible? (a) Determination based on screening and testing. If you are the... eligible based upon the results of donor screening in accordance with § 1271.75 and donor testing in... provisions only if: (1) Donor screening in accordance with § 1271.75 indicates that the donor: (i) Is...
... determine whether a donor is eligible? (a) Determination based on screening and testing. If you are the... eligible based upon the results of donor screening in accordance with § 1271.75 and donor testing in... provisions only if: (1) Donor screening in accordance with § 1271.75 indicates that the donor: (i) Is...
Chauhan, H P S; Carpenter, Jaswant; Joshi, Sapana
The bis(N,N-dimethyldithiocarbamato-S,S')antimony(III) complexes have been obtained by the reaction of chloro bis(N,N-dimethyldithiocarbamato-S,S')antimony(III) with corresponding oxo or thio donor ligands such as sodium benzoate 1, sodium thioglycolate 2, phenol 3, sodium 1-propanethiolate 4, potassium thioacetate 5, sodium salicylate 6, ethane-1,2-dithiolate 7 and disodium oxalate 8. These complexes have been characterized by the physicochemical [melting point, molecular weight determination and elemental analysis (C, H, N, S and Sb)], spectral [UV-Visible, FT-IR, far IR, NMR (1H and 13C)], thermogravimetric (TG & DTA) analysis, ESI-Mass and powder X-ray diffraction studies. Thermogravimetric analysis of the complexes confirmed the final decomposition product as highly pure antimony sulfide (Sb2S3) and powder X-ray diffraction studies show that the complexes are in lower symmetry with monoclinic crystal lattice and nano-ranged particle size (11.51-20.82 nm). The complexes have also been screened against some bacterial and fungal strains for their antibacterial and antifungal activities and compared with standard drugs. These show that the complexes have greater activities against some human pathogenic bacteria and fungi than the activities of standard drugs. Copyright © 2014 Elsevier B.V. All rights reserved.
Chauhan, H. P. S.; Carpenter, Jaswant; Joshi, Sapana
The bis(N,N-dimethyldithiocarbamato-S,S‧)antimony(III) complexes have been obtained by the reaction of chloro bis(N,N-dimethyldithiocarbamato-S,S‧)antimony(III) with corresponding oxo or thio donor ligands such as sodium benzoate 1, sodium thioglycolate 2, phenol 3, sodium 1-propanethiolate 4, potassium thioacetate 5, sodium salicylate 6, ethane-1,2-dithiolate 7 and disodium oxalate 8. These complexes have been characterized by the physicochemical [melting point, molecular weight determination and elemental analysis (C, H, N, S and Sb)], spectral [UV-Visible, FT-IR, far IR, NMR (1H and 13C)], thermogravimetric (TG & DTA) analysis, ESI-Mass and powder X-ray diffraction studies. Thermogravimetric analysis of the complexes confirmed the final decomposition product as highly pure antimony sulfide (Sb2S3) and powder X-ray diffraction studies show that the complexes are in lower symmetry with monoclinic crystal lattice and nano-ranged particle size (11.51-20.82 nm). The complexes have also been screened against some bacterial and fungal strains for their antibacterial and antifungal activities and compared with standard drugs. These show that the complexes have greater activities against some human pathogenic bacteria and fungi than the activities of standard drugs.
Changing blood donor screening criteria from permanent deferral for men who have sex with men to individual sexual risk assessment: no evidence of a significant impact on the human immunodeficiency virus epidemic in Italy
Suligoi, Barbara; Pupella, Simonetta; Regine, Vincenza; Raimondo, Mariangela; Velati, Claudio; Grazzini, Giuliano
Background In 2001, the criteria for blood donor eligibility in Italy were modified by a ministerial decree from a permanent deferral for "men who have sex with men" to an individual risk assessment of sexual behaviours. The aim of this study was to evaluate the impact of this change in donor screening criteria on the human immunodeficiency virus epidemic among blood donors in Italy. Materials and methods We used the data obtained from the Italian blood donor epidemiological surveillance system. We compared data collected in 2009 and 2010, when the individual risk assessment policy was applied, with data collected in 1999 when permanent deferral was applied for men who have sex with men based on a declaration of sexual orientation. We evaluated the change over time in the relative proportion of HIV antibody-positive donors who likely acquired the infection from men who have sex with men vs heterosexual sexual exposure; the relative risk was calculated using 1999 as the reference year. Results In all 3 years, the majority of HIV antibody-positive donors reported sexual exposure as a risk factor for HIV infection; this proportion increased over time, although not statistically significantly. Heterosexuals always accounted for at least 40% of all HIV antibody-positive cases. The rate of HIV antibody-positive donors increased similarly in men who have sex with men and heterosexuals; specifically, the rate of HIV antibody-positive cases per 100,000 donors was more than 2-fold higher among men who have sex with men in 2009–2010 than in 1999 (2009–2010 vs 1999, RR =2.8; P =0.06), and that among heterosexuals was 1.5 fold higher (P =0.18). Discussion When comparing the period before (1999) and after (2009–2010), the implementation of the individual risk assesment policy in 2001, no significant increase in the proportion of men who have sex with men compared to heterosexuals was observed among HIV antibody-positive blood donors, suggesting that the change in donor
Schwettmann, Lutz; Külpmann, Wolf-Rüdiger; Vidal, Christian
Two commercially available drug-screening assays were evaluated: the Roche kinetic interaction of microparticles in solution (KIMS) assay and the Microgenics cloned enzyme donor immunoassay (CEDIA). Urine samples from known drug-abuse patients were analyzed for amphetamines, barbiturates, benzodiazepines, benzoylecgonine, cannabinoids, LSD, methadone and opiates. Samples with discordant findings for the two assays were analyzed by gas chromatography/mass spectrometry (GC/MS) or gas chromatography/electron capture detection (GC/ECD). Amphetamines showed 96.0% concordant results, with two false positive findings by CEDIA, three by KIMS and a further two false negatives by KIMS. Barbiturates showed 99.4% concordant results, with one false negative by KIMS. Benzodiazepines showed 97.4% concordant results, with two false negatives by KIMS (cutoff 100 microg/L, CEDIA cutoff 300 microg/L). Benzoylecgonine showed 17.8% concordant positive and 82.2% concordant negative results and no false finding by either assay. Cannabinoids showed 99.3% concordant results, with one sample negative by KIMS at a cutoff of 50 microg/L and positive by CEDIA (cutoff 25 microg/L). For LSD, 6.7% of findings were not in agreement. Methadone showed 97.5% concordant results, with two false positives by CEDIA, and one false positive and one false negative by KIMS. Opiates showed 96.9% concordant results, with no false KIMS results, but four false positives by CEDIA. The results indicate that the agreement of the CEDIA and KIMS results for the eight drugs is rather good (93.3-100%).
Lavoué, Vincent; Vigneau, Cécile; Duros, Solène; Boudjema, Karim; Levêque, Jean; Piver, Pascal; Aubard, Yves; Gauthier, Tristan
The aim of this systematic review was to evaluate and compare the pros and cons of using living donors or brain-dead donors in uterus transplantation programs, 2 years after the first worldwide live birth after uterus transplantation. The Medline database and the Central Cochrane Library were used to locate uterine transplantation studies carried out in human or nonhuman primates. All types of articles (case reports, original studies, meta-analyses, reviews) in English or French were considered for inclusion. Overall, 92 articles were screened and 44 were retained for review. Proof of concept for human uterine transplantation was demonstrated in 2014 with a living donor. Compared with a brain-dead donor strategy, a living donor strategy offers greater possibilities for planning surgery and also decreases cold ischemia time, potentially translating into a higher success rate. However, this approach poses ethical problems, given that the donor is exposed to surgery risks but does not derive any direct benefit. A brain-dead donor strategy is more acceptable from an ethical viewpoint, but its feasibility is currently unproven, potentially owing to a lack of compatible donors, and is associated with a longer cold ischemia time and a potentially higher rejection rate. The systematic review demonstrates that uterine transplantation is a major surgical innovation for the treatment of absolute uterine factor infertility. Living and brain-dead donor strategies are not mutually exclusive and, in view of the current scarcity of uterine grafts and the anticipated future rise in demand, both will probably be necessary.
Kuhns, Mary C; Kleinman, Steven H; McNamara, Anne L; Rawal, Bhupat; Glynn, Simone; Busch, Michael P
Studies showing a significant correlation between hepatitis B surface antigen (HBsAg) and hepatitis B virus (HBV) deoxyribonucleic acid (DNA) levels have focused on the HBV seroconversion window period. HBsAg levels relative to HBV DNA results in 200 HBsAg-positive, anti-hepatitis B core antigen (HBc)-reactive blood donations were analyzed using quantitative polymerase chain reaction (PCR) (detection limit 400 copies/mL), two research PCR assays with increasing sensitivities (65 copies/mL and 1.3 copies/mL, respectively), and a quantitative HBsAg assay; HBsAg and HBV DNA levels were correlated with HBV serologic profiles; and the potential for replacing HBsAg screening with nucleic acid testing (NAT) was analyzed. Serologic profiles for over 90 percent of the donor samples were consistent with chronic HBV infection. Correlation between HBsAg and HBV DNA concentrations was weak (correlation coefficient = 0.33). Thirty-six percent (72/200) of donor samples had DNA levels under 400 copies per mL. Retesting of the 72 samples by more sensitive PCR assays showed that 60 out of 200 (30%) were positive by PCR with sensitivity of 65 copies per mL, whereas 6 out of 200 (3%) required PCR sensitivity of 1.3 copies per mL for positivity. Three percent (6/200) were negative by all three NAT assays. HBV DNA levels in HBsAg-positive, anti-HBc-reactive blood donations can be extremely low. About 6 percent of donations would be negative by current minipool HBV NAT methods. About 3 percent of donations would remain undetected by sensitive single-donor NAT. These results indicate caution in any consideration of dropping HBsAg screening.
Bent, C; Fananapazir, G; Tse, G; Corwin, M T; Vu, C; Santhanakrishnan, C; Perez, R V; Troppmann, C
In previous studies with different donor selection criteria and noncontemporary surgical techniques, graft arterial stenosis (GAS) has been reported to occur more frequently in adult recipients of pediatric en bloc renal allografts (EBKT) as compared to single adult donor allografts. The purpose of our study was to evaluate the incidence of GAS within our EBKT recipient population and to evaluate clinical and imaging features of those cases with GAS. In a retrospective cohort study, we analyzed 182 EBKT performed at a single institution. We identified cases of suspected GAS based on clinical factors, lab results, and noninvasive imaging. Diagnosis of GAS was confirmed by digital subtraction angiography. Two EBKT recipients (1.1% of 182) had angiographically confirmed GAS at 2.5 and 4.5 months after transplant. In both cases, the stenoses were short segment within the proximal (perianastomotic) donor aorta, color Doppler ultrasound demonstrated peak systolic velocities of >400 cm/s, and poststenotic parvus tardus waveforms were present. Both patients underwent angioplasty and demonstrated postintervention improvement in renal function and blood pressure. Restenosis did not occur during follow up. In conclusion, recipients of EBKT have a low incidence of GAS, similar to the lowest reported for adult single allografts.
Maple, Peter A C; Beard, Stuart; Parry, Ruth P; Brown, Kevin E
Human parvovirus 4 (ParV4), a newly described member of the family Parvoviridae, like B19V, has been found in pooled plasma preparations. The extent, and significance, of ParV4 exposure in UK blood donors remain to be determined and reliable detection of ParV4 immunoglobulin (Ig)G, using validated methods, is needed. With ParV4 virus-like particles a ParV4 IgG time-resolved fluorescence immunoassay (TRFIA) was developed. There is no gold standard or reference assay for measuring ParV4 IgG and the utility of the TRFIA was first examined using a panel of sera from people who inject drugs (PWIDS)--a high-prevalence population for ParV4 infection. Western blotting was used to confirm the specificity of TRFIA-reactive sera. Two cohorts of UK blood donor sera comprising 452 sera collected in 1999 and 156 sera collected in 2009 were tested for ParV4 IgG. Additional testing for B19V IgG, hepatitis C virus antibodies (anti-HCV), and ParV4 DNA was also undertaken. The rate of ParV4 IgG seroprevalence in PWIDS was 20.7% and ParV4 IgG was positively associated with the presence of anti-HCV with 68.4% ParV4 IgG-positive sera testing anti-HCV-positive versus 17.1% ParV4 IgG-negative sera. Overall seropositivity for ParV4 IgG, in 608 UK blood donors was 4.76%. The ParV4 IgG seropositivity for sera collected in 1999 was 5.08%, compared to 3.84% for sera collected in 2009. No ParV4 IgG-positive blood donor sera had detectable ParV4 DNA. ParV4 IgG has been found in UK blood donors and this finding needs further investigation. © 2013 American Association of Blood Banks.
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Wiegand, J; Luz, B; Mengelkamp, A-K; Moog, R; Koscielny, J; Halm-Heinrich, I; Susemihl, C; Bentzien, F; Diekmann, J; Wernet, D; Karger, R; Angert, K; Schmitt-Thomssen, A; Kiefel, V; Lutter, K; Hesse, R; Kätzel, R; Opitz, A; Luhm, J; Barz, D; Leib, U; Matthes, G; Tillmann, H L
Prevalence data concerning viral hepatitis and human immunodeficiency virus (HIV) in the general population are usually scarce. We aimed for a large cohort representative of the general population that required little funding. Autologous blood donors are relatively representative of the general population, and are tested for viral hepatitis and HIV in many countries. However, frequently these data are not captured for epidemiologic purposes. We analysed data from well over 35,000 autologous blood donors as recorded in 21 different transfusion centres for anti-hepatitis C virus (HCV), HBsAg and anti-HIV, as well as TPHA if available. We found a lower prevalence of hepatitis B virus and HCV in East vs West Germany, 0.2%vs 0.32% and 0.16%vs 0.32% respectively, which confirms earlier data in smaller cohorts, thus supporting the value of our approach. HIV was too rare to disclose significant differences, 0.01%vs 0.02%. TPHA was higher in East (0.34%) vs West Germany (0.29%) without significant differences. HCV was more frequent in women vs men. Transfusion institutes managing autologous blood donations should be used as a resource for epidemiological data relating to viral hepatitis and HIV, if such testing is performed routinely. This approach generates data relating to the general population with special emphasis on undiagnosed cases.
Revelli, Nicoletta; Villa, Maria Antonietta; Paccapelo, Cinzia; Manera, Maria Cristina; Rebulla, Paolo; Migliaccio, Anna Rita; Marconi, Maurizio
In 2005, the government of Lombardy, an Italian region with an ethnically varied population of approximately 9.8 million inhabitants including 250,000 blood donors, founded the Lombardy Rare Donor Programme, a regional network of 15 blood transfusion departments coordinated by the Immunohaematology Reference Laboratory of the Ca' Granda Ospedale Maggiore Policlinico in Milan. During 2005 to 2012, Lombardy funded LORD-P with 14.1 million euros. During 2005-2012 the Lombardy Rare Donor Programme members developed a registry of blood donors and a bank of red blood cell units with either rare blood group phenotypes or IgA deficiency. To do this, the Immunohaematology Reference Laboratory performed extensive serological and molecular red blood cell typing in 59,738 group O or A, Rh CCDee, ccdee, ccDEE, ccDee, K- or k- donors aged 18-55 with a record of two or more blood donations, including both Caucasians and ethnic minorities. In parallel, the Immunohaematology Reference Laboratory implemented a 24/7 service of consultation, testing and distribution of rare units for anticipated or emergent transfusion needs in patients developing complex red blood cell alloimmunisation and lacking local compatible red blood cell or showing IgA deficiency. Red blood cell typing identified 8,747, 538 and 33 donors rare for a combination of common antigens, negative for high-frequency antigens and with a rare Rh phenotype, respectively. In June 2012, the Lombardy Rare Donor Programme frozen inventory included 1,157 red blood cell units. From March 2010 to June 2012 one IgA-deficient donor was detected among 1,941 screened donors and IgA deficiency was confirmed in four previously identified donors. From 2005 to June 2012, the Immunohaematology Reference Laboratory provided 281 complex red blood cell alloimmunisation consultations and distributed 8,008 Lombardy Rare Donor Programme red blood cell units within and outside the region, which were transfused to 2,365 patients with no
Gentil Govantes, Miguel Ángel; Pereira Palomo, Porfirio
Donor protection should always be taken account during the selection and assessment of a living donor. On these terms, the evaluation of a potential donor must include these issues: 1) The donor act is altruistic, consciousness and out of coercion; 2) Life expectancy and quality of life of the recipient will improve after the living donor kidney transplantation; 3) The donor has normal renal function and the potential risk of developing nephropathy in the long term follow up is scarce (familiar nephropathies and other processes that may increase the potential risk for renal disease in the future, like severe hypertension, diabetes, etc must be ruled out). The glomerular filtrate should meet criteria for the normal function corresponding to age furthermore the absence of proteinuria and urine smear is normal; 4) The screening in the donor should contemplate those clinical situations or diseases non related to the kidney function but might elevate the surgical and/or anesthesia risk besides disease transmission to the recipient (as neoplasia or infections); 5) The surgical act is possible without technical difficulties and always performed after a negative result of the crossmatch between donor and recipient. The living donor evaluation process will follow a different schedule based on each particular case and the center facilities. Any case, the mentioned process is divided in two parts: The first one contains an initial screening (using non invasive and low cost tests) that allows discarding contraindications for donation (in both donor and recipient). In a second phase the assessment of the donor varies with donor characteristics. However, a test for renal function is mandatory besides imaging techniques (like angioTC), screening for transmissible diseases and a detailed evaluation for psychosocial aspects preferably made by professional. Moreover Spanish policy on living donation requires a report with information about the consent for donation developed by an
The significance of repeat testing in Turkish blood donors screened with HBV, HCV and HIV immunoassays and the importance of S/CO ratios in the interpretation of HCV/HIV screening test results and as a determinant for further confirmatory testing.
Acar, Ali; Kemahli, Sabri; Altunay, Husnu; Kosan, Erdogan; Oncul, Oral; Gorenek, Levent; Cavuslu, Saban
The purpose of this study was to investigate the intra-assay correlations amongst initial reactive and repeat screening results used in enzyme immunoassays (EIAs) for hepatitis B virus (HBV), hepatitis C virus (HCV) and HIV in blood donors. This study evaluated the value of using the power of the signal to cut-off (S/CO) ratio index for confirming anti-HCV/HIV reactive screening results, thereby touching upon the utility of S/CO indices in determining whether further confirmatory testing was necessary. Screening test results of the 72,695 blood donors were evaluated over a 1-year period. Correlation analysis among each initial test and retests was done by Pearson r test. Appropriate S/CO values to determine the need of the confirmation testing was investigated by ROC analyses. EIA intra-assay correlations were of statistical significance and were determined as follows: 0.948 for anti-HCV, 0.827 for anti-HIV and 0.948 for HBsAg. The threshold S/CO ratio values which predicted more than 95% of the confirmation test result were 3.8 for HCV and 5.6 for HIV. We were able to demonstrate a strong level of intra-assay correlation amongst EIAs, thereby eliminating the need for repetition of the screening test. Hence, we suggest that repeat screening should only be limited to HBV and HIV tests with low EIA S/CO ratios. Thus, using the power of the S/CO ratio in determining the need for HCV confirmation testing can be a cost-effective measure, especially if the S/CO value is >or=3.8.
Wang, Szu-Han; Lin, Ping-Yi; Wang, Jiun-Yi; Huang, Mei-Feng; Lin, Hui-Chuan; Hsieh, Chia-En; Hsu, Ya-Lan; Chen, Yao-Li
Donor safety and preservation of donor health after living liver donation are of paramount importance. In addition, the preoperative mental state of a donor is an important factor in determining the psychological impact of donor hepatectomy. Thus, we aimed to explore the mental health status of living liver donors after hepatectomy. We enrolled 60 donors who were scheduled to undergo living donor hepatectomy during the period January 2014 to March 2015 at a single medical center. Mental health status was measured before and 3 months after surgery using 3 self-report questionnaires, namely the Center for Epidemiologic Studies Depression Scale (CES-D) to assess depressive symptoms, the World Health Organization Quality of Life (WHOQOL-BREF) questionnaire to measure quality of life, and the Chinese Health Questionnaire (CHQ) to screen for minor psychiatric disorders. A comparison of the pre- and postdonation CES-D scores revealed a significant reduction in depressive symptoms after surgery (P = .031). There were significant improvements in the physical health domain (P = .031), the psychological health domain (P = .005), the social relationships domain (P = .005), and the environmental health domain (P = .010) of the WHOQOL-BREF. There were no significant changes in CHQ scores after donor hepatectomy (P = .136). All donors reported that they would donate again if required. Approximately one-third (33.3%) of donors experienced more pain than they had anticipated in the immediate postoperative period, and 20.0% of donors had complications after donor hepatectomy. Donor mental health status tended to improve as donors regained physical function during the 1st 3 months of recovery. Long-term monitoring of living donors' mental health is needed to minimize the adverse psychological outcomes of living liver donation.
Samdal, H H; Skaug, K; Stigum, H; Hervig, T; Kjeldsen-Kragh, J; Skar, A G
Approximately one third of the Norwegian blood donor population has been tested for infection with human T-lymphotropic virus type I and II (HTLV-I/II). This study was initiated to provide an indication as to whether or not the Norwegian transfusion service should screen the entire donor population for HTLV I/II. No HTLV-I infections were found among the blood donors. One new donor was confirmed HTLV-II positive. This individual had previously used drugs intravenously. HTLV-I/II infection can be regarded as a marker for risk behaviour, and testing can be of significance in the quality assurance of the transfusion service. We recommend that the entire blood donor population be tested for HTLV-I/II infections, and thereafter only new donors. The benefit of this scheme should be evaluated in the future.
Jia, Fan; Gampala, Srinivas S.L.; Mittal, Amandeep; Luo, Qingjun; Rock, Christopher D.
The 14,200 available full length Arabidopsis thaliana cDNAs in the Universal Plasmid System (UPS) donor vector pUNI51 should be applied broadly and efficiently to leverage a “functional map-space” of homologous plant genes. We have engineered Cre-lox UPS host acceptor vectors (pCR701- 705) with N-terminal epitope tags in frame with the loxH site and downstream from the maize Ubiquitin promoter for use in transient protoplast expression assays and particle bombardment transformation of monocots. As an example of the utility of these vectors, we recombined them with several Arabidopsis cDNAs encoding Ser/Thr protein phosphatase type 2C (PP2Cs) known from genetic studies or predicted by hierarchical clustering meta-analysis to be involved in ABA and stress responses. Our functional results in Zea mays mesophyll protoplasts on ABA-inducible expression effects on the Late Embryogenesis Abundant promoter ProEm:GUS reporter were consistent with predictions and resulted in identification of novel activities of some PP2Cs. Deployment of these vectors can facilitate functional genomics and proteomics and identification of novel gene activities. PMID:19499346
...- Length and Abbreviated Donor History Questionnaires and Accompanying Materials for Use in Screening... ``Guidance for Industry: Implementation of an Acceptable Full-Length and Abbreviated Donor History... guidance document recognizes the standardized full-length and abbreviated donor history questionnaires...
Mandelbrot, Didier A.; Pavlakis, Martha
Living donation is a common procedure in the United States. Substantial variation exists among transplant centers in their protocols and exclusion criteria for potential living donors. In the absence of clinical trial data to guide decisions about exclusion criteria, knowledge of current practices is an important first step in guiding the formulation of donor protocols as well as future studies. Certain trends in live donation practices have become apparent from surveys of transplant programs over the past few decades. Over the past 25 years, opposition in the US to living unrelated donation has gone from strong to essentially nonexistent. With respect to donor age, programs have become less strict regarding upper age limits, but stricter regarding younger donor candidates. Protocols regarding kidney function, blood pressure and diabetes screening also continue to evolve. Although donor follow up is mandated by the OPTN for two years after donation, a majority of donors are lost to follow up by one year. The most commonly cited barriers to donor follow up include donor inconvenience, cost issues including reimbursement to care providers, as well as direct and indirect costs to donors. Here, we review the current knowledge about living donor practices in the U.S. PMID:22732040
Mandelbrot, Didier A; Pavlakis, Martha
Living kidney donation is a common procedure in the United States. Substantial variation exists between transplant centers in their protocols and exclusion criteria for potential living donors. In the absence of clinical trial data to guide decisions about exclusion criteria, knowledge of current practices is an important first step in guiding the formulation of donor protocols and future studies. Certain trends in living donation practices have become apparent from surveys of transplant programs over the past few decades. Over the past 25 years, opposition to living unrelated donation in the United States has gone from strong to essentially nonexistent. With respect to donor age, programs have become less strict regarding upper age limits but stricter regarding younger donor candidates. Protocols regarding kidney function, blood pressure, and diabetes screening also continue to evolve. Although donor follow-up is mandated by the Organ Procurement and Transplantation Network for 2 years after donation, a majority of donors are lost to follow-up by 1 year. The most commonly cited barriers to donor follow-up include donor inconvenience, cost issues including reimbursement to care providers, and direct and indirect costs to donors. In this article, we review the current knowledge about living donor practices in the United States. Copyright © 2012 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.
Reiss, Robert F
Current FDA regulations and AABB standards do not adequately protect the well-being of blood donors. Several practices have adverse consequences for donors, including: elevated incidence of donation related reactions and injuries, iron deficiency anemia in premenopausal women, and inadequate counseling of donors to obtain medical follow-up for health risks identified during pre-donation health screening. These practices can be improved without impacting negatively on the national blood supply. In addition to revising current blood collection operations, blood centers should explore the feasibility of establishing expanded donor health screening programs and determining their effectiveness in improving donor health, donor recruitment, and donor retention.
... Accompanying Materials for Use in Screening Frequent Donors of Blood and Blood Components'' dated October 2011... Abbreviated Donor History Questionnaire and Accompanying Materials for Use in Screening Frequent Donors of Blood and Blood Components; Availability AGENCY: Food and Drug Administration, HHS. ACTION: Notice...
... Accompanying Materials for Use in Screening Frequent Donors of Blood and Blood Components'' dated May 2013. The... Abbreviated Donor History Questionnaire and Accompanying Materials for Use in Screening Frequent Donors of Blood and Blood Components; Availability AGENCY: Food and Drug Administration, HHS. ACTION: Notice...
... Screening Donors of Source Plasma; Availability AGENCY: Food and Drug Administration, HHS. ACTION: Notice... Questionnaires and Accompanying Materials for Use in Screening Donors of Source Plasma'' dated July 2011. The... consistent with FDA's requirements and recommendations for collecting Source Plasma donor history...
Srijinda, Songsak; Suwanasophon, Chamaiporn; Visawapoka, Unchalee; Pongsavee, Malinee
The Rhesus (Rh) blood group is the most polymorphic human blood group and it is clinically significant in transfusion medicine. Especially, D antigen is the most important and highly immunogenic antigen. Due to anti-D, it is the cause of the hemolytic disease of the newborn and transfusion reaction. About 0.1%-0.5% of Asian people are RhD-negative, whereas in the Thai population, the RhD-negative blood type only occurs in 0.3%. Approximately 10%-30% of RhD-negative in Eastern Asian people actually were D-elute (DEL) phenotype, the very weak D antigen that cannot be detected by indirect antiglobulin test (IAT). There are many reports about anti-D immunization in RhD-negative recipients through the transfusion of red blood cells from individuals with DEL phenotype. D-elute phenotype screening in Thai RhD-negative blood donors was studied to distinguish true RhD-negative from DEL phenotype. A total of 254 Thai serologically RhD-negative blood donors were tested for RhCE phenotypes and anti-D adsorption/elution test. In addition, RhC(+) samples were tested for RHD 1227A allele by SSP-PCR technique. The RhD-negative phenotype samples consisted of 131 ccee, 4 ccEe, 1 ccEE, 101 Ccee, 16 CCee, and 1 CcEe. The 42 Ccee and 8 CCee phenotype samples were typed as DEL phenotype and 96% of DEL samples were positive for RHD 1227A allele. The incidence of RhC(+) was 46.4%, and 48 of the 118 RhC(+) samples were positive for both anti-D adsorption/elution test and SSP-PCR technique for RHD 1227A allele. The sensitivity and specificity were 96% and 100%, respectively, for RHD 1227A detection as compared with the adsorption/elution test. In conclusion, RhC(+) phenotype can combine with anti-D adsorption/elution test and RHD 1227A allele SSP-PCR technique for distinguishing true RhD-negative from DEL phenotype.
Widge, A.; Cleland, J.
Background: This paper documents how couples and providers access donor materials for conception in the Indian context and perceptions about using them. The objective is to facilitate understanding of critical issues and relevant concerns. Methods: A postal survey was conducted with a sample of 6000 gynaecologists and in-depth interviews were conducted with 39 gynaecologists in four cities. Results: Donor gametes are relatively more acceptable than a few years ago, especially if confidentiality can be maintained, though lack of availability of donor materials is sometimes an impediment to infertility treatment. Donor sperms are usually accessed from in-house or commercial sperm banks, pathology laboratories, IVF centres, professional donors, relatives or friends. There is scepticism about screening procedures of sperm banks. Donor eggs are usually accessed from voluntary donors, friends, relatives, egg sharing programmes, donation from other patients, advertising and commercial donors. There are several concerns regarding informed consent for using donated gametes, using relatives and friends gametes, the unregulated use of gametes and embryos, record keeping and documentation, unethical and corrupt practices and commercialisation. Conclusion: These issues need to be addressed by patients, providers and regulatory authorities by providing information, counselling, ensuring informed consent, addressing exploitation and commercialisation, ensuring monitoring, proper documentation and transparency. PMID:24753849
Waxman, Dan A
Volunteer donor apheresis has evolved from early plasmapheresis procedures that collected single components into technically advanced multicomponent procedures that can produce combinations of red blood cells, platelets, and plasma units. Blood collection and utilization is increasing annually in the United States. The number of apheresis procedures is also increasing such that single donor platelet transfusions now exceed platelet concentrates from random donors. Donor qualifications for apheresis vary from those of whole blood. Depending on the procedure, the donor weight, donation interval, and platelet count must be taken into consideration. Adverse effects of apheresis are well known and fortunately occur in only a very small percentage of donors. The recruitment of volunteer donors is one of the most challenging aspects of a successful apheresis program. As multicomponent apheresis becomes more commonplace, it is important for collection centers to analyze the best methods to recruit and collect donors.
Should blood donors be routinely screened for glucose-6-phosphate dehydrogenase deficiency? A systematic review of clinical studies focusing on patients transfused with glucose-6-phosphate dehydrogenase-deficient red cells.
Renzaho, Andre M N; Husser, Eliette; Polonsky, Michael
The risk factors associated with the use of glucose-6-phosphate dehydrogenase (G6PD)-deficient blood in transfusion have not yet been well established. Therefore, the aim of this review was to evaluate whether whole blood from healthy G6PD-deficient donors is safe to use for transfusion. The study undertook a systematic review of English articles indexed in COCHRANE, MEDLINE, EMBASE, and CINHAL, with no date restriction up to March 2013, as well as those included in articles' reference lists and those included in Google Scholar. Inclusion criteria required that studies be randomized controlled trials, case controls, case reports, or prospective clinical series. Data were extracted following the Preferred Reporting Items for Systematic Reviews using a previously piloted form, which included fields for study design, population under study, sample size, study results, limitations, conclusions, and recommendations. The initial search identified 663 potentially relevant articles, of which only 13 studies met the inclusion criteria. The reported effects of G6PD-deficient transfused blood on neonates and children appear to be more deleterious than effects reported on adult patients. In most cases, the rise of total serum bilirubin was abnormal in infants transfused with G6PD-deficient blood from 6 hours up to 60 hours after transfusion. All studies on neonates and children, except one, recommended a routine screening for G6PD deficiency for this at-risk subpopulation because their immature hepatic function potentially makes them less able to handle any excess bilirubin load. It is difficult to make firm clinical conclusions and recommendations given the equivocal results, the lack of standardized evaluation methods to categorize red blood cell units as G6PD deficient (some of which are questionable), and the limited methodological quality and low quality of evidence. Notwithstanding these limitations, based on our review of the available literature, there is little to
Jr, Christopher S Kovacs; Koval, Christine E; van Duin, David; de Morais, Amanda Guedes; Gonzalez, Blanca E; Avery, Robin K; Mawhorter, Steven D; Brizendine, Kyle D; Cober, Eric D; Miranda, Cyndee; Shrestha, Rabin K; Teixeira, Lucileia; Mossad, Sherif B
Selection of the appropriate donor is essential to a successful allograft recipient outcome for solid organ transplantation. Multiple infectious diseases have been transmitted from the donor to the recipient via transplantation. Donor-transmitted infections cause increased morbidity and mortality to the recipient. In recent years, a series of high-profile transmissions of infections have occurred in organ recipients prompting increased attention on the process of improving the selection of an appropriate donor that balances the shortage of needed allografts with an approach that mitigates the risk of donor-transmitted infection to the recipient. Important advances focused on improving donor screening diagnostics, using previously excluded high-risk donors, and individualizing the selection of allografts to recipients based on their prior infection history are serving to increase the donor pool and improve outcomes after transplant. This article serves to review the relevant literature surrounding this topic and to provide a suggested approach to the selection of an appropriate solid organ transplant donor.
Jr, Christopher S Kovacs; Koval, Christine E; van Duin, David; de Morais, Amanda Guedes; Gonzalez, Blanca E; Avery, Robin K; Mawhorter, Steven D; Brizendine, Kyle D; Cober, Eric D; Miranda, Cyndee; Shrestha, Rabin K; Teixeira, Lucileia; Mossad, Sherif B
Selection of the appropriate donor is essential to a successful allograft recipient outcome for solid organ transplantation. Multiple infectious diseases have been transmitted from the donor to the recipient via transplantation. Donor-transmitted infections cause increased morbidity and mortality to the recipient. In recent years, a series of high-profile transmissions of infections have occurred in organ recipients prompting increased attention on the process of improving the selection of an appropriate donor that balances the shortage of needed allografts with an approach that mitigates the risk of donor-transmitted infection to the recipient. Important advances focused on improving donor screening diagnostics, using previously excluded high-risk donors, and individualizing the selection of allografts to recipients based on their prior infection history are serving to increase the donor pool and improve outcomes after transplant. This article serves to review the relevant literature surrounding this topic and to provide a suggested approach to the selection of an appropriate solid organ transplant donor. PMID:25032095
Kim, Soo Jin; Kim, Myoung Soo; Park, Kiil
Nearly 20 years of experience at Severance Hospital has shown that utilizing exchange donors increases the donor pool safely, with outcomes comparable to living related donor grafts. The exchange donor program is invaluable for incompatible donor-recipient pairs to consecutively proceed to transplantation. Recently, newer desensitization protocols have been devised to approach incompatible donor-recipient pairs, but not without risks. These desensitization protocols may be an alternative when confronting the limitations in the exchange program. Therefore, the exchange program and the desensitization protocols should be complementary, not competing strategies and centers should weigh the merits and limitations of each protocol in each incompatible donor-recipient pair to select the optimal method for a safe and successful transplantation.
Woodworth, Michael H; Neish, Emma M; Miller, Nancy S; Dhere, Tanvi; Burd, Eileen M; Carpentieri, Cynthia; Sitchenko, Kaitlin L; Kraft, Colleen S
Fecal microbiota transplantation is an efficacious and inexpensive therapy for recurrent Clostridium difficile infection, yet its safety is thought to depend on appropriate fecal donor screening. FDA guidance for regulation of this procedure is in flux, but screening and manufacture of fecal material from asymptomatic donors present many challenges to clinical laboratories. This minireview summarizes FDA regulatory changes, principles of donor selection, and recommended laboratory screening practices for fecal microbiota transplantation.
Jensen, T O; Darley, D R; Goeman, E E; Shaw, K; Marriott, D J; Glanville, A R
Donor-derived tuberculosis (TB) is an increasingly recognized complication of solid organ transplantation. We report a case of isoniazid-resistant pulmonary TB in a lung transplant recipient. The patient acquired the infection from the lung donor who was previously empirically treated with isoniazid for latent TB. The case highlights the caveat that, while adequate treatment of latent TB with isoniazid is presumed, meticulous screening of donors is required.
Callum, Pamela; Urbina, Maria Teresa; Falk, Rena E; Alvarez-Diaz, Jorge A; Benjamin, Isaac; Sims, Charles A
To discuss the diagnosis of spinal muscular atrophy in a child conceived using donor gametes. None. None. Offspring of gamete donors. None. None. A child conceived using gametes from anonymous sperm and ova donors was diagnosed with spinal muscular atrophy type 1. Gamete donor facilities are not required to perform extensive genetic testing on their donors; however, the well-being of the children conceived through assisted reproductive technologies should be a primary objective of reproductive medicine. The risk for specific medical problems in donor offspring can be significantly reduced by incorporating carrier screening for common, severe disorders such as spinal muscular atrophy into donor screening practices. Future efforts should focus on communicating the limitations of genetic screening to donor gamete recipients and educating them about their reproductive options. Copyright 2010 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.
Kulkarni, Swati; Vasantha, K; Ghosh, Kanjaksha
Screening the donor population for clinically important antigens and creating a database of phenotyped donors will eliminate the tedious task of large scale screening for antigen negative units. The aim of the present study is to identify donors lacking common antigens and a combination of common antigens to establish an antigen negative inventory. Blood samples of 1221 regular blood donors were phenotyped for the clinically important common antigens of the Rh, Duffy, Kell, Kidd and MNS blood group systems using standard tube technique. Out of 1221 total donors tested, we observed that 261 donors lacked a combination of clinically important common antigens (C, D, e, Fya, Jka, s). After excluding the RhD negative donors in this study 15.56% lacked a combination of two or three common antigens. Of all donors, 3.2% lacked Fya and Jka antigens, 1.96% Fya and s, 1.88% Jka and s antigens and 0.57% lacked three common antigens. An antigen negative inventory of donors who lack a single common antigen or a combination of common antigens was prepared from regular donors which will prove useful for efficient management of transfusion therapy in patients with multiple antibodies against common antigens. Copyright © 2016 Elsevier Ltd. All rights reserved.
López, J. Cristóbal
O-Glycosyl donors, despite being one of the last successful donors to appear, have developed themselves into a burgeoning class of glycosyl donors. They can be classified in two main types: O-alkyl and O-aryl (or hetaryl) glycosyl donors. They share, however, many characteristics, they can be (1) synthesized from aldoses, either by modified Fisher glycosidation (O-alkyl) or by nucleophilic aromatic substitution (O-aryl or O-hetaryl), (2) stable to diverse chemical manipulations, (3) directly used for saccharide coupling, and (4) chemoselectively activated. Among these, n-pentenyl glycosides stand apart. They were the first O-alkyl glycosyl donors to be described and have paved the way to many conceptual developments in oligosaccharide synthesis. The development of the chemoselectivity-based "armed-disarmed" approach for saccharide coupling, including its stereoelectronic or torsional variants, now extended to other kinds of glycosyl donors, was first recognized in n-pentenyl glycosides. The chemical manipulation of the anomeric substituent in the glycosyl donor to induce reactivity differences between related species (sidetracking) was also introduced in n-pentenyl glycosides. An evolution of this concept, the "latent-active" strategy for glycosyl couplings, first described in thioglycosyl donors (vide infra), has been elegantly applied to O-glycosyl donors. Thus, allyl and vinyl glycosides, 2-(benzyloxycarbonyl)benzyl (BCB) glycosides and 2'-carboxybenzyl (CB) glycosides are useful "latent-active" glycosyl pairs. Finally, unprotected 3-methoxy-2-pyridyl (MOP) glycosides have been used in glycosylation processes with moderate success.
A new NCI study has found that, among patients with severe aplastic anemia who received a hematopoietic cell transplant from an unrelated donor, those whose donor white blood cells had longer telomeres had higher survival rates five-years after transplant
Thomas, M. A.
The shifting ideological winds of foreign aid donors have driven their policy towards governments in poor countries. Donors supported state-led development policies in poor countries from the 1940s to the 1970s; market and private-sector driven reforms during the 1980s and 1990s; and returned their attention to the state with an emphasis on…
Otero, J; Fresno, M F; Escudero, D; Seco, M; González, M; Peces, R
The transmission of infectious and neoplastic diseases is a potential risk of tissue allografting. In this study, we analyzed the occurrence of occult disease in tissue donors as detected by standard screening and autopsy. Whereas 18% of the potential donors initially evaluated were eliminated on the basis of their medical and social histories, laboratory screening and autopsy revealed that an additional 9% of tissue donors had undetected, transmissible disease that prohibited tissue donation. This report emphasizes once again the risk of occult disease being transplanted with grafts and the need for autopsy to reduce the likelihood of this occurring. If donor selection, appropriate screening tests, and autopsy are carefully carried out, the risk of transmitting diseases from tissue allografts can be kept to a minimum.
Choudhury, Nabajyoti; Ray, Deepanjan
Introduction Inherited thrombocytopenias, including inherited giant platelet disorders (IGPD) are relatively rare, but their prevalence is probably underestimated. Harris platelet syndrome, the most common IGPD reported from Indian subcontinent, mostly from eastern part, is characterised by a low platelet count, high mean platelet volume (MPV) and absence of bleeding. Aim A short study was conducted to assess the prevalence of giant platelets in voluntary donors of single donor platelets (SDP) and analyse the effect of transfusion of such SDPs in patients. Materials and Methods Voluntary donors of SDPs were screened as per standard guidelines prior to the procedure. A complete blood count (including MPV) along with a peripheral smear was done. A total of 45 donors were screened for plateletpheresis. Following plateletpheresis from these donors, a platelet count from the collection bag was done after one hour. The SDP was transfused as a single unit or divided into two and transfused to the same patient at two different occasions, as per clinical need. Platelet counts on pateints were done after one hour and the platelet recovery was noted. Results Out of the 45 donors who were screened, 30 (66.67%) were found to have giant platelets. It was observed that the pre procedure platelet counts in donors having giant platelets were relatively low (1.5 -1.7 lacs) and so also the platelet yield (2.7-3x1011) compared to donors who did not, but the post transfusion platelet recovery was greater. Conclusion Since presence of giant platelets has been seen to be common in the Eastern part of India, a peripheral smear examination should always be considered during screening of plateletpheresis donors to avoid rejecting donors with giant platelets whose platelet counts are given falsely low by autoanalysers. PMID:26266124
Oocyte donation is a complex situation that requires the applicant couple to deal with the presence of the donor in the history of the child conception. Accepting the eggs is not the same thing than accepting the donor. Her place in the child's life depends on how his parents will accept her phantasmal reality beyond her real person. Paying attention to the story told by the donors on their motivations may help parents internalize this conception to three. We show from two clinical observations, that the generosity of donors is connected to personal issues that do not relate to unborn child or its parents. If there are two mothers in oocyte donation, they are not really in competition because there are also two children: the child conceived through donation is that of the project of the couple, the child to which the donor thinks, is and will remain in phantasmal domain, i.e. linked to the personal history of the donor. We also show that the psychological interview fully responds to the donor expectations when it seeks to highlight her motives.
IIB.3 Hypothesis 3 – Algorithm to Predict Best Donor 10 IIB.3.1 Aim 1 – Phase I of EM Haplotype Logic No Activity 10 IIB.3.2 Aim 2 – Enhancement...1.1 Aim 1 – Donor Recipient Pair Project Open 12 IIC.2 Hypothesis 1 – Role of Other Loci and GVHD 13 IIC.2.1 Aim 1 – Analysis of Non-HLA Loci Open 13...and on the nuances of HLA typing can be used to design computer algorithms to predict the best matched donor. IIB.3.1 Aim 1: Phase I of EM
AlGorithm to Predict Best Donor Task 1 -Incorporate Frequencies into Matchin" AI"orithm Open Task 2 - Enhancement of EM Algorithm Open Task 3 - Optimal...Immunooenetic Studies Ob.jective 1- Influence ofHLA Mismatches Task I - Donor Recipient Pair Project Open Objective 1- Role of Other Loci and GVHD Task I...typing can be used to design computer algorithms to predict the best matched donor. IIB.3. Task 1: Period 8 Activity: Phase I of EM Worked on a
Algorithm No Activity 13 IIB.3 Hypothesis 3 – Algorithm to Predict Best Donor 14 IIB.3.1 Aim 1 – Phase I of EM Haplotype Logic No Activity 14 IIB...of HLA Mismatches 15 IIC.1.1 Aim 1 – Donor Recipient Pair Project Open 15 IIC.2 Hypothesis 1 – Role of Other Loci and GVHD 16 IIC.2.1 Aim 1...frequencies and on the nuances of HLA typing can be used to design computer algorithms to predict the best matched donor. IIB.3.1 Aim 1: Phase I of EM
Huh, Kyu Ha; Kim, Hyun Jung; Jeon, Kyung Ock; Kiml, Beom Seok; Kim, Yu Seun; Park, Kill
Exchange-donor programs may prevent the current loss of many suitable living donors. Both incompatible donor-recipient pairs--with ABO incompatibility or positive cross-matches--and compatible pairs who wish to locate more suitable donors should be encouraged to participate in exchange-donor programs. Advantages and limitations of exchange-donor programs must be carefully explained to prevent interfamilial conflict. Exchange-donor programs may relieve shortages of donor organs and offer good posttransplant outcomes. Therefore, this program should be widely implemented.
Deger, S; Giessing, M; Roigas, J; Wille, A H; Lein, M; Schönberger, B; Loening, S A
Laparoscopic live donor nephrectomy (LDN) has removed disincentives of potential donors and may bear the potential to increase kidney donation. Multiple modifications have been made to abbreviate the learning curve while at the same time guarantee the highest possible level of medical quality for donor and recipient. We reviewed the literature for the evolution of the different LDN techniques and their impact on donor, graft and operating surgeon, including the subtleties of different surgical accesses, vessel handling and organ extraction. We performed a literature search (PubMed, DIMDI, medline) to evaluate the development of the LDN techniques from 1995 to 2003. Today more than 200 centres worldwide perform LDN. Hand-assistance has led to a spread of LDN. Studies comparing open and hand-assisted LDN show a reduction of operating and warm ischaemia times for the hand-assisted LDN. Different surgical access sites (trans- or retroperitoneal), different vessel dissection approaches, donor organ delivery techniques, delivery sites and variations of hand-assistance techniques reflect the evolution of LDN. Proper techniques and their combination for the consecutive surgical steps minimize both warm ischaemia time and operating time while offering the donor a safe minimally invasive laparoscopic procedure. LDN has breathed new life into the moribund field of living kidney donation. Within a few years LDN could become the standard approach in living kidney donation. Surgeons working in this field must be trained thoroughly and well acquainted with the subtleties of the different LDN techniques and their respective advantages and disadvantages.
Bryant, Barbara J.; Yau, Yu Ying; Arceo, Sarah M.; Daniel-Johnson, Jennifer; Hopkins, Julie A.; Leitman, Susan F.
Background Iron depletion/deficiency in blood donors frequently results in deferrals for low hemoglobin, yet blood centers remain reluctant to dispense iron replacement therapy to donors. Study Design and Methods During a 39-month period, 1236 blood donors deferred for hemoglobin <12.5 g/dL and 400 non-deferred control donors underwent health history screening and laboratory testing (CBC, iron studies). Iron depletion and deficiency were defined as ferritin of 9–19 mcg/L and <9 mcg/L in females and 18–29 mcg/L and <18 mcg/L in males. Deferred donors and iron-deficient control donors were given a 60-pack of ferrous sulfate 325 mg tablets, and instructed to take one tablet daily. Another 60-pack was dispensed at all subsequent visits. Results In the low hemoglobin group, 30% and 23% of females and 8% and 53% of males had iron depletion or deficiency, respectively, compared with 29% and 10% of females and 18% and 21% of males in the control group. Iron depleted/deficient donors taking iron showed normalization of iron-related laboratory parameters, even as they continued to donate. Compliance with oral iron was 68%. Adverse gastrointestinal effects occurred in 21% of donors. The study identified 13 donors with serious medical conditions, including eight with GI bleeding. No donors had malignancies or hemochromatosis. Conclusion Iron depletion or deficiency was found in 53% of female and 61% of male low hemoglobin donors, and in 39% of female and male control donors. Routine administration of iron replacement therapy is safe, effective, and prevents the development of iron depletion/deficiency in blood donors. PMID:22211316
Novelo-Garza, Bárbara Alicia; Benítez-Arvizu, Gamaliel; Peña-Benítez, América; Galván-Cervantes, Jorge; Morales-Rojas, Alejandro
The American trypanosomiasis is the second parasitic disease in importance after paludism and one of the main mechanism of transmission is a blood transfusion. Our objective was to measure the effect the Tripanosoma Cruzi screening test in blood banks in the Mexican Institute of Social Security. Information was obtained from each unit of blood collected. The Tripanosoma cruzi prevalence was calculated only in samples with double reactivity in the blood banks. Of 71 blood banks, only 26 had been doing T. Cruzi screen; after implementation of integrated services 55 are doing the screening. There were 935 donors with double reactivity to the T. Cruzi test from 230,074 samples. The national prevalence was 0.406%. The seroprevalence was 0.013% to 3.118%. The screening of the T. cruzi improved the detection and increased the safety and the prevention of its transmission by blood transfusion.
de Charro, F T; Akveld, H E; Hessing, D J
The development of medical knowledge has resulted in a demand in society for donor organs, but the recruitment of donor organs for transplantation is difficult. This paper aims to provide some general insights into the complex interaction processes involved. A laissez-faire policy, in which market forces are relied on, is not acceptable from an ethical and legal point of view in most western European countries. Especially at the demand side of the exchange of donor organs, commercialism is to be opposed. We judge the use of commercial incentives at the supply side less unacceptable in theory but not feasible in western European countries. Since market forces are deemed unacceptable as instruments for coordinating demand and supply of donor organs, donor procurement has to be considered as a collective good, and therefore governments are faced with the responsibility of making sure that alternative interaction and distribution mechanisms function. The role of organ procurement agencies (OPAs) in societal interaction concerning postmortem organ donation is described using a two-dimensional conceptualisation scheme. Medical aspects of living organ donation are described. An international comparative description of legal systems to regulate living organ donation in western European countries completes this survey.
... record number; (2) A statement whether, based on the results of screening and testing, the donor has been... the case of an HCT/P from a donor who is ineligible based on screening and released under paragraph (b... address of the testing laboratory or laboratories; (ii) Results and interpretation of all donor...
... record number; (2) A statement whether, based on the results of screening and testing, the donor has been... the case of an HCT/P from a donor who is ineligible based on screening and released under paragraph (b... address of the testing laboratory or laboratories; (ii) Results and interpretation of all donor...
7 IIB.3 Hypothesis 3 – Algorithm to Predict Best Donor IIB.3.1 Aim 1 – Phase I of EM Haplotype Logic No Activity 7 IIB.3.2 Aim 2 – Enhancement...Recipient Pair Project Open 9 IIC.2 Hypothesis 1 – Role of Other Loci and GVHD IIC.2.1 Aim 1 – Analysis of Non-HLA Loci Open 10 IIC.2.2 Aim 2 – Related...and haplotype frequencies and on the nuances of HLA typing can be used to design computer algorithms to predict the best matched donor. IIB.3.1 Aim
Task 4 – Genotype Lists & Matching Algorithm Open 9 IIB.3 Objective 3 – Algorithm to Predict Best Donor IIB.3 Task 1 – Incorporate Frequencies into...of HLA Mismatches IIC.1 Task 1 – Donor Recipient Pair Project Open 12 IIC.2 Objective 1 – Role of Other Loci and GVHD IIC.2 Task 1 – Analysis...3: Registry data on HLA allele and haplotype frequencies and on the nuances of HLA typing can be used to design computer algorithms to predict the
Closed 12 IIB.2 Aim 4 – Genotype Lists & Matching Algorithm No Activity 12 IIB.3 Hypothesis 3 – Algorithm to Predict Best Donor IIB.3 Aim 1 – Phase I...Mismatches IIC.1 Aim 1 – Donor Recipient Pair Project Open 15 IIC.2 Hypothesis 1 – Role of Other Loci and GVHD IIC.2 Aim 1 – Analysis of Non-HLA...potential to type as DRB1*1506 and those where one or both haplotypes could not be predicted were retained for further typing (N=221). National
Terry, M A; Ousley, P J; Rich, L F; Wilson, D J
To describe a case in which an eye donor had prior bilateral photorefractive keratectomies and to elucidate possible methods of evaluation and screening of donor tissue. Case report. A 62-year-old eye donor was reported to have received radial keratotomy before his death. Further investigation by the eye bank showed a history of photorefractive keratectomy (PRK), not radial keratotomy. The corneas were therefore not used for transplantation, and the eyes were evaluated by slit-lamp examination, photography, corneal topography, and histology. Slit-lamp and photographic examination did not indicate the presence of PRK ablations. Corneal topography mapping with the TMS-1 was relatively ambiguous for identifying PRK flattening, while multiple data formatting of the cornea with the Orbscan resulted in the strongest suggestion of prior PRK. Histologic analysis showed central corneal thinning and loss of Bowman's membrane consistent with PRK. In the absence of a positive donor history for PRK, current methods of screening donor tissue for prior PRK often are insufficient to exclude these corneas from use in transplantation. More refined placido imagery corneal topography or newer technologies such as the Orbscan may allow more sensitive and specific methods of donor tissue screening.
Jayaprakash, P A; Shanmugam, J; Hariprasad, D
Of 8085 volunteer donors attending the blood bank at SCTIMST screened for hepatitis B surface antigen (HBsAg) carrier state by counterimmunoelectrophoresis, 103 (1.27%) were HBsAg positive. The personal data of donors showed a higher rate of HBsAg among men than women and in the age group of 21 to 30 years than in the other age groups. A significantly higher rate was noted among donors belonging to the lower socioeconomic group (p less than 0.05).
Del Valle, Alfonso P; Bradley, Leanne; Said, Tamer
A previous review of 22 studies from eight countries, conducted between 1980 and 2003, concluded that semen donors who are older, married or are fathers are less likely to be financially motivated. Despite the Assisted Human Reproduction Act coming into force in 2004, no data originating from Canada have been published on this topic. The objective of this study was to validate these findings in the Canadian population within the context of an anonymous semen donor programme in Canada. A survey of 301 donor applicants was conducted to collect demographic data including age, marital status, paternity status and occupation, in addition to information assessing donor eligibility and willingness to donate without reimbursement. Eligible candidates were screened to determine their acceptance or exclusion from the semen donor programme. The results showed that the relationships found between donor applicant demographics and their willingness to participate without reimbursement do not appear to be consistent with earlier published studies in various countries. Further screening resulted in a recruitment rate of less than 1%. Additional studies will be required to investigate the feasibility of altruistic semen donation programmes in Canada, and to determine the potential impact of these findings on Canadians who rely on donor gamete services to build their families.
Tendulkar, Anita Amar; Jain, Puneet Ashok; Velaye, Sanjay
BACKGROUND AND OBJECTIVES: The occurrence of hemolysis due to transfusion of ABO plasma-incompatible platelets (PLTs) is challenging. There has been no consensus for critical antibody titers in the transfusion community. This study was conducted to understand the trends of anti-A and anti-B antibody titer levels in O group donors and to identify any specific patterns of distribution in relation to age and gender. MATERIALS AND METHODS: A total of 1635 Group O PLT donors were randomly selected for this prospective study. Serial 2-fold doubling dilutions were prepared for each sample to calculate the titer of anti-A and anti-B in a standard 96 well micro-plate. Tube technique was used for comparison with the microplate method for 100 samples. RESULTS: Out of 1635 donors, 1430 (87.46%) were males and 205 (12.54%) were females. The median titer for anti-A and anti-B was 128 with range from 4 to 2048. Spearman's correlation coefficient for microplate versus tube technique was estimated to be 0.803 (P < 0.01, two-tailed). 57.12% and 51.19% of all donors had titers ≥128 for anti-A and anti-B, respectively. The geometric mean of anti-A and anti-B was 155.7 and 137.28, respectively. The titers were significantly higher (P < 0.001) in female donors. An inverse relation between titer levels and age was seen. CONCLUSION: Microplate can be used to perform titers in resource-constrained settings. Screening for critical titers in O group donors is essential as they are more implicated in hemolytic transfusion reactions. In the absence of a global consensus on this topic, institutes may need to formulate their own guidelines on handling ABO plasma-incompatible PLT transfusions. PMID:28316436
This task is closed. IID.1 Task 3: Expand Immuno- biology Research Period 1 Activity: • No activity this quarter. National Marrow Donor Program...Development Authority IT Information Technology BBMT Biology of Blood and Marrow Transplant IRB Institutional Review Board BCP Business...Stem Cell Transplantation CREG Cross Reactive Groups OCR /ICR Optical Character Recognition/Intelligent Character Recognition CSS Center Support
... instructions before and after surgery. • Have a compatible blood type. • Have an emotional tie with the recipient. • Not ... test is to find out if the donor's blood type matches the recipient’s blood type. Next, the transplant ...
When times get tough, grown children often turn to their parents for help--for some extra cash, even somewhere to stay. For colleges and universities, that role is filled by alumni donors. In 2011, with education budgets slashed across the country, giving accounted for 6.5 percent of college expenditures, according to the Council for Aid to…
When times get tough, grown children often turn to their parents for help--for some extra cash, even somewhere to stay. For colleges and universities, that role is filled by alumni donors. In 2011, with education budgets slashed across the country, giving accounted for 6.5 percent of college expenditures, according to the Council for Aid to…
Hindawi, S; Badawi, M; Fouda, F; Mallah, B; Mallah, B; Rajab, H; Madani, T A
Screening all blood donors for human T-cell lymphotropic viruses 1 and 2 (HTLV 1 and HTLV 2) is mandatory in Saudi Arabia. The aim of this study is to evaluate the results and costs associated with the current testing policy for HTLV 1 and HTLV 2 in blood donors at King Abdulaziz University Hospital (KAUH), Jeddah. Donor-testing results from Blood Transfusion Services at KAUH were reviewed over a 10-year period, from January 2006 through December 2015. All donors were screened using chemiluminescent microparticle immunoassay. Reactive samples were then tested by Western blot for confirmation. Costs associated with testing were calculated. Data of 107 419 donations in the study period were reviewed. Saudi nationals constituted 51 168 donors (47·6%). Of 107 419 blood donors tested for HTLV 1 and HTLV 2 antibody, and 95 (0·088%) donors were reactive to screening tests. None of the samples found to be reactive to screening tests was positive by Western blot. The average cost of testing was US$ 171 870 per year. No donors were confirmed to have HTLV 1 and HTLV 2 in this cohort exceeding 100 000 donors. We propose changes to the policy mandating universal testing by replacing it with universal leukodepletion coupled with targeted screening to donors coming from endemic area or donors at risk. Such changes are expected to lead to a reduction of testing cost without affecting safety. © 2017 British Blood Transfusion Society.
... following information must accompany the HCT/P: (i) The results of any donor screening required under § 1271... before the donor-eligibility determination is complete? 1271.60 Section 1271.60 Food and Drugs FOOD AND... TISSUE-BASED PRODUCTS Donor Eligibility § 1271.60 What quarantine and other requirements apply before...
... following information must accompany the HCT/P: (i) The results of any donor screening required under § 1271... before the donor-eligibility determination is complete? 1271.60 Section 1271.60 Food and Drugs FOOD AND... TISSUE-BASED PRODUCTS Donor Eligibility § 1271.60 What quarantine and other requirements apply before...
Hajhosseini, Babak; Stewart, Bryan; Tan, Jane C; Busque, Stephan; Melcher, Marc L
The objectives of this study were to evaluate and compare the performance of the deceased donor registries of the 50 states and the District of Columbia and to identify possible predictive factors of donor designation. Data were collected retrospectively by Donate Life America using a questionnaire sent to Donor Designation Collaborative state teams between 2007 and 2010. By the end of 2010, there were 94,669,081 designated donors nationwide. This accounted for 39.8 per cent of the U.S. population aged 18 years and over. The number of designated organ donors and registry-authorized recovered donors increased each year; however, the total number of recovered donors in 2010 was the lowest since 2004. Donor designation rate was significantly higher when license applicants were verbally questioned at the Department of Motor Vehicles (DMV) regarding their willingness to register as a donor and when DMV applicants were not given an option on DMV application forms to contribute money to support organ donation, compared with not being questioned verbally, and being offered an option to contribute money. State registries continue to increase the total number of designated organ donors; however, the current availability of organs remains insufficient to meet the demand. These data suggest that DMV applicants who are approached verbally regarding their willingness to register as a donor and not given an option on DMV application forms to contribute money to support organ donation might be more likely to designate themselves to be a donor.
Valapour, M; Kahn, JP; Bailey, R; Matas, AJ
Living organ donors – 50% of solid organ donors in the United States – represent a unique population who accept medical risk for the benefit of another. One of the main justifications for this practice has been respect for donor autonomy, as realized through informed consent. In this retrospective study of living donors, we investigate 2 key criteria of informed consent: (1) depth of understanding and (2) degree of voluntariness. In our survey of 262 living kidney donors 2 to 40 months post donation, we found that more than 90% understood the effects of living donation on recipient outcomes, the screening process, and the short-term medical risks of donation. In contrast, only 69% understood the psychological risks of donation; 52% the long-term medical risks of donation; and 32%, the financial risks of donation. Understanding the effects of living donation on recipient outcomes was the only factor that would affect donors' decision to donate again. 40% of donors reported feeling some pressure to donate. Donors who are related to the recipient were more likely to report feeling pressure to donate. We conclude that more studies of informed consent are needed to identify factors that may compromise the validity of informed consent. PMID:21158924
Rudow, Dianne LaPointe; Brown, Robert S
As a result of the cadaveric organ shortage, the number of centers performing living donor liver transplantation has increased. Living donor liver transplantation provides immediate organ availability and avoids the risk of life-threatening complications that occur with long waiting times for cadaveric organs; however, it puts a healthy person at risk for little personal gain. A standardized approach to donor evaluation ensures safety to potential donors. Careful medical (physical examination as well as laboratory and radiological evaluation) and psychological evaluation is imperative to reduce donor complications and ensure good outcomes in recipients. A social worker and psychiatrist assess for mental competency, provide emotional support, and can serve as independent donor advocates. Informed understanding and consent are crucial aspects of the evaluation and include ensuring that the donor understands all potential complications and is free of coercion. Safety of the donor must be the highest priority.
... Living Donation / Being a Living Donor / Risks Facts History Organs Frequently Asked Questions Discussing Living Donation Types Related Non-Related Non-Directed Paired Donation Blood Type Incompatible Positive Crossmatch Being a Living Donor ...
McCurdy, Shannon R; Fuchs, Ephraim J
The substantial evidence of the safety of human leukocyte antigen (HLA)-haploidentical (haplo) blood or marrow transplantation (BMT) has led to its increasing utilization. When prioritizing HLA-matched grafts, patients frequently have few or no donors from whom to choose. However, a given patient may have multiple suitable haplo donors. Therefore factors other than HLA-match become critical for selecting the best donor. We recommend a donor selection algorithm based on the donor-specific antibodies, ABO match, donor age, donor sex, and cytomegalovirus (CMV) serostatus match. Despite provocative initial evidence, further studies are warranted to determine whether there is any benefit to selecting a haplo donor based on the number of HLA-mismatches, natural killer cell alloreactivity, or the presence of non-inherited maternal HLA antigens. Copyright © 2016 Elsevier Inc. All rights reserved.
Watters, W. W.; Sousa-Poza, J.
Artificial insemination (donor) [A.I.D.] in humans is a medical procedure that has been carried out for roughly 50 years. Its legal status has not yet been established; its moral implications are still hotly contested, and its psychological and psychiatric implications are only now coming under scientific scrutiny. The use of this procedure in couples who are psychologically unsuited for it can have unfortunate consequences. The obstetrician should seek the assistance of a dynamically oriented psychiatrist in screening couples who ask for artificial insemination (donor). Parenthood, in line with psychoanalytic ego psychology, is seen as a phase of ego development. The potential for mothering and fathering children is a later stage in growth than the capacity to conceive and sire them. It is the psychiatrist's role to assess the couple's motivation for A.I.D. in the light of the extent to which they have achieved this degree of ego development. PMID:20328602
Winters, Jeffrey L
A decreasing blood donor pool in the presence of increasing blood transfusion demands has resulted in the need to maximally utilize each blood donor. This has led to a trend in the increasing use of automated blood collections. While apheresis donation shares many reactions and injuries with whole blood donation, because of the differences, unique complications also exist. Overall, evidence in the literature suggests that the frequency of reactions to apheresis donation is less than that seen in whole blood donation, though the risk of reactions requiring hospitalization is substantially greater. The most common apheresis-specific reaction is hypocalcemia due to citrate anticoagulation, which, while usually mild, has the potential for severely injuring the donor. Other reactions to apheresis donation are uncommon (e.g., hypotension) or rare (e.g., air embolism). More worrisome, and in need of additional study, are the long-term effects of apheresis donation. Recent evidence suggests that repeated apheresis platelet donations may adversely effect thrombopoiesis as well as bone mineralization. Granulocyte donation has also been implicated in unexpected long-term consequences.
Sonetti, D.; Maloney, J. D.; Montgomery, S. P.; Rademacher, B. L.; Taylor, L. J.; Smith, J. A.; Striker, R.
Donor infection status should be considered when accepting an organ for transplant. Here we present a case of Chagas disease developing after a lung transplant where the donor was known to be Trypanosoma cruzi antibody positive. The recipient developed acute Trypanosoma cruzi infection with reactivation after treatment. Chagas disease-positive donors are likely to be encountered in the United States; donor targeted screening is needed to guide decisions regarding organ transplant and posttransplant monitoring.
Zuck, T F; Cumming, P D; Wallace, E L
The safety of blood for transfusion depends, in part, on the reliability of the health history given by volunteer blood donors. To improve reliability, a pilot study evaluated the use of an interactive computer-based audiovisual donor interviewing system at a typical midwestern blood center in the United States. An interactive video screening system was tested in a community donor center environment on 395 volunteer blood donors. Of the donors using the system, 277 completed surveys regarding their acceptance of and opinions about the system. The study showed that an interactive computer-based audiovisual donor screening system was an effective means of conducting the donor health history. The majority of donors found the system understandable and favored the system over a face-to-face interview. Further, most donors indicated that they would be more likely to return if they were to be screened by such a system. Interactive computer-based audiovisual blood donor screening is useful and well accepted by donors; it may prevent a majority of errors and accidents that are reportable to the FDA; and it may contribute to increased safety and availability of the blood supply.
Shi, Ling; Wang, Jingxing; Liu, Zhong; Stevens, Lori; Sadler, Andrew; Ness, Paul; Shan, Hua
Summary Despite a steady increase in total blood collections and voluntary non-remunerated blood donors, China continues to have many challenges with its blood donation system. The country's donation rate remains low at 9%o, with over 60% of donors being first-time donors. Generally there is a lack of adequate public awareness about blood donation. The conservative donor selection criteria, the relatively long donation interval, and the small donation volume have further limited blood supply. To ensure a sufficient and safe blood supply that meets the increasing clinical need for blood products, there is an urgent need to strengthen the country's blood donor management. This comprehensive effort should include educating and motivating more individuals especially from the rural areas to be involved in blood donation, developing rational and evidence-based selection criteria for donor eligibility, designing a donor follow-up mechanism to encourage more future donations, assessing the current donor testing strategy, improving donor service and care, building regional and national shared donor deferral database, and enhancing the transparency of the blood donation system to gain more trust from the general public. The purpose of the review is to provide an overview of the key process of and challenges with the blood donor management system in China. PMID:25254023
Bharucha, Z S
Quality management of a BTS starts with safe donor recruitment and donor care. In the South-East Asia region (SEAR) almost all countries except Thailand depend heavily on replacement of blood from relatives and friends. Most of these countries except Bangla Desh have ruled out the paid-donor system; however in the guise of replacement donation it still exists. Lack of resources, lack of professional management, myths and misconceptions arising from cultural and social differences form a barrier to blood donation. Most of the countries still do not have a National Blood Policy and/or a well planned blood programme. Besides recruitment, the donor screening and donor management are also not well addressed. The donors are mainly males of 20-35 years who come from the middle class of the society. Only 3-6 % of females donate blood. Most of the donors donate once in a lifetime as there is no emphasis on retention programmes. Only 5-10 % are repeat donors. The autologous transfusions are not widely practised. However, insistence on directed donors has increased. The prevalence of transfusion-transmissible infections in the region is variable; HIV 0-1.6 %, HBV 0.06-8.5 %, HCV 1.2-3 %. Training of staff and volunteers involved in the programme has started. Countries such as India and Sri Lanka are introducing NBP and moving towards reorganisation of their blood programme. All countries have now realised a need for regulation and implementation of a quality system as well as increased their efforts towards donor recruitment and retention. To improve the safety of blood supply, all are trying to phase out the replacement system and move towards 100 % voluntary non- remunerated regular blood donation. The aim of the presentation is to highlight the problems encountered as well as strategies used in making adequate and safe blood available.
Silver-Coated Nylon Dressing Plus Active DC Microcurrent for Healing of Autogenous Skin Donor Sites Edward W. Malin, MD, Chaya M. Galin, BSN, RN... microcurrent in comparison to silver-coated dressing with sham microcurrent on wound-closure time for autogenous skin donor sites. Methods: Four...hundred five patients were screened for treatment of their donor sites using a silver-coated nylon dressing with either sham or active microcurrent
Kotton, C N
Transplant tourism, travel with the intent of receiving or donating a transplanted organ, has grown immensely in the past decade but is not without risks. Solid organ donors are potential carriers of infection and rates of infection are high in transplant recipients. Returning transplant recipients should be screened for blood-borne pathogens, including human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV), as well as bacteremia, urinary tract infections, and other endemic pathogens (malaria, tuberculosis, Chagas disease, and so on). Efforts should be made to optimize posttransplantation prophylaxis against infection. Although donor-derived parasitic infections are rare, rates of morbidity and mortality are high. Increases in world travel and migration will likely contribute to increases in donor-derived parasitic infection. Appropriate epidemiological screening and diagnostic testing, including blood smears, serology, and stool assays, may help reduce the risk of such transmission.
Tortorella, Sara; Mastropasqua Talamo, Maurizio; Cardone, Antonio; Pastore, Mariachiara; De Angelis, Filippo
A systematic computational investigation on the optical properties of a group of novel benzofulvene derivatives (Martinelli 2014 Org. Lett. 16 3424-7), proposed as possible donor materials in small molecule organic photovoltaic (smOPV) devices, is presented. A benchmark evaluation against experimental results on the accuracy of different exchange and correlation functionals and semi-empirical methods in predicting both reliable ground state equilibrium geometries and electronic absorption spectra is carried out. The benchmark of the geometry optimization level indicated that the best agreement with x-ray data is achieved by using the B3LYP functional. Concerning the optical gap prediction, we found that, among the employed functionals, MPW1K provides the most accurate excitation energies over the entire set of benzofulvenes. Similarly reliable results were also obtained for range-separated hybrid functionals (CAM-B3LYP and wB97XD) and for global hybrid methods incorporating a large amount of non-local exchange (M06-2X and M06-HF). Density functional theory (DFT) hybrids with a moderate (about 20-30%) extent of Hartree-Fock exchange (HFexc) (PBE0, B3LYP and M06) were also found to deliver HOMO-LUMO energy gaps which compare well with the experimental absorption maxima, thus representing a valuable alternative for a prompt and predictive estimation of the optical gap. The possibility of using completely semi-empirical approaches (AM1/ZINDO) is also discussed.
Desai, Rajeev; Neuberger, James
Cancers in solid organ recipients may be classified as donor transmitted, donor derived, de novo or recurrent. The risk of donor-transmitted cancer is very low and can be reduced by careful screening of the donor but cannot be abolished and, in the United Kingdom series is less than 0.03%. For donors with a known history of cancer, the risks will depend on the nature of the cancer, the interventions given and the interval between diagnosis and organ donation. The risks of cancer transmission must be balanced against the risks of death awaiting a new graft and strict adherence to current guidelines may result increased patient death. Organs from selected patients, even with high-grade central nervous system (CNS) malignancy and after a shunt, can, in some circumstances, be considered. Of potential donors with non-CNS cancers, whether organs may be safely used again depends on the nature of the cancer, the treatment and interval. Data are scarce about the most appropriate treatment when donor transmitted cancer is diagnosed: sometimes substitution of agents and reduction of the immunosuppressive load may be adequate and the impact of graft removal should be considered but not always indicated. Liver allograft recipients are at increased risk of some de novo cancers, especially those grafted for alcohol-related liver disease and hepatitis C virus infection. The risk of lymphoproliferative disease and cancers of the skin, upper airway and bowel are increased but not breast. Recipients should be advised to avoid risk behavior and monitored appropriately.
... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Determination of donor suitability for human..., DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) REGULATIONS UNDER CERTAIN OTHER ACTS ADMINISTERED BY THE FOOD AND DRUG ADMINISTRATION HUMAN TISSUE INTENDED FOR TRANSPLANTATION Donor Screening and...
Pasricha, Sant-Rayn; McQuilten, Zoe K; Keller, Anthony J; Wood, Erica M
Iron deficiency anemia is an important reason for blood donor deferral. We prospectively determined whether screening donors with hemoglobin (Hb) and iron indices before donation can predict subsequent deferral due to anemia. We recruited premenopausal, eligible (nonanemic) female donors. Hb, ferritin, soluble transferrin receptor (sTfR), and hepcidin were measured, and the sTfR/(log)ferritin (sTfR-F) index was calculated. After 6 months, the donor database was reviewed and whether donors had returned and undergone successful donation was recorded. Of donors, 59 of 261(22.6%) were iron depleted (ferritin < 15 ng/mL). Iron-depleted donors had donated more often in the previous year, were younger, and had lower Hb. After a minimum of 6 months, 145 eligible donors had returned; of these 10 (6.9%) were deferred for anemia. Donors who developed anemia had significantly lower Hb, ferritin, and hepcidin and higher sTfR and sTfR-F at baseline. The area under the receiver operating characteristic curve for Hb as a predictor of deferral was 0.86, and for ferritin was 0.88. Hb of less than 130 g/L and ferritin of less than 10 ng/mL combined had sensitivity 80% and specificity 96% in predicting deferral. Screening with Hb and iron indices enables prediction of donors at risk of subsequent anemia and who would most benefit from prevention strategies. © 2011 American Association of Blood Banks.
Erim, Y; Senf, W
In the Essen University Clinic for Psychotherapy and Psychosomatics, between January and December 2000, 54 potential liver donors and 12 kidney donors were examined. All the kidney donors were found to be suitable; 7 potential liver donors were rejected on psychosomatic grounds. Reasons for the rejection were addiction (1 donor), suspected financial dependency of the donor on the recipient (1 donor) and, in the case of one donor not related to the recipient, the apparent lack of a special emotional attachment. During the actual evaluation interview, 4 potential donors reversed their original decision. Such a psychosomatic evaluation is a great help for donors in clarifying their motives and their decision.
Pitassi, Luiza Helena Urso; de Paiva Diniz, Pedro Paulo Vissotto; Scorpio, Diana Gerardi; Drummond, Marina Rovani; Lania, Bruno Grosselli; Barjas-Castro, Maria Lourdes; Gilioli, Rovilson; Colombo, Silvia; Sowy, Stanley; Breitschwerdt, Edward B.; Nicholson, William L.; Velho, Paulo Eduardo Neves Ferreira
Bartonella species are blood-borne, re-emerging organisms, capable of causing prolonged infection with diverse disease manifestations, from asymptomatic bacteremia to chronic debilitating disease and death. This pathogen can survive for over a month in stored blood. However, its prevalence among blood donors is unknown, and screening of blood supplies for this pathogen is not routinely performed. We investigated Bartonella spp. prevalence in 500 blood donors from Campinas, Brazil, based on a cross-sectional design. Blood samples were inoculated into an enrichment liquid growth medium and sub-inoculated onto blood agar. Liquid culture samples and Gram-negative isolates were tested using a genus specific ITS PCR with amplicons sequenced for species identification. Bartonella henselae and Bartonella quintana antibodies were assayed by indirect immunofluorescence. B. henselae was isolated from six donors (1.2%). Sixteen donors (3.2%) were Bartonella-PCR positive after culture in liquid or on solid media, with 15 donors infected with B. henselae and one donor infected with Bartonella clarridgeiae. Antibodies against B. henselae or B. quintana were found in 16% and 32% of 500 blood donors, respectively. Serology was not associated with infection, with only three of 16 Bartonella-infected subjects seropositive for B. henselae or B. quintana. Bartonella DNA was present in the bloodstream of approximately one out of 30 donors from a major blood bank in South America. Negative serology does not rule out Bartonella spp. infection in healthy subjects. Using a combination of liquid and solid cultures, PCR, and DNA sequencing, this study documents for the first time that Bartonella spp. bacteremia occurs in asymptomatic blood donors. Our findings support further evaluation of Bartonella spp. transmission which can occur through blood transfusions. PMID:25590435
... Depression Screening Substance Abuse Screening Alcohol Use Screening Depression Screening (PHQ-9) - Instructions The following questions are ... this tool, there is also text-only version . Depression Screening - Manual Instructions The following questions are a ...
The safety of transfusion is still improving and very important is raising of education among donors. The important element is also awareness of the possibility of withdrawing themselves from the donation process when they know that their blood isn't suitable for recipients. The aim of this study was checked of donor's knowledge about the risk of transfusion transmitted infections. The 581 regular donors (86.2% men, mean age 32 years) who answered of questions about tests which are performed in donation, and about their knowledge of transmission infections by transfusions. Donors gave blood average four times a year, for 11 years. Over 85% of respondents believed that blood is safe. More than half of donors knew that during donation can be detected anemia, syphilis, jaundice, but 50% believed that the hepatitis viruses can be detected after one week after infection. More than 80% of donors knew about the possibility of detecting of HIV infection, but 11% written that HIV can be detected after one day after infection. Approximately 50% of donors believed that can be detected diabetes during donation, and more than 12% of them--that can be detected thyropathy and cancer. The 30% of blood donors didn't know what tests were performed in the blood donations. Donors (80%) knew about the risk groups. Donors (50%) knew correct temporary disqualification periods after surgery and tattoo also, but 17% of them indicated a shorter period of disqualification. 43% of donors shortened the time after gastroscopy. Over 30% of donors didn't know about risks of infection in case of contact with alien blood. A lot of donors (63.3%) knew about the possibility of withdrawing themselves from the donation and 43.5% of them knew about this rule. The donor doesn't need to know the details of detection of infections in blood, but donor need to know that he should be aware that even a few months is needed to obtain a reliable result, which translates into transfusion safety. For this purpose
Scolari, Maria Piera; Comai, G; La Manna, G; Liviano D'Arcangelo, G; Monti, M; Feliciangeli, G; Stefoni, S
When possible, living donor transplantation represents the best therapeutic strategy for patients suffering from chronic renal failure. Studying the donor allows a complete and thorough clinical, laboratory and instrumental assessment that guarantees good organ function whilst protecting the health of the donor. The main parameters considered within this framework are age, renal function, nephrological complications, comorbidities (diabetes, hypertension, obesity, etc.), malignancies, and infection. Moreover, particular attention is paid to the sociopsychological aspects of the donation, particularly related to the donor, the recipient, and the entire family situation.
Minimal residual disease refers to the tumour cells that are still present in a given patient after completion of a therapeutic scheme. The demonstration and quantification of residual neoplastic cells has a crucial impact in clinical decision making, for it might prompt continuation of treatment, while the absence of such cells might serve as evidence to withdraw therapy. Therefore, both sensitivity and specificity of the methods used to unravel residual neoplastic cells must be highly reliable and robust. Flow cytometry has been widely used for this purpose, and its clinical performance depends mainly on the criteria of interpretation, rather than in the technique by itself; molecular biology techniques have proved to be highly sensitive and specific but unfortunately they cannot be used in all patients or in all types of leukemia. Finally, the development of donor cell leukemia in transplanted patients, might mimic residual disease and add more confusion to an already controversial issue. These topics are discussed in this paper.
Robbins, Karen C
Prior to 2007, living kidney donors who donated a kidney to a person with chronic kidney disease were screened, educated, and cared for by the same healthcare team caring for the recipient of the transplant. The independent living donor advocate or advocate team was created out of the need to ensure that the rights of the person donating a kidney are protected, respected, and maintained. Transplant programs must now have an advocate or advocate team who is separate from the recipient healthcare team to provide objective support for the donor, without regard for the recipient, and avoid any perception of a conflict of interest between the donor and recipient.
Pujani, Mukta; Jyotsna, P Lalita; Pahuja, Sangeeta; Pathak, Chintamani; Jain, Manjula
Background: The demand for plateletpheresis is increasing day by day due to its many merits over random donor platelets. However, in our country, there is a dearth of apheresis donors due to greater devotion and time required for the procedure and lack of awareness. Aim: The aim of the present study is to analyse the reasons for deferral of apheresis donors at a tertiary care center. Materials and Methods: This retrospective analysis was conducted to study the causes, frequency and the type of plateletpheresis donor deferral at regional blood transfusion center, Lady Hardinge Medical College and associated Shrimati Sucheta Kriplani Hospital and Kalawati Saran Childrens’ Hospital. The study was undertaken over a period of two years (from January 2010 to December 2011. Results: Out of a total of 343 donors screened, 87 donors were deferred, the overall deferral rate being 25.36%. The most frequent cause of deferral was a low platelet count accounting for 43.5% of all the causes followed by a low hemoglobin level (27.05%). Among the donors deferred for anaemia, 15 out of 23 (65.2%) had hemoglobin in the range of 11.5-12.4gm%, representing 17.2% of all deferrals. Conclusion: Based on these findings and the scarcity of apheresis donors in our country, we are of the opinion that the selection criteria for plateletpheresis donors should be revised to accommodate more donors and reduce deferral rate without compromising on the health of the donors. PMID:25177566
Doughty, Heidi; Maguire, A; Fitchett, G; Parker, P
Military elements increasingly operate in small teams in remote areas with no immediate blood product support. Planners and operators may endorse collection of fresh whole blood from pretested donors in emergency situations. The biggest risk of transfusion is the accidental use of ABO incompatible blood which can be fatal. The risk may be mitigated by using only group O LOw (OLO) titre donors with plasma containing low levels of the naturally occurring antibody to group A and B red cells. This paper reviews the ABO blood group distribution in potential blood donors from a high readiness UK medical regiment and explores the feasibility of using only group OLO donors in small teams. A retrospective review of routine volunteer blood donor samples was undertaken at 6 monthly intervals during a 2-year period. Personnel were tested in groups when available during training to create multiple donor panels to simulate small teams. 206 donation samples were collected from 157 potential donors. All donors were acceptable based on the lifestyle questionnaire, serology and microbiology screen. Of the 206 samples reviewed, 85 (41%) were group O (D pos and D neg). 14 group O (16.5%) were shown to have high titre of anti-A or B. Therefore, 71, that is, 34% overall were suitable as OLO donors. The donor panel size varied from 15 to 44. The absolute number of OLO donors in each panel ranged from 4 to 17 and the number of O neg donors was 0-3. A third of samples were suitable as OLO donors; however, there were insufficient 'universal' donors within smaller subgroups (<10). In this situation, we recommend the careful use of both group O and group A donors or the use of a buddy-buddy blood group matrix. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Walker, Mary Margaret
A discussion of donor records in college and university fund-raising programs looks at a variety of issues, including who sees them (administrators, donors, volunteers, and members of the legal profession), how access to them is controlled, and what is kept in them. Suggestions are offered for managing such records, and the experiences of a number…
Newman, Bruce H.
Summary The emphasis on high-school blood drives and acceptance of 16-year-old blood donors led to more research on physiologic and psychological ways to decrease vasovagal reaction rates in young blood donors and to increase donor retention. Research on how to accomplish this has been advantageous for the blood collection industry and blood donors. This review discussed the current situation and what can be done psychologically, physiologically, and via process improvements to decrease vasovagal reaction rates and increase donor retention. The donation process can be significantly improved. Future interventions may include more dietary salt, a shorter muscle tension program to make it more feasible, recommendations for post-donation muscle tension / squatting / laying down for lightheadedness, more donor education by the staff at the collection site, more staff attention to donors with fear or higher risk for a vasovagal reaction (e.g. estimated blood volume near 3.5 l, first-time donor), and a more focused donation process to ensure a pleasant and safer procedure. PMID:25254024
Hoogendijk-van den Akker, Judith M; Warlé, Michiel C; van Zuilen, Arjan D; Kloke, Heinrich J; Wever, Kim E; d'Ancona, Frank C H; Ӧzdemir, Denise M D; Wetzels, Jack F M; Hoitsma, Andries J
As the beginning of living-donor kidney transplantation, physicians have expressed concern about the possibility that unilateral nephrectomy can be harmful to a healthy individual. To investigate whether the elevated intra-abdominal pressure (IAP) during laparoscopic donor nephrectomy causes early damage to the remaining kidney, we evaluated urine biomarkers after laparoscopic donor nephrectomy. We measured albumin and alpha-1-microglobulin (α-1-MGB) in urine samples collected during and after open and laparoscopic donor nephrectomy and laparoscopic cholecystectomy and colectomy. Additionally, kidney injury molecule 1 (KIM-1) and neutrophil gelatinase-associated lipocalin (NGAL) were measured in urine samples collected during and after laparoscopic donor nephrectomy and colectomy. The same biomarkers were studied in patients randomly assigned to standard or low IAP during laparoscopic donor nephrectomy. We observed a peak in urinary albumin excretion during all procedures. Urine α-1-MGB rose in the postoperative period with a peak on the third postoperative day after donor nephrectomy. Urine α-1-MGB did not increase after laparoscopic cholecystectomy and colectomy. After laparoscopic nephrectomy, we observed slight increases in urine KIM-1 during surgery and in urine NGAL at day 2-3 after the procedure. After laparoscopic colectomy, both KIM-1 and NGAL were increased in the postoperative period. There were no differences between the high- and low-pressure procedure. Elevated urinary α-1-MGB suggests kidney damage after donor nephrectomy, occurring irrespective of IAP during the laparoscopic procedure.
Nzengu-Lukusa, Franck; Yuma-Ramazani, Sylvain; Sokolua-Mvika, Eddy; Dilu-Keti, Angèle; Malenga-Nkanga, Blanchard; Shuli, Jean Baptiste; Nzongola-Nkasu, Donatien Kayembe; Mbayo-Kalumbu, Ferdinand; Ahuka-Mundeke, Steve
In the Democratic Republic of Congo (DRC), the practice of blood transfusion is common with more than two hundred thousand one million blood donation per year has been made between 2007 and 2011. However, no report on iron deficiency and iron deficiency anemia as a result of a donation blood in DS is available in this country. This study aimed to estimate the extend of iron deficiency, anemia and iron deficiency anemia in volunteer blood donors (DS) in the National Blood Transfusion Center (CNTS) in Kinshasa, DRC. A cross-sectional study was conducted in CNTS where Kinshasa volunteer blood donors were included. Socio demographic information and blood samples were collected. Hematological parameters and Serum ferritin was assessed using respectively standard colorimetric and ELISA techniques. A total of 386 DS were included in this study. The prevalence of iron deficiency and iron deficiency anemia were respectively 63.2% (244/386) and 25.9% (100/386) of DS. Anemia was found in 36.5% (141/386) at the time of blood donation. Anemia, iron deficiency and iron-deficiency anemia are highly prevalent among blood donors in Kinshasa, DRC. Hence the needs to review the screening tests for the selection of blood donors and also include serum ferritin measurement for the routine assessment of blood donors, especially among regular blood donors.
...: Recommendations for Screening, Testing, and, Management of Blood Donors and Blood and Blood Components Based on... entitled ``Guidance for Industry: Recommendations for Screening, Testing, and Management of Blood Donors and Blood and Blood Components Based on Screening Tests for Syphilis,'' dated March 2013. The...
Kiss, Joseph E
More than 9 million individuals donate blood annually in the United States. Between 200 and 250 mg of iron is removed with each whole blood donation, reflecting losses from the hemoglobin in red blood cells. Replenishment of iron stores takes many months, leading to a high rate of iron depletion. In an effort to better identify and prevent iron deficiency, blood collection centers are now considering various strategies to manage donor iron loss. This article highlights laboratory and genetic tests to assess the iron status of blood donors and their applicability as screening tests for blood donation. Copyright © 2015 Elsevier Inc. All rights reserved.
The dead donor rule justifies current practice in organ procurement for transplantation and states that organ donors must be dead prior to donation. The majority of organ donors are diagnosed as having suffered brain death and hence are declared dead by neurological criteria. However, a significant amount of unrest in both the philosophical and the medical literature has surfaced since this practice began forty years ago. I argue that, first, declaring death by neurological criteria is both unreliable and unjustified but further, the ethical principles which themselves justify the dead donor rule are better served by abandoning that rule and instead allowing individuals who have suffered severe and irreversible brain damage to become organ donors, even though they are not yet dead and even though the removal of their organs would be the proximal cause of death.
O'Brien, S F; Osmond, L; Choquet, K; Yi, Q-L; Goldman, M
Mandatory predonation reading materials inform donors about risk factors for transmissible disease, possible complications of donation and changes to the donation process. We aimed to assess the attention to predonation reading materials and factors which may affect attention. A national survey in 2008 of 18,108 blood donors asked about self-assessed attention to reading the materials. In face-to-face interviews, 441 donors completed additional questions about reading the materials and a literacy test. Qualitative interviews of 27 donors assessed their approach to reading. In the national survey, most of the first-time donors said they read all or most of the materials (90.9% first-time vs. 57.6% repeat donors, P < 0.001) and 66% vs. 23.1% reported reading them carefully (P < 0.001). In face-to-face interviews comparing those who read materials carefully, skimmed or did not read, most knew that donors are informed of positive transmissible disease test results (97.1%, 95.5, 98.0 P > 0.05), but fewer recalled seeing the definition of sex (77.2%, 56.9, 24.2 P < 0.001). Literacy was poor (30.5% frustration level, 60.3% instructional, 9.2% independent) but similar when those who read materials carefully, skimmed or did not read were compared (P > 0.05). Qualitative interviews showed that donors are reluctant to read any more than necessary and decide based on perceived importance or relevance. Attention to predonation reading materials tends to be better among first-time donors. The effectiveness is limited by low motivation to read, especially for repeat donors, as well as poor literacy. © 2015 International Society of Blood Transfusion.
The National Heart, Lung, and Blood Institute retrovirus epidemiology donor studies (Retrovirus Epidemiology Donor Study and Retrovirus Epidemiology Donor Study-II): twenty years of research to advance blood product safety and availability.
Kleinman, Steven; King, Melissa R; Busch, Michael P; Murphy, Edward L; Glynn, Simone A
The Retrovirus Epidemiology Donor Study (REDS), conducted from 1989 to 2001, and the REDS-II, conducted from 2004 to 2012, were National Heart, Lung, and Blood Institute-funded, multicenter programs focused on improving blood safety and availability in the United States. The REDS-II also included international study sites in Brazil and China. The 3 major research domains of REDS/REDS-II have been infectious disease risk evaluation, blood donation availability, and blood donor characterization. Both programs have made significant contributions to transfusion medicine research methodology by the use of mathematical modeling, large-scale donor surveys, innovative methods of repository sample storage, and establishing an infrastructure that responded to potential emerging blood safety threats such as xenotropic murine leukemia virus-related virus. Blood safety studies have included protocols evaluating epidemiologic and/or laboratory aspects of human immunodeficiency virus, human T-lymphotropic virus 1/2, hepatitis C virus, hepatitis B virus, West Nile virus, cytomegalovirus, human herpesvirus 8, parvovirus B19, malaria, Creutzfeldt-Jakob disease, influenza, and Trypanosoma cruzi infections. Other analyses have characterized blood donor demographics, motivations to donate, factors influencing donor return, behavioral risk factors, donors' perception of the blood donation screening process, and aspects of donor deferral. In REDS-II, 2 large-scale blood donor protocols examined iron deficiency in donors and the prevalence of leukocyte antibodies. This review describes the major study results from over 150 peer-reviewed articles published by these 2 REDS programs. In 2011, a new 7-year program, the Recipient Epidemiology and Donor Evaluation Study-III, was launched. The Recipient Epidemiology and Donor Evaluation Study-III expands beyond donor-based research to include studies of blood transfusion recipients in the hospital setting and adds a third country, South Africa
Hâţu, G; Brumboiu, M I; Czernichow, P; Bocşan, I S
Blood products safety is based on different criteria including the selection of blood donors. Blood donors referred to Cluj County (Romania) Blood Transfusion Centre in January-March 2012 completed a self-administered questionnaire and were examined by a physician. Data collected from first-time and repeat donors were compared for possible risk factors for hepatitis C infection. In total, 1100 donors were selected. In first-time donors, most frequent factors were age<26 years, female gender and history of health care procedures. Behavioural risk factors (e.g. drug use, sexual promiscuity) may not be properly filtered out in blood donors, suggesting the necessity of improving the health screening process. Copyright © 2014 Elsevier Masson SAS. All rights reserved.
Schmidt, Alexander H.; Solloch, Ute V.; Baier, Daniel; Grathwohl, Alois; Hofmann, Jan; Pingel, Julia; Stahr, Andrea; Ehninger, Gerhard
Large registries of potential unrelated stem cell donors have been established in order to enable stem cell transplantation for patients without HLA-identical related donors. Donor search is complicated by the fact that the stored HLA information of many registered donors is incomplete. We carried out a project that was aimed to improve chances of patients with ongoing donor searches to find an HLA-matched unrelated donor. For that purpose, we carried out additional donor center-initiated HLA-DRB1 typing of donors who were only typed for the HLA loci A and B so far and were potential matches for patients in need of a stem cell transplant. In total, 8,861 donors were contacted for donor center-initiated HLA-DRB1 typing within 1,089 donor searches. 12 of these donors have donated stem cells so far, 8 thereof for their respective target patients. We conclude that chances of patients with ongoing donor searches to find an HLA-matched unrelated donor can indeed be improved by donor-center initiated typing that is carried out in addition to the standard donor search process. Our results also raise questions regarding the appropriate use of incompletely typed donors within unrelated donor searches. PMID:21625451
Ross, Lainie Friedman
There are more than 325 living kidney donors who have developed end-stage renal disease and have been listed on the Organ Procurement and Transplantation Network (OPTN)/United Network for Organ Sharing (UNOS) deceased donor kidney wait list. The OPTN/UNOS database records where these kidney donors are listed and, if they donated after April 1994, where that donation occurred. These 2 locations are often not the same. In this commentary, I examine whether a national living donor registry should be created and whether transplantation centers should be notified when one of their living kidney donors develops end-stage renal disease. I consider and refute 5 potential objections to center notification. I explain that transplantation centers should look back at these cases and input data into a registry to attempt to identify patterns that could improve donor evaluation protocols. Creating a registry and mining the information it contains is, in my view, our moral and professional responsibility to future patients and the transplantation endeavor. As individuals and as a community, we need to acknowledge the many unknown risks of living kidney donation and take responsibility for identifying these risks. We then must share information about these risks, educate prospective donors about them, and attempt to minimize them.
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Hiesse, Christian; Pessione, Fabienne; Cohen, Sophie
FROM AN EPIDEMIOLOGICAL POINT OF VIEW: The epidemiology of renal transplantation had greatly changed over the past 10 years. The increasing number of patients with renal failure and candidates for transplantation increases the demand for grafts, whereas the sampling rate of organs remains stable. The mean age of the donors is rising, hence underlining the question of the use of organs of so-called "borderline" quality. THE WEAK POINTS OF ELDERLY GRAFTS: Aging of the kidneys affects the structure of the parenchyma and renal function, which decreases, notably in hypertensive persons. The elderly graft exhibits a critical mass of nephrons that is insufficient to fulfil the functional requirements of a poorly equipped recipient. The recipient is more sensitive to the added agressions: prolonged ischemia and immunological and medicinal agressions. THE RESULTS OF RENAL GRAFT FROM ELDERLY DONORS: They are quantitatively and qualitatively inferior to those of renal transplants from "ideal" donors. The donor's age is a significant factor influencing negatively influences the survival of the transplanted kidney, but dependent on past vascular history. Good results regarding the maintenance of dialysis are obtained by selecting the donors and by avoiding added risk factors. THE ASSESSMENT OF A GRAFT FROM AN ELDERLY DONOR: This, basically, relies on clinical criteria: donor's history, cause of death and accurate measurement of the renal function. A biopsy of the graft, at the time of sampling, provides useful information. TRANSPLANTATION STRATEGY OF A GRAFT FROM AN ELDERLY DONOR: Donor-recipient matching by age is a common approach. Grafting of both kidneys in the same recipient is a method presently under assessment. The episode of ischemia must be reduced and the immunosuppressive therapy adapted.
Godin, Gaston; Germain, Marc
This study tested the efficacy of interventions to recruit new plasma donors among whole blood donors. A sample of 924 donors was randomized to one of three conditions: control; information only by nurse; and information plus self-positive image message by nurse (SPI). Participants in the control condition only received a leaflet describing the plasma donation procedure. In the two experimental conditions the leaflet was explained face-to-face by a nurse. The dependent variables were the proportion of new plasma donors and the number of donations at six months. Overall, 141 (15.3%) new plasma donors were recruited at six months. There were higher proportions of new plasma donors in the two experimental conditions compared to the control condition (P < .001); the two experimental conditions did not differ. Also, compared to the control condition, those in the experimental conditions (all Ps < .001) gave plasma more often (information only by nurse: d = .26; SPI: d = .32); the SPI intervention significantly outperformed (P < .05) the information only by nurse condition. The results suggest that references to feelings of SPI such as feeling good and being proud and that giving plasma is a rewarding personal experience favor a higher frequency of plasma donation.
This study tested the efficacy of interventions to recruit new plasma donors among whole blood donors. A sample of 924 donors was randomized to one of three conditions: control; information only by nurse; and information plus self-positive image message by nurse (SPI). Participants in the control condition only received a leaflet describing the plasma donation procedure. In the two experimental conditions the leaflet was explained face-to-face by a nurse. The dependent variables were the proportion of new plasma donors and the number of donations at six months. Overall, 141 (15.3%) new plasma donors were recruited at six months. There were higher proportions of new plasma donors in the two experimental conditions compared to the control condition (P < .001); the two experimental conditions did not differ. Also, compared to the control condition, those in the experimental conditions (all Ps < .001) gave plasma more often (information only by nurse: d = .26; SPI: d = .32); the SPI intervention significantly outperformed (P < .05) the information only by nurse condition. The results suggest that references to feelings of SPI such as feeling good and being proud and that giving plasma is a rewarding personal experience favor a higher frequency of plasma donation. PMID:25530909
Paglieroni, T G; Janatpour, K; Gosselin, R; Crocker, V; Dwyre, D M; MacKenzie, M R; Holland, P V; Larkin, E C
Platelet function abnormalities have been reported in blood donors who have not consumed aspirin. Our objective was to identify factors other than aspirin that may contribute to impaired platelet function in qualified volunteer blood donors. Blood samples were obtained from 24 donors following routine blood donation. Donors completed a study questionnaire that included questions about recent food consumption, medication and medical history. Platelet activation was measured using monoclonal antibodies and flow cytometry. CD62P expression and PAC-1 binding on platelets were used as indicators of platelet activation. Platelet function was measured on a platelet function analyser (PFA-100) using both collagen/epinephrine (cEPI) and collagen/ADP (cADP) cartridges. Fifty-four per cent of donors (13 of 24) had normal platelet function. Thirty-eight per cent (nine of 24) had prolonged cEPI closure times, of whom four (17%) had no cEPI closure (> 300 seconds). No closure was associated with aspirin use (two donors) or chocolate consumption (two donors) before donation. Two donors (8%) had either a shortened cEPI or cADP closure time. Platelet dysfunction in qualified blood donors is underestimated. Platelet function screening can identify donors with diet-related platelet dysfunction or with poor recollection of aspirin use.
Mahan, G. D.
We calculate the binding energy of an electron bound to a donor in a semiconductor inverse opal. Inverse opals have two kinds of cavities, which we call octahedral and tetrahedral, according to their group symmetry. We put the donor in the center of each of these two cavities and obtain the binding energy. The binding energies become very large when the inverse opal is made from templates with small spheres. For spheres less than 50 nm in diameter, the donor binding can increase to several times its unconfined value. Then electrons become tightly bound to the donor and are unlikely to be thermally activated to the semiconductor conduction band. This conclusion suggests that inverse opals will be poor conductors.
Mahan, G. D.
We calculate the binding energy of an electron bound to a donor in a semiconductor inverse opal. Inverse opals have two kinds of cavities, which we call octahedral and tetrahedral, according to their group symmetry. We put the donor in the center of each of these two cavities and obtain the binding energy. The binding energies become very large when the inverse opal is made from templates with small spheres. For spheres less than 50 nm in diameter, the donor binding can increase to several times its unconfined value. Then electrons become tightly bound to the donor and are unlikely to be thermally activated to the semiconductor conduction band. This conclusion suggests that inverse opals will be poor conductors.
Emani, Sitaramesh; Sai-Sudhakar, Chittoor B.; Higgins, Robert S. D.; Whitson, Bryan A.
There is increased scrutiny on the quality in health care with particular emphasis on institutional heart transplant survival outcomes. An important aspect of successful transplantation is appropriate donor selection. We review the current guidelines as well as areas of controversy in the selection of appropriate hearts as donor organs to ensure optimal outcomes. This decision is paramount to the success of a transplant program as well as recipient survival and graft function post-transplant. PMID:25132976
Nna, Emmanuel; Mbamalu, Chinenye; Ekejindu, Ifeoma
Hepatitis B virus infection is endemic in many parts of sub-Saharan Africa including Nigeria. Occult hepatitis B virus infection (OBI) is a challenging clinical problem characterized by the absence of Hepatitis B surface Antigen (HBsAg) and low viral DNA load. We aimed at determining the prevalence of OBI among repeat blood donors in Abakaliki, south-eastern Nigeria. Of 113 informed consented repeat blood donors enrolled into the study, 12 donors (10.6%) tested positive to both serological HBsAg screening, anti-HBc total and hepatitis B virus (HBV) DNA Nested PCR tests. One donor (0.9%) tested HBsAg positive, anti-HBC positive but Nested PCR negative. All donors were negative for HIV 1 and 2 and HCV infections. Of the 100 HbsAg negative repeat blood donors, 8.0% (eight donors) were HBV DNA positive by nested PCR method and anti-HBc total positive by ELISA. The median viral load, determined by real time PCR-Taqman chemistry, in the OBI blood samples was 51 IU/ml compared to 228 IU/ml of the HBsAg screen positive donors. The observed OBI prevalence of 8.0% corroborated with high endemicity of HBV infection in Abakaliki. We therefore recommend routine HBV DNA testing by real time PCR method on all sero-negative blood donations in Abakaliki and for a similar policy to be evaluated across the sub-Saharan Africa. PMID:24995918
Nna, Emmanuel; Mbamalu, Chinenye; Ekejindu, Ifeoma
Hepatitis B virus infection is endemic in many parts of sub-Saharan Africa including Nigeria. Occult hepatitis B virus infection (OBI) is a challenging clinical problem characterized by the absence of Hepatitis B surface Antigen (HBsAg) and low viral DNA load. We aimed at determining the prevalence of OBI among repeat blood donors in Abakaliki, south-eastern Nigeria. Of 113 informed consented repeat blood donors enrolled into the study, 12 donors (10·6%) tested positive to both serological HBsAg screening, anti-HBc total and hepatitis B virus (HBV) DNA Nested PCR tests. One donor (0·9%) tested HBsAg positive, anti-HBC positive but Nested PCR negative. All donors were negative for HIV 1 and 2 and HCV infections. Of the 100 HbsAg negative repeat blood donors, 8·0% (eight donors) were HBV DNA positive by nested PCR method and anti-HBc total positive by ELISA. The median viral load, determined by real time PCR-Taqman chemistry, in the OBI blood samples was 51 IU/ml compared to 228 IU/ml of the HBsAg screen positive donors. The observed OBI prevalence of 8·0% corroborated with high endemicity of HBV infection in Abakaliki. We therefore recommend routine HBV DNA testing by real time PCR method on all sero-negative blood donations in Abakaliki and for a similar policy to be evaluated across the sub-Saharan Africa.
Tavil, Betul; Gulhan, Bora; Ozcelik, Ugur; Cetin, Mualla; Tezcan, Ilhan; Tuncer, Murat; Uckan, Duygu
The preliminary study was performed to determine the frequency of tuberculin skin test (TST) positivity among 26 patients and their donors screened by TST to investigate whether tuberculin positivity of a recipient or donor influenced the rate of tuberculosis disease, transplant-related events, and to evaluate the effectiveness of isoniazide (INAH) prophylaxis administered to those with positive TST. The frequency of TST positivity was 23% (n = 6) among recipients and also 23% (n = 6) among donors. Two recipients and five donors with positive TST received INAH prophylaxis for six months. Our use of INAH prophylaxis in transplant patients was very conservative because of the risk of drug interaction. The transplantation procedure was not postponed for either recipient or donor TST positivity. Despite the high frequency of tuberculosis in our country, we have not detected any case of tuberculosis in our center, either among the purified protein derivative-screened (n = 26) or non-screened (n = 128) patients except for disseminated tuberculosis infection because of BCG vaccination in two patients with severe combined immunodeficiency. In conclusion, TST positivity in either recipient or donor may not be a contraindication for bone marrow transplantation and the procedure may not be postponed. Pretransplantation TST screening may be needed in countries where tuberculosis is common in the general population.
Rugano, Emilio Kariuki
This descriptive and causal comparative study sought to identify motivations for alumni donor acquisition and retention in Christian institutions of higher learning. To meet this objective, motivations for alumni donors, lapsed donors, and non-donors were analyzed and compared. Data was collected through an electronic survey of a stratified sample…
Rugano, Emilio Kariuki
This descriptive and causal comparative study sought to identify motivations for alumni donor acquisition and retention in Christian institutions of higher learning. To meet this objective, motivations for alumni donors, lapsed donors, and non-donors were analyzed and compared. Data was collected through an electronic survey of a stratified sample…
Desai, Rajeev; Neuberger, James
Cancers in solid organ recipients may be classified as donor transmitted, donor derived, de novo or recurrent. The risk of donor-transmitted cancer is very low and can be reduced by careful screening of the donor but cannot be abolished and, in the United Kingdom series is less than 0.03%. For donors with a known history of cancer, the risks will depend on the nature of the cancer, the interventions given and the interval between diagnosis and organ donation. The risks of cancer transmission must be balanced against the risks of death awaiting a new graft and strict adherence to current guidelines may result increased patient death. Organs from selected patients, even with high-grade central nervous system (CNS) malignancy and after a shunt, can, in some circumstances, be considered. Of potential donors with non-CNS cancers, whether organs may be safely used again depends on the nature of the cancer, the treatment and interval. Data are scarce about the most appropriate treatment when donor transmitted cancer is diagnosed: sometimes substitution of agents and reduction of the immunosuppressive load may be adequate and the impact of graft removal should be considered but not always indicated. Liver allograft recipients are at increased risk of some de novo cancers, especially those grafted for alcohol-related liver disease and hepatitis C virus infection. The risk of lymphoproliferative disease and cancers of the skin, upper airway and bowel are increased but not breast. Recipients should be advised to avoid risk behavior and monitored appropriately. PMID:24876738
Gallian, Pierre; Lhomme, Sébastien; Piquet, Yves; Sauné, Karine; Abravanel, Florence; Assal, Azzedine; Tiberghien, Pierre
We screened plasma samples (minipools of 96 samples, corresponding to 53,234 blood donations) from France that had been processed with solvent–detergent for hepatitis E virus RNA. The detection rate was 1 HEV-positive sample/2,218 blood donations. Most samples (22/24) from viremic donors were negative for IgG and IgM against HEV. PMID:25340881
O'Brien, Sheila F; Chiavetta, Jo Anne; Fan, Wenli; Xi, Guoliang; Yi, Qi-Long; Goldman, Mindy; Scalia, Vito; Fearon, Margaret A
Because Trypanosoma cruzi (T. cruzi) infection in Canada and the United States is largely contracted in endemic countries, targeted testing of blood donors with risk travel may improve safety. The operational validity of a travel question suitable for donor screening was tested, and it was field-tested. After 1331 donors completed a short travel question, operational validity was assessed by detailed travel histories in face-to-face interviews. Two nationwide donor surveys were carried out assessing donor responses to similar travel questions in 2001 (13,623 donors) and in 2006 (20,037 donors). All donors in Toronto, Ontario, answered a travel question in 1997 and those born in or who spent 6 months or more in Mexico, Central America, or South America were tested for antibody to T. cruzi. There was 97.3 percent agreement between the travel question and detailed interviews, with 15 donors (1.1%) failing to acknowledge risk travel (false-negative questioning responses). Of these, 6 donors were born there and 7 others had less than 1 year of cumulative travel. In 2001 and 2006, there were 2.1 and 2.0 percent of donors with risk travel, respectively, but 16.5 and 11.2 percent of these donors were identified only because they were born there (travel not acknowledge). There were 1337 (1.6%) donors in Toronto in 1997 with risk travel and none were positive for the presence of T. cruzi antibody. Donors can answer a short question about cumulative time in Latin America with similar accuracy to detailed questioning, but screening questions should also include country of birth.
Isley, Lauren; Falk, Rena E; Shamonki, Jaime; Sims, Charles A; Callum, Pamela
To illustrate the burden of inherited disease on donor-conceived offspring based on mode of inheritance and to provide guidance on methods of risk reduction. An 8.5-year retrospective review of outcome reports and donor management to summarize medical risks to donor-conceived offspring that presented after the sperm donors were qualified for participation in the donor program. Not applicable. None. None. Description of our experience with newly identified medical risks in donor-conceived offspring as well as how this information was ascertained and managed. More than half of the indications to restrict donor specimen distribution were due to multifactorial disorders. Approximately one third of the restrictions involved autosomal recessive disorders. The remainder of the restrictions were due to the other indications, including autosomal dominant disorders. The risks for multifactorial disorders or undiagnosed autosomal dominant disease cannot be significantly reduced or eliminated with routine donor screening procedures. Ongoing risk assessment is essential to identify new genetic risks for autosomal dominant and multifactorial disorders. These assessments require an investment of resources and genetics professionals in the long-term management of changing health information as well as collaboration among gamete facilities, recipients, donors, and their health care providers. Copyright © 2016 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.
Hays, Rebecca E; Thomas, Amy Elaine; Mathias, Erin; Mezrich, Joshua; Mandelbrot, Didier A
Living organ donation involves significant out-of-pocket costs, which burden donor candidates and may be an obstacle to donation. There is a single US grant (the National Living Donor Assistance Center-NLDAC) to cover live donor travel costs. Although there may be center-specific variability in grant utilization, prospective donors-and their intended recipients-must also meet eligibility criteria. In fact, the NLDAC grant is used by <10% of US live donors annually. We studied 154 consecutive kidney donor clinic evaluations (November 1, 2014-August 30, 2015) to determine eligibility and usage patterns during the evaluation process. Of these, 63 (41%) were local, had travel benefits, or declined. Of the remaining 91 prospective donors who might have benefited from grant support, only 29 (32%) obtained the grant. The other 62 (68%) did not meet eligibility screening. The major reason prospective donors were ineligible was that the recipient's household income was outside the required means test (ie, >300% of the federal poverty level) (n=51; 82%). The remaining exclusions (n=11; 18%) included being a nondirected donor, not meeting residency requirements, and "other." Expanding NLDAC eligibility criteria-by broadening the recipient means test or by taking steps to eliminate it from the NLDAC charter-would reduce financial burdens associated with live donation. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Ribas-Silva, Rejane Cristina; Eid, Andressa Ahmad
Background Dengue is an urban arbovirus whose etiologic agent is a virus of the genus Flavorius with four distinct antigen serotypes (DENV-1, DENV-2, DENV-3 and DENV-4) that is transmitted to humans through the bite of the mosquito Aedes aegypti. The Campo Mourão region in Brazil is endemic for dengue fever. Obtective The aim of this study was to evaluate the presence of IgG and IgM antibodies specific to the four serotypes of dengue in donors of the blood donor service in the city of Campo Mourão. Methods Epidemiological records were evaluated and 4 mL of peripheral blood from 213 blood donors were collected in tubes without anticoagulant. Serum was then obtained and immunochromatographic tests were undertaken (Imuno-Rápido Dengue IgM/IgGTM). Individuals involved in the study answered a social and epidemiological questionnaire on data which included age, gender and diagnosis of dengue. Results Only three (1.4%) of the 213 blood tests were positive for IgG anti-dengue antibodies. No donors with IgM antibody, which identifies acute infection, were identified. Conclusions The results of the current analysis show that the introduction of quantitative or molecular serological methods to determine the presence of anti-dengue antibodies or the detection of the dengue virus in blood donors in endemic regions should be established so that the quality of blood transfusions is guaranteed. PMID:23049418
Diekamp, Ulrich; Gneißl, Johannes; Rabe, Angela; Kießig, Stephan T.
Background Reports on unexpected events (UEs) during blood donation (BD) inadequately consider the role of technical UEs. Methods Defined local and systemic UEs were graded by severity; technical UEs were not graded. On January 1, 2008, E.B.P.S.-Logistics (EBPS) installed the UE module for plasma management software (PMS). Donor room physicians entered UEs daily into PMS. Medical directors reviewed entries quarterly. EBPS compiled data on donors, donations, and UEs from January 1, 2008 to June 30, 2011. Results 6,605 UEs were observed during 166,650 BDs from 57,622 donors for a corrected incidence of 4.30% (0.66% local, 1.59% systemic, 2.04% technical UEs). 2.96% of BDs were accompanied by one UE and 0.45% by >1 UE (2-4). 6.3% of donors donating blood for their first time, 3.5% of those giving blood for their second time, and 1.9% of donors giving their third or more BD experienced UEs. Most common UEs were: discontinued collections due to venous access problems, repeated venipuncture, and small hematomas. Severe circulatory UEs occurred at a rate of 16 per 100,000 BDs. Conclusions Technical UEs were common during BD. UEs accompanied first and second donations significantly more often than subsequent donations. PMID:26195932
Studer, Sean M; Orens, Jonathan B
The current availability of lung donors is far exceeded by the number of potential transplant recipients who are waiting for an organ. This disparity results in significant morbidity and mortality for those on the waiting list. Although it is desirable to increase overall consent rates for organ donation, doing so requires an intervention to affect societal response. In contrast, increased procurement of organs from marginal donors and improved donor management may be realized through increased study and practice changes within the transplant community. Transplantation of organs from marginal or extended-criteria donors may result in some increase in complications or mortality, but this possibility must be weighed against the morbidity and risk of death risk faced by individuals on the waiting list. The effects of this trade-off are currently being studied in kidney transplantation, and perhaps in the near future lung transplantation may benefit from a similar analysis. Until that time, the limited data regarding criteria for donor acceptability must be incorporated into practice to maximize the overall benefits of lung transplantation.
This paper is concerned with only one of the problems encountered in selecting donors for artificial insemination, that of choosing suitable donors. In Belgium medical students have generally been the donors of semen but Dr Schoysman examines the other choices of potential donors and outlines certain criteria for selecting them: these criteria are more explicit than those outlined by Professor Kerr and Miss Rogers on page 32. He also touches on the question of payment to donors. PMID:1165573
Sims, Jessica A; Thomas, Katherine M; Hopwood, Christopher J; Chen, Serena H; Pascale, Claudia
Although psychological evaluations are an integral element of screening for third-party reproduction and the Personality Assessment Inventory (PAI) is commonly used for these evaluations, little is known about the psychometric properties or normative scores on the PAI among egg donors and carriers. We evaluated the PAI among 1,044 egg donors and gestational carriers from various fertility clinics across the United States. PAI scales were generally internally consistent in this population, although range restriction appeared to attenuate reliability on several scales. The PAI profiles of egg donors and carriers had elevated positive impression management and suppressed clinical scale scores relative to the community standardization sample, as would be expected given the contingencies of this assessment context. Scores were similar across egg donors and carriers and were similar whether the carrier or donor was known or not known to the prospective parents. Sample-specific norms are provided for the use of the PAI in this setting.
Hwang, Shin; Lee, Sung-Gyu; Moon, Deok-Bog; Song, Gi-Won; Ahn, Chul-Soo; Kim, Ki-Hun; Ha, Tae-Yong; Jung, Dong-Hwan; Kim, Kwan-Woo; Choi, Nam-Kyu; Park, Gil-Chun; Yu, Young-Dong; Choi, Young-Il; Park, Pyoung-Jae; Ha, Hea-Seon
ABO incompatibility is the most common cause of donor rejection during the initial screening of adult patients with end-stage liver disease for living donor liver transplantation (LDLT). A paired donor exchange program was initiated to cope with this problem without ABO-incompatible LDLT. We present our results from the first 6 years of this exchange adult LDLT program. Between July 2003 and June 2009, 1351 adult LDLT procedures, including 16 donor exchanges and 7 ABO-incompatible LDLT procedures, were performed at our institution. Initial donor-recipient ABO incompatibilities included 6 A to B incompatibilities, 6 B to A incompatibilities, 1 A to O incompatibility, 1 A+O (dual graft) to B incompatibility, 1 O to AB incompatibility, and 1 O to A incompatibility. Fourteen matches (87.5%) were ABO-incompatible, but 2 (12.5%) were initially ABO-compatible. All ABO-incompatible donors were directly related to their recipients, but 2 compatible donors were each undirected and unrelated directed. After donor reassignment through paired exchange (n = 7) or domino pairing (n = 1), the donor-recipient ABO status changed to A to A in 6, B to B in 6, O to O in 1, A to AB in 1, A+O to A in 1, and O to B in 1, and this made all matches ABO-identical (n = 13) or ABO-compatible (n = 3). Two pairs of LDLT operations were performed simultaneously on an elective basis in 12 and on an emergency basis in 4. All donors recovered uneventfully. Fifteen of the 16 recipients survived, but 1 died after 54 days. In conclusion, an exchange donor program for adult LDLT appears to be a feasible modality for overcoming donor-recipient ABO incompatibility. (c) 2010 AASLD.
Botkin, J R
Transplantation technology has been refined in recent years and now offers hope to pediatric patients with a variety of end stage disease processes. The lack of available donors for the smallest potential organ recipients has led to the suggestion that anencephalic infants be used as organ donors. This suggested policy is contrary to current law and raises fundamental ethical issues relating to the definition of death and the treatment of the dying. The technical issues in the potential organ supply from this source are described and the opposing ethical positions developing in this debate are discussed.
Fiaschetti, P; Pretagostini, R; Stabile, D; Peritore, D; Oliveti, A; Gabbrielli, F; Cenci, S; Ricci, A; Vespasiano, F; Grigioni, W F
The aim of the study was to evaluate the experience of the Centre-Sud Transplant Organization (OCST) area using cadaveric donor with neoplastic diseases to evaluate the possibility of transmission to recipients. From January 1, 2003, to December 31, 2010, the neoplastic risk has been reported to be 5.4% (377/4654 referred donors). In 2003, the number of donors with a tumor and their mean age were respectively: 60 (10.3%) and 59.6 ± 19.9; 2004: 33 (5.2%) and 61.4 ± 15.9; 2005: 32 (6%) and 62.8 ± 15.5; 2006: 46 (7%) and 60.7 ± 19.1; 2007: 51 (7%) and 58.9 ± 16; in 2008: 58 (7%) and 59.7 ± 19.6; 2009: 47 (7%) and 57 ± 26; 2010: 49 (7%) and 64 ± 16. The organ most affected by tumor has been the central nervous system (18%). The tumor was diagnosed before in 325 (86%) cases, versus during organ retrieval in 48 (12.7%) donor operations but before, which four cases (1%) occured after transplantation. According to the histological types and grades, 28 evaluated donors (8.2%) were suitable for transplantation. The histological types were: thyroid carcinoma (n = 3); prostate carcinoma (n = 8), renal clear cell carcinoma (n = 7), oncocytoma (n = 1), meningiomas (n = 2), dermofibrosarcoma (n = 1); verrucous carcinoma of the vulva (n = 1), colon adenocarcinoma (n = 1), grade II astrocytoma (n = 1), adrenal gland tumor (n = 1), gastric GIST (n = 1), oligodendroglioma (n = 1). Forty-five organs were retrieved (22 livers, 19 kidneys, 3 hearts, and 1 pancreas) and transplanted into 44 recipients with 1 liver-kidney combined transplantation. Four recipients died due to causes not related to the tumor. No donor-transmitted tumor was detected among the recipients. Donation is absolutely not indicated in cases of tumors with high metastatic potential and high grades. Performing an accurate evaluation of the donor, taking into account the histological grade, currently can allow, organ retrieval and transplantation with an acceptable risk.
Landaburu, I; Gonzalvo, M-C; Clavero, A; Ramirez, J-P; Yoldi, A; Mozas, J; Zamora, S; Martinez, L; Castilla, J-A
To evaluate the clinical utility of genetic testing for cystic fibrosis (CF) and spinal muscular atrophy (SMA) in sperm donors. We studied the results of the genetic tests for CF and SMA applied to 372 sperm donor candidates. The CF carrier screening test analysed 32 mutations on the CFTR gene. Regarding SMA, the carrier test studied possible deletions of SMN1/2 by Multiplex Ligation-dependent Probe Amplification (MLPA) methodology. The carrier frequency obtained was greater for SMA than for CF. After adjusting the results obtained for the sensitivity of the tests, and taking into account the prevalence of female carriers in our population, the probability of transmission of the disease to the child from a donor with a negative genetic test was about five times lower in the case of SMA than in CF, although this difference was not statistically significant. The number of donors needed to screen (NNS) to avoid the occurrence of a child being affected by CF and SMA in our population was similar in both cases (1591 vs. 1536). This study demonstrates the need to include SMA among the diseases for which genetic screening is performed in the process of sperm donor selection. We believe that testing donors for SMA is as important and as useful as doing so for CF. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.
Hartmann, B T; Pang, W W; Keil, A D; Hartmann, P E; Simmer, K
Until the establishment of the PREM Bank (Perron Rotary Express Milk Bank) donor human milk banking had not occurred in Australia for the past 20 years. In re-establishing donor human milk banking in Australia, the focus of the PREM Bank has been to develop a formal and consistent approach to safety and quality in processing during the operation of the human milk bank. There is currently no existing legislation in Australia that specifically regulates the operation of donor human milk banks. For this reason the PREM Bank has utilised existing and internationally recognised management practices for managing hazards during food production. These tools (specifically HACCP) have been used to guide the development of Standard Operating Procedures and Good Manufacturing Practice for the screening of donors and processing of donor human milk. Donor screening procedures are consistent with those recommended by other human milk banks operating internationally, and also consistent with the requirements for blood and tissue donation in Australia. Controlled documentation and record keep requirements have also been developed that allow complete traceability from individual donation to individual feed dispensed to recipient and maintain a record of all processing and storage conditions. These operational requirements have been developed to reduce any risk associated with feeding pasteurised donor human milk to hospitalised preterm or ill infants to acceptable levels.
Yao, Felix; Seed, Clive; Farrugia, Albert; Morgan, David; Wood, David; Zheng, Ming-Hao
Screening of musculoskeletal tissue donors with nucleic acid testing (NAT) for human immunodeficiency virus (HIV) and hepatitis C virus (HCV) has been implemented in the United States and other developed nations. However, in contrast to the donor demographics in the United States, the majority of Australian musculoskeletal tissue donations are primarily from living surgical donors. The objective of our study was to determine and compare the risk of viral infection associated with musculoskeletal tissue donation from living and nonliving donors in Australia. We studied serum samples from 12 415 consecutive musculoskeletal tissue donors between 1993 and 2004. This included 10 937 surgical donations, and 1478 donations obtained from postmortem organ donation patients and cadaveric donors. Current mandatory retesting of surgical donors 6 months postdonation reduces the risk of viral infection by approximately 95% by eliminating almost all donors in the window period. The addition of nucleic acid amplification testing for nonliving donors would similarly reduce the window period, and consequently the residual risk by approximately 50% for hepatitis B virus, 55% for HIV, and 90% for HCV. NAT, using appropriately validated assays for nonliving donors, would reduce the residual risk to levels comparable to that in living donors (where the 95% reduction for quarantining pending the 180-day re-test is included).
Tamim, Hala; Musharrafieh, Umayya; Ramia, Sami; Almawi, Wassim Y; Al-Jisr, Tamima; Ayoub, Tanios; Nabulsi-Majzoub, Malak; Kazma, Hassan; Baz, Elizabeth Kfoury
Human T-cell lymphotropic virus type I (HTLV-I) is associated with certain hematologic and neurologic disorders. Seroprevalence studies demonstrated that the distribution of HTLV-I is heterogeneous worldwide and not specific to 1 region. Because blood is one of the major routes of transmission of the virus, blood banks of several countries routinely screen all blood donations for HTLV-I. The aim of the present study was to assess the seroprevalence rate of HTLV-I/II antibodies among Lebanese blood donors. Between August 2001 and March 2002, consecutive blood samples of 3529 blood donors were collected at blood banks of 4 major hospitals in Lebanon. Initial enzyme-linked immunosorbent assay (ELISA) screening resulted in 23 (0.7%) positive samples, of which 12 (0.3%) were reconfirmed positive by ELISA. Further analysis by Western blot resulted in 2 (0.06%) positive samples, of which 1 tested positive for HTLV-I by PCR (0.028%). Although its very low prevalence among Lebanese blood donors does not support routine screening of Lebanese blood donors for HTLV-I, screening of blood donors from other nationalities may be exercised, especially those from HTLV-I endemic areas.
Eberhardt, R. N.
Leukocyte separation-and-retrieval device utilizes granulocyte and monocyte property of leukoadhesion to glass surfaces as basis of their separation from whole blood. Device is used with single donor technique and has application in biological and chemical processing, veterinary research and clinical care.
Most major donors don't need another plaque or formal dinner. Development officers need to be more imaginative and less materialistic in expressing their institution's thanks, personalizing them by tying the gesture in with something distinctive about the institution or the gift. Development office teamwork and care help promote donor…
Aluwihare, A. P. R.
Physician migration from the developing to developed region of a country or the world occurs for reasons of financial, social, and job satisfaction. It is an old phenomenon that produces many disadvantages for the donor region or nation. The difficulties include inequities with the provision of health services, financial loss, loss of educated…
Eberhardt, R. N.
Leukocyte separation-and-retrieval device utilizes granulocyte and monocyte property of leukoadhesion to glass surfaces as basis of their separation from whole blood. Device is used with single donor technique and has application in biological and chemical processing, veterinary research and clinical care.
Diekamp, Ulrich; Gneißl, Johannes; Rabe, Angela; Kießig, Stephan T.
Summary Background Reports on unexpected donor events (UEs) during preparatory plasmapheresis (PPP) are scarce, and rarely consider technical UEs. Methods Defined local and systemic UEs were graded by severity; technical UEs were not graded. On January 1, 2008, E.B.P.S.-Logistics (EBPS) installed the UE module for plasma management software (PMS). Donor room physicians entered UEs daily into the PMS. Medical directors reviewed entries quarterly. EBPS compiled data on donors, donations and UEs from January 1, 2008 to June 30, 2011. Results 66,822 UEs were observed during 1,107,846 PPPs for a corrected incidence of 6.55% (1.4% local, 0.55% systemic, 4.6% technical UEs). 3.36% of PPPs were accompanied by 1 UE and 1.18% by >1 UE (2-5). 13.7% of donors undergoing PPP for the first time, 9.7% of those having a second PPP and 4.0% of those having a third or more PPPs were associated with UEs. Most common UEs were repeated venipuncture, and broken-off collection due to venous access problems and small hematomas. Severe systemic UEs occurred at a rate of 36 per 100,000 PPPs. Conclusions Technical UEs were common with PPP. UEs accompanied first and second donations significantly more frequently than for subsequent donations. PMID:24847188
Brunkhart, Donald E.; Ellis, Frank R.
The paper will describe the American National Red Cross' national hepatitis surveillance registry known as the Donor Defferal Registry (DDR), and its implementation in the Missouri/Illinois Region. Attention will be given specially to computer structure and processing strategy, impact on the clinical incidence of hepatitis and the cost of the DDR.
Ali, Nadir; Moinuddin; Ahmed, Syed Azhar; Chotani, Rashid A; Fisher-Hoch, Susan P
To determine the frequency of HCV RNA in an anti-HCV non-reactive blood donor population with normal ALT, and its cost effectiveness. An observational study. Baqai Institute of Haematology, Baqai Medical University, Karachi, and Combined Military Hospital, Malir Cantt, Karachi, from May 2006 to April 2008. After initial interview and mini-medical examination, demographic data of blood donors was recorded, and anti-HCV, HBsAg and HIV were screened by third generation ELISA. Those reactive to anti-HCV, HbsAg and/or HIV were excluded. Four hundred consecutive donors with ALT within the reference range of 15-41 units/L were included in study. HCV RNA RT-PCR was performed on 5 sample mini-pools using Bio-Rad Real time PCR equipment. All 400 donors were male, with mean age 27 years SD + 6.2. ALT of blood donors varied between 15-41 U/L with mean of 31.5+6.4 U/L, HCV RNA was detected in 2/400 (0.5%) blood donors. Screening one blood bag for HCV RNA costs Rs 4,000.00 equivalent to 50 US dollars, while screening through 5 sample mini-pools was Rs. 800.00 equivalent to approximately 10 US dollars. HCV RNA frequency was 0.5% (2/400) in the studied anti-HCV non-reactive normal ALT blood donors. Screening through mini-pools is more cost-effective.
Kiss, Joseph E.
Synopsis Over 9 million individuals donate blood annually in the US. Between 200 to 250 mg of iron is removed with each whole blood donation, reflecting losses from the hemoglobin in red blood cells. This amount represents approximately 25% of the average iron stores in men and almost 75% of the iron stores in women. Replenishment of iron stores takes many months, leading to a high rate of iron depletion, especially in frequent blood donors (e. g., more than 2 times per year). In large epidemiologic studies, donation frequency, female gender, and younger age (reflecting menstrual status), are particularly associated with iron depletion. Currently, a minimum capillary hemoglobin of 12.5 gm/dl is the sole requirement for donor qualification in the US as far as iron levels are concerned, yet it is known that hemoglobin level is a poor surrogate for low iron. In an effort to better identify and prevent iron deficiency, blood collection centers are now considering various strategies to manage donor iron loss, including changes in acceptable hemoglobin level, donation interval, donation frequency, testing of iron status, and iron supplementation. This chapter highlights laboratory and genetic tests to assess the iron status of blood donors and their applicability as screening tests for blood donation. PMID:25676373
Visser, M; Mochtar, M H; de Melker, A A; van der Veen, F; Repping, S; Gerrits, T
What do identifiable sperm donors feel about psychosocial counselling? Identifiable sperm donors found it important that psychosocial counselling focused on emotional consequences and on rules and regulations and they expected to have access to psychosocial counselling at the time that donor-offspring actually sought contact. Most studies on sperm donors are on anonymous donors and focus on recruitment, financial compensation, anonymity and motivations. There is limited knowledge on the value that identifiable sperm donors place on psychosocial counselling and what their needs are in this respect. We performed a qualitative study from March until June 2014 with 25 identifiable sperm donors, who were or had been a donor at the Centre for Reproductive Medicine of the Academic Medical Centre in Amsterdam any time between 1989 and 2014. We held semi-structured in-depth interviews with identifiable sperm donors with an average age of 44 years. The interviews were fully transcribed and analysed using the constant comparative method of grounded theory. Twelve out of 15 donors (former donors ITALIC! n = 8, active donors ITALIC! n = 7) who had received a counselling session during their intake procedure found it important that they had been able to talk about issues such as the emotional consequences of donation, disclosure to their own children, family and friends, future contact with donor-offspring and rules and regulations. Of the 10 former donors who had received no counselling session, 8 had regretted the lack of intensive counselling. In the years following their donation, most donors simply wanted to know how many offspring had been born using their sperm and had no need for further counselling. Nevertheless, they frequently mentioned that they were concerned about the well-being of 'their' offspring. In addition, they would value the availability of psychosocial counselling in the event that donor-offspring actually sought contact. A limitation of our study is its
Background Posttransfusion hepatitis B virus (HBV) infection still occurs although its incidence has been substantially reduced since the introduction of screening of hepatitis B surface antigen (HBsAg) in blood donors. This study aimed to investigate the occult HBV infection in accepted blood donors in Nanjing, China. Results The lower detection limit of the nested PCR in this study was estimated to be 20 copies/ml HBV DNA. The positive rate of occult HBV infection was 0.13% (5 of 2972) in the accepted blood donors. Sequencing data showed that the amplified HBV sequences were not identical each other and to the known sequences cloned in our laboratory, excluding the false-positive caused by cross-contamination. Phylogenetic analysis showed that the HBV in all five donors was genotype B; a single base deletion was detected in the S region of HBV DNA from one donor, and no mutation was observed in the "a" determinant of HBsAg from four other donors. All five donors were negative for anti-HBs and one was positive for anti-HBc. Conclusions The prevalence of occult HBV infection in the accepted blood donors in Nanjing, China is relatively high. The data would be meaningful in adapting strategy to eliminate posttransfusion HBV infection in China. PMID:20718994
Usman, Muhammad; Rahman, Rajib; Salfi, Joe; Bocquel, Juanita; Voisin, Benoit; Rogge, Sven; Klimeck, Gerhard; Hollenberg, Lloyd L. C.
Atomistic tight-binding (TB) simulations are performed to calculate the Stark shift of the hyperfine coupling for a single arsenic (As) donor in silicon (Si). The role of the central-cell correction is studied by implementing both the static and the non-static dielectric screenings of the donor potential, and by including the effect of the lattice strain close to the donor site. The dielectric screening of the donor potential tunes the value of the quadratic Stark shift parameter (η2) from -1.3 × 10-3 µm2 V-2 for the static dielectric screening to -1.72 × 10-3 µm2 V-2 for the non-static dielectric screening. The effect of lattice strain, implemented by a 3.2% change in the As-Si nearest-neighbour bond length, further shifts the value of η2 to -1.87 × 10-3 µm2 V-2, resulting in an excellent agreement of theory with the experimentally measured value of -1.9 ± 0.2 × 10-3 µm2 V-2. Based on our direct comparison of the calculations with the experiment, we conclude that the previously ignored non-static dielectric screening of the donor potential and the lattice strain significantly influence the donor wave function charge density and thereby leads to a better agreement with the available experimental data sets.
Nuchprayoon, C; Tanprasert, S; Chumnijarakij, T; Thanomchat, S; O'Prasert, B; Adulwijit, S
Of 782,190 volunteer blood donors in Bangkok and nearby areas, who were screened for infection with human immunodeficiency type 1 (HIV-1) from January 1988 through December 1992, 3,219 tested positive on both enzyme immuno assay and Western blot assay. The identification variables of the donor were collected. The majority of HIV seropositive blood donors were male. The average age (median) of HIV seropositive was 26-29 years all through 1988-2992. The prevalence of HIV seropositive in male donors was higher than that in females. HIV seropositivity was confirmed in blood donations from first-time male donors in this study during 1988-1992. This rate has increased progressively from 0.87/1,000 in 1988 to 15.95/1,000 in 1992 with much higher rates in repeat donors. The repeat male donors increased from 0.77/1,000 in 1988 to 5.26/1,000 in 1991 and since then showed a decreased rate to 3.93/1,000 in 1992. Female donors were infected with HIV more frequently with the prevalence by sex ratio M:F rising from 27:1 in 1988 to 6.6:1 in 1992. Comparing the seropositive rate between first time and repeat female donors, the results showed an increase in rate from 0.11/1,000 in 1990 to 2.02/1,000 in 1992, but essentially the same rate in report donors. A majority of HIV seropositive blood donors (1990-1992) lived in Bangkok (42-49%) and among those who lived in one eastern province (Samut Prakan), 90-93% lived in the industrial areas. Of those who lived in Chon Buri Province, 73-88% lived in Sattaheep District, which is a naval base.
Wiberg, A; Granstam, A; Ingvast, S; Härkönen, T; Knip, M; Korsgren, O; Skog, O
In this study we aim to describe the characteristics of non-diabetic organ donors with circulating diabetes-associated autoantibodies collected within the Nordic Network for Islet Transplantation. One thousand and thirty organ donors have been screened in Uppsala for antibodies against glutamic acid decarboxylase (GADA) and islet antigen-2 (IA-2A). The 32 non-diabetic donors that tested positive for GADA (3.3% of all non-diabetic donors) were studied in more detail, together with 32 matched controls. Mean age among the autoantibody-positive donors was 52.6 (range 21-74), family history of type 1 diabetes (T1D) was unknown, and no donor was genetically predisposed for T1D regarding the human leucocyte antigen (HLA) locus. Subjects were analysed for islet cell antibodies (ICA), insulin autoantibodies (IAA) and zinc transporter 8 antibodies (ZnT8A), and pancreas morphology and clinical data were examined. Eight non-diabetic donors tested positive for two antibodies and one donor tested positive for four antibodies. No insulitis or other signs of a diabetic process were found in any of the donors. While inflammatory cells were present in all donors, subjects with high GADA titres had significantly higher CD45 cell numbers in exocrine tissue than controls. The extent of fibrosis was more pronounced in autoantibody-positive donors, even in subjects with lower GADA titres. Notably, it is possible that events not related directly to T1D (e.g. subclinical pancreatitis) may induce autoantibodies in some cases. © 2015 British Society for Immunology.
Wiberg, A; Granstam, A; Ingvast, S; Härkönen, T; Knip, M; Korsgren, O; Skog, O
In this study we aim to describe the characteristics of non-diabetic organ donors with circulating diabetes-associated autoantibodies collected within the Nordic Network for Islet Transplantation. One thousand and thirty organ donors have been screened in Uppsala for antibodies against glutamic acid decarboxylase (GADA) and islet antigen-2 (IA-2A). The 32 non-diabetic donors that tested positive for GADA (3·3% of all non-diabetic donors) were studied in more detail, together with 32 matched controls. Mean age among the autoantibody-positive donors was 52·6 (range 21–74), family history of type 1 diabetes (T1D) was unknown, and no donor was genetically predisposed for T1D regarding the human leucocyte antigen (HLA) locus. Subjects were analysed for islet cell antibodies (ICA), insulin autoantibodies (IAA) and zinc transporter 8 antibodies (ZnT8A), and pancreas morphology and clinical data were examined. Eight non-diabetic donors tested positive for two antibodies and one donor tested positive for four antibodies. No insulitis or other signs of a diabetic process were found in any of the donors. While inflammatory cells were present in all donors, subjects with high GADA titres had significantly higher CD45 cell numbers in exocrine tissue than controls. The extent of fibrosis was more pronounced in autoantibody-positive donors, even in subjects with lower GADA titres. Notably, it is possible that events not related directly to T1D (e.g. subclinical pancreatitis) may induce autoantibodies in some cases. PMID:26313035
van Rood, J J; Oudshoorn, M
The term 'an HLA matched donor' is in general used without giving exact information on the level of resolution of the HLA typing. This can lead to misunderstandings. A proposal is formulated to agree on using six match categories according to the HLA typing technique used to indicate the level of confidence of the matching.
Lamb, Kellan N; Squitieri, Richard A; Chintala, Srinivasa R; Kwong, Ada J; Balmond, Edward I; Soldi, Cristian; Dmitrenko, Olga; Castiñeira Reis, Marta; Chung, Ryan; Addison, J Bennett; Fettinger, James C; Hein, Jason E; Tantillo, Dean J; Fox, Joseph M; Shaw, Jared T
Metal carbenes appended with two electron-donating groups, known as "donor/donor" carbenes, undergo diastereo- and enantioselective rhodium-catalyzed C-H insertion reactions with ether substrates to form benzodihydrofurans. Unlike the reactions of metal carbenes with electron-withdrawing groups attached, the attenuated electrophilicity enables these reactions to be conducted in Lewis basic solvents (e.g., acetonitrile) and in the presence of water. The diazo precursors for these species are prepared in situ from hydrazone using a mild and chemoselective oxidant (MnO2 ). Although this sequence often can be performed in one-pot, control experiments have elucidated why a "two-pot" process is often more efficient. A thorough screening of achiral catalysts demonstrated that sterically encumbered catalysts are optimal for diastereoselective reactions. Although efficient insertion into allylic and propargylic C-H bonds is observed, competing dipolar cycloaddition processes are noted for some substrates. The full substrate scope of this useful method of benzodihydrofuran synthesis, mechanisms of side reactions, and computational support for the origins of stereoselectivity are described. © 2017 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.
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Wolfman, Samuel; Shaked, Tali
Informed consent of the patient to medical treatment is an essential prerequisite for any invasive medical procedure. However in emergency cases, when the patient is unable to sign a consent form due to unconsciousness or to psychotic state, than the primary medical consideration shall take place. In such a case, in order to save life or even prevent a major medical hazard to the patient, doctors are allowed, in certain cases and in accordance with well accepted medical practice, to perform invasive procedures, major surgery or risky pharmacological treatment, without the explicit consent of the patient. All the above refers to the cases when avoidance of such non-consented treatment may harm severely the health and wellbeing of the patient and there is no doubt that such treatment is for the ultimate benefit of the patient. The question, however, shall arise when such a medical procedure is not necessarily for the benefit of the patient, but rather for the benefit of somebody else. Such is the case in the transplantation area and the question of living donor-donee relationship. This paper shall analyze the legal situation in cases of non competent donors whose consent cannot be considered legal consent given in full understanding and out of free will. It will also compare three legal systems, the Israeli, the American and the traditional Jewish law, with regard to the different approaches to this human problem, where the autonomy of the donor may be sacrificed for the purpose of saving life of another person.
Doll, L S; Petersen, L R; White, C R; Ward, J W
Between May 1988 and September 1989, 829 human immunodeficiency virus type 1 (HIV-1)-seropositive donors were identified from 3,919,000 units of blood donated at 20 United States (US) blood centers. Of the 829,512 (62%) were interviewed to assess behavioral characteristics of the largest subgroup, men reporting sex with men, use of the confidential unit exclusion (CUE) and reasons for donation among all donors. Among 216 men reporting sex with men, 97 percent had male and 72 percent had female sexual contact since 1978. The majority identified themselves as bisexual (29%) or heterosexual (26%). Although 61 percent of 512 donors were aware of their risk behavior at donation, including 57 percent of those infected through heterosexual transmission, only 5 percent used the CUE. Reasons for donation included failure to read carefully (46%) or comprehend (15%) the deferral materials, pressure to donate (27%), a desire to be tested for HIV-1 (15%), and a reliance on screening to identify infected blood (10%). Reasons given for a perception of being at low risk included no recent risk behaviors, infrequent risk behaviors, or modification of risk behaviors. To reach high-risk donors, centers should assess whether referral materials provide necessary medical information and are clearly written for persons with diverse cultural and language backgrounds. Staff should be encouraged to avoid the use of culturally stigmatized terms and behaviors that may be perceived as high pressure.
Ellingson, K; Seem, D; Nowicki, M; Strong, D M; Kuehnert, M J
To prevent unintentional transmission of bloodborne pathogens through organ transplantation, organ procurement organizations (OPOs) screen potential donors by serologic testing to identify human immunodeficiency virus (HIV) and hepatitis C virus (HCV) infection. Newly acquired infection, however, may be undetectable by serologic testing. Our objective was to estimate the incidence of undetected infection among potential organ donors and to assess the significance of risk reductions conferred by nucleic acid testing (NAT) versus serology alone. We calculated prevalence of HIV and HCV-stratified by OPO risk designation-in 13,667 potential organ donors managed by 17 OPOs from 1/1/2004 to 7/1/2008. We calculated incidence of undetected infection using the incidence-window period approach. The prevalence of HIV was 0.10% for normal risk potential donors and 0.50% for high risk potential donors; HCV prevalence was 3.45% and 18.20%, respectively. For HIV, the estimated incidence of undetected infection by serologic screening was 1 in 50,000 for normal risk potential donors and 1 in 11,000 for high risk potential donors; for HCV, undetected incidence by serologic screening was 1 in 5000 and 1 in 1000, respectively. Projected estimates of undetected infection with NAT screening versus serology alone suggest that NAT screening could significantly reduce the rate of undetected HCV for all donor risk strata.
Elyamany, Ghaleb; Al amro, Mohamed; Pereira, Winston Costa; Alsuhaibani, Omar
Introduction Syphilis is one of the known transfusion-transmissible infections and causes 100,000 deaths yearly, with around 90% of these deaths occurring in the developing world. Little data is available regarding the prevalence of syphilis among Saudi blood and stem cell donors. We conducted a survey on the incidence of syphilis among all blood and stem cell donors. Methods This study was conducted at the Prince Sultan Military Medical City in Riyadh, Saudi Arabia in the 10 years period data during 2006–2015. Data were analyzed about full history, physical examination, age, sex, weight, profession, marital status, number of the donations, data of last donation, having a relation who received blood transfusion, as well as the screening test results of the donated blood. We determined the seroprevalence of infection and compared by sex and other variable through frequency analysis, Chi square, Fisher, and prevalence ratios. Results Approximately 240,000 blood donors were screened and studied in the period of study. Most of the blood donors were male (98.3%) and 89% of them were citizens of Saudi Arabia. According to our findings, we estimated that, in the last 10 years, approximately 0.044% of all the blood donors were syphilis positive cases. No cases were detected as positive for syphilis among stem cell donors. Only 60 blood donors tested positive for syphilis. In addition, we studied 202 stem cell transplant donors during the same period, of which 59% were male and none texted positive for syphilis. Conclusions A concerted effort between the government, health care providers, regulatory bodies and accreditation agencies have all contributed in eliminating the risk of spreading syphilis among blood donors. PMID:27757184
Zou, Shimian; Dodd, Roger Y; Stramer, Susan L; Strong, D Michael
Tissue-banking organizations in the United States have introduced various review and testing procedures to reduce the risk of the transmission of viral infections from tissue grafts. We estimated the current probability of undetected viremia with hepatitis B virus (HBV), hepatitis C virus (HCV), human immunodeficiency virus (HIV), and human T-lymphotropic virus (HTLV) among tissue donors. Rates of prevalence of hepatitis B surface antigen (HBsAg) and antibodies against HIV (anti-HIV), HCV (anti-HCV), and HTLV (anti-HTLV) were determined among 11,391 donors to five tissue banks in the United States. The data were compared with those of first-time blood donors in order to generate estimated incidence rates among tissue donors. The probability of viremia undetected by screening at the time of tissue donation was estimated on the basis of the incidence estimates and the window periods for these infections. The prevalence of confirmed positive tests among tissue donors was 0.093 percent for anti-HIV, 0.229 percent for HBsAg, 1.091 percent for anti-HCV, and 0.068 percent for anti-HTLV. The incidence rates were estimated to be 30.118, 18.325, 12.380, and 5.586 per 100,000 person-years, respectively. The estimated probability of viremia at the time of donation was 1 in 55,000, 1 in 34,000, 1 in 42,000, and 1 in 128,000, respectively. The prevalence rates of HBV, HCV, HIV, and HTLV infections are lower among tissue donors than in the general population. However, the estimated probability of undetected viremia at the time of tissue donation is higher among tissue donors than among first-time blood donors. The addition of nucleic acid-amplification testing to the screening of tissue donors should reduce the risk of these infections among recipients of donated tissues. Copyright 2004 Massachusetts Medical Society
Biasini, Augusto; Stella, Marcello; Malaigia, Laura; China, Mariachiara; Azzalli, Milena; Laguardia, Maria Chiara; Rizzo, Vittoria
Human milk is very valuable in premature infant nutrition. The collection, screening, processing and distribution of donor human milk are described in this report. These activities take place in the Donor Human Milk Bank (DHMB) of the Large Romagna Area (LRA) in Italy, the development of which is also described here. Over the years, the activities of this bank, which is located in Cesena Hospital, in the center of the LRA, have developed from an informal and domestic-level activity to become a multistep controlled process designed to prevent the possibility of disease transmission. This little food-supply industry, run by a multi-disciplinary team with strict rules and diverse responsibilities, complies with the Hazards Analysis and Critical Control Points (HACCP) system.
Chegaev, Konstantin; Lazzarato, Loretta; Rolando, Barbara; Marini, Elisabetta; Lopez, Gloria V; Bertinaria, Massimo; Di Stilo, Antonella; Fruttero, Roberta; Gasco, Alberto
Models of amphiphilic NO-donor antioxidants 24-26 were designed and synthesized. The products were obtained by linking a lipophilic tail (C(6), C(8), C(10)) with a polar head constituted by the 2,6-dimethoxyphenol antioxidant joined to the NO-donor 3-furoxancarboxamide substructure through a bridge containing a quaternary ammonium group. Compound 23, containing the shortest C(2)-alkyl chain, was also studied as a reference. The antioxidant properties (TBARS and LDL oxidation assays) and the vasodilator properties of the compounds were studied in vitro. The ability of these products to interact with phospholipid vesicles was also investigated by NMR techniques. The results indicate that both activities are modulated by the ability of the compounds to accumulate on phospholipid layers.
Sharma, Amit; Ashworth, April; Behnke, Martha; Cotterell, Adrian; Posner, Marc; Fisher, Robert A.
Background Donor selection criteria for adult-to-adult living donor liver transplantation vary with the medical center of evaluation. Living donor evaluation utilizes considerable resources and the non-maturation of potential into actual donors may sometimes prove fatal for patients with end stage liver disease. On the contrary, a thorough donor evaluation process is mandatory to ensure safe outcomes in otherwise healthy donors. We aimed to study the reasons for non-maturation of potential right lobe liver donors at our transplant center. Methods A retrospective data analysis of all potential living liver donors evaluated at our center from 1998 to 2010 was done. Results Overall 324 donors were evaluated for 219 potential recipients and 171 (52.7%) donors were disqualified. Common reasons for donor non-maturation included: (1) Donor reluctance, 21% (2) >10% macro-vesicular steatosis, 16% (3) assisted donor withdrawal, 14% (4) inadequate remnant liver volume, 13% (5) psychosocial issues, 7% and thrombophilia, 7%. Ten donors (6%) were turned down due to anatomical variations (8 biliary and 2 arterial anomalies). Donors older than 50 years and those with BMI over 25 were less likely to be accepted for donation. Conclusions We conclude that donor reluctance, hepatic steatosis and assisted donor withdrawal are major reasons for non-maturation of potential into actual donors. Anatomical variations and underlying medical conditions were not a major cause of donor rejection. A system in practice to recognize these factors early in the course of donor evaluation to improve the efficiency of the selection process and ensure donor safety is proposed. PMID:23128999
Tagny, Claude T; Nguefack-Tsague, Georges; Fopa, Diderot; Ashu, Celestin; Tante, Estel; Ngo Balogog, Pauline; Donfack, Olivier; Mbanya, Dora; Laperche, Syria; Murphy, Edward
In sub-Saharan Africa improving the deferral of at-risk blood donors would be a cost-effective approach to reducing transfusion-transmitted human immunodeficiency virus (HIV) infections. We performed a pilot case-control study to identify the risk factors for HIV infection and to develop an adapted donor history questionnaire (DHQ) for sub-Saharan Africa. We recruited 137 HIV-positive donors (cases) and 256 HIV-negative donors (controls) and gathered risk factor data using audio computer-assisted self-interview. Variables with univariate associations were entered into a logistic regression model to assess independent associations. A scoring scheme to distinguish between HIV-positive and HIV-negative donors was developed using receiver operating characteristics curves. We identified 16 risk factors including sex with sex worker, past history or treatment for sexually transmitted infections, and having a partner who used injected or noninjected illegal drugs. Two novel risks were related to local behavior: polygamy (odds ratio [OR], 22.7; 95% confidence interval [CI], 5.9-86.7) and medical or grooming treatment on the street (OR, 1.8; 95% CI, 1.0-3.0). Using the 16 selected items the mean scores (>100) were 82.6 ± 6.7 (range, 53.2-95.1) and 85.1 ± 5.2 for HIV-negative donors versus 77.9 ± 6.8 for HIV-positive ones (p = 0.000). Donors who scored between 80 and 90 were more likely to be HIV negative than those who scored less (OR, 31.4; 95% CI, 3.1-313.9). We identified both typical and novel HIV risk factors among Cameroonian blood donors. An adapted DHQ and score that discriminate HIV-negative donors may be an inexpensive means of reducing transfusion-transmitted HIV through predonation screening. © 2017 AABB.
The production of n-type semiconducting diamond has been a long-standing experimental challenge. The first-principles simulation of shallow dopants in semiconductors has been a long-standing theoretical challenge. A desirable theoretical goal is to identify impurities that will act as shallow donors in diamond and assess their experimental viability. I will discuss this identification process for the LiN4 donor complex. It builds a scientific argument from several models and computational results in the absence of computational tools that are both trustworthy and computationally tractable for this task. I will compare the theoretical assessment of viability with recent experimental efforts to co-dope diamond with lithium and nitrogen. Finally, I discuss the computational tools needed to facilitate future work on this problem and some preliminary simulations of donors near diamond surfaces. Sandia National Laboratories is a multi-program lab managed and operated by Sandia Corp., a wholly owned subsidiary of Lockheed Martin Corp., for the U.S. Department of Energy's National Nuclear Security Administration under Contract DE-AC04-94AL85000.
Basile, Joyce E; Donnenfeld, Alan E
To determine the percentage of potential ovum donors who have an increased risk for fetal harm. Couples using an ovum donor to conceive a pregnancy are expecting to select someone who poses a low genetic risk to their offspring. Currently, most genetic carrier screening of these donors is performed at the discretion of the fertility center. This investigation involves a review of family history and genetic carrier test results of oocyte donor candidates. A total of 210 (22.1%) of 950 potential oocyte donors had at least one fetal risk factor based on family history. Of 244 prospective donors who had genetic testing, 15 (6.1%) were found to be carriers of hereditary diseases that could pose an increased risk to a fetus. A genetic assessment is a critical step in the evaluation of prospective oocyte donors, because almost one quarter of donors had a family history of a disease that could pose an increased fetal risk. Disclosure of ovum donor carrier status and, when applicable, testing of partners is required before accepting a potential ovum donor in an infertility program.
Cairo, Mitchell S; Rocha, Vanderson; Gluckman, Eliane; Hale, Gregory; Wagner, John
Allogeneic stem cell transplantation has been demonstrated to be curative in a wide variety of pediatric malignant and nonmalignant diseases, and can be traced back over 50 years ago to the original report of Thomas et al. HLA matched sibling donors have been the gold standard for pediatric recipients requiring allogeneic donors for both nonmalignant and malignant conditions. However, only 25% of potential pediatric recipients possesses an HLA-matched sibling donor, and the frequency is even less in those with genetic nonmalignant conditions because of genetically affected other siblings within the family. Therefore, 75% to 90% of potential pediatric recipients require alternative allogeneic donor cells for treatment of their underlying conditions. Potential alternative allogeneic donor sources include unrelated cord blood donors, unrelated adult donors, and haploidentical family donors. In this article we review the experience of both unrelated cord blood donor and haploidentical family donor transplants in selected pediatric malignant and nonmalignant conditions.
Uwingabiye, Jean; Zahid, Hafidi; Unyendje, Loubet; Hadef, Rachid
This study aims to determine the prevalence of human immunodeficiency virus (HIV) infections and hepatitis B virus (HBV) and hepatitis C virus (HCV) infections among blood donors at the Blood Donor Center, Mohammed V Military Teaching Hospital between 2010 and 2012. We conducted a retrospective study among military blood donors aged 18-50 years, with a male predominance (95%). Pre-donation interview is the first selection barrier for individuals at risk. Biological screening was performed by liquid enzyme immunoassay technique using antibodies and/or antigen. Fourth generation combined HCV and HIV antigen/antibody ELISA (enzyme-linked immunosorbent assay) test was used. The Blood Donor Center and the laboratory of virology used the same technique performed in duplicate to confirm results. Out of 25661 tested samples, the prevalence rate of HBV infections was 3.97 ‰ (n = 102), the prevalence rate of HCV infections was 2.45 ‰ (n = 63) and the prevalence rate of HIV infections was 0.15 ‰ (n = 4). A single case with HBV and HCV virus co-infection (0.039 ‰) was registered, no association between HIV-HBV, HIV-HCV or HBV, HCV and HIV infections was recorded. The low seroprevalence rates of viral markers recorded in our study show improvement in preventive measures for donor selection and screening tests. The registered prevalence encourages the use of combined reagent, which is the only alternative to molecular biology in developing countries.
Sreejith, Sivaramapanicker; Divya, Kizhumuri P; Jayamurthy, Purushothaman; Mathew, Jomon; Anupama, V N; Philips, Divya Susan; Anees, Palappuravan; Ajayaghosh, Ayyappanpillai
The excited state intra molecular charge transfer (ICT) property of fluorophores has been extensively used for the design of fluorescent chemosensors. Herein, we report the synthesis and properties of three donor–π-acceptor–π-donor (D–π-A–π-D) based molecular probes BP, BT and BA. Two heteroaromatic rings, pyrrole (BP), and thiophene (BT) and a non-heteroaromatic ring N-alkoxy aniline (BA) were selected as donor moieties which were linked to a bipyridine binding site through a vinylic linkage. The heteroaromatic systems BP and BT perform selective and ratiometric emission signalling for zinc ions whereas the non-heteroaromatic probe BA does not. The advantages of the D–π-A–π-D design strategy in the design of ICT based probes for the selective fluorescent ratiometric signalling of zinc ions in biological media is discussed. Further, the use of BP, BT and BA for imaging Zn(2+) ions from MCF-7 cell lines is demonstrated.
Ma, Chun-Hui; Guo, Ru-Hua; Wu, Wei-Jian; Yan, Jun-Xiong; Yu, Jin-Lin; Zhu, Ye-Hua; He, Qi-Tong; Luo, Yi-Hong; Huang, Lu; Ye, Rui-Yun
This study was aimed to evaluate the impact of regular donating platelets on serum ferritin (SF) of donors. A total of 93 male blood donors including 24 initial plateletpheresis donors and 69 regular plateletpheresis donors were selected randomly. Their SF level was measured by ELISA. The results showed that the SF level of initial plateletpheresis donors and regular plateletpheresis donors were 91.08 ± 23.38 µg/L and 57.16 ± 35.48 µg/L respectively, and all were in normal levels, but there was significant difference between the 2 groups (p < 0.05). The SF level decreased when the donation frequency increased, there were no significant differences between the groups with different donation frequency. Correlation with lifetime donations of platelets was not found. It is concluded that regular plateletpheresis donors may have lower SF level.
Soubrane, Olivier; Gateau, Valérie; Lefève, Céline
Live donor liver transplant (LDLT) was first reported in the 1990s and quickly raised ethical considerations, mainly related to the risk brought to the donor. The question of donor safety was even more accurate with the occurrence of laparoscopy, a technique which could allegedly increase the risk of severe intraoperative complications. Besides the questions of justice and autonomy, donor safety remains the main ethical debate of LDLT. Considering the lack of comparative assessment of postoperative outcomes, the Jury of the last Consensus meeting held in Japan in 2014 called for the creation of international registries to help to determine the benefit/risk ratio of laparoscopic donor hepatectomy. Since randomized studies are very unlikely to occur, benchmarking comparisons, between liver and kidney donors for instance, may also help to define standard practice. At last, donors' points of view should also be taken into account in the evaluation of those innovative procedures. © 2016 Japanese Society of Hepato-Biliary-Pancreatic Surgery.
Jeremiah, Zaccheaus Awortu; Koate, Baribefe Banavule
There is paucity of information on the effect of blood donation on iron stores in Port Harcourt, Nigeria. The present study was, therefore, designed to assess, using a combination of haemoglobin and iron status parameters, the development of anaemia and prevalence of iron deficiency anaemia in this area of Nigeria. Three hundred and forty-eight unselected consecutive whole blood donors, comprising 96 regular donors, 156 relatives of patients and 96 voluntary donors, constituted the study population. Three haematological parameters (haemoglobin, packed cell volume, and mean cell haemoglobin concentration) and four biochemical iron parameters (serum ferritin, serum iron, total iron binding capacity and transferrin saturation) were assessed using standard colorimetric and ELISA techniques. The prevalence of anaemia alone (haemoglobin <11.0 g/dL) was 13.7%. The prevalence of isolated iron deficiency (serum ferritin <12 ng/mL) was 20.6% while that of iron-deficiency anaemia (haemoglobin <11.0 g/dL + serum ferritin <12.0 ng/mL) was 12.0%. Among the three categories of the donors, the regular donors were found to be most adversely affected as shown by the reduction in mean values of both haematological and biochemical iron parameters. Interestingly, anaemia, iron deficiency and iron-deficiency anaemia were present almost exclusively among regular blood donors, all of whom were over 35 years old. Anaemia, iron deficiency and iron-deficiency anaemia are highly prevalent among blood donors in Port Harcourt, Nigeria. It will be necessary to review the screening tests for the selection of blood donors and also include serum ferritin measurement for the routine assessment of blood donors, especially among regular blood donors.
Jeremiah, Zaccheaus Awortu; Koate, Baribefe Banavule
Background There is paucity of information on the effect of blood donation on iron stores in Port Harcourt, Nigeria. The present study was, therefore, designed to assess, using a combination of haemoglobin and iron status parameters, the development of anaemia and prevalence of iron deficiency anaemia in this area of Nigeria. Materials and Methods Three hundred and forty-eight unselected consecutive whole blood donors, comprising 96 regular donors, 156 relatives of patients and 96 voluntary donors, constituted the study population. Three haematological parameters (haemoglobin, packed cell volume, and mean cell haemoglobin concentration) and four biochemical iron parameters (serum ferritin, serum iron, total iron binding capacity and transferrin saturation) were assessed using standard colorimetric and ELISA techniques. Results The prevalence of anaemia alone (haemoglobin <11.0 g/dL) was 13.7%. The prevalence of isolated iron deficiency (serum ferritin <12 ng/mL) was 20.6% while that of iron-deficiency anaemia (haemoglobin <11.0 g/dL + serum ferritin <12.0 ng/mL) was 12.0%. Among the three categories of the donors, the regular donors were found to be most adversely affected as shown by the reduction in mean values of both haematological and biochemical iron parameters. Interestingly, anaemia, iron deficiency and iron-deficiency anaemia were present almost exclusively among regular blood donors, all of whom were over 35 years old. Conclusion Anaemia, iron deficiency and iron-deficiency anaemia are highly prevalent among blood donors in Port Harcourt, Nigeria. It will be necessary to review the screening tests for the selection of blood donors and also include serum ferritin measurement for the routine assessment of blood donors, especially among regular blood donors. PMID:20383305
Germain, Marc; Delage, Gilles; Blais, Claudia; Maunsell, Elizabeth; Décary, Francine; Grégoire, Yves
The theory that elevated iron stores can induce vascular injury and ischemia remains controversial. We conducted a cohort study of the effect of blood donation on the risk of coronary heart disease (CHD) by taking advantage of the quasi-random exclusion of donors who obtained a falsely reactive test for a transmissible disease (TD) marker. Whole blood donors who were permanently disqualified because of a false-reactive test between 1990 and 2007 in the province of Quebec were compared to donors who remained eligible, matched for baseline characteristics. The incidence of CHD after entry into the study was determined through hospitalization and death records. We compared eligible and disqualified donors using an "intention-to-treat" framework. Overall, 12,357 donors who were permanently disqualified were followed for 124,123 person-years of observation, plus 50,889 donors who remained eligible (516,823 person-years). On average, donors who remained eligible made 0.36 donation/year during follow-up and had an incidence of hospitalizations or deaths attributable to CHD of 3.60/1000 person-years, compared to 3.52 among permanently disqualified donors (rate ratio, 1.02; 95% confidence interval, 0.92-1.13). Donors who remained eligible did not have a lower risk of CHD, compared to donors who were permanently disqualified due to a false-reactive TD marker. Because of the quasi-random nature of false-reactive screening tests, this natural experiment has a level of validity approaching that of a randomized trial evaluating the effect of regular blood donation on CHD risk. These results do not support the iron hypothesis. © 2013 American Association of Blood Banks.
Sauter, Jürgen; Solloch, Ute V.; Giani, Anette S.; Hofmann, Jan A.; Schmidt, Alexander H.
The heterogeneous nature of HLA information in real-life stem cell donor registries may hamper unrelated donor searches. It is even possible that fully HLA-matched donors with incomplete HLA information are not identified. In our simulation study, we estimated the probability of these unnecessarily failed donor searches. For that purpose, we carried out donor searches in several virtual donor registries. The registries differed by size, composition with respect to HLA typing levels, and genetic diversity. When up to three virtual HLA typing requests were allowed within donor searches, the share of unnecessarily failed donor searches ranged from 1.19% to 4.13%, thus indicating that non-identification of completely HLA-matched stem cell donors is a problem of practical relevance. The following donor registry characteristics were positively correlated with the share of unnecessarily failed donor searches: large registry size, high genetic diversity, and, most strongly correlated, large fraction of registered donors with incomplete HLA typing. Increasing the number of virtual HLA typing requests within donor searches up to ten had a smaller effect. It follows that the problem of donor non-identification can be substantially reduced by complete high-resolution HLA typing of potential donors. PMID:26876789
Sauter, Jürgen; Solloch, Ute V.; Giani, Anette S.; Hofmann, Jan A.; Schmidt, Alexander H.
The heterogeneous nature of HLA information in real-life stem cell donor registries may hamper unrelated donor searches. It is even possible that fully HLA-matched donors with incomplete HLA information are not identified. In our simulation study, we estimated the probability of these unnecessarily failed donor searches. For that purpose, we carried out donor searches in several virtual donor registries. The registries differed by size, composition with respect to HLA typing levels, and genetic diversity. When up to three virtual HLA typing requests were allowed within donor searches, the share of unnecessarily failed donor searches ranged from 1.19% to 4.13%, thus indicating that non-identification of completely HLA-matched stem cell donors is a problem of practical relevance. The following donor registry characteristics were positively correlated with the share of unnecessarily failed donor searches: large registry size, high genetic diversity, and, most strongly correlated, large fraction of registered donors with incomplete HLA typing. Increasing the number of virtual HLA typing requests within donor searches up to ten had a smaller effect. It follows that the problem of donor non-identification can be substantially reduced by complete high-resolution HLA typing of potential donors.
Goldman, Mindy; Uzicanin, Samra; Scalia, Vito; O'Brien, Sheila F
The adequacy of communication and knowledge of donors and physicians regarding iron needs and the relationship between hemoglobin (Hb) and iron stores require evaluation to address donor iron deficiency. A prospective cohort study was performed on 550 successful donors and 50 donors deferred for low Hb (<125 g/L on repeat fingerstick). Donors participated in an on-clinic interview and had serum ferritin measured. They were mailed their results and recontacted regarding follow-up. Most donors are unaware of possible health impacts of donation and do not discuss donation with their physician. In successful donors, mean ferritin levels were 37 and 131 μg/L in first-time and reactivated (no donation for 2 years) females and males and 19 and 29 μg/L in frequent repeat females and males, respectively (p < 0.0001), with infrequent donors having intermediate results. Mean ferritin was 12 μg/L in donors deferred for low Hb. Twenty of 22 donors failing initial Hb testing and passing on repeat testing had ferritin below 25 μg/L. On follow-up, 63 of 164 donors (38%) with low ferritin were taking iron supplements 2 months postdonation. Iron deficiency is frequent, particularly in female donors and frequent donors. A fail on initial Hb testing followed by a pass on repeat testing is likely to be due to iron deficiency and borderline anemia. Donors and physicians need to be more aware of iron needs associated with blood donation and appropriate treatment for low iron stores. © 2013 American Association of Blood Banks.
Piątosa, Barbara; Kwiatkowska, Aneta; Rubik, Jacek; Jarmużek, Wioletta; Kluge, Przemysław; Grenda, Ryszard
Despite prospective crossmatching and modern immunosuppression, early acute rejection is still present in cadaveric renal transplantation. The purpose of this study was to evaluate the incidence of preformed anti-donor antibodies, detected by 2 solid-phase techniques, and to analyze their impact on early renal allograft outcome. Flow crossmatch detecting the presence of anti-donor IgG and IgM antibodies was performed in pre-transplant sera of 279 patients with negative cytotoxic crossmatch. Screening for IgG antibodies detected by bead-based multiplex technique was performed in sera of 69 patients from the FCXM group. The incidence of early biopsy-proven rejection and graft failure within 3 months after transplantation was analyzed. Anti-donor IgG antibodies were detected in 33 patients (11.8%) by flow crossmatch and in 10 patients by multiplex (14.5%). IgM antibodies were detected in 23 patients (8.2%). All multiplex-positive sera were also positive for IgG by flow crossmatch, but in 18 cases no antibodies were found by multiplex technique. Biopsy-proven acute rejection within 3 months after transplantation was observed in 16 patients, and 5 allografts were lost due to immunological reasons. Presence of IgG antibodies was found to have no effect on early outcome, while the presence of IgM antibodies was associated with significantly higher rejection rate and immune-related graft failure. Anti-donor IgG antibodies detected by bead-based and cell-based technique have no impact on biopsy-proven rejection rate or graft failure. Anti-donor IgM detected by flow crossmatch have significant impact on early transplantation outcome.
Financial compensation of women donating oocytes for infertility therapy or for research is justified on ethical grounds and should acknowledge the time, inconvenience, and discomfort associated with screening, ovarian stimulation, and oocyte retrieval, and not vary according to the planned use of the oocytes, the number or quality of oocytes retrieved, the number or outcome of prior donation cycles, or the donor's ethnic or other personal characteristics. This document replaces the document of the same name, last published in 2007 (Fertil Steril 2007;88:305-9). Copyright © 2016 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.
Hirn, M Y; Krusius, T
Both allogeneic bone grafting and blood transfusion may transmit infections from the donor to the recipient. The most effective means to reduce the risk of infection is careful donor selection and screening of donors for markers of infection. The risk of blood transfusion-transmitted HIV infection in Finland, calculated with the incidence/window period model, is approximately 1:3,300,000. The calculated risk for hepatitis B (HBV) and C (HCV) is 1:217,000 and 1:147,000 donations, respectively. In bone banking we can further reduce the risks by retesting the living donors. Retesting 2 months after donation seems to be sufficient, at least in countries with a low incidence of transplantation-transmitted infections.
Aghaie, Afsaneh; Aaskov, John; Chinikar, Sadegh; Niedrig, Matthias; Banazadeh, Soudabeh; Mohammadpour, Hashem Khorsand
Risk of dengue virus in the blood supply has been demonstrated in recent studies. In this paper, Chabahar in Sistan and Baluchestan province, south east of Iran, was selected for studying dengue infection because of its climatic and geographical situation in the middle of the transit way between East Asia and other countries. The blood samples were taken from volunteer healthy donors who were referred to the Chabahar Blood Center for blood donation. The presence of dengue virus (DENV) was studied by detecting IgG to DENV by enzyme linked immune sorbent assay (ELISA). Reactive ELISA results were confirmed by an immune flouorescence assay (IFA). According to the results, some of the healthy donors were infected by DENV, which could not been recognized in donor selection. Therefore, special attention should be paid to the criteria of donor selection and additional screening tests are recommended. Copyright © 2013 Elsevier Ltd. All rights reserved.
Gratia, Pierre; Hu, Wayne; Joyce, Austin; Ribeiro, Raquel H.
Attempts to modify gravity in the infrared typically require a screening mechanism to ensure consistency with local tests of gravity. These screening mechanisms fit into three broad classes; we investigate theories which are capable of exhibiting more than one type of screening. Specifically, we focus on a simple model which exhibits both Vainshtein and kinetic screening. We point out that due to the two characteristic length scales in the problem, the type of screening that dominates depends on the mass of the sourcing object, allowing for different phenomenology at different scales. We consider embedding this double screening phenomenology in a broader cosmological scenario and show that the simplest examples that exhibit double screening are radiatively stable.
Walker, Franklin E. [15 Way Points Rd., Danville, CA 94526; Wasley, Richard J. [4290 Colgate Way, Livermore, CA 94550
An improved explosive composition is disclosed and comprises a major portion of an explosive having a detonation velocity between about 1500 and 10,000 meters per second and a minor amount of a donor additive comprising an organic compound or mixture of organic compounds capable of releasing low molecular weight free radicals or ions under mechanical or electrical shock conditions and which is not an explosive, or an inorganic compound or mixture of inorganic compounds capable of releasing low molecular weight free radicals or ions under mechanical or electrical shock conditions and selected from ammonium or alkali metal persulfates.
This paper gives an overview of the research that has been done into people created by donor insemination (DI) (note 1), shows how the secretive way DI is carried out makes objective knowledge of their situation impossible to obtain and describes how doctors support this secrecy. It argues that DI is a social experiment whose potential justifications are implicit theories that have either been falsified or are unfalsifiable, and that consequently DI is conducted unscientifically and unethically. In conclusion, it questions the integrity of the industry and the institutions that support it, and considers where we should go from here.
Lieshout-Krikke, R W; Molenaar-de Backer, M W A; van Swieten, P; Zaaijer, H L
Hepatitis B virus (HBV) surface antigen (HBsAg) is a reliable marker for HBV infection, but HBsAg-negative forms of HBV infection occur. The introduction of HBV DNA screening of Dutch blood donors, which were not preselected for absence of HBV core antibodies, enabled the characterization of HBsAg-negative HBV infection in healthy persons and a comparison of the HBV genomes involved. The screening of 4.4 million Dutch blood donations identified 23 HBsAg-negative, HBV DNA-positive persons. Serological testing of the index donations, follow-up samples and archived earlier samples was performed to determine the nature of each HBV DNA-only case. Despite low viral loads HBV DNA could be sequenced in 14 out of 23 donors, allowing HBV genotyping and the analysis of mutations in the HBV surface gene. Four types of HBsAg-negative HBV infection were detected: infection in the early stage before occurrence of HBsAg; suppressed infection after vaccination; HBV genotype G infection with decreased HBsAg production; and chronic occult (HBsAg negative) HBV infection. In the donors with occult HBV genotype D infection the HBV surface gene showed multiple "escape" mutations in the HBsAg a-determinant and CTL epitopes, while in an occult genotype A case the surface gene showed no mutations. HBsAg-negative forms of HBV infection in healthy blood donors explain the ongoing transmission of HBV via blood transfusion, if donor screening is limited to HBsAg. The screening of blood donors for HBV DNA and HBV core antibodies seems to cover all stages and variants of HBV infection.
Screening for colon cancer; Colonoscopy - screening; Sigmoidoscopy - screening; Virtual colonoscopy - screening; Fecal immunochemical test; Stool DNA test; sDNA test; Colorectal cancer - screening; Rectal ...
Burke, Wylie; Tarini, Beth; Press, Nancy A.; Evans, James P.
Current approaches to genetic screening include newborn screening to identify infants who would benefit from early treatment, reproductive genetic screening to assist reproductive decision making, and family history assessment to identify individuals who would benefit from additional prevention measures. Although the traditional goal of screening is to identify early disease or risk in order to implement preventive therapy, genetic screening has always included an atypical element—information relevant to reproductive decisions. New technologies offer increasingly comprehensive identification of genetic conditions and susceptibilities. Tests based on these technologies are generating a different approach to screening that seeks to inform individuals about all of their genetic traits and susceptibilities for purposes that incorporate rapid diagnosis, family planning, and expediting of research, as well as the traditional screening goal of improving prevention. Use of these tests in population screening will increase the challenges already encountered in genetic screening programs, including false-positive and ambiguous test results, overdiagnosis, and incidental findings. Whether this approach is desirable requires further empiric research, but it also requires careful deliberation on the part of all concerned, including genomic researchers, clinicians, public health officials, health care payers, and especially those who will be the recipients of this novel screening approach. PMID:21709145
Gao, Zhan; Zhang, Yu; Shan, Hua; Shi, Ling; Liu, Jing; Xu, Min; Zeng, Peibin; Liu, Yu; He, Miao
Although screening strategies have been routinely implemented in blood centers, the residual risk of transfusion-transmitted hepatitis B virus (HBV) still poses a public health concern in China. The aim of this study is to investigate the HBV blood screening reactive rate and to illustrate the demographics of the corresponding blood donors with revealing of heterogeneity between previous studies and discovering potentially negligent threats. Literature reporting the HBV screening reactive rate in Chinese blood donors was identified by systematic searching of four electronic databases. We followed the Preferred Reporting of Items for Systematic Reviews and Meta-Analyses guidelines, and data manipulation and statistical analyses were performed by Stata 12.0. Our results showed that the pooled postdonation screening reactive rate was 1.32% (95% confidence interval [CI], 1.28%-1.36%) with a significant variation from 3.93% (95% CI, 3.45%-4.40%) before 1998 to 1.22% (95% CI, 1.18%-1.27%) after 1998 when the Blood Donation Law was implemented. Importantly, the HBV screening reactive rates were significantly higher among replacement and planned donors than among individual voluntary donors. Our results indicated blood centers in China should recruit more individual and group voluntary donors and convert more eligible first-time donors into repeat donors to reduce the risk of transfusion-transmitted HBV. © 2017 AABB.
Jamale, Tukaram E; Hase, Niwrutti K; Iqbal, Anwar M
Effects of laparoscopic donor nephrectomy (LDN) on graft function, especially early post-transplant, have been controversial. To assess and compare early and late graft function in kidneys procured by open and laparoscopic methods, a retrospective observational study was carried out on 37 recipients-donors who underwent LDN after introduction of this technique in February 2007 at our center, a tertiary care nephrology referral center. Demographic, immunological and intraoperative variables as well as immunosuppressive protocols and number of human leukocyte antigen (HLA) mismatches were noted. Early graft function was assessed by serum creatinine on Days two, five, seven, 14 and 28 and at the time of discharge. Serum creatinine values at three months and at one year post-transplant were considered as the surrogates of late graft function. Data obtained were compared with the data from 33 randomly selected kidney transplants performed after January 2000 by the same surgical team, in whom open donor nephrectomy was used. Pearson's chi square test, Student's t test and Mann-Whitney U test were used for statistical analysis. Early graft function (serum creatinine on Day five 2.15 mg/dL vs 1.49 mg/dL, P = 0.027) was poorer in the LDN group. Late graft function as assessed by serum creatinine at three months (1.45 mg/dL vs 1.31 mg/dL, P = 0.335) and one year (1.56 mg/dL vs 1.34 mg/dL, P = 0.275) was equivalent in the two groups. Episodes of early acute graft dysfunction due to acute tubular necrosis were significantly higher in the LDN group (37.8% vs 12.1%, Z score 2.457, P = 0.014). Warm ischemia time was significantly prolonged in the LDN group (255 s vs 132.5 s, P = 0.002). LDN is associated with slower recovery of graft function and higher incidence of early acute graft dysfunction due to acute tubular necrosis. Late graft function at one year is however comparable.
Kirkman, Maggie; Bourne, Kate; Fisher, Jane; Johnson, Louise; Hammarberg, Karin
STUDY QUESTION What are the expectations and experiences of anonymous gamete donors about contact with their donor offspring? SUMMARY ANSWER Rather than consistently wanting to remain distant from their donor offspring, donors' expectations and experiences of contact with donor offspring ranged from none to a close personal relationship. WHAT IS KNOWN ALREADY Donor conception is part of assisted reproduction in many countries, but little is known about its continuing influence on gamete donors' lives. STUDY DESIGN, SIZE, DURATION A qualitative research model appropriate for understanding participants' views was employed; semi-structured interviews were conducted during January–March 2013. PARTICIPANTS/MATERIALS, SETTING, METHODS Before 1998, gamete donors in Victoria, Australia, were subject to evolving legislation that allowed them to remain anonymous or (from 1988) to consent to the release of identifying information. An opportunity to increase knowledge of donors' expectations and experiences of contact with their donor offspring recently arose in Victoria when a recommendation was made to introduce mandatory identification of donors on request from their donor offspring, with retrospective effect. Pre-1998 donors were invited through an advertising campaign to be interviewed about their views, experiences and expectations; 36 sperm donors and 6 egg donors participated. MAIN RESULTS AND THE ROLE OF CHANCE This research is unusual in achieving participation by donors who would not normally identify themselves to researchers or government inquiries. Qualitative thematic analysis revealed that most donors did not characterize themselves as parents of their donor offspring. Donors' expectations and experiences of contact with donor offspring ranged from none to a close personal relationship. LIMITATIONS, REASONS FOR CAUTION It is not possible to establish whether participants were representative of all pre-1998 donors. WIDER IMPLICATIONS OF THE FINDINGS Anonymous
Møller, Kristian H.; Tram, Camilla M.; Hansen, Anne S.; Kjaergaard, Henrik G.
Hydroperoxides are formed in the atmosphere following autooxidation of a wide variety of volatile organics emitted from both natural and anthropogenic sources. This raises the question of whether they can form hydrogen bonds that facilitate aerosol formation and growth. Using a combination of Fourier transform infrared spectroscopy, FT-IR, and ab initio calculations, we have compared the gas phase hydrogen bonding ability of tert-butylhydroperoxide (tBuOOH) to that of tert-butanol (tBuOH) for a series of bimolecular complexes with different acceptors. The hydrogen bond acceptor atoms studied are nitrogen, oxygen, phosphorus and sulphur. Both in terms of calculated redshifts and binding energies (BE), our results suggest that hydroperoxides are better hydrogen bond donors than the corresponding alcohols. In terms of hydrogen bond acceptor ability, we find that nitrogen is a significantly better acceptor than the other three atoms, which are of similar strength. We observe a similar trend in hydrogen bond acceptor ability with other hydrogen bond donors including methanol and dimethylamine.
König, Arne; Skrzypek, Jan; Löffler, Harald; Oeffner, Frank; Grzeschik, Karl-Heinz; Happle, Rudolf
Congenital hemidysplasia with ichthyosiform nevus and limb defects (MIM 308050, CHILD) syndrome is an X-linked dominant, male-lethal, multisystem birth defect. Patients suffer from an inflammatory nevus that covers large areas, predominantly of one side of the body, with a sharp midline demarcation. Treatment of CHILD nevus is notoriously difficult. The aim of this study was to develop a novel surgical approach for this disorder. In 2 patients, the CHILD nevus was dermabraded, and the area was covered with split skin grafts obtained from a contralateral unaffected donor region. In a third patient, papillomatous, strawberry-like lesions on fingers and toes were excised, and the defects were covered with full-thickness grafts obtained from the unaffected left, gluteal area. Highly satisfying functional and cosmetic results were documented during a follow-up period ranging from 3 to 8 years. The favorable outcome, superior to that obtained by simple dermabrasion or extensive plastic surgery, can best be explained by the donor dominance of the grafted skin samples that carried, in all or most cells, the mutant X chromosome in an inactivated form. Copyright (c) 2010 S. Karger AG, Basel.
For 20 years, the organization set up to insure the blood transfusion safety has never stopped strengthening. It is based on clinical and epidemiological selection of the blood donation candidates, biologic selection of blood donations and different physico-chemical techniques for pathogens reduction or inactivation in blood products. In France, this organization is optimized by the assertion of the voluntary and non-remunerated character of blood donation registered in the law of January 4th, 1993. The blood donors selection is structured in three successive stages. The first stage is the pre-donation information. The second stage begins with reading and filling out an info-questionnaire which prepare for an interview with a physician. This interview is specially directed to prevention of transfusion-transmitted infections and the prevention of adverse reactions after a 400 to 600 mL collection of whole blood or components. Finally, the third stage is the delivery of a post-donation information which invites the donor to contact the "établissement français du sang" (EFS) in case of a new event arisen after the donation or in case of reviewing of its own answers during the medical interview.
The use of donor human milk is increasing for high-risk infants, primarily for infants born weighing <1500 g or those who have severe intestinal disorders. Pasteurized donor milk may be considered in situations in which the supply of maternal milk is insufficient. The use of pasteurized donor milk is safe when appropriate measures are used to screen donors and collect, store, and pasteurize the milk and then distribute it through established human milk banks. The use of nonpasteurized donor milk and other forms of direct, Internet-based, or informal human milk sharing does not involve this level of safety and is not recommended. It is important that health care providers counsel families considering milk sharing about the risks of bacterial or viral contamination of nonpasteurized human milk and about the possibilities of exposure to medications, drugs, or herbs in human milk. Currently, the use of pasteurized donor milk is limited by its availability and affordability. The development of public policy to improve and expand access to pasteurized donor milk, including policies that support improved governmental and private financial support for donor milk banks and the use of donor milk, is important.
de Groot, Ingrid B; Stiggelbout, Anne M; van der Boog, Paul J M; Baranski, Andrzej G; Marang-van de Mheen, Perla J
Health related quality of life (HRQoL) of living kidney donors on average is good, but some donors experience a low HRQoL after donation. This study assessed the prevalence of reduced HRQoL and explored associations with pre- and post-donation variables. 316 donors (response rate 74%) who donated a kidney between 1997 and 2009 filled in a questionnaire. HRQoL was measured using the Short-Form 36; fatigue using the Multidimensional Fatigue Inventory; societal participation using the Utrecht Scale for Evaluation of Rehabilitation-Participation. Donors on average had better HRQoL than the general population. However, 12% had a reduced physical (PCS) and 18% a reduced mental (MCS) HRQoL. Donors with reduced HRQoL reported greater fatigue (P < 0.01), lower societal participation (P < 0.01) and showed a trend towards statistical significance in experiencing more donor-recipient relationship changes (P = 0.07). Prior to donation, donors with reduced PCS had a higher BMI (P < 0.05) and more often smoked (P < 0.05). Donors with reduced MCS had higher expectations (P < 0.05). Reduced HRQoL is associated with higher BMI, smoking and higher expectations prior to donation. These results may be used to develop a screening instrument to select donors at high risk for reduced HRQoL. © 2012 The Authors. Transplant International © 2012 European Society for Organ Transplantation.
Brubaker, Scott A; Robert Rigney, P
This report contains selected excerpts, presented as a summary, from a public workshop sponsored by the American Association of Tissue Banks (AATB) held to discuss West Nile Virus (WNV) and scientific considerations for tissue donors. The daylong workshop was held 9 July 2010 at the Ritz-Carlton Hotel at Tyson's Corner in McLean, Virginia, United States (U.S.). The workshop was designed to determine and discuss scientific information that is known, and what is not known, regarding WNV infection and transmission. The goal is to determine how to fill gaps in knowledge of WNV and tissue donation and transplantation by pursuing relevant scientific studies. This information should ultimately support decisions leading to appropriate tissue donor screening and testing considerations. Discussion topics were related to identifying these gaps and determining possible solutions. Workshop participants included subject-matter experts from the U.S. Food and Drug Administration, the Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, Health Canada, the Public Health Agency of Canada, AATB-accredited tissue banks including reproductive tissue banks, accredited eye banks of the Eye Bank Association of America, testing laboratories, and infectious disease and organ transplantation professionals. After all presentations concluded, a panel addressed this question: "What are the scientific considerations for tissue donors and what research could be performed to address those considerations?" The slide presentations from the workshop are available at: http://www.aatb.org/2010-West-Nile-Virus-Workshop-Presentations.
Barnes, Danielle; Park, K T
Tremendous acceleration has been made in understanding the gut microbiota in the past decade and, with it, further understanding of the pathologic role of dysbiosis and the use of fecal microbiota transplantation (FMT) as therapy. FMT has been studied in many disease states including the most common indication of Clostridium difficile infection (CDI), though many questions regarding stool donor selection remain. Though traditionally, one donor has provided stool for one patient, research is underway to explore many donor selection considerations from the use of pooled donor stool to selection of a high diversity donor. It is well-known that dietary intake shapes the gut microbiota and the potential implications of this on FMT donor selection are being explored. Though further high-quality research is needed, optimizing the fecal microbiota inoculum holds great promise.
Arpesella, Giorgio; Gherardi, Sonia; Bombardini, Tonino; Picano, Eugenio
Background The heart transplant is a treatment of the heart failure, which is not responding to medications, and its efficiency is already proved: unfortunately, organ donation is a limiting step of this life-saving procedure. To counteract heart donor shortage, we should screen aged potential donor hearts for initial cardiomyopathy and functionally significant coronary artery disease. Donors with a history of cardiac disease are generally excluded. Coronary angiography is recommended for most male donors older than 45 years and female donors older than 50 years to evaluate coronary artery stenoses. A simpler way to screen aged potential donor hearts for initial cardiomyopathy and functionally significant coronary artery disease should be stress echocardiography. Case report A marginal donor (A 57 year old woman meeting legal requirements for brain death) underwent a transesophageal (TE) Dipyridamole stress echo (6 minutes accelerated protocol) to rule out moderate or severe heart and coronary artery disease. Wall motion was normal at baseline and at peak stress (WMSI = 1 at baseline and peak stress, without signs of stress inducible ischemia). The pressure/volume ratio was 9.6 mmHg/ml/m2 at baseline, increasing to 14 mmHg/ml/m2 at peak stress, demonstrating absence of latent myocardial dysfunction. The marginal donor heart was transplanted to a recipient "marginal" for co-morbidity ( a 63 year old man with multiple myeloma and cardiac amyloidosis , chronic severe heart failure, NYHA class IV). Postoperative treatment and early immunosuppressant regimen were performed according to standard protocols. The transplanted heart was assessed normal for dimensions and ventricular function at transthoracic (TT) echocardiography on post-transplant day 7. Coronary artery disease was ruled out at coronary angiography one month after transplant; left ventriculography showed normal global and segmental LV function of the transplanted heart. Conclusion For the first time stress
Van Pilsum Rasmussen, S E; Henderson, M L; Kahn, J; Segev, D
From its infancy, live donor transplantation has operated within a framework of acceptable risk to donors. Such a framework presumes that risks of living donation are experienced by the donor while all benefits are realized by the recipient, creating an inequitable distribution that demands minimization of donor risk. We suggest that this risk-tolerance framework ignores tangible benefits to the donor. A previously proposed framework more fully considers potential benefits to the donor and argues that risks and benefits must be balanced. We expand on this approach, and posit that donors sharing a household with and/or caring for a potential transplant patient may realize tangible benefits that are absent in a more distantly related donation (e.g. cousin, nondirected). We term these donors, whose well-being is closely tied to their recipient, "interdependent donors." A flexible risk-benefit model that combines risk assessment with benefits to interdependent donors will contribute to donor evaluation and selection that more accurately reflects what is at stake for donors. In so doing, a risk-benefit framework may allow some donors to accept greater risk in donation decisions. © 2017 The American Society of Transplantation and the American Society of Transplant Surgeons.
Pedrazzini, B; Waldvogel, S; Vaucher, P; Cornuz, J; Heinzer, R; Tissot, J-D; Favrat, B
Restless legs syndrome (RLS) is a frequent condition with a prevalence of 5-15% in the general population. Clinical and genetic observations have shown that iron deficiency, highly prevalent among blood donors, can be related to RLS. The objective of this study was to assess the prevalence of RLS in female blood donors 1 week after blood donation. One week after blood donation, 291 female blood donors, aged <50 years, self-responded to all four RLS questions defined by the 1995 International RLS study group. Blood donation rate, fatigue, aerobic capacity, menstruation, mood disorder and quality of life were also assessed along with haemoglobin and ferritin blood concentrations. Prevalence of RLS in female blood donors 1 week after blood donation was 6·9% (CI 95% 4·2-10·4%). Female blood donors with RLS had a higher prevalence of hyper-menorrhaea (P = 0·033) and were significantly more tired (P = 0·001). We observed no associations between RLS and number of previous donations (P = 0·409), aerobic capacity (P = 0·476), mood disorder (P = 0·169), quality of life (P = 0·356), haemoglobin (P = 0·087), and serum ferritin level (P = 0·446). Restless legs syndrome prevalence in female blood donors is not as important as described in some other studies, which could reassure blood donors. The prevalence of hypermenorrhaea and fatigue is higher in RLS blood donors. Therefore, screening for fatigue and hypermenorrhaea could be considered as these symptoms are associated with RLS in female blood donors. © 2013 International Society of Blood Transfusion.
Vaezjalali, Maryam; Rashidpour, Shabnam; Rezaee, Hanieh; Hajibeigi, Bashir; Zeidi, Majid; Gachkar, Latif; Aghamohamad, Shadi; Najafi, Ronak; Goudarzi, Hossein
Background Presence of occult hepatitis B infection (OBI) renders HBs antigen (HBsAg) undetectable by ELISA. Therefore it is valuable to evaluate the frequency of OBI among healthy blood donors to improve and perhaps change the strategies of blood screening to reduce the risk of HBV transmission. Objectives The aim of this study was to determine the presence of HBcAb and HBV DNA among Iranian HBsAg negative healthy blood donors who donated their blood to the Tehran Blood Transfusion Center during 2011. Patients and Methods 1000 serum specimens negative for HBsAg, HCV antibody and HIV antibody were collected from healthy blood donors and tested for HBcAb. Presence of hepatitis B viral DNA was checked in HBcAb positive samples by nested PCR with two sets of primers to amplify part of HBV S gene. Results There were 64 women and 936 men in the population under study. The mean ± SD age of the donors was 38 ± 11 years. 80 out of 1000 samples (8%) were found to be positive for HBcAb. HBV DNA was detected in 50% of HBcAb positive specimens. The mean ± SD age of donors without HBV DNA was 37.7 ± 10.5 years and for donors with HBV DNA was 40.9 ± 11.2 years (P = 0.05). Conclusions OBI was prevalent among 50% of HBcAb positive healthy blood donors. The frequency of positive HBcAb among healthy HBsAg negative blood donors was comparable to previous studies reported from Iran. On the other hand, the frequency of HBV DNA in HBsAg negative blood donors was higher than previous reports. PMID:23675384
Fujita, N.; Jones, R.; Öberg, S.; Briddon, P. R.
In this letter, the authors investigate the electrical properties of nitrogen related shallow thermal donor (STD) candidates and their concentrations under different doping conditions by means of density functional theory. Experimentally, the existence of STDs containing one nitrogen atom and both even and odd numbers of oxygen atoms has been proposed. However, so far first principles studies have not presented a candidate for the latter. Here, they show that the NO defect possesses a shallow donor level. Adding one or two more oxygen atoms results in the donor level to become shallower. The fraction of shallow nitrogen related donors to N dimers increases in material with low concentration of nitrogen.
Vodkin, Irine; Kuo, Alexander
Mortality rates on the liver transplant waiting list are increasing. The shortage of organs has resulted in higher utilization of extended criteria donors (ECDs), with centers pushing the limits of what is acceptable for transplantation. Donor quality is more appropriately represented as a continuum of risk, and careful selection and matching of ECD grafts with recipients may lead to excellent outcomes. Although there is no precise definition for what constitutes an ECD liver, this review focuses on frequently cited characteristics, including donor age, steatosis, donation after cardiac death, and donors with increased risk of disease transmission.
Chan, See Ching; Fan, Sheung Tat
Living donor liver transplantation (LDLT) has gone through its formative years and established as a legitimate treatment when a deceased donor liver graft is not timely or simply not available at all. Nevertheless, LDLT is characterized by its technical complexity and ethical controversy. These are the consequences of a single organ having to serve two subjects, the donor and the recipient, instantaneously. The transplant community has a common ground on assuring donor safety while achieving predictable recipient success. With this background, a reflection of the development of LDLT may be appropriate to direct future research and patient-care efforts on this life-saving treatment alternative. PMID:18176956
Ali, Nadir; Ahmed, Syed Azhar; Moinuddin; Hoch, Susan Fisher; Chotani, Rashid A
The objective of this study was to find out the frequency of HCV RNA in anti-HCV non-reactive blood donors with raised alanine amino transferase (ALT). The study was conducted at Baqai Institute of Haematology, Baqai Medical University, Karachi, in collaboration with Combined Military Hospital, Malir Cantt, Karachi. The demographic data of blood donors was recorded, and anti-HCV, HBsAg and HIV were screened. Four hundred consecutive donors with raised ALT above the reference range were included in study. HCV RNA RT-PCR was performed on 5 sample minipools using Bio-Rad Real time PCR equipment. HCV RNA was detected in 1/400 (0.25%) blood donors. Finding of raised ALT in blood donors warrants further investigations. In case, if raised ALT is unexplained presence of HCV RNA may be suspected.
Ciurea, Stefan O.; Thall, Peter F.; Wang, Xuemei; Wang, Sa A.; Hu, Ying; Cano, Pedro; Aung, Fleur; Rondon, Gabriela; Molldrem, Jeffrey J.; Korbling, Martin; Shpall, Elizabeth J.; de Lima, Marcos; Champlin, Richard E.
Anti-HLA donor-specific Abs (DSAs) have been reported to be associated with graft failure in mismatched hematopoietic stem cell transplantation; however, their role in the development of graft failure in matched unrelated donor (MUD) transplantation remains unclear. We hypothesize that DSAs against a mismatched HLA-DPB1 locus is associated with graft failure in this setting. The presence of anti-HLA Abs before transplantation was determined prospectively in 592 MUD transplantation recipients using mixed-screen beads in a solid-phase fluorescent assay. DSA identification was performed using single-Ag beads containing the corresponding donor's HLA-mismatched Ags. Anti-HLA Abs were detected in 116 patients (19.6%), including 20 patients (3.4%) with anti-DPB1 Abs. Overall, graft failure occurred in 19 of 592 patients (3.2%), including 16 of 584 (2.7%) patients without anti-HLA Abs compared with 3 of 8 (37.5%) patients with DSA (P = .0014). In multivariate analysis, DSAs were the only factor highly associated with graft failure (P = .0001; odds ratio = 21.3). Anti-HLA allosensitization was higher overall in women than in men (30.8% vs 12.1%; P < .0001) and higher in women with 1 (P = .008) and 2 or more pregnancies (P = .0003) than in men. We conclude that the presence of anti-DPB1 DSAs is associated with graft failure in MUD hematopoietic stem cell transplantation. PMID:21967975
Ciurea, Stefan O; Thall, Peter F; Wang, Xuemei; Wang, Sa A; Hu, Ying; Cano, Pedro; Aung, Fleur; Rondon, Gabriela; Molldrem, Jeffrey J; Korbling, Martin; Shpall, Elizabeth J; de Lima, Marcos; Champlin, Richard E; Fernandez-Vina, Marcelo
Anti-HLA donor-specific Abs (DSAs) have been reported to be associated with graft failure in mismatched hematopoietic stem cell transplantation; however, their role in the development of graft failure in matched unrelated donor (MUD) transplantation remains unclear. We hypothesize that DSAs against a mismatched HLA-DPB1 locus is associated with graft failure in this setting. The presence of anti-HLA Abs before transplantation was determined prospectively in 592 MUD transplantation recipients using mixed-screen beads in a solid-phase fluorescent assay. DSA identification was performed using single-Ag beads containing the corresponding donor's HLA-mismatched Ags. Anti-HLA Abs were detected in 116 patients (19.6%), including 20 patients (3.4%) with anti-DPB1 Abs. Overall, graft failure occurred in 19 of 592 patients (3.2%), including 16 of 584 (2.7%) patients without anti-HLA Abs compared with 3 of 8 (37.5%) patients with DSA (P = .0014). In multivariate analysis, DSAs were the only factor highly associated with graft failure (P = .0001; odds ratio = 21.3). Anti-HLA allosensitization was higher overall in women than in men (30.8% vs 12.1%; P < .0001) and higher in women with 1 (P = .008) and 2 or more pregnancies (P = .0003) than in men. We conclude that the presence of anti-DPB1 DSAs is associated with graft failure in MUD hematopoietic stem cell transplantation.
Garg, Ketan; Kaushik, Ankit; Sharma, Richa; Rawat, DS; Mandal, AK
Introduction With increasing demand of platelet component each day, blood bank plays a pivotal role in ensuring supply of safe blood as and when required. Plateletpheresis procedure is a relatively simple, safe and important adjunct to blood bank inventory. However, recruitment of healthy blood donors is a challenge that the health industry is facing today. Aim To determine the reasons and rates of apheresis donor deferral along with investigation of adverse reactions encountered during the procedure. Materials and Methods Records of single donor apheresis were retrospectively analysed from 1st January 2010 to 31st December 2014. The study was carried out at Blood Bank, Safdarjung Hospital, New Delhi, India. The donor details that were studied included – age, sex, type of donation (voluntary/replacement/ repeat), reason for donor deferral and type of adverse reaction, if encountered during the procedure. Results Among the 478 donors screened for plateletpheresis procedure during a study period of 5 years, 134 (28.03%) were deferred. Temporary deferrals accounted for majority (93.28%) of the deferrals. Low platelet count (50.75%) was the main reason of donor deferral followed by low haemoglobin (20.89%). Amongst the 344 selected donors, 15 (4.36%) had some type of adverse reaction associated with the procedure. Conclusion We suggest that the selection criteria for plateletpheresis donors should be revised to deal with shortage of apheresis donors. The criteria regarding minimum pre-procedure platelet count (above1.5 lac/μl) and haemoglobin (above 12.5 g/dl) need to be lowered so as to suit the Indian scenario. The lower adverse reaction rates, 14/344 (4.06%) associated with this procedure encourages safety of donors and is important in recruitment of new donors. PMID:28050376
Wang, Yan; Miao, Wen-Dan; Zhai, Li-Xue
In this paper, we derive an analytical expression for the screened Coulomb potential between charge carriers in quasi-one-dimensional (Q1D) semiconductor structures. As an application, this potential has been used to investigate the screening effect on the binding energy of a neutral donor (D0) in quantum wires (QWRs). It is found that the screening effect decreases the neutral donor binding energy, and the screening effects are more obvious in wide QWRs than that in narrow ones. Dependence of screening length on temperature and carrier concentration has also been discussed.
van Tilborgh-de Jong, A J W; Wiersum-Osselton, J C; Touw, D J; Schipperus, M R
The TRIP national hemovigilance and biovigilance office receives reports on side-effects and incidents associated with transfusion of labile blood products. Anaphylactic reactions accounted for the largest number of serious transfusion reactions in the period 2008-2012. In most cases, no cause is found for these reactions. TRIP data show that anaphylactic reactions occur relatively frequently with transfusion of plasma or platelet concentrates. Data from blood services show that 10% or more of plasma donors regularly use medication which is permitted under donation guidelines. It is conceivable that medication taken by the donor in plasma for transfusion could cause an anaphylactic transfusion reaction in the recipient. This exploratory study investigated the presence of drugs or drug metabolites in donor plasma. Samples (5 ml) were taken from thawed, quarantine fresh frozen plasma units (FFP) which had to be rejected for transfusion because of leaks or length of time after thawing. The samples were analysed for approximately 1000 drugs and drug metabolites using a toxicological screening method. Eighty-seven samples were analysed. Toxicological screening was positive in fourteen samples (16%). In eleven samples, one substance was found, and in three samples, the presence of two or three drugs was detected. After freezing, storage and thawing of fresh FFP, it is possible to detect medication taken by the donor. Further investigation is recommended to analyse whether donors' medication in plasma can be implicated in some cases of allergic or anaphylactic reactions in transfusion recipients. © 2014 International Society of Blood Transfusion.
Fornés, Maria Gema; Jiménez, Maria Angustias; Eisman, Marcela; Gómez Villagrán, Jose Luis; Villalba, Rafael
Careful donor selection and implementation of tests of appropriate sensitivity and specificity are of paramount importance for minimizing the risk of transmitting infectious diseases from donors to corneal allograft recipients. Reported cases of viral transmission with corneal grafts are very unusual. Nevertheless potential virus transmission through the engraftment cannot be ruled out. According to European Guideline 2006/17/EC, screening for antibodies for Hepatitis B core antigen (anti HBc) is mandatory, and when this test is positive, some criteria must be established before using corneas. Despite the continuous progress in screening tests, donors carrying an occult hepatitis B infection (OBI) can cause transplant-transmitted hepatitis B. To date, Nucleic Acid Testing (NAT) is not an obligatory assay in corneal tissue setting neither in our country nor in the rest of European countries. Herein, we report three cornea donors that were rejected with the diagnosis of OBI through the testing of sensitive NAT and the serological profile of Hepatitis B virus. The aim of this report is to emphasize the need to include NAT in new reviews of EU Tissues and Cells Directives in order to increase level of security in tissue donation as well as not to reject a high number of donors with isolated profile of anti HBc in geographical areas with high prevalence of Hepatitis B, that could be rejected without a true criterion of Hepatitis B infection.
Vollmer, Tanja; Diekmann, Juergen; Eberhardt, Matthias; Knabbe, Cornelius; Dreier, Jens
Asymptomatic hepatitis E virus (HEV) infections have been found in blood donors from various European countries, but the natural course is rarely specified. Here, we compared the progression of HEV viraemia, serostatus and liver-specific enzymes in 10 blood donors with clinically asymptomatic genotype 3 HEV infection, measuring HEV RNA concentrations, plasma concentrations of alanine/aspartate aminotransferase, glutamate dehydrogenase and bilirubin and anti-HEV IgA, IgM and IgG antibodies. RNA concentrations ranged from 77.2 to 2.19×10(5) IU/mL, with viraemia lasting from less than 10 to 52 days. Donors showed a typical progression of a recent HEV infection but differed in the first detection of anti-HEV IgA, IgM and IgG and seropositivity of the antibody classes. The diagnostic window between HEV RNA detection and first occurrence of anti-HEV antibodies ranged from eight to 48 days, depending on the serological assay used. The progression of laboratory parameters of asymptomatic HEV infection was largely comparable to the progression of symptomatic HEV infection, but only four of 10 donors showed elevated liver-specific parameters. Our results help elucidate the risk of transfusion-associated HEV infection and provide a basis for development of screening strategies. The diagnostic window illustrates that infectious blood donors can be efficiently identified only by RNA screening.
Vollmer, Tanja; Diekmann, Juergen; Eberhardt, Matthias; Knabbe, Cornelius; Dreier, Jens
Asymptomatic hepatitis E virus (HEV) infections have been found in blood donors from various European countries, but the natural course is rarely specified. Here, we compared the progression of HEV viraemia, serostatus and liver-specific enzymes in 10 blood donors with clinically asymptomatic genotype 3 HEV infection, measuring HEV RNA concentrations, plasma concentrations of alanine/aspartate aminotransferase, glutamate dehydrogenase and bilirubin and anti-HEV IgA, IgM and IgG antibodies. RNA concentrations ranged from 77.2 to 2.19×105 IU/mL, with viraemia lasting from less than 10 to 52 days. Donors showed a typical progression of a recent HEV infection but differed in the first detection of anti-HEV IgA, IgM and IgG and seropositivity of the antibody classes. The diagnostic window between HEV RNA detection and first occurrence of anti-HEV antibodies ranged from eight to 48 days, depending on the serological assay used. The progression of laboratory parameters of asymptomatic HEV infection was largely comparable to the progression of symptomatic HEV infection, but only four of 10 donors showed elevated liver-specific parameters. Our results help elucidate the risk of transfusion-associated HEV infection and provide a basis for development of screening strategies. The diagnostic window illustrates that infectious blood donors can be efficiently identified only by RNA screening. PMID:27608433
Guarnaccia, Cinzia; Giannone, Francesca; Falgares, Giorgio; Caligaris, Aldo Ozino; Sales-Wuillemin, Edith
Both donors and non-donors have a positive image of blood donation, so donors and non-donors do not differ regarding their views on donation but do differ in converting their opinion into an active deed of donation. Several studies have identified altruism and empathy as the main factors underlying blood donation. However, a mixture of various motivational factors mould the complex behaviour of donation. This paper presents an exploratory study on differences of social representations of blood donation between blood donors and non-donors, in order to understand the reasons that bring someone to take the decision to become a blood donor. Participants filled in the Adapted Self-Report Altruism Scale, Toronto Empathy Questionnaire and answered a test of verbal association. Descriptive and correlation analyses were carried out on quantitative data, while a prototypic analysis was used for qualitative data. The study was carried out on a convenience sample of 786 individuals, 583 donors (mean age: 35.40 years, SD: 13.01 years; 39.3% female) and 203 non-donors (mean age: 35.10 years, SD: 13.30 years; 67.5% female). Social representations of donors seem to be more complex and articulated than those of non-donors. The terms that appear to be central were more specific in donors (life, needle, blood, help, altruism were the words most associated by non-donors; life, aid, altruism, solidarity, health, love, gift, generosity, voluntary, control, needed, useful, needle were the words most associated by donors). Furthermore, non-donors associated a larger number of terms referring to negative aspects of blood donation. Aspects related to training and the accuracy of any information on blood donation seem to be important in the decision to become a donor and stabilise the behaviour of donation over time, thus ensuring the highest levels of quality and safety in blood establishments.
Guarnaccia, Cinzia; Giannone, Francesca; Falgares, Giorgio; Caligaris, Aldo Ozino; Sales-Wuillemin, Edith
Background Both donors and non-donors have a positive image of blood donation, so donors and non-donors do not differ regarding their views on donation but do differ in converting their opinion into an active deed of donation. Several studies have identified altruism and empathy as the main factors underlying blood donation. However, a mixture of various motivational factors mould the complex behaviour of donation. This paper presents an exploratory study on differences of social representations of blood donation between blood donors and non-donors, in order to understand the reasons that bring someone to take the decision to become a blood donor. Materials and methods Participants filled in the Adapted Self-Report Altruism Scale, Toronto Empathy Questionnaire and answered a test of verbal association. Descriptive and correlation analyses were carried out on quantitative data, while a prototypic analysis was used for qualitative data. Results The study was carried out on a convenience sample of 786 individuals, 583 donors (mean age: 35.40 years, SD: 13.01 years; 39.3% female) and 203 non-donors (mean age: 35.10 years, SD: 13.30 years; 67.5% female). Social representations of donors seem to be more complex and articulated than those of non-donors. The terms that appear to be central were more specific in donors (life, needle, blood, help, altruism were the words most associated by non-donors; life, aid, altruism, solidarity, health, love, gift, generosity, voluntary, control, needed, useful, needle were the words most associated by donors). Furthermore, non-donors associated a larger number of terms referring to negative aspects of blood donation. Discussion Aspects related to training and the accuracy of any information on blood donation seem to be important in the decision to become a donor and stabilise the behaviour of donation over time, thus ensuring the highest levels of quality and safety in blood establishments. PMID:26674814
Sellors, John W; Hayward, Robert; Swanson, Graham; Ali, Anita; Haynes, R Brian; Bourque, Ronald; Moore, Karen-Ann; Lohfeld, Lynne; Dalby, Dawn; Howard, Michelle
Background Self-administered computer-assisted blood donor screening strategies may elicit more accurate responses and improve the screening process. Methods Randomized crossover trial comparing responses to questions on a computerized hand-held tool (HealthQuiz, or HQ), to responses on the standard written instrument (Donor Health Assessment Questionnaire, or DHAQ). Randomly selected donors at 133 blood donation clinics in the area of Hamilton, Canada participated from 1995 to 1996. Donors were randomized to complete either the HQ or the DHAQ first, followed by the other instrument. In addition to responses of 'yes' and 'no' on both questionnaires, the HQ provided a response option of 'not sure'. The primary outcome was the number of additional donors deferred by the HQ. Results A total of 1239 donors participated. Seventy-one potential donors were deferred as a result of responses to the questionnaires; 56.3% (40/71) were deferred by the DHAQ, and an additional 43.7% (31/71) were deferred due to risks identified by the HQ but not by the DHAQ. Fourteen donors self-deferred; 11 indicated on the HQ that they should not donate blood on that day but did not use the confidential self-exclusion option on the DHAQ, and three used the self-exclusion option on the DHAQ but did not indicate that they should not donate blood on the HQ. The HQ identified a blood contact or risk factor for HIV/AIDS or sexually transmitted infection that was not identified by the DHAQ in 0.1% to 2.7% of donors. Conclusion A self-administered computerized questionnaire may increase risk reporting by blood donors. PMID:12191432
Japhet, Margaret Oluwatoyin; Adewumi, Moses Olubusuyi; Adesina, Olufisayo Adeyemi; Donbraye, Emmanuel
Blood transfusion service centers in Nigeria screen donated blood for markers of HIV infection using antibody- (Ab) based rapid test and in some centers, positives are re-tested using Ab-based ELISA. Paucity of data exists on p24 antigen prevalence among HIV Ab-negative donors in Nigeria. This study aims at detecting HIV p24 antigen among prospective blood donors in Osun State, Nigeria. Prospective blood donors negative for HIV antibodies using Determine test kit were re-tested using BIORAD GENSCREEN Ultra Ag-Ab ELISA kit, a fourth-generation ELISA kit that detects HIV antibodies/p24 antigen. Of the 169 HIV Ab-negative prospective donors, 10 (5.9%) were positive for HIV p24 antigen and 70% (7/10) of them were in the age range 18-30 years. Results of this study show that blood transfusion is still one of the major routes of HIV transmission in Nigeria and a higher proportion is among youth. Inclusion of p24 antigen testing into the blood donor screening will help reduce transfusion associated HIV in Nigeria if Nucleic Acid Testing (NAT) of all blood donor samples is not affordable; also, HIV enlightenment programs tailored toward youth may help reduce this rate among donors since more young people donate blood in low/middle-income countries than in high-income countries.
Martín-Santana, J D; Beerli-Palacio, A
Recent years have seen the level of blood donation at a world level come to a standstill or even decline. This situation requires blood donation services to make efforts to increase donor recruitment and retention, as well as to increase the frequency of donations among current donors. In order to obtain good results, it is essential to understand the factors that affect intention to donate. To determine the explanatory power of a set of factors on intention to donate blood, as well as evaluating the ability of current donors to motivate others. A questionnaire was administered to a sample of 1015 Spanish individuals. Results indicate that (i) motivations and hindering factors have the greatest explanatory power on intention to donate, (ii) experience as a donor is the most explanatory factor on future intention and (iii) there are significant behavioural and sociodemographic differences between donors and non-donors. These findings suggest that it is necessary (i) to enhance the donor retention for maintaining the donation system using a personal and frequent communication with donors not only to remind them to schedule their next donation, but also to attract more donors; (ii) to recapture temporarily deferred donors, as they are less reluctant towards donation; (iii) to describe in detail how donation affects donors and clarify the importance of donation for society and (iv) to develop member get member programs in which current donors act as motivators amongst friends, coworkers and family. © 2012 The Authors. Transfusion Medicine © 2012 British Blood Transfusion Society.
Park, K; Lee, J H; Huh, K H; Kim, S I; Kim, Y S
To alleviate the organ shortage, the use of more living donors is strongly recommended world wide. A living donor exchange (swap) program was launched in Korea. After the success of a direct swap program between two families, we have developed the swap-around program to expand the donor pool by enrolling many kinds of unrelated donors. Herein, we report our results of a living donor exchange program. This retrospectively review of 978 recipients of kidney transplants from living donors, included analysis of donor-recipient relationships, mode of donor recruitment, episodes of acute rejection, and 5-year patient/graft survivals. Transplantation was performed in 101 patients (10.3%) by way of the swap program. The proportion of swap patients among the number of unrelated donor renal transplants has been increasing from 4.2% to 46.6%. The incidence of acute rejection and 5-year patient/graft survival rates were comparable between the groups. We have achieved some success in reducing the organ shortage with a swap program in addition to our current unrelated living donor programs without jeopardizing graft survival. Potentially exchangeable donors should undergo strict medical evaluation by physicians and social evaluation by social workers and coordinators as a pre-requisite for kidney transplantation. Expanding the swap around program to a regional or national pool could be an option to reduce the organ donor shortage in the future.
Andermann, Anne; Blancquaert, Ingeborg
Abstract OBJECTIVE To provide a primer for primary care professionals who are increasingly called upon to discuss the growing number of genetic screening services available and to help patients make informed decisions about whether to participate in genetic screening, how to interpret results, and which interventions are most appropriate. QUALITY OF EVIDENCE As part of a larger research program, a wide literature relating to genetic screening was reviewed. PubMed and Internet searches were conducted using broad search terms. Effort was also made to identify the gray literature. MAIN MESSAGE Genetic screening is a type of public health program that is systematically offered to a specified population of asymptomatic individuals with the aim of providing those identified as high risk with prevention, early treatment, or reproductive options. Ensuring an added benefit from screening, as compared with standard clinical care, and preventing unintended harms, such as undue anxiety or stigmatization, depends on the design and implementation of screening programs, including the recruitment methods, education and counseling provided, timing of screening, predictive value of tests, interventions available, and presence of oversight mechanisms and safeguards. There is therefore growing apprehension that economic interests might lead to a market-driven approach to introducing and expanding screening before program effectiveness, acceptability, and feasibility have been demonstrated. As with any medical intervention, there is a moral imperative for genetic screening to do more good than harm, not only from the perspective of individuals and families, but also for the target population and society as a whole. CONCLUSION Primary care professionals have an important role to play in helping their patients navigate the rapidly changing terrain of genetic screening services by informing them about the benefits and risks of new genetic and genomic technologies and empowering them to
... GENERAL REQUIREMENTS FOR BLOOD, BLOOD COMPONENTS, AND BLOOD DERIVATIVES § 630.6 Donor notification. (a) Notification of donors. You, an establishment that collects blood or blood components, must make reasonable... tests for evidence of infection with a communicable disease agent(s) as required by § 610.41 of this...
... 42 Public Health 1 2014-10-01 2014-10-01 false Donors. 35.64 Section 35.64 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICAL CARE AND EXAMINATIONS HOSPITAL AND STATION MANAGEMENT Contributions for the Benefit of Patients § 35.64 Donors. Authorized contributions...
... 42 Public Health 1 2012-10-01 2012-10-01 false Donors. 35.64 Section 35.64 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICAL CARE AND EXAMINATIONS HOSPITAL AND STATION MANAGEMENT Contributions for the Benefit of Patients § 35.64 Donors. Authorized contributions...
... 42 Public Health 1 2013-10-01 2013-10-01 false Donors. 35.64 Section 35.64 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICAL CARE AND EXAMINATIONS HOSPITAL AND STATION MANAGEMENT Contributions for the Benefit of Patients § 35.64 Donors. Authorized contributions...
Brown, Judith Belle; Karley, Mary Lou; Boudville, Neil; Bullas, Ruth; Garg, Amit X.; Muirhead, Norman
This article describes the experiences, feelings, and ideas of living kidney donors. Using a phenomenological, qualitative research approach, the authors interviewed 12 purposefully selected living kidney donors (eight men and four women), who were between four and 29 years since donation. Interviews were audiotaped, and transcribed verbatim, and…
Mast, Alan E.
Low hemoglobin deferral occurs in about 10% of attempted whole blood donations and commonly is a consequence of iron deficiency anemia. Pre-menopausal women often have iron deficiency anemia caused by menstruation and pregnancy and have low hemoglobin deferral on their first donation attempt. Frequent donors also develop iron deficiency and iron deficiency anemia because blood donation removes a large amount of iron from the donor and the 56-day minimum inter-donation interval for donors in the United States is not sufficient for recovery of hemoglobin and iron stores. Other causes for low hemoglobin deferral range from a medically insignificant deferral of a woman with hemoglobin between 12.0 and 12.4 g/dL, which is within the normal reference range but below the 12.5 g/dL needed to donate blood, to anemia caused by an unrecognized malignancy in a “healthy” individual attempting to donate blood. The diverse causes of anemia in blood donors make it difficult to provide accurate information to donors about the cause of their low hemoglobin deferral and complicate implementation of programs to prevent them by blood collecting agencies. This article reviews how hemoglobin is measured and the demographics and causes of low hemoglobin deferral in blood donors. It provides recommendations for how blood collection agencies can provide donors with accurate information about the cause of their deferral and discusses programs that can be implemented to decrease these deferrals in regular donors. PMID:24332843
... the reason for that decision; (ii) Where appropriate, the types of donation of blood or blood... GENERAL REQUIREMENTS FOR BLOOD, BLOOD COMPONENTS, AND BLOOD DERIVATIVES § 630.6 Donor notification. (a) Notification of donors. You, an establishment that collects blood or blood components, must make...
... the reason for that decision; (ii) Where appropriate, the types of donation of blood or blood... GENERAL REQUIREMENTS FOR BLOOD, BLOOD COMPONENTS, AND BLOOD DERIVATIVES § 630.6 Donor notification. (a) Notification of donors. You, an establishment that collects blood or blood components, must make...
Friedman, E A; Friedman, A L
Continuous growth of the end stage renal disease population treated by dialysis, outpaces deceased donor kidneys available, lengthens the waiting time for a deceased donor transplant. As estimated by the United States Department of Health & Human Services: '17 people die each day waiting for transplants that can't take place because of the shortage of donated organs.' Strategies to expand the donor pool--public relations campaigns and Drivers' license designation--have been mainly unsuccessful. Although illegal in most nations, and viewed as unethical by professional medical organizations, the voluntary sale of purchased donor kidneys now accounts for thousands of black market transplants. The case for legalizing kidney purchase hinges on the key premise that individuals are entitled to control of their body parts even to the point of inducing risk of life. One approach to expanding the pool of kidney donors is to legalize payment of a fair market price of about 40,000 dollars to donors. Establishing a federal agency to manage marketing and purchase of donor kidneys in collaboration with the United Network for Organ Sharing might be financially self-sustaining as reduction in costs of dialysis balances the expense of payment to donors.
Brown, Judith Belle; Karley, Mary Lou; Boudville, Neil; Bullas, Ruth; Garg, Amit X.; Muirhead, Norman
This article describes the experiences, feelings, and ideas of living kidney donors. Using a phenomenological, qualitative research approach, the authors interviewed 12 purposefully selected living kidney donors (eight men and four women), who were between four and 29 years since donation. Interviews were audiotaped, and transcribed verbatim, and…
... of donation of blood or blood components that the donor should not donate in the future; (3) Where... the reason for that decision; (ii) Where appropriate, the types of donation of blood or blood... GENERAL REQUIREMENTS FOR BLOOD, BLOOD COMPONENTS, AND BLOOD DERIVATIVES § 630.6 Donor notification....
Owens, Casey; Broussard, Elizabeth; Surawicz, Christina
Clostridium difficile diarrhea is a common and severe infectious disease. Antibiotics, which are standard initial treatment, are less effective for treating refractory or recurrent infection. Fecal microbiota transplantation, where healthy donor stool is transplanted into a patient, is an alternative to antibiotic therapy that requires standardization for donors and patients. Copyright © 2013 Elsevier Ltd. All rights reserved.
Yousefinejad, Vahid; Darvishi, Nazila; Arabzadeh, Masoumeh; Soori, Masoumeh; Magsudlu, Mahtab; Shafiayan, Madjid
Aims and Background: Iron deficiency is one of the most common nutritional disorders worldwide and blood donation may cause iron depletion. Limited studies with large sample size have been done on male donors. The aim of this study is to determine the prevalence of iron deficiency and iron deficiency anemia among male donors in the Kurdistan Organization of Blood Transfusion in Iran. Materials and Methods: This was a cross-sectional study. Sample size was 1184 blood donors selected by systematic random sampling. Hemoglobin, serum iron, serum ferritin, total iron banding capacity (TIBC) and transferin saturation were measured in donors. Iron depletion, lack of iron stores, iron deficiency, iron deficiency anemia and anemia were evaluated among them. Data was analyzed with SPSS software and X2, one-way ANOVA, and LSD test. Results: Iron deficiency, anemia, iron deficiency anemia, iron depletion and lack of iron resources were seen in 2.3, 4.08, 2.14, 22.76 and 4.66 percent respectively. There was a significant relationship of iron deficiency and iron deficiency anemia with instances of donation and interval from last donation (P < 0.05). A significant relationship was seen between iron deficiency and iron deficiency anemia among blood donors with more than ten times blood donation (P < 0.05). Conclusions: This study showed regular male donors require especial attention. Therefore, serum ferritin is recommended as a more adequate index to use for iron deficiency screening and planning purposes for iron supplementation among them. PMID:20859513
Guimbretiere, J; Toscer, M; Harousseau, H
Automation of donor management flow path is controlled by: --a 3 slip "port a punch" card, --the groupamatic unit with a result sorted out on punch paper tape, --the management computer off line connected to groupamatic. Data tracking at blood collection time is made by punching a card with the donor card used as a master card. Groupamatic performs: --a standard blood grouping with one run for registered donors and two runs for new donors, --a phenotyping with two runs, --a screening of irregular antibodies. Themanagement computer checks the correlation between the data of the two runs or the data of a single run and that of previous file. It updates the data resident in the central file and prints out: --the controls of the different blood group for the red cell panel, --The listing of error messages, --The listing of emergency call up, --The listing of collected blood units when arrived at the blood center, with quantitative and qualitative information such as: number of blood, units collected, donor addresses, etc., --Statistics, --Donor cards, --Diplomas.
Senthilkumari, Srinivasan; Neethu, Mohan; Santhi, Radhakrishnan; Krishnadas, Subbiah Ramaswami; Muthukkaruppan, Veerappan
Purpose: The purpose of this study is to develop methods to identify glaucoma by examining the optic nerve head (ONH) of donor's eyes when information on the preexisting ocular disease is unavailable. Materials and Methods: The ONH of the donor's eyes was evaluated under a stereomicroscope for the cup-disc ratio (CDR) and focal retinal rim thinning. The vertical diameter of the cup and disc was also measured using a precalibrated eyepiece micrometer. The suspect eyes were subjected to histological analysis to confirm the presence of specific glaucomatous changes. Results: A total of 202 eyes from 119 donors (68 males and 51 females, aged 42–96) were evaluated for glaucoma. Among them, 190 (94%) eyes showing vertical CDR in the of 0.0–0.6 range were considered nonglaucomatous and the remaining eyes with >0.6 as glaucoma suspect. The calculated mean CDR of the two groups (0.3 ± 0.16, 0.62 ± 0.27) was highly significant (P = 0.0003). Of 12 eyes suspected of glaucoma, 7 eyes from 5 donors showed specific glaucomatous changes by histology. The prevalence of glaucoma was 4.2% among the donors studied. Conclusions: A simple method of screening fresh donor eyes for selecting those with glaucoma features using CDR and histological analysis was reported. This method helps to obtain biologically active human ocular tissue for glaucoma research on gene expression, ultrastructural/proteome changes, and outflow mechanism. PMID:26458478
Graham, Susanna; Jadva, Vasanti; Freeman, Tabitha; Ahuja, Kamal; Golombok, Susan
The objective of this study was to examine the motivations, experiences and future expectations of identity-release egg donors in the UK following the removal of donor anonymity and the increase in financial compensation for egg donation. This exploratory, in-depth qualitative study comprised semi-structured interviews with 11 women who had attended an egg donation screening appointment at a UK clinic during a four-month period in 2014. Interviews were conducted two to six weeks after the woman had donated or had withdrawn/been rejected from the donation process. Participants' primary motivation for donating was to help infertile women have their 'own child', and the recent increase in financial compensation did not seem to play a significant role in their decision. All were happy to be identifiable and contacted by children born as a result of their donation. However, some were hesitant about providing non-identifying information about themselves for these offspring and wished for further information about the recipient(s) of their eggs and the outcome of their donation. Whilst this study was limited due to the small sample size, it is the first study of UK egg donors following the rise in donor compensation and suggests that other strategies may be more effective in increasing donor numbers.
Mao, B.-Y.; Lagowski, J.; Gatos, H. C.
The generation kinetics of thermal donors at 450 C in Czochralski-grown silicon was found to be altered by high-temperature preannealing (e.g., 1100 C for 30 min). Thus, when compared with as-grown Si, high-temperature preannealed material exhibits a smaller concentration of generated thermal donors and a faster thermal donor saturation. A unified mechanism of nucleation and oxygen diffusion-controlled growth (based on solid-state plate transformation theory) is proposed to account for generation kinetics of thermal donors at 450 C, in as-grown and high-temperature preannealed Czochralski silicon crystals. This mechanism is consistent with the main features of the models which have been proposed to explain the formation of oxygen thermal donors in silicon.
When transplantation started all organs were retrieved from patients immediately after cardio-respiratory arrest, i.e. from non-heart-beating donors. After the recognition that death resulted from irreversible damage to the brainstem, organ retrieval rapidly switched to patients certified dead after brainstem testing. These heart-beating-donors have become the principal source of organs for transplantation for the last 30 years. The number of heart-beating-donors are declining and this is likely to continue, therefore cadaveric organs from non-heart-beating donor offers a large potential of resources for organ transplantation. The aim of this study is to examine clinical outcomes of non-heart-beating donors in the past 10 years in the UK as an way of decreasing pressure in the huge waiting list for organs transplantation. PMID:18297216
Bialkowski, Walter; Bruhn, Roberta; Edgren, Gustaf; Papanek, Paula
An estimated 2.4 million volunteer apheresis blood donation procedures were performed in the United States in 2010 and increases in the proportion of transfused blood products derived from apheresis blood collections have been consistently reported. Anticoagulation is required during apheresis and is achieved with citrate. Donor exposure to citrate causes an acute physiological response in the donor maintaining serum mineral homeostasis. Some data are available on the sequelae of this acute response in the days and weeks following exposure, raising questions about bone mineral density in regular apheresis donors. New research is emerging that addresses the potential long term health outcomes of repeated citrate exposure. This article reviews the acute physiological response to citrate anticoagulation in volunteer blood donors, presents contrasting perspectives on the potential effects of citrate exposure on bone density, and identifies key knowledge gaps in our understanding of long term health outcomes in apheresis donors. PMID:26607494
Akkina, Sanjeev K.; Asrani, Sumeet K.; Peng, Yi; Stock, Peter; Kim, Ray; Israni, Ajay K.
Due to the shortage of deceased donor organs, transplant centers accept organs from marginal deceased donors, including older donors. Organ-specific donor risk indices have been developed to predict graft survival using various combinations of donor and recipient characteristics. We will review the kidney donor risk index (KDRI) and liver donor risk index (LDRI) and compare and contrast their strengths, limitations, and potential uses. The Kidney Donor Risk Index has a potential role in developing new kidney allocation algorithms. The Liver Donor Risk Index allows for greater appreciation of the importance of donor factors, particularly for hepatitis C-positive recipients; as the donor risk index increases, rates of allograft and patient survival among these recipients decrease disproportionately. Use of livers with high donor risk index is associated with increased hospital costs independent of recipient risk factors, and transplanting livers with high donor risk index into patients with Model for End-Stage Liver Disease scores < 15 is associated with lower allograft survival; use of the Liver Donor Risk Index has limited this practice. Significant regional variation in donor quality, as measured by the Liver Donor Risk Index, remains in the United States. We also review other potential indices for liver transplant, including donor-recipient matching and the retransplant donor risk index. While substantial progress has been made in developing donor risk indices to objectively assess donor variables that affect transplant outcomes, continued efforts are warranted to improve these indices to enhance organ allocation policies and optimize allograft survival. PMID:22287036
Said, Zeinab N; El Sayed, Manal H; Salama, Iman I; Aboel-Magd, Enas K; Mahmoud, Magda H; El Setouhy, Maged; Mouftah, Faten; Azzab, Manal B; Goubran, Heidi; Bassili, Amal; Esmat, Gamal E
AIM: To identify blood donors with occult hepatitis B virus (HBV) infection (OBI) to promote safe blood donation. METHODS: Descriptive cross sectional study was conducted on 3167 blood donors negative for hepatitis B surface antigen (HBsAg), hepatitis C antibody (HCV Ab) and human immunodeficiency virus Ab. They were subjected to the detection of alanine aminotransferase (ALT) and aspartate transaminase (AST) and screening for anti-HBV core antibodies (total) by two different techniques; [Monoliza antibodies to hepatitis B core (Anti-HBc) Plus-Bio-Rad] and (ARC-HBc total-ABBOT). Positive samples were subjected to quantitative detection of antibodies to hepatitis B surface (anti-HBs) (ETI-AB-AUK-3, Dia Sorin-Italy). Serum anti-HBs titers > 10 IU/L was considered positive. Quantitative HBV DNA by real time polymerase chain reaction (PCR) (QIAGEN-Germany) with 3.8 IU/mL detection limit was estimated for blood units with negative serum anti-HBs and also for 32 whose anti-HBs serum titers were > 1000 IU/L. Also, 265 recipients were included, 34 of whom were followed up for 3-6 mo. Recipients were investigated for ALT and AST, HBV serological markers: HBsAg (ETI-MAK-4, Dia Sorin-Italy), anti-HBc, quantitative detection of anti-HBs and HBV-DNA. RESULTS: 525/3167 (16.6%) of blood units were positive for total anti-HBc, 64% of those were anti-HBs positive. Confirmation by ARCHITECT anti-HBc assay were carried out for 498/525 anti-HBc positive samples, where 451 (90.6%) confirmed positive. Reactivity for anti-HBc was considered confirmed only if two positive results were obtained for each sample, giving an overall prevalence of 451/3167 (14.2%) for total anti-HBc. HBV DNA was quantified by real time PCR in 52/303 (17.2%) of anti-HBc positive blood donors (viral load range: 5 to 3.5 x 105 IU/mL) with a median of 200 IU/mL (mean: 1.8 x 104 ± 5.1 x 104 IU/mL). Anti-HBc was the only marker in 68.6% of donors. Univariate and multivariate logistic analysis for identifying risk
This article explores the processes through which Australian recipients select unknown donors for use in assisted reproductive technologies and speculates on how those processes may affect the future life of the donor-conceived person. I will suggest that trust is an integral part of the exchange between donors, recipients, and gamete agencies in donor conception and heavily informs concepts of relatedness, race, ethnicity, kinship, class, and visibility. The decision to be transparent (or not) about a child's genetic parentage affects recipient parents' choices of donor, about who is allowed to "know" children's genetic backgrounds, and how important it is to be able to "pass" as an unassisted conception. In this way, recipients must trust the process, institutions, and individuals involved in their treatment, as well as place trust in the future they imagine for their child. The current market for donor gametes reproduces normative conceptions of the nuclear family, kinship, and relatedness by facilitating "matching" donors to recipients by phenotype and cultural affinities. Recipient parents who choose not to prioritize "matching," and actively disclose the process of children's conceptions, may embark on a project of queering heteronormative family structures and place great trust in both their own children and changing social attitudes to reduce stigma and generate acceptance for non-traditional families.
Abdullah, Saleh M
Regular blood donation can lead to iron deficiency. Screening donors' serum ferritin levels at the time of first donation and subsequently once every year is a very rational way to pick up iron deficiency in a voluntary blood donor population. The aim of this study was to determine the effect of blood donation and the prevalence of erythropoiesis with iron deficiency (sideropenia) in Saudi male blood donors. The study was prospectively conducted, between December 2008 and March 2009, on 182 male native Saudi blood donors at King Fahd Central Hospital in Jazan region, Saudi Arabia. Each donor gave 450 ± 50 mL of whole blood. Following the donation, samples were removed into 2.5 mL EDTA tubes for measurement of mean cell volume (MCV) and mean corpuscular haemoglobin (MCH) and into 7.5 mL plain tubes for estimation of iron and serum ferritin concentrations. The blood donors were divided into five groups, according to the number of donations they had given in the preceding 3 years. The blood donors in group I were first-time donors, with no previous history of blood donation. Group II donors had donated once in the last 3 years. Subjects in groups III, IV and V had donated more than once in the preceding 3 years and were considered regular donors. The mean serum iron was significantly higher among subjects with no previous history of blood donation (group I) than among regular donors who had donated twice or more. The difference in serum ferritin concentration was statistically significant (p<0.05) when comparing regular donors in group III (72.4 μg/L), group IV (67.4 μg/L) and group V (26.2 μg/L) with first-time blood donors (131.4 μg/L). In contrast, the difference in the concentration of serum ferritin between subjects in group II (98.9 μg/L), who had donated once in the last 3 years, and in first-time blood donors (131.4 μg/L) was not statistically significant (p<0.131). None of the group I donors suffered from iron deficiency, whereas 2.8% of the donors who
Watanabe, K K; Busch, M P; Schreiber, G B; Zuck, T F
Although immunoglobulin (Ig) preparations including RhIg have been noted for their record of safety, recent reports of hepatitis C virus (HCV) transmission by some Ig preparations have raised concern. This analysis examined the safety of RhIg manufactured in the US by comparing the prevalence and incidence of viral markers in Rh-negative and Rh-positive female blood donors. Demographic and viral marker data were analyzed for allogeneic donations collected from female donors of childbearing age (17-49 years of age) from April 1992 to May 1996. Prevalence and incidence rates were calculated for HCV, human immunodeficiency virus (HIV), and hepatitis B surface antigen (HBsAg). Of the 624,939 female donors included in the study, 96,355 (15.4%) were Rh-negative and 528,584 (84.6%) Rh-positive. There were no significant differences in the prevalence of HCV and HIV between Rh-negative and Rh-positive female donors. HBsAg prevalence was significantly higher among non-white compared to white donors. Following implementation of the more sensitive EIA 2.0 screening test for HCV in April 1992, prevalence and incidence rates declined over time at similar rates for Rh-negative and Rh-positive female donors. Rh-negative female donors had similar prevalence and incidence rates for most viral markers compared to Rh-positive female donors. This analysis supports the historical safety of RhIg.
Goldberg, Abbie E; Allen, Katherine R
In this exploratory qualitative study of 11 young adults, ages 19-29 years, we examine how young people who were raised by lesbian parents make meaning out of and construct their relationships with known donors. In-depth interviews were conducted to examine how participants defined their family composition, how they perceived the role of their donors in their lives, and how they negotiated their relationships with their donors. Findings indicate that mothers typically chose known donors who were family friends, that the majority of participants always knew who their donors were, and that their contact with donors ranged from minimal to involved. Further, participants perceived their donors in one of three ways: as strictly donors and not members of their family; as extended family members but not as parents; and as fathers. The more limited role of donors in participants' construction of family relationships sheds light on how children raised in lesbian, gay, and bisexual families are contributing to the redefinition and reconstruction of complex kinship arrangements. Our findings hold implications for clinicians who work with lesbian-mother families, and suggest that young adulthood is an important developmental phase during which interest in and contact with the donor may shift, warranting a transfer of responsibility from mother to offspring in terms of managing the donor-child relationship.
Chang, Peter C; Saha, Sharmeela; Gomes, Amanda M; Padiyar, Aparna; Bodziak, Kenneth A; Poggio, Emilio D; Hricik, Donald E; Augustine, Joshua J
In living-donor kidney transplantation, various donor factors, including gender, age, and baseline kidney function, predict allograft function and recipient outcomes after transplantation. Because higher phosphorus is predictive of vascular injury in healthy adults, the effect of donor phosphorus levels on recipient renal function after transplantation was investigated. Phosphorus levels in 241 living donors were analyzed from a 7-year period, and recipient renal function and acute rejection at 1 year posttransplantation were examined controlling for other influencing factors, including multiple donor variables, HLA matching, and acute rejection. Female and African-American donors had significantly higher phosphorus levels predonation. By multivariable analysis, higher donor phosphorus correlated with higher recipient serum creatinine (slope=0.087, 95% confidence interval [CI]: 0.004 to 0.169, P=0.041) and lower recipient estimated GFR (slope=-4.321, 95% CI: -8.165 to -0.476, P=0.028) at 12 months. Higher donor phosphorus also displayed an independent correlation with biopsy-proven acute rejection and delayed or slow graft function after transplantation. In a cohort of living kidney donors, higher donor phosphorus correlated with female gender and African-American ethnicity and was an independent risk factor for early allograft dysfunction after living-donor kidney transplantation. Copyright © 2011 by the American Society of Nephrology
Labott, S; Pfammatter, A
Previous research has begun to delineate the complicated reactions experienced by bone marrow and stem cell donors. The purpose of this study was to examine the influence of the donor-recipient relationship on the related donor's emotional reactions. Twenty-eight adult stem cell donors completed questionnaires before donation, 30 days post stem cell infusion, and 1 year after infusion. Questionnaires addressed the donor-recipient relationship, depression, mood, guilt and responsibility, self-esteem, ambivalence about donation and reactions to the donation itself. Results indicated that most donors reported little ambivalence about donation, and their reactions to the donation itself were generally positive. Closer and more positive donor-recipient relationships were associated with less anticipated guilt and responsibility if the transplant did not work. The relationships between the donor and the recipient did not change over time. Mood disturbance and depression were low overall, not related to the donor-recipient relationship, and did not significantly change over time. These results indicate that related stem cell donors are generally without significant emotional distress, and are comfortable with the donation process. Further, a more positive relationship with the recipient may help donors to avoid feeling guilty and responsible if the transplant does not work.
Blatyta, Paula Fraiman; Custer, Brian; Gonçalez, Thelma Terezinha; Birch, Rebecca; Lopes, Maria Esther; Ferreira, Maria Ines Lopes; Proietti, Anna Barbara Carneiro; Sabino, Ester Cerdeira; Page, Kimberly; de Almeida Neto, Cesar
Background HIV risk factor screening among blood donors remains a cornerstone for the safety of blood supply and is dependent on prospective donor self-disclosure and an attentive predonation interview. Residual risk of HIV transmission through blood transfusion is higher in Brazil than in many other countries. Audio computer-assisted structured-interview (ACASI) has been shown to increase self-reporting of risk behaviors. Study design and methods This cross-sectional study was conducted between January 2009 and March 2011 at four Brazilian blood centers to identify the population of HIV-negative eligible blood donors that answered face-to-face interviews without disclosing risks, but subsequently disclosed deferrable risk factors by ACASI. Compared to the donor interview, the ACASI contained expanded content on demographics, sexual behavior and other HIV risk factors questions. Results 901 HIV-negative blood donors were interviewed. On the ACASI, 13% of donors (N=120) declared a risk factor that would have resulted in deferral that was not disclosed during the face-to-face assessment. The main risk factors identified were recent unprotected sex with an unknown or irregular partner (49 donors), sex with a person with exposure to blood/ fluids (26 donors), multiple sexual partners (19 donors), and male-male sexual behavior (10 donors). Independent factors associated with the disclosure of any risk factor for HIV were age (≥40 years vs. 18–25 years, AOR=0.45; 95% CI 0.23–0.88) and blood center (Hemope vs. Hemominas, AOR=2.51; 95% CI 1.42–4.44). Conclusion ACASI elicited increased disclosure of HIV risk factors among blood donors. ACASI may be a valuable modality of interview to be introduced in Brazilian blood banks. PMID:23521083
Anand, Rohit; Song, Yang; Garg, Shashank; Girotra, Mohit; Sinha, Amitasha; Sivaraman, Anita; Phillips, Laila; Dutta, Sudhir K
Fecal microbiota transplantation (FMT) is emerging as an effective therapy for the treatment of recurrent Clostridium difficile infection (RCDI). Selecting an appropriate donor is vital to the success of FMT. However, the relationship between age of donors and the efficacy of FMT has not been examined to date. The aim of this study was to examine the effect of age of healthy donors on their fecal microbiota and assess the impact of these changes on the clinical efficacy of FMT. This IRB-approved prospective study enrolled donors who were deemed healthy for FMT after careful detailed screening for infectious diseases per institutional protocol. The study was conducted between January 2011 and October 2014. Fecal samples were processed and analyzed using 16S rRNA gene amplicon sequencing. Differences in relative abundance and diversity of the donor fecal microbiota were analyzed in donors above and below 60 years of age. Effect of fecal microbiota from donors of different age groups on the efficacy of FMT was also evaluated. Twenty-eight healthy human subjects from ages 20-82 years were enrolled as donors for FMT. All patients receiving FMT from their respective donors had resolution of RCDI symptoms and had a negative C. difficile toxin test 4-12 weeks after FMT. Genomic analysis showed that the relative abundance of phylum Actinobacteria and family Bifidobacteriaceae was reduced in the donors ≥60 years of age (p < 0.05). However, Bacteroidetes-to-Fermicutes ratio did not demonstrate a significant change between the two groups. Furthermore, microbial diversity did not change significantly with advancing age. These observations suggest that aging in healthy donors is associated with compositional alterations in the fecal microbiome without change in the overall microbial diversity. These changes do not seem to affect the clinical efficacy of FMT in RCDI patients over 12 months.
Baart, A Mireille; van Noord, Paulus A H; Vergouwe, Yvonne; Moons, Karel G M; Swinkels, Dorine W; Wiegerinck, Erwin T; de Kort, Wim L A M; Atsma, Femke
Blood donors that meet the hemoglobin (Hb) criteria for donation may have undetected subclinical iron deficiency. The aim of this study was to assess the prevalence of subclinical iron deficiency in whole blood donors with Hb levels above cutoff levels for donation by measuring zinc protoporphyrin (ZPP) levels. In addition, prevalence rates based on other iron variables were assessed for comparison. The study population comprised 5280 Dutch whole blood donors, who passed the Hb criteria for donation. During donor screening, Hb levels were measured in capillary samples (finger prick), and venous blood samples were taken for measurements of ZPP and other iron variables. These variables included ferritin, transferrin saturation, soluble transferrin receptor (sTfR), hepcidin, red blood cell mean corpuscular volume (MCV), and mean cell Hb (MCH). With a ZPP cutoff level of at least 100 μmol/mol heme, subclinical iron deficiency was present in 6.9% of male donors and in 9.8% of female donors. Based on other iron variables, iron deficiency was also observed. Prevalence rates ranged from 4.8% (based on transferrin saturation) to 27.4% (based on hepcidin concentration) in men and from 5.6% (based on sTfR concentration) to 24.7% (based on hepcidin concentration) in women. Results from this study showed that subclinical iron deficiency is prevalent among blood donors that meet the Hb criteria for blood donation, based on ZPP levels and on other iron variables. This finding needs attention because these donors are at increased risk of developing iron deficiency affecting Hb formation and other cellular processes. © 2012 American Association of Blood Banks.
Williams, Katherine E; Stemmle, Pascale G; Westphal, Lynn M; Rasgon, Natalie L
BACKGROUND IVF, using donor oocytes, has become increasingly common. The donation procedure carries psychiatric risks, including depression, anxiety and rarely, psychosis, and this risk increases when there is a past history of psychiatric illness. We report on the psychiatric status, at intake assessment, of a group of candidate oocyte donors. METHODS The authors reviewed clinical records of 63 women continuously presenting to a University medical center for psychiatric evaluation as part of the screening process for oocyte donation. A board certified psychiatrist administered a structured clinical interview to candidate donors, and self-report measures were obtained from 28 women. RESULTS There was a significant discrepancy between psychiatric history of depression and current mood status, as measured by both clinical interview and psychometric self-report data. Nearly one-quarter of candidate donors (22%) reported a history of major depressive disorder; however, all candidate donors denied current mood disturbance on clinical interview, and mean Beck depression inventory and profile of mood states scores were lower than expected compared with psychometric norms (P < 0.0005), epidemiological data and the recurrent nature of depressive disorders. CONCLUSIONS Candidate donors may minimize psychiatric symptoms. Given the potential for ovarian stimulation protocols to induce or exacerbate mood symptoms, and the moderate heritability of mood disorders, careful evaluation of candidate donor affective disorder history is recommended. This evaluation should focus on sensitivity to mood destabilization during times of hormonal change. Measures that examine whether a candidate donor may have a tendency to present herself in an overly favorable manner, and/or a tendency to minimize symptoms, are recommended.
Charles, K S; Hughes, P; Gadd, R; Bodkyn, C J; Rodriguez, M
The majority of blood donations in Trinidad and Tobago are made as replacement by family members or friends. National Blood Transfusion Policy was drafted in 2007 to promote voluntary, repeated donation. The objective of this study is to assess the current rate and reasons for donor deferral, and the aim is to guide the proposed donor education and recruitment programme. A retrospective study of pre-donation deferral of prospective blood donors at the National Blood Transfusion Centre, Port of Spain, Trinidad and Tobago, was conducted. Records of all pre-donation deferrals over a 12-month period were studied. As many as 11,346 pre-donation screening interviews were conducted. There were 4043 (35.6%) deferrals. The most common reasons for donor deferral were exposure to high-risk sexual activity (27.6%), low haemoglobin 22.2% and hypertension 17.5%. Other reasons such as medication, chronic medical illness, tattoos, travel history, recent pregnancy, surgery or presentation outside the accepted age limit caused 33.8% of all deferrals and the majority (34.7%) of male deferrals. Low haemoglobin (44.5%) was the most common reason among females. The rate of deferral of voluntary donors was not significantly different from that for replacement donors (31.7 vs. 35.4%, P = 0.25). This study exposed a lack of public awareness as the principal reason for an unacceptably high rate of donor deferral. Donor education about selection criteria needs to be urgently addressed as an objective of the National Policy. Monitoring and evaluation of deferral rates and reasons could be used as one indicator of the effectiveness of the Policy.
Contreras, M; Hewitt, P E; Barbara, J A; Mochnaty, P Z
The acquired immune deficiency syndrome (AIDS) occurs most commonly in homosexual men. This group carries the greatest risk of transmitting AIDS by blood transfusion. Both promiscuous and nonpromiscuous male homosexuals should refrain from giving blood. A leaflet stating this advice was prepared by the Department of Health and Social Security, United Kingdom. In July 1984 a questionnaire was given to all donors attending a blood donor clinic in the west end of London, England. 53% were male. Donors were given a leaflet on AIDS and a questionnaire to complete in private. Those who considered themselves to be in a high risk group were asked to designate their blood for research purposes only. Serum samples from donors who confirmed that they were in the high risk category were tested for antihepatitis B core antigen and anti-human T lymphotropic virus type III (anti-HTLV-III) in addition to the routine screening of donors for hepatitis B surface antigen and syphilis. All high risk donors were men. Homosexuality was the only high risk factor. Of 5000 questionnaires administered between July and October, 614 were not completed or had ambiguous answers. 38 donors who completed the questionnaire beonged to a high risk group. Of these, 7 were positive for antihepatitis B core antigen; none were positive for anti-HTLV-III, T pallidum hemagglatination, or hepatits B surface antigen. Although the homosexual donors had a much lower incidence of sexually transmitted disease than those attending special clinics, this should not encourage complacency. All possible measures must be taken to prevent homosexuals from donating blood.
... identify S. aureus and the mecA gene that confers resistance to methicillin, oxacillin, nafcillin, dicloxacillin, and other similar antibiotics. Molecular MRSA screening is becoming more widespread. Some ...
Foulke, J. M.
An attempt was made to measure the response to an announcement of hypertension screening at the Goddard Space Center, to compare the results to those of previous statistics. Education and patient awareness of the problem were stressed.
... health. Depending on your age, sex, and medical history, you may need to be screened for things like: Certain types of cancer High blood pressure or high cholesterol Diabetes Osteoporosis (weak bones) ...
Learn More about Your Child’s Development: Developmental Monitoring and Screening Taking a first step, waving “bye-bye,” and pointing to something interesting are all developmental milestones, ...
Health Physics Society Specialists in Radiation Safety Airport Screening Fact Sheet Adopted: May 2011 Photo courtesy of Dan Paluska/ ... safe level. An American National Standards Institute/Health Physics Society industry standard states that the maxi- mum ...
... available for a limited number of diseases, including cystic fibrosis , fragile X syndrome , sickle cell disease , and Tay– ... are already pregnant are offered carrier screening for cystic fibrosis, hemoglobinopathies , and spinal muscular atrophy . You can have ...
Foulke, J. M.
An attempt was made to measure the response to an announcement of hypertension screening at the Goddard Space Center, to compare the results to those of previous statistics. Education and patient awareness of the problem were stressed.
Shimada, Masaki; Tsuchiya, Mizuho; Sakamoto, Ryota; Yamanoi, Yoshinori; Nishibori, Eiji; Sugimoto, Kunihisa; Nishihara, Hiroshi
The development of disilane-bridged donor-acceptor-donor (D-Si-Si-A-Si-Si-D) and acceptor-donor-acceptor (A-Si-Si-D-Si-Si-A) compounds is described. Both types of compound showed strong emission (λem =ca. 500 and ca. 400 nm, respectively) in the solid state with high quantum yields (Φ: up to 0.85). Compound 4 exhibited aggregation-induced emission enhancement in solution. X-ray diffraction revealed that the crystal structures of 2, 4, and 12 had no intermolecular π-π interactions to suppress the nonradiative transition in the solid state.
Shahshahani, Hayedeh J; Meraat, Nahid; Mansouri, Fatemeh
Haemoglobin screening methods need to be highly sensitive to detect both low and high haemoglobin levels and avoid unnecessary rejection of potential blood donors. The aim of this study was to evaluate the accuracy of measurements by HemoCue in blood donors. Three hundred and fourteen randomly selected, prospective blood donors were studied. Single fingerstick blood samples were obtained to determine the donors' haemoglobin levels by HemoCue, while venous blood samples were drawn for measurement of the haemoglobin level by both HemoCue and an automated haematology analyser as the reference method. The sensitivity, specificity, predictive values and correlation between the reference method and HemoCue were assessed. Cases with a haemoglobin concentration in the range of 12.5-17.9 g/dL were accepted for blood donation. Analysis of paired results showed that haemoglobin levels measured by HemoCue were higher than those measured by the reference method. There was a significant correlation between the reference method and HemoCue for haemoglobin levels less than 12.5 g/dL. The correlation was less strong for increasing haemoglobin levels. Linear correlation was poor for haemoglobin levels over 18 g/dL. Thirteen percent of donors, who had haemoglobin levels close to the upper limit, were unnecessarily rejected. HemoCue is suitable for screening for anaemia in blood donors. Most donors at Yazd are males and a significant percentage of them have haemoglobin values close to the upper limit for acceptance as a blood donor; since these subjects could be unnecessarily rejected on the basis of HemoCue results and testing with this method is expensive, it is recommended that qualitative methods are used for primary screening and accurate quantitative methods used in clinically suspicious cases or when qualitative methods fail.
Duerinckx, Nathalie; Timmerman, Lotte; Van Gogh, Johan; van Busschbach, Jan; Ismail, Sohal Y; Massey, Emma K; Dobbels, Fabienne
Evaluating a person's suitability for living organ donation is crucial, consisting not only of a medical but also of a thorough psychosocial screening. We performed a systematic literature review of guidelines, consensus statements, and protocols on the content and process of psychosocial screening of living kidney and liver donor candidates. We searched PubMed, Embase, CINAHL, and PsycINFO until June 22, 2011, following the PRISMA guidelines, complemented by scrutinizing guidelines databases and references of identified publications. Thirty-four publications were identified, including seven guidelines, six consensus statements, and 21 protocols or programs. Guidelines and consensus statements were inconsistent and lacked concreteness for both their content and process, possibly explaining the observed variability in center-specific evaluation protocols and programs. Overall, recommended screening criteria are not evidence-based and an operational definition of the concept "psychosocial" is missing, causing heterogeneity in terminology. Variation also exists on methods used to psychosocially evaluate potential donors. The scientific basis of predonation psychosocial evaluation needs to be strengthened. There is a need for high-quality prospective psychosocial outcome studies in living donors, a uniform terminology to label psychosocial screening criteria, and validated instruments to identify risk factors.
Hepatocellular carcinoma (HCC) is one of the most frequently diagnosed tumour diseases throughout the world. In the vast majority of cases those affected are high-risk patients with chronic viral hepatitis and/or liver cirrhosis, which means there is a clearly identifiable target group for HCC screening. With resection, transplantation, and interventional procedures for local ablation, following early diagnosis curative treatment options are available with which 5-year survival rates of over 60% can be reached. Such early diagnosis is a reality only in a minority of patients, however, and in the majority of cases the disease is already in an advanced stage at diagnosis. One of the objects of HCC screening is diagnosis in an early stage when curative treatment is still possible. Precisely this is achieved by screening, so that the proportion of patients treated with curative intent is decisively higher. There is not yet any clear evidence as to whether this leads to a lowering of the mortality of HCC. As lower mortality is the decisive indicator of success for a screening programme the benefit of HCC screening has so far been neither documented nor refuted. Nonetheless, in large regions of the world it is the practice for high-risk patients to undergo HCC screening in the form of twice-yearly ultrasound examination and determination of AFP.
Gaillard, François; Pavlov, Patrik; Tissier, Anne-Marie; Harache, Benoit; Eladari, Dominique; Timsit, Marc-Olivier; Fournier, Catherine; Léon, Carine; Hignette, Chantal; Friedlander, Gérard; Correas, Jean-Michel; Weinmann, Pierre; Méjean, Arnaud; Houillier, Pascal; Legendre, Christophe; Courbebaisse, Marie
Screening of living kidney donors may require scintigraphy to split glomerular filtration rate (GFR). To determine the usefulness of computed tomography (CT) to split GFR, we compared scintigraphy-split GFR to CT-split GFR. We evaluated CT-split GFR as a screening test to detect scintigraphy-split GFR lower than 40 mL/min/1.73 m(2)/kidney. This was a monocentric retrospective study on 346 potential living donors who had GFR measurement, renal scintigraphy, and CT. We predicted GFR for each kidney by splitting GFR using the following formula: Volume-split GFR for a given kidney = measured GFR*[volume of this kidney/(volume of this kidney + volume of the opposite kidney)]. The same formula was used for length-split GFR. We compared length- and volume-split GFR to scintigraphy-split GFR at donation and with a 4-year follow-up. A better correlation was observed between length-split GFR and scintigraphy-split GFR (r = 0.92) than between volume-split GFR and scintigraphy-split GFR (r = 0.89). A length-split GFR threshold of 45 mL/min/1.73 m(2)/kidney had a sensitivity of 100 % and a specificity of 75 % to detect scintigraphy-split GFR less than 40 mL/min/1.73 m(2)/kidney. Both techniques with their respective thresholds detected living donors with similar eGFR evolution during follow-up. Length-split GFR can be used to detect patients requiring scintigraphy. • Excellent correlation between kidney length and scintigraphy predicted GFR • Kidney length screening detects all donors with GFR lower than 40 mL/min/1.73 m (2) • Kidney length screening can replace scintigraphy screening.
Carpenter, Melissa K.
Summary Several human embryonic stem cell (hESC)-derived cell therapeutics have entered clinical testing and more are in various stages of preclinical development. The U.S. Food and Drug Administration (FDA) regulates these products under existing regulations and has stated that these products do not constitute a new class of biologic. However, as human tissue, hESCs are subject to regulations that were developed before hESCs were first described. The regulations have not been revised since 2005, well before the first hESC-derived product entered clinical studies. The current regulations require donors of hESCs to be tested in the same manner as donors of tissues intended for transplantation. However, because hESC-derived cell products are more than minimally manipulated, they are also subject to the same end-of-production release testing as most other biologic agents. In effect, this makes hESC products subject to redundant testing. No other biologic is subject to a similar testing requirement. Furthermore, the regulations that require donor testing are specifically applicable to hESC cells harvested from donors after a date in 2005. It is unclear which regulations cover hESCs harvested before 2005. Ambiguity in the guidelines and redundant testing requirements have unintentionally created a burdensome regulatory paradigm for these products and reluctance on the part of developers to invest in these promising therapeutics. We propose a simple solution that would address FDA safety concerns, eliminate regulatory uncertainty and risk, and provide flexibility for the FDA in the regulation of hESC-derived cell therapies. Significance Regulatory ambiguity concerning donor eligibility screening and testing requirements for human embryonic stem cell lines, in particular those lines created before 2005, are causing significant concern for drug developers. Technically, most of these lines fail to meet eligibility under U.S. Food and Drug Administration (FDA) rules for
Determination of Eligibility in Related Pediatric Hematopoietic Cell Donors: Ethical and Clinical Considerations. Recommendations from a Working Group of the Worldwide Network for Blood and Marrow Transplantation Association.
Bitan, Menachem; van Walraven, Suzanna M; Worel, Nina; Ball, Lynne M; Styczynski, Jan; Torrabadella, Marta; Witt, Volker; Shaw, Bronwen E; Seber, Adriana; Yabe, Hiromasa; Greinix, Hildegard T; Peters, Christina; Gluckman, Eliane; Rocha, Vanderson; Halter, Joerg; Pulsipher, Michael A
Related donors for hematopoietic cell (HC) transplantation are a growing population in recent years because of expanding indications for allogeneic transplantation. The safety and welfare of the donor are major concerns for the transplantation community, especially for related sibling donors of young recipients who are children and, thus, not able to fully consent. Because donation of HC does not improve the donor's own physical health and carries a risk of side effects, careful assessment of medical risks specific to the individual donor, as well as consideration of ethical and legal aspects associated with donation from a child, must be considered. In addition, donor centers must balance the needs of both the donor and the recipient, understanding the inherent conflict parents may have as they can be overly focused on the very sick child receiving a transplant, rather than on the relatively less significant health or emotional problems that a sibling donor may have, which could impact risk with donation. Likewise, consideration must be made regarding the nature of the relationship of the sibling donor to the recipient and also aspects of performing research on pediatric HC donors. In this article, as members of the Donor Issues Committee of the Worldwide Network for Blood and Marrow Transplantation, we review key ethical concerns associated with pediatric donation and then give recommendations for screening potential child donors with underlying health conditions. These recommendations are aimed at protecting the physical and emotional well-being of childhood donors and arise out of the Third International Conference on Health and Safety of Donors sponsored by the Worldwide Network for Blood and Marrow Transplantation.
In Egypt there is no doubt that chronic liver diseases are a major health concern. Hepatitis C virus (HCV) prevalence among the 15−59 years age group is estimated to be 14.7%. The high prevalence of chronic liver diseases has led to increasing numbers of Egyptian patients suffering from end stage liver disease (ESLD), necessitating liver transplantation (LT). We reviewed the evolution of LT in Egypt and the current status. A single center was chosen as an example to review the survival and mortality rates. To date, deceased donor liver transplantation (DDLT) has not been implemented in any program though Egyptian Parliament approved the law in 2010. Living donor liver transplantation (LDLT) seemed to be the only logical choice to save many patients who are in desperate need for LT. By that time, there was increase in number of centers doing LDLT (13 centers) and increase in number of LDLT cases [2,400] with improvement of the results. Donor mortality rate is 1.66 per 1,000 donors; this comprised four donors in the Egyptian series. The exact recipient survival is not accurately known however, and the one-year, three-year and five-year survival were 73.17%, 70.83% and 64.16% respectively in the International Medical Center (IMC) in a series of 145 adult to adult living donor liver transplantation (AALDLT) cases. There was no donor mortality in this series. LDLT are now routinely and successfully performed in Egypt with reasonable donor and recipient outcomes. Organ shortage remains the biggest hurdle facing the increasing need for LT. Although LDLT had reasonable outcomes, it carries considerable risks to healthy donors. For example, it lacks cadaveric back up, and is not feasible for all patients. The initial success in LDLT should drive efforts to increase the people awareness about deceased organ donation in Egypt. PMID:27115003
Amer, Khaled E; Marwan, Ibrahim
In Egypt there is no doubt that chronic liver diseases are a major health concern. Hepatitis C virus (HCV) prevalence among the 15-59 years age group is estimated to be 14.7%. The high prevalence of chronic liver diseases has led to increasing numbers of Egyptian patients suffering from end stage liver disease (ESLD), necessitating liver transplantation (LT). We reviewed the evolution of LT in Egypt and the current status. A single center was chosen as an example to review the survival and mortality rates. To date, deceased donor liver transplantation (DDLT) has not been implemented in any program though Egyptian Parliament approved the law in 2010. Living donor liver transplantation (LDLT) seemed to be the only logical choice to save many patients who are in desperate need for LT. By that time, there was increase in number of centers doing LDLT (13 centers) and increase in number of LDLT cases [2,400] with improvement of the results. Donor mortality rate is 1.66 per 1,000 donors; this comprised four donors in the Egyptian series. The exact recipient survival is not accurately known however, and the one-year, three-year and five-year survival were 73.17%, 70.83% and 64.16% respectively in the International Medical Center (IMC) in a series of 145 adult to adult living donor liver transplantation (AALDLT) cases. There was no donor mortality in this series. LDLT are now routinely and successfully performed in Egypt with reasonable donor and recipient outcomes. Organ shortage remains the biggest hurdle facing the increasing need for LT. Although LDLT had reasonable outcomes, it carries considerable risks to healthy donors. For example, it lacks cadaveric back up, and is not feasible for all patients. The initial success in LDLT should drive efforts to increase the people awareness about deceased organ donation in Egypt.
Cheng, Yu-Fan; Ou, Hsin-You; Yu, Chun-Yen; Tsang, Leo Leung-Chit; Huang, Tung-Liang; Chen, Tai-Yi; Hsu, Hsien-Wen; Concerjero, Allan M; Wang, Chih-Chi; Wang, Shih-Ho; Lin, Tsan-Shiun; Liu, Yueh-Wei; Yong, Chee-Chien; Lin, Yu-Hung; Lin, Chih-Che; Chiu, King-Wah; Jawan, Bruno; Eng, Hock-Liew; Chen, Chao-Long
The shortage of deceased donor liver grafts led to the use of living donor liver transplant (LDLT). Patients who undergo LDLT have a higher risk of complications than those who undergo deceased donor liver transplantation (LT). Interventional radiology has acquired a key role in every LT program by treating the majority of vascular and non-vascular post-transplant complications, improving graft and patient survival and avoiding, in the majority of cases, surgical revision and/or re-transplant. The aim of this paper is to review indications, diagnostic modalities, technical considerations, achievements and potential complications of interventional radiology procedures after LDLT.
Abdullah, Saleh M.
Background. Regular blood donation can lead to iron deficiency. Screening donors’ serum ferritin levels at the time of first donation and subsequently once every year is a very rational way to pick up iron deficiency in a voluntary blood donor population. The aim of this study was to determine the effect of blood donation and the prevalence of erythropoiesis with iron deficiency (sideropenia) in Saudi male blood donors. Materials and methods. The study was prospectively conducted, between December 2008 and March 2009, on 182 male native Saudi blood donors at King Fahd Central Hospital in Jazan region, Saudi Arabia. Each donor gave 450±50 mL of whole blood. Following the donation, samples were removed into 2.5 mL EDTA tubes for measurement of mean cell volume (MCV) and mean corpuscular haemoglobin (MCH) and into 7.5 mL plain tubes for estimation of iron and serum ferritin concentrations. The blood donors were divided into five groups, according to the number of donations they had given in the preceding 3 years. The blood donors in group I were first-time donors, with no previous history of blood donation. Group II donors had donated once in the last 3 years. Subjects in groups III, IV and V had donated more than once in the preceding 3 years and were considered regular donors. Results. The mean serum iron was significantly higher among subjects with no previous history of blood donation (group I) than among regular donors who had donated twice or more. The difference in serum ferritin concentration was statistically significant (p<0.05) when comparing regular donors in group III (72.4 μg/L), group IV (67.4 μg/L) and group V (26.2 μg/L) with first-time blood donors (131.4 μg/L). In contrast, the difference in the concentration of serum ferritin between subjects in group II (98.9 μg/L), who had donated once in the last 3 years, and in first-time blood donors (131.4 μg/L) was not statistically significant (p<0.131). None of the group I donors suffered from
Althoff, Tim; Leskovec, Jure
Online crowdfunding platforms like DonorsChoose.org and Kick-starter allow specific projects to get funded by targeted contributions from a large number of people. Critical for the success of crowdfunding communities is recruitment and continued engagement of donors. With donor attrition rates above 70%, a significant challenge for online crowdfunding platforms as well as traditional offline non-profit organizations is the problem of donor retention. We present a large-scale study of millions of donors and donations on DonorsChoose.org, a crowdfunding platform for education projects. Studying an online crowdfunding platform allows for an unprecedented detailed view of how people direct their donations. We explore various factors impacting donor retention which allows us to identify different groups of donors and quantify their propensity to return for subsequent donations. We find that donors are more likely to return if they had a positive interaction with the receiver of the donation. We also show that this includes appropriate and timely recognition of their support as well as detailed communication of their impact. Finally, we discuss how our findings could inform steps to improve donor retention in crowdfunding communities and non-profit organizations. PMID:27077139
Hidaka, Masaaki; Eguchi, Susumu; Takatsuki, Mitsuhisa; Soyama, Akihiko; Ono, Shinichiro; Adachi, Tomohiko; Natsuda, Koji; Kugiyama, Tota; Hara, Takanobu; Okada, Satomi; Imamura, Hajime; Miuma, Satoshi; Miyaaki, Hisamitsu
Background There have been no previous reports how Kupffer cells affect the outcome of living donor liver transplantation (LDLT) with an elderly donor. The aim of this study was to elucidate the influence of Kupffer cells on LDLT. Methods A total of 161 adult recipients underwent LDLT. The graft survival, prognostic factors for survival, and graft failure after LDLT were examined between cases with a young donor (<50, n = 112) and an elderly donor (≥50, N = 49). The Kupffer cells, represented by CD68-positive cell in the graft, were examined in the young and elderly donors. Results In a multivariable analysis, a donor older than 50 years, sepsis, and diabetes mellitus were significant predictors of graft failure after LDLT. The CD68 in younger donors was significantly more expressed than that in elderly donors. The group with a less number of CD68-positive cells in the graft had a significantly poor survival in the elderly donor group and prognostic factor for graft failure. Conclusions The worse outcome of LDLT with elderly donors might be related to the lower number of Kupffer cells in the graft, which can lead to impaired recovery of the liver function and may predispose patients to infectious diseases after LDLT. PMID:27819035
Hsueh, Yuling; Buch, Holger; Hollenberg, Lloyd; Simmons, Michelle; Klimeck, Gerhard; Rahman, Rajib
The phonon induced relaxation times (T1) of electron spins bound to single phosphorous (P) donors and P donor clusters in silicon is computed using the atomistic tight-binding method. The electron-phonon Hamiltonian is directly computed from the strain dependent tight-binding Hamiltonian, and the relaxation time is computed from Fermi's Golden Rule using the donor states and the electron-phonon Hamiltonian. The self-consistent Hartree method is used to compute the multi-electron wavefunctions in donor clusters. The method takes into account the full band structure of silicon including the spin-orbit interaction, and captures both valley repopulation and single valley g-factor shifts in a unified framework. The single donor relaxation rate varies proportionally to B5, and is of the order of seconds at B =2T, both in good agreement with experimental single donor data (A. Morello et. al., Nature 467, 687 (2010)). T1 calculations in donor clusters show variations for different electron numbers and donor numbers and locations. The computed T1 in a 4P:5e donor cluster match well with a scanning tunneling microscope patterned P donor cluster (H. Buch et. al., Nature Communications 4, 2017 (2013)).
Althoff, Tim; Leskovec, Jure
Online crowdfunding platforms like DonorsChoose.org and Kick-starter allow specific projects to get funded by targeted contributions from a large number of people. Critical for the success of crowdfunding communities is recruitment and continued engagement of donors. With donor attrition rates above 70%, a significant challenge for online crowdfunding platforms as well as traditional offline non-profit organizations is the problem of donor retention. We present a large-scale study of millions of donors and donations on DonorsChoose.org, a crowdfunding platform for education projects. Studying an online crowdfunding platform allows for an unprecedented detailed view of how people direct their donations. We explore various factors impacting donor retention which allows us to identify different groups of donors and quantify their propensity to return for subsequent donations. We find that donors are more likely to return if they had a positive interaction with the receiver of the donation. We also show that this includes appropriate and timely recognition of their support as well as detailed communication of their impact. Finally, we discuss how our findings could inform steps to improve donor retention in crowdfunding communities and non-profit organizations.
Guthoff, Martina; Nadalin, Silvio; Fritsche, Andreas; Königsrainer, Alfred; Häring, Hans-Ulrich; Heyne, Nils
Transplant centers are increasingly confronted with medically complex living kidney donor candidates. Considerable differences exist among centers regarding handling of these patients and little data is available on characteristics, evaluation outcome and declination criteria. We now demonstrate impaired glucose metabolism to be the largest single cause of donor declination. Follow-up of 133 donor-recipient pairs, presenting to our transplant center between 03/2007 and 06/2012 was included in the analysis. Evaluation outcome of donor-recipient pairs was assessed and declinations stratified into donor or recipient reasons and underlying conditions. 65 donor-recipient pairs (49%) were accepted for transplantation, 68 (51%) were declined upon first evaluation. 77% of declinations were for donor- and 23% for recipient reasons. Almost half of donor declinations resulted from increased cardiovascular risk with the presence of diabetes mellitus or prediabetes as the largest single cause of declination. Glucose metabolism is key in donor risk assessment and precludes kidney donation if abnormal. The high prevalence emphasizes the need for prevention. Prediabetes defines a cohort at risk and response to lifestyle intervention allows for individual risk stratification, thereby potentially increasing the number of persons eligible for kidney donation. Unification of evaluation criteria, as well as prospective long-term follow-up is required to account for increasingly complex living kidney donors.
Boo, Michael; van Walraven, Suzanna M; Chapman, Jeremy; Lindberg, Brian; Schmidt, Alexander H; Shaw, Bronwen E; Switzer, Galen E; Yang, Edward; Egeland, Torstein
Hematopoietic stem cell transplantation is a curative procedure for life-threatening hematologic diseases. Donation of hematopoietic stem cells (HSCs) from an unrelated donor, frequently residing in another country, may be the only option for 70% of those in need of unrelated hematopoietic stem cell transplantation. To maximize the opportunity to find the best available donor, individual donor registries collaborate internationally. To provide homogeneity of practice among registries, the World Marrow Donor Association (WMDA) sets standards against which registries are accredited and provides guidance and regulations about unrelated donor safety and care. A basic tenet of the donor registries is that unrelated HSC donation is an altruistic act; nonpayment of donors is entrenched in the WMDA standards and in international practice. In the United States, the prohibition against remuneration of donors has recently been challenged. Here, we describe the reasons that the WMDA continues to believe that HSC donors should not be paid because of ethical concerns raised by remuneration, potential to damage the public will to act altruistically, the potential for coercion and exploitation of donors, increased risk to patients, harm to local transplantation programs and international stem cell exchange, and the possibility of benefiting some patients while disadvantaging others.
Lei, Jianyong; Yan, Lunan; Wang, Wentao
To evaluate the safety to donors of living-donor liver transplantation. This study included 300 consecutive living liver tissue donors who underwent operations at our center from July 2002 to December 2012. We evaluated the safety of donors with regard to three aspects complications were recorded prospectively and stratified by grade according to Clavien's classification, and the data were compared in two stages (the first 5 years' experience (pre-January 2008) and the latter 5 years' experience (post-January 2008); laboratory tests such as liver function and blood biochemistry were performed; and the health-related quality of life was evaluated. There was no donor mortality at our center, and the overall morbidity rate was 25.3%. Most of the complications of living donors were either grade I or II. There were significantly fewer complications in the latter period of our study than in the initial period (19.9% vs 32.6%, P<0.001), and biliary complications were the most common complications, with an incidence of 9%. All of the liver dysfunction was temporary; however, the post-operative suppression of platelet count lasted for years. Although within the normal range, eight years after operation, 22 donors showed lower platelet levels (189 × 10(9)/L) compared with the pre-operative levels (267 × 10(9)/L) (P<0.05). A total of 98.4% of donors had returned to their previous levels of social activity and work, and 99.2% of donors would donate again if it was required and feasible. With the exception of two donors who experienced grade III complications (whose recipients died) and a few cases of abdominal discomfort, fatigue, chronic pain and scar itching, none of the living donors were affected by physical problems. With careful donor selection and specialized patient care, low morbidity rates and satisfactory long-term recovery can be achieved after hepatectomy for living-donor liver transplantation.
Kollman, Craig; Spellman, Stephen R.; Zhang, Mei-Jie; Hassebroek, Anna; Anasetti, Claudio; Antin, Joseph H.; Champlin, Richard E.; Confer, Dennis L.; DiPersio, John F.; Fernandez-Viña, Marcelo; Hartzman, Robert J.; Horowitz, Mary M.; Hurley, Carolyn K.; Karanes, Chatchada; Maiers, Martin; Mueller, Carlheinz R.; Perales, Miguel-Angel; Setterholm, Michelle; Woolfrey, Ann E.; Yu, Neng
There are >24 million registered adult donors, and the numbers of unrelated donor transplantations are increasing. The optimal strategy for prioritizing among comparably HLA-matched potential donors has not been established. Therefore, the objective of the current analyses was to study the association between donor characteristics (age, sex, parity, cytomegalovirus serostatus, HLA match, and blood group ABO match) and survival after transplantation for hematologic malignancy. The association of donor characteristics with transplantation outcomes was examined using either logistic or Cox regression models, adjusting for patient disease and transplantation characteristics associated with outcomes in 2 independent datasets: 1988 to 2006 (N = 6349; training cohort) and 2007 to 2011 (N = 4690; validation cohort). All donor-recipient pairs had allele-level HLA typing at HLA-A, -B, -C, and -DRB1, which is the current standard for selecting donors. Adjusting for patient disease and transplantation characteristics, survival was better after transplantation of grafts from young donors (aged 18-32 years) who were HLA matched to recipients (P < .001). These findings were validated for transplantations that occurred between 2007 and 2011. For every 10-year increment in donor age, there is a 5.5% increase in the hazard ratio for overall mortality. Increasing HLA disparity was also associated with worsening survival. Donor age and donor-recipient HLA match are important when selecting adult unrelated donors. Other donor characteristics such as sex, parity, and cytomegalovirus serostatus were not associated with survival. The effect of ABO matching on survival is modest and must be studied further before definitive recommendations can be offered. PMID:26527675
Lieshout-Krikke, Ryanne W; Oei, Welling; Habets, Karin; Pasker-de Jong, Pieternel C M
Donors returning from areas with outbreaks of infectious diseases may donate infectious blood back home. Geographic donor deferral is an effective measure to ensure the blood safety, but donor deferral may pose a threat for the blood supply especially after holiday seasons. Insight into the travel behavior of blood donors is a first step to define appropriate deferral strategies. This study describes the travel behavior of Dutch donors, the actual deferral, and the consequences of deferral strategies on donor availability. A questionnaire designed to assess travel behavior (destination, frequency, and duration of travels) was sent to 2000 Dutch donors. The impact of travel deferral policies on donor availability was calculated, expressed as proportionate decrease in donor availability. The deferral policies considered were 1) deferral based on entire countries instead of affected regions where an infection is prevalent and 2) deferral after any travel outside Europe ("universal deferral"). Of the 1340 respondents, 790 (58.9%) donors traveled within Europe only, 61 (4.6%) outside Europe only, and 250 (18.7%) within and outside Europe. The deferral for entire countries and universal deferral would lead to 11.1 and 11.4% decrease in donor availability, respectively. Most Dutch donors traveled outside the Netherlands, while 23.2% traveled outside Europe. Universal deferral resulted in an additional decrease in donor availability of 0.3% compared with deferral for entire countries instead of affected regions where an infection is prevalent. Thus, the universal deferral could be considered as a simpler and safer measure. © 2014 AABB.
Singh, Ashutosh; Chaudhary, Rajendra; Sonker, Atul; Pandey, Hem Chandra
Iron deficiency is associated with neuropsychological changes such as restless leg syndrome (RLS), pica, hair loss, etc. Our objective was to assess usefulness of history of RLS and pica in relation with iron stores in blood donors. During medical examination, apart from routine questionnaires specific history of RLS and pica was elicited. Along with hemoglobin markers of iron deficiency such as s. iron, s. ferritin and mean corpuscular volume were analyzed. Out of 400 blood donors 41 had h/o pica/RLS/pagophagia. Positive and negative predictive value of above history is 73.17% and 80.5% respectively. We recommend the use of a screening question for pica and/or RLS in blood donor questionnaire. Copyright © 2015 Elsevier Ltd. All rights reserved.
Apt B, Werner; Heitmann G, Ingrid; Jercic L, M Isabel; Jotré M, Leonor; Muñoz C del V, Patricia; Noemí H, Isabel; San Martin V, Ana M; Sapunar P, Jorge; Torres H, Marisa; Zulantay A, Inés
In this chapter it is emphasized the importance to guarantee safety and high quality blood transfusions. Besides, the following topics are analyzed: the importance of Trypanosoma cruzi infection acquired by blood transfusions, the obligatory screening implemented in Chilean blood banks and serological diagnostic techniques used that for, the seroprevalence observed, the importance to confirm results and methods recommended in this purpose and, to notify the donor once the infection is confirmed. In addition a facsímil of a letter used to notify the positive donor is included as guidelines to make advice after, attaching a pro-forma of clinical-epidemiological registration to refer the donor to medical evaluation and treatment.
Wu, Yun; Xu, Kun; Ren, Chonghua; Li, Xinyi; Lv, Huijiao; Han, Furong; Wei, Zehui; Wang, Xin; Zhang, Zhiying
The clustered regularly interspaced short palindromic repeat (CRISPR)/CRISPR-associated protein 9 (Cas9) system has recently emerged as a simple, yet powerful genome engineering tool, which has been widely used for genome modification in various organisms and cell types. However, screening biallelic genome-modified cells is often time-consuming and technically challenging. In this study, we incorporated two different surrogate reporter cassettes into paired donor plasmids, which were used as both the surrogate reporters and the knock-in donors. By applying our dual surrogate reporter-integrated donor system, we demonstrate high frequency of CRISPR/Cas9-mediated biallelic genome integration in both human HEK293T and porcine PK15 cells (34.09% and 18.18%, respectively). Our work provides a powerful genetic tool for assisting the selection and enrichment of cells with targeted biallelic genome modification. © 2017 Federation of European Biochemical Societies.
Namen-Lopes, M S S; Martins, M L; Drummond, P C; Lobato, R R; Carneiro-Proietti, A B F
The objective of this study was to perform lookback study in recipients of blood components from human T-lymphotropic virus (HTLV) seropositive donors. HTLV-1/2 may be transmitted by blood transfusion. Brazil is an endemic area for the virus and its screening in blood donors is mandatory since 1993. Hemominas Foundation (HF) is the public transfusion centre in Minas Gerais, Brazil. Data on HTLV-1/2 seropositive donors and recipients from 1993 to 2004 were obtained at HF and 24 contracting hospitals. From 1993 to 2004, HTLV-1/2 enzyme immunoassay (EIA) was performed in 918 678 donations of approximately 422 600 blood donor candidates. Of these, 456 donors (0.1%) were reactive and confirmed by Western blot (WB): 449 HTLV-1 and 7 HTLV-2. Sixty-six (14.5%) were repeat donors and had 194 blood cellular components produced from their previous donations. Of the distributed components, 119/146 (81.5%) had the recipient traced, with a total of 114 individuals. Of these, only 13 recipients were tested: six (46%) were HTLV-1 positive (four recipients of red cell units, two of platelets) and seven (54%) were negative (six of red cell units and one of platelets). Eleven did not respond and 62/114 (54.0%) were deceased. Another 28/114 (25.0%) could not be located. All six seropositive HTLV-1 recipients identified had no symptoms suggestive of HTLV-1-associated diseases. Acellular components, when used alone, were not associated with HTLV seropositivity. HTLV-1 transmission by cellular blood components occurred before screening for the virus was introduced. Haemovigilance was difficult to perform due to unavailability of computer systems before 1999 and to inadequate medical records at hospitals.
Karmakar, Prasanta Ray; Shrivastava, Prabha; Ray, Tapobrata Guha
Seroprevalence of transfusion transmissible infections (TTIs) among blood donors can be used to monitor the prevalence among apparently healthy adult population. The present study was conducted to determine the profile of blood donors and seroprevalence of TTI among them. Retrospective analysis of the donors of a blood bank attached with a tertiary care hospital of Kolkata in 2011 was carried out. Data were analyzed with SPSS version 17. Majority (85%) of the donors were male, two-third in the age group of 21-40 years. Among the donors 2.79% were positive for any of the screened TTIs. Seroprevalence was highest for hepatitis B (1.41%) followed by human immunodeficiency virus (0.60%) and hepatitis C (0.59%) and least for syphilis (0.23%). Seropositivity increased with age up to 50 years. There was no significant difference in seropositivity between male and female. Highly sensitive donor screening and public awareness program can make transfusion of blood products safe.
Living donor liver transplant (LDLT) accounts for a small volume of the transplants in the USA. Due to the current liver allocation system based on the model for end-stage liver disease (MELD), LDLT has a unique role in providing life-saving transplantation for patients with low MELD scores and significant complications from portal hypertension, as well as select patients with hepatocellular carcinoma (HCC). Donor safety is paramount and has been a topic of much discussion in the transplant community as well as the general media. The donor risk appears to be low overall, with a favorable long-term quality of life. The latest trend has been a gradual shift from right-lobe grafts to left-lobe grafts to reduce donor risk, provided that the left lobe can provide adequate liver volume for the recipient. PMID:27115007
SERUR, DAVID; BRETZLAFF, GRETCHEN; CHRISTOS, PAUL; DESROSIERS, FARRAH; CHARLTON, MARIAN
Most non-directed donors (NDDs) decide to donate on their own and contact the transplant centre directly. Some NDDs decide to donate in response to community solicitation such as newspaper ads or donor drives. We wished to explore whether subtle coercion might be occurring in such NDDs who are part of a larger community. One successful organization in a community in Brooklyn, NY, provides about 50 NDDs per year for recipients within that community. The donors answer ads in local papers and attend donor drives. Herein, we evaluated the physical and emotional outcomes of community-solicited NDDs in comparison to traditional NDDs who come from varied communities and are not responding to a specific call for donation. An assessment of coercion was used as well. PMID:26511772
Serur, David; Bretzlaff, Gretchen; Christos, Paul; Desrosiers, Farrah; Charlton, Marian
Most non-directed donors (NDDs) decide to donate on their own and contact the transplant centre directly. Some NDDs decide to donate in response to community solicitation such as newspaper ads or donor drives. We wished to explore whether subtle coercion might be occurring in such NDDs who are part of a larger community. One successful organization in a community in Brooklyn, NY, provides about 50 NDDs per year for recipients within that community. The donors answer ads in local papers and attend donor drives. Herein, we evaluated the physical and emotional outcomes of community-solicited NDDs in comparison to traditional NDDs who come from varied communities and are not responding to a specific call for donation. An assessment of coercion was used as well. © 2015 Asian Pacific Society of Nephrology.
Fischer, Gerald B.
Discusses why volatile markets and new donor expectations make now a good time to rework payout rates and gift agreements to bolster financial and strategic performance. Suggests seven options for action. (EV)
Birch, Samuel C M
Miller, Truog, and Brock have recently argued that the "dead donor rule," the requirement that donors be determined to be dead before vital organs are procured for transplantation, cannot withstand ethical scrutiny. In their view, the dead donor rule is inconsistent with existing life-saving practices of organ transplantation, lacks a cogent ethical rationale, and is not necessary for maintenance of public trust in organ transplantation. In this paper, the second of these claims will be evaluated. (The first and third are not addressed.) The claim that the dead donor rule lacks a cogent ethical rationale will be shown to be an expression of the contemporary rejection of the moral significance of the traditional distinction between killing and allowing to die. The moral significance of this traditional distinction, and the associated norm that doctors should not kill their patients, will be defended, and this critique of it shown to be unsuccessful.
Palanisamy, Amudha; Persad, Paul; Koty, Patrick P.; Douglas, Laurie L.; Stratta, Robert J.; Rogers, Jeffrey; Reeves-Daniel, Amber M.; Orlando, Giuseppe; Farney, Alan C.; Beaty, Michael W.; Pettenati, Mark J.; Iskandar, Samy S.; Grier, David D.; Kaczmorski, Scott A.; Doares, William H.; Gautreaux, Michael D.; Freedman, Barry I.; Powell, Bayard L.
We report the rare occurrence of donor-derived myeloid sarcoma in two kidney transplant patients who received organs from a single deceased donor. There was no evidence of preexisting hematologic malignancy in the donor at the time of organ recovery. Both recipients developed leukemic involvement that appeared to be limited to the transplanted organ. Fluorescence in situ hybridization (FISH) and molecular genotyping analyses confirmed that the malignant cells were of donor origin in each patient. Allograft nephrectomy and immediate withdrawal of immunosuppression were performed in both cases; systemic chemotherapy was subsequently administered to one patient. Both recipients were in remission at least one year following the diagnosis of donor-derived myeloid sarcoma. These cases suggest that restoration of the immune system after withdrawal of immunosuppressive therapy and allograft nephrectomy may be sufficient to control HLA-mismatched donor-derived myeloid sarcoma without systemic involvement. PMID:25977825
Palanisamy, Amudha; Persad, Paul; Koty, Patrick P; Douglas, Laurie L; Stratta, Robert J; Rogers, Jeffrey; Reeves-Daniel, Amber M; Orlando, Giuseppe; Farney, Alan C; Beaty, Michael W; Pettenati, Mark J; Iskandar, Samy S; Grier, David D; Kaczmorski, Scott A; Doares, William H; Gautreaux, Michael D; Freedman, Barry I; Powell, Bayard L
We report the rare occurrence of donor-derived myeloid sarcoma in two kidney transplant patients who received organs from a single deceased donor. There was no evidence of preexisting hematologic malignancy in the donor at the time of organ recovery. Both recipients developed leukemic involvement that appeared to be limited to the transplanted organ. Fluorescence in situ hybridization (FISH) and molecular genotyping analyses confirmed that the malignant cells were of donor origin in each patient. Allograft nephrectomy and immediate withdrawal of immunosuppression were performed in both cases; systemic chemotherapy was subsequently administered to one patient. Both recipients were in remission at least one year following the diagnosis of donor-derived myeloid sarcoma. These cases suggest that restoration of the immune system after withdrawal of immunosuppressive therapy and allograft nephrectomy may be sufficient to control HLA-mismatched donor-derived myeloid sarcoma without systemic involvement.
Zhou, Shengze; Farwaha, Hardeep; Murphy, John A
In the past decade, a host of exceptionally strong organic electron donors has been designed and prepared; their redox potentials are more negative than any previous neutral organic donors and extend beyond E(1/2) = -1 V vs. the saturated calomel electrode (SCE). Their ability to reduce a wide range of organic functional groups has been demonstrated and this article provides an overview of the main advances in the area and the guiding principles for the design of these reagents.
Pavlov; Zhukavin; Orlova; Shastin; Kirsanov; Hubers; Auen; Riemann
The observation of far-infrared stimulated emission from shallow donor transitions in silicon is reported. Lasing with a wavelength of 59 &mgr;m due to the neutral donor intracenter 2p(0)-->1s(E) transition in Si:P pumped by CO2 laser radiation is obtained. Populations of D0 and D- center states and the balance of the radiation absorption and amplification are theoretically analyzed.
Yuan, Shan; Chang, Shelley; Uyeno, Kasie; Almquist, Gay; Wang, Shirong
The rapid rise of mobile communication technologies has the potential to dramatically change and improve blood donor recruitment and retention efforts. E-mail invitations were sent to blood donors in a large metropolitan area to participate in a Web-based survey designed to gauge their readiness and interest level for a blood donation mobile application ("app"). A total of 982 ethnically diverse respondents of various age groups and prior donation experiences were surveyed. Among the respondents, 87.3% had ready access to smart phones. E-mail was chosen by 62.1% as the currently preferred method when contacted by the blood center, followed by texting (10.1%). App features desired by most respondents were the abilities to request appointments 24/7 (76.8%) and to receive appointment confirmations quickly (81.3%). Many were concerned about receiving too many alerts or messages (64.1%) or insufficient protection for personal information (53.5%). Overall, 67.7% of respondents indicated that they were likely to use a blood donation mobile app. Likelihood was not significantly different by sex or ethnicity, and the impact of education level was limited. Donors who currently made donation appointments via telephone or a website were equally likely to use such an app. However, donors older than 45 years were less likely than younger donors (p = 0.001), and donors with more than five lifetime donations were more likely than less frequent donors to use such an app (p = 0.02). In a metropolitan area, donors are very receptive to using a mobile app to manage their donations. © 2015 AABB.
Zarean, Mehdi; Shafiei, Reza; Gholami, Maryam; Fata, Abdolmajid; Rahmati Balaghaleh, Mansour; Kariminik, Ashraf; Tehranian, Farahnaz; Hasani, Ali; Akhavan, Arash
The present investigation aims to evaluate the prevalence of IgM and IgG anti-T. gondii antibodies and the associated risk factors among healthy blood donors in Mashhad city, Razavi Khorasan province, Iran. We screened a total of 500 serum samples by census method from apparently healthy blood donors of the Mashhad Blood Transfusion Organization (MBTO) for IgG and IgM anti-T. gondii antibodies by enzyme linked immunosorbent assay (ELISA). We found that 29.6%, 25%, 1.4%, and 3.2% of tested donors were positive for anti-T. gondii antibodies, only IgG antibody, both IgM and IgG, and IgM antibody alone, respectively. Several risk factors which were significantly related to T. gondii seropositivity in the univariate analysis at P < 0.05 included female gender (OR = 3.222, P < 0.001), age more than 40 years (P = 0.026), and sausage/hot dog consumption (OR = 4.472, P < 0.001). The results of this study can be a warning for blood transfusion organizations to pay special attention to toxoplasmosis among blood donors and also design screening programs for prevention of transfusion-transmitted toxoplasmosis.
The epidemiological situation regarding blood-borne infections in Sweden is favourable and under very good control. The prevalence of infectious markers in the blood-donor population is low. In 1993 the frequencies of confirmed positive tests were three in 1,000,000 for human immunodeficiency virus type-1 (HIV-1), one in 100,000 for hepatitis B virus (HBV) and three in 100,000 for hepatitis C virus (HCV). The safety of the blood supply is high and relies on strict donor selection, information on risky behaviour, and screening for syphilis, HBV and antibodies to hepatitis B core antigen, HCV, HIV-1, HIV-2 and human T-cell leukaemia virus type I and II (HTLV-I/-II). No donors with syphilis have been identified for many years. Screening for anti-HTLV-I/-II was introduced in February 1994 and no results have been reported yet. Donation is usually not permitted at the first visit, as the risk of transfusion-transmitted infections is greater in first-time donors. The risk of acquiring a transfusion-transmitted infection is low, but still a few cases of HBV and HCV infection occur each year among about 150,000 patients receiving transfusions. As far as we know, HIV infection has not been transmitted by blood components in Sweden since 1985.
Mirabet, Vicente; Álvarez, Manuel; Luis-Hidalgo, Mar; Galán, Juan; Puig, Nieves; Larrea, Luis; Arbona, Cristina
The implementation of nucleic acid testing in donor screening has improved the safety of tissue allografts. Although infectious disease transmission can be considered a rare event, the detection of occult hepatitis B infection remains challenging. The studies concerning this risk are mainly based on testing blood specimens. This work shows the correlation between results of samples obtained from donor blood and the corresponding tissue washing solution. Hepatitis B virus deoxyribonucleic acid was detected both in bone allografts from donors with serological profiles associated to active hepatitis B infection and occult hepatitis B infection. These results suggest that hepatitis B virus seems to concentrate in bone marrow even when a low viral load is present in peripheral blood. Even detection at molecular level is not enough to avoid the risk of hepatitis B virus transmission and a multiparametrical evaluation is required in tissue donor screening. The role of clinicians in recognition and reporting of allograft-associated infections is a major concern for the acquisition of experience to be applied in risk control of disease transmission.
Tagariello, Giuseppe; Di Gaetano, Rosanna; Sartori, Roberto; Zanotto, Daniela; Belvini, Donata; Radossi, Paolo; Risato, Renzo; Roveroni, Giovanni; Salviato, Roberta; Tassinari, Cristina; Toffano, Nunzio
Background It is not rare to observe in blood donors a level of haematocrit (Hct) above or close to the highest normal limit. In the case of blood donors the diagnosis and clinical evaluation of this alteration may be complicated by regular blood donations that can mask an underlying disease such as polycythaemia vera. Recently a single acquired mutation in the Janus kinase 2 gene (JAK2) on chromosome 9 was identified and it was found that the incidence of this mutation was high in patients with polycythaemia vera. Material and Methods From the January 1, 2006 to December 31, 2006 all consecutive donors with a Hct above 50% if males (n=84) and 46% if females (n=19) underwent JAK2 mutation analysis. Seventy-nine donors (59 males and 20 females) whose Hct was normal at their last blood donation were randomly selected and used as controls. Results Among the group of blood donors with a high Hct, we identified one donor who was positive for the JAK2 mutation. This man had a Hct of 50.6% at his last donation, while his average Hct in the preceding year was 51.7%. The prevalence of the JAK2 mutation could be estimated to be 1%, 0.6% or 0.02% in the three different populations considered: donors with a Hct level above the upper limit of normal, all tested donors or the entire donor cohort attending our transfusion service, respectively. Conclusions The present study suggests that apparently healthy subjects with repeatedly high levels of Hct may have the acquired mutation in JAK2. Laboratory screening tests for JAK2 may be offered to blood donors at transfusion services with expertise in molecular genetics. PMID:19503632
... Physician Resources Professions Site Index A-Z Carotid Artery Screening What is carotid artery screening? Who should ... information about carotid artery screening? What is carotid artery screening? Screening examinations are tests performed to find ...
Background Transfusion-transmitted infections are a major problem associated with blood transfusion. The aim of this study was to determine prevalence and trends of HBV, HCV and HIV in blood donors in Argentina. Methods A retrospective study was carried out in blood donors of 27 transfusion centers covering the whole country over a period of eight years (2004-2011). Serologic screening assays for HBsAg, anti-HBc, anti-HCV, and anti-HIV were performed in all centers and nucleic acid amplification testing (NAT) was performed in 2 out of the 27 centers. Results The 2,595,852 samples tested nationwide from 2004 to 2011 showed that the prevalence of HBsAg decreased from 0.336% to 0.198% (p < 0.0001), that of anti-HBc from 2.391% to 2.007% (p < 0.0001), that of anti-HCV from 0.721% to 0.460%, (p < 0.0001) and that of anti-HIV from 0.208% to 0.200 (p = 0.075). The prevalence of HBV, HCV and HIV was unevenly distributed among the different regions of the country. Two out of 74,838 screening- negative samples were positive in NAT assays (1 HIV-RNA and 1 HCV-RNA); moreover, HBV-DNA, HCV-RNA and HIV-RNA were detected in 60.29, 24.54 and 66.67% of screening-positive samples of the corresponding assays. As regards donors age, positive HBV-DNA and HCV-RNA donors were significantly older than healthy donors (46.6, 50.5 and 39.5 y respectively, p < 0.001). Conclusions Argentina has a low prevalence of HBsAg, anti-HCV and anti-HIV in blood donors, with a decreasing trend for HBsAg, anti-HBc and anti-HCV but not for anti-HIV over the last 8 years. The uneven distribution of transfusion-transmitted infections prevalence among the different regions of the country highlights the need to implement regional awareness campaigns and prevention. The discrepancy between samples testing positive for screening assays and negative for NAT assays highlights the problem of blood donors who test repeatedly reactive in screening assays but are not confirmed as positive upon further testing. The
Razdan, Manik; Smith, Kenneth J; Bryce, Cindy L; Degenholtz, Howard B
Transplant medicine's impact on America's public health is seriously limited by acute shortage of transplantable organs. Consequently, the United Sates has witnessed considerable investment in the promotion of organ donor registries. Although there is no evidence to support that donor registry promotion alleviates organ shortage, this belief continues to drive investments into registry promotion. In this study, return on investment in donor registry promotion was examined using cost-outcomes analysis. Cost of promoting the donor registry was estimated in US dollars whereas the outcome was measured as the number of individuals who join the registry (registrants) and their value in terms of organ donors. The study was conducted from the perspective of a regional Organ Procurement Organization (OPO). Costs were directly obtained from the OPO. The number of new registrants was obtained from the OPO and the departments of motor vehicles that maintain the donor registry. The value of registrants in terms of organ donors was computed based on a registrant's age-dependent risk of dying and age-dependent probability of becoming an organ donor. Six thousand seven hundred eight individuals joined the organ donor registry (95% confidence interval [95% CI], 5429-7956) at a cost of $455 per registrant (95% CI, US $383-US $562). These individuals result in 4.2 present-day donors (95% CI, 2.5-6.6) at a cost of US $726 000 (95% CI, US $462000-US $1.2 million). Because the cost per registrant and cost per donor is less than society's willingness to pay, donor registry promotion offers positive return on investment. Investment in registry promotion should at the minimum be maintained at current levels.
Glycosylations of 4,6-tethered glucosazide donors with a panel of model acceptors revealed the effect of acceptor nucleophilicity on the stereoselectivity of these donors. The differences in reactivity among the donors were evaluated in competitive glycosylation reactions, and their relative reactivities were found to be reflected in the stereoselectivity in glycosylations with a set of fluorinated alcohols as well as carbohydrate acceptors. We found that the 2-azido-2-deoxy moiety is more β-directing than its C-2-O-benzyl counterpart, as a consequence of increased destabilization of anomeric charge development by the electron-withdrawing azide. Additional disarming groups further decreased the α-selectivity of the studied donors, whereas substitution of the 4,6-benzylidene acetal with a 4,6-di-tert-butyl silylidene led to a slight increase in α-selectivity. The C-2-dinitropyridone group was also explored as an alternative for the nonparticipating azide group, but this protecting group significantly increased β-selectivity. All studied donors exhibited the same acceptor-dependent selectivity trend, and good α-selectivity could be obtained with the weakest acceptors and most reactive donors. PMID:28401764
Two Australian government inquiries have recently called for the release of information to donor-conceived people about their gamete donors. A national inquiry, recommended 'as a matter of priority' that uniform legislation to be passed nationwide. A state-based inquiry argued that all donor-conceived people should have access to information and called for the enactment of retrospective legislation that would override donor anonymity. This paper responds to an opinion piece published in Human Reproduction in October 2012 by Professor Pennings in which he criticized such recommendations and questioned the motives of people that advocate for information release. I answer the arguments of Pennings, and argue that all parties affected by donor conception should be considered, and a compromise reached. The contact veto system is one such compromise. I discuss the education and support services recommended by the Victorian government and question Pennings' assertions that legislation enabling information release will lead to a decrease in gamete donation. Finally, I rebut Pennings' assertion that there is a 'hidden agenda' behind the call for information release. There is no such agenda in my work. If there is from others, then it is their discriminatory views that need to be addressed, not the move toward openness and honesty or the call for information by donor-conceived people.
Haberal, M; Gulay, H; Tokyay, R; Oner, Z; Enunlu, T; Bilgin, N
From November 3, 1975 to November 3, 1990, 874 kidney transplants were performed at out centers. Of these, 675 (77.2%) were from living donors and 199 (22.8%) were from cadaver donors. Five hundred eighty (66.4%) of the living donors were first degree related while 99 (11.3%) were unrelated or second degree related donors, 29 of which were spouses. All donor recipient pairs were ABO-compatible, with the exception of one pair. Donor recipient relations were wife to husband in 25 cases and husband to wife in 4 cases. All were first grafts and started functioning during surgery. In this series, the follow-up for the recipients was 4 to 64 months (mean 33.5 +/- 4.5 months). One-year patient survival and graft survival rates were 92.4% and 81.9%, respectively. Two-year patient survival and graft survival rates were 92.4% and 78.2%, respectively. The single ABO-incompatible case is also doing well, 21 months postoperatively. This study demonstrates that the interspouse kidney transplantation may be used when cadaver organ shortage is a problem. While providing the couple with a better quality of life, interspouse kidney transplantation also enables the couple to share the joy of giving and receiving the "gift of life" from one another.
Wang, Jingxing; Liu, Jing; Yao, Fuzhu; Wen, Guoxin; Li, Julin; Huang, Yi; Lv, Yunlai; Wen, Xiuqiong; Wright, David; Yu, Qilu; Guo, Nan; Ness, Paul; Shan, Hua
Background There is little data on HIV prevalence, incidence or residual risks for transfusion transmitted HIV infection among Chinese blood donors. Methods Donations from five Chinese blood centers in 2008–2010 were screened using two rounds of ELISA testing for anti-HIV-1/2. A reactive result in either or both rounds led to Western Blot confirmatory testing. HIV prevalence and demographic correlates among first time donors, incidence rate and demographic correlates among repeat donors were examined. Weighted multivariable logistic regression analysis examined correlates of HIV confirmatory status among first time donors. Residual risks for transfusion transmitted HIV infection were evaluated based on incidence among repeat donors. Results Among 821,320 donations, 40% came from repeat donors.1,837 (0.34%) first time and 577 (0.17%) repeat donations screened reactive for anti-HIV-1/2, among which 1,310 and 419 were tested by Western Blot. 233 (17.7%) first time and 44 (10.5%) repeat donations were confirmed positive. Estimated prevalence was 66 infections per 100,000 (95% CI: 59–74) first time donors. Estimated incidence was 9/100,000 (95% CI: 7–12) person-years among repeat donors. Weighted multivariable logistic regression analysis indicate that first time donors 26–45 years old were 1.6–1.8 times likely to be HIV positive than those 25 years and younger. Donors with some college or above education were less likely to be HIV positive than those with middle school education, ORs ranging from 0.35 to 0.60. Minority were 1.6 times likely to be HIV positive than Han majority donors (OR: 1.6; CI: 1.2–2.1). No difference in prevalence was found between gender. Current HIV TTI residual risk was 5.4 (1.2–12.5) infections per million whole blood donations. Conclusion Despite the declining HIV epidemic China, estimated residual risks for transfusion transmitted HIV infection are still high, highlighting the potential blood safety yield of NAT implementation
Keechilot, Cinzia S; Shenoy, Veena; Kumar, Anil; Biswas, Lalitha; Vijayrajratnam, Sukhithasri; Dinesh, Kavitha; Nair, Prem
With the introduction of highly sensitive hepatitis B surface antigen immunoassay, transfusion associated HBV infection have reduced drastically but they still tend to occur due to blood donors with occult hepatitis B infection (OBI) and window period (WP) infection. Sera from, 24338 healthy voluntary blood donors were screened for HBsAg, HIV and HCV antibody using Vitros Enhanced Chemiluminescent Immunoassay. The median age of the donor population was 30 (range 18-54) with male preponderance (98%). All serologically negative samples were screened by nucleic acid testing (NAT) for viral DNA and RNA. NAT-positive samples were subjected to discriminatory NAT for HBV, HCV, and HIV and all samples positive for HBV DNA were tested for anti-HBc, anti-HBs, HBeAg. Viral load was determined using artus HBV RG PCR Kit. Of the 24,338 donors screened, 99.81% (24292/24338) were HBsAg negative of which NAT was positive for HBV DNA in 0.0205% (5/24292) donors. Four NAT positive donors had viral load of <200 IU/ml making them true cases of OBI. One NAT positive donor was negative for all antibodies making it a case of WP infection. Among OBI donors, 75% (3/4) were immune and all were negative for HBeAg. Precise HBV viral load could not be determined in all (5/5) NAT positive donors due to viral loads below the detection limit of the artus HBV RG PCR Kit. The overall incidence of OBI and WP infections was found to be low at 1 in 6503 and 1 in 24214 donations, respectively. More studies are needed to determine the actual burden of WP infections in Indian blood donors.
Garcia, Melissa N; Murray, Kristy O; Hotez, Peter J; Rossmann, Susan N; Gorchakov, Rodion; Ontiveros, Alejandra; Woc-Colburn, Laila; Bottazzi, Maria Elena; Rhodes, Charles E; Ballantyne, Christie M; Aguilar, David
Chagas disease, infection with the parasite Trypanosoma cruzi, has recently been identified as an important emerging parasitic disease in the United States. To describe the cardiac abnormalities in T. cruzi-positive blood donors in southeastern Texas, a pilot study of donors who had screened positive from 2007 to 2012 was performed. This one-time assessment included (1) a questionnaire to evaluate the source of infection, cardiac symptoms, and health co-morbidities; (2) electrocardiography; (3) echocardiography if electrocardiographic findings were abnormal; and (4) measurement of a high-sensitivity troponin T biomarker. Of those with confirmed infection, 41% (7 of 17) had electrocardiographic abnormalities consistent with Chagas cardiomyopathy. In addition, 36% (6 of 17) were suspected to be locally acquired cases. High-sensitivity troponin T serum levels increased with cardiac severity. In conclusion, cardiologists should consider Chagas disease in their differential diagnoses for patients who may have clinically compatible electrocardiographic changes or nonischemic cardiomyopathy, even if the patients have no histories of residing in Chagas-endemic countries. Copyright © 2015 Elsevier Inc. All rights reserved.
Rodionov, Ya. I.; Syzranov, S. V.
We study transport in a Weyl semimetal with donor and acceptor impurities. At sufficiently high temperatures transport is dominated by electron-electron interactions, while the low-temperature resistivity comes from the scattering of quasiparticles on screened impurities. Using the diagrammatic technique, we calculate the conductivity σ (T ,ω ,nA,nD) in the impurities-dominated regime as a function of temperature T , frequency ω , and the concentrations nA and nD of acceptors and donors and discuss the crossover behavior between the regimes of low and high temperatures and impurity concentrations. In a sufficiently compensated material [| nA-nD|≪ (nA+nD) ] with a small effective fine structure constant α ,σ (ω ,T ) ∝T2/(T-2-i ω .const) in a wide interval of temperatures. For very low temperatures, or in the case of an uncompensated material, the transport is effectively metallic. We discuss experimental conditions necessary for realizing each regime.
Tyszka, K.; Moraru, D.; Samanta, A.; Mizuno, T.; Tabe, M.; Jabłoński, R.
We comparatively study donor-induced quantum dots in Si nanoscale-channel transistors for a wide range of doping concentration by analysis of single-electron tunneling transport and surface potential measured by Kelvin probe force microscopy (KPFM). By correlating KPFM observations of donor-induced potential landscapes with simulations based on Thomas-Fermi approximation, it is demonstrated that single-electron tunneling transport at lowest gate voltages (for smallest coverage of screening electrons) is governed most frequently by only one dominant quantum dot, regardless of doping concentration. Doping concentration, however, primarily affects the internal structure of the quantum dot. At low concentrations, individual donors form most of the quantum dots, i.e., “donor-atom” quantum dots. In contrast, at high concentrations above metal-insulator transition, closely placed donors instead of individual donors form more complex quantum dots, i.e., “donor-cluster” quantum dots. The potential depth of these “donor-cluster” quantum dots is significantly reduced by increasing gate voltage (increasing coverage of screening electrons), leading to the occurrence of multiple competing quantum dots.
Tyszka, K.; Moraru, D.; Samanta, A.; Mizuno, T.; Jabłoński, R.; Tabe, M.
We comparatively study donor-induced quantum dots in Si nanoscale-channel transistors for a wide range of doping concentration by analysis of single-electron tunneling transport and surface potential measured by Kelvin probe force microscopy (KPFM). By correlating KPFM observations of donor-induced potential landscapes with simulations based on Thomas-Fermi approximation, it is demonstrated that single-electron tunneling transport at lowest gate voltages (for smallest coverage of screening electrons) is governed most frequently by only one dominant quantum dot, regardless of doping concentration. Doping concentration, however, primarily affects the internal structure of the quantum dot. At low concentrations, individual donors form most of the quantum dots, i.e., "donor-atom" quantum dots. In contrast, at high concentrations above metal-insulator transition, closely placed donors instead of individual donors form more complex quantum dots, i.e., "donor-cluster" quantum dots. The potential depth of these "donor-cluster" quantum dots is significantly reduced by increasing gate voltage (increasing coverage of screening electrons), leading to the occurrence of multiple competing quantum dots.
Erhabor, O; Ejele, O A; Nwauche, C A
This study was undertaken to establish the sero-epidemology of Hepatitis C Virus (HCV) antibodies among blood donors in Port Harcourt, Nigeria. One Thousand Five Hundred consecutive blood donors presenting to the blood transfusion unit of the University of Port Harcourt Teaching Hospital between January and April, 2003 comprising of 1481 males and 19 females were screened for hepatitis C antibodies using the commercially available Clinotech anti-HCV test strips. All initially positive samples were subsequently tested using a second-generation Trinity Biotec enzyme linked immunosorbent assay. HCV antibodies were detected in 7 (0.5%) of donors. Although statistically not significant, the overall sero prevalence of HCV antibodies was higher in males 7 (0.5%) compared to zero prevalence among females. (chi-squared = 1.94, p = 1.000). Commercial remunerated donors had a higher prevalence of anti-HCV anti-bodies 5 (0.8%) compared to family replacement donors (0.2%) (chi-squared = 1.25, p = 0.26). The highest infection rate occurred in the 18 - 27 years age group 7 (0.7%). This study shows a 0.5% prevalence of HCV antibodies among blood donors and describes their demographic characteristics. This calls for urgent implementation of a universal donor screening for HCV antibodies and setting up of a national blood transfusion service run on the basis of voluntary, non-remunerated low risk donors.
Nattrass, Nicoli; Hodes, Rebecca; Cluver, Lucie
Donor financing for HIV prevention and treatment has shifted from supporting disease-specific ("vertical") programs to health systems strengthening ("horizontal") programs intended to integrate all aspects of care. We examine the consequences of shifting resources from three perspectives: first, through a broad analysis of the changing policy context of health care financing; second, through an account of changing priorities for HIV treatment in South Africa; and third, through a description of some clinical consequences that the authors observed in a research study examining adherence to antiretroviral therapy (ART) and sexual health among adolescents. We note that AIDS responses are neither completely vertical nor horizontal but rather increasingly diagonal, as disease-specific protocols operate alongside integrated supply chain management, human resource development, and preventive screening. We conclude that health care programs are better conceived of as networks of policies requiring different degrees of integration into communities.
Wiseman, Alexander C; Wainright, Jennifer L; Sleeman, Elizabeth; McBride, Maureen A; Baker, Tim; Samana, Ciara; Stock, Peter
Donor pancreas utilization rates for whole organ transplant have remained low and have decreased over time. To identify the reasons for nonuse of pancreas from donors who meet common baseline acceptance criteria, we examined Organ Procurement and Transplantation Network data from 2005 to 2007 and identified a subgroup of 1763 "potential pancreas donors" defined by age (19-40 years), body mass index (<30 kg/m), successful liver donation, and negative viral serology testing, which were not used. We characterize this cohort of potential donors including reasons for refusal, factors that may contribute to pancreas acceptance and function, and potential explanations for the lack of growth in pancreas organ utilization.
Ballen, Karen K; King, Roberta J; Chitphakdithai, Pintip; Bolan, Charles D; Agura, Edward; Hartzman, Robert J; Kernan, Nancy A
In the 20 years since the National Marrow Donor Program (NMDP) facilitated the first unrelated donor transplant, the organization has grown to include almost 7 million donors, and has facilitated over 30,000 transplants on 6 continents. This remarkable accomplishment has been facilitated by the efforts of over 600 employees, and an extensive international network including 171 transplant centers, 73 donor centers, 24 cord blood banks, 97 bone marrow collection centers, 91 apheresis centers, 26 HLA typing laboratories, and 26 Cooperative Registries. In this article, we review the history of the NMDP, and cite the major trends in patient demographics, graft sources, and conditioning regimens over the last 20 years.
Treat, Eric G; Miller, Eric T; Kwan, Lorna; Connor, Sarah E; Maliski, Sally L; Hicks, Elisabeth M; Williams, Kristen C; Whitted, Lauren A; Gritsch, Hans A; McGuire, Suzanne M; Mone, Thomas D; Veale, Jeffrey L
The disparity between kidney transplant candidates and donors necessitates innovations to increase organ availability. Transporting kidneys allows for living donors and recipients to undergo surgery with a familiar transplant team, city, friends, and family. The effect of shipping kidneys and prolonged cold ischemia time (CIT) with living donor transplantation outcomes is not clearly known. This retrospective matched (age, gender, race, and year of procedure) cohort study compared allograft outcomes for shipped live donor kidney transplants and nonshipped living donor kidney transplants. Fifty-seven shipped live donor kidneys were transplanted from 31 institutions in 26 cities. The mean shipping distance was 1634 miles (range 123-2811) with mean CIT of 12.1 ± 2.8 h. The incidence of delayed graft function in the shipped cohort was 1.8% (1/57) compared to 0% (0/57) in the nonshipped cohort. The 1-year allograft survival was 98% in both cohorts. There were no significant differences between the mean serum creatinine values or the rates of serum creatinine decline in the immediate postoperative period even after adjusted for gender and differences in recipient and donor BMI. Despite prolonged CITs, outcomes for shipped live donor kidney transplants were similar when compared to matched nonshipped living donor kidney transplants.
Hertz, R.; Nelson, M.K.; Kramer, W.
This study explores the attitudes and experiences of 57 sperm donors who responded to a survey posted online in the United States and indicated that they had had contact with their donor-conceived offspring or the parents of their donor-conceived offspring. On average, 18 years had elapsed since the respondents donated sperm. In the interim between donating and having contact with offspring, most had become curious about their offspring. Most made contact through a bank or online registry. Most respondents had communicated with at least one offspring at least once and most had exchanged photos with offspring. Approximately two-thirds had met in person once; the same proportion had communicated over email or text. Other forms of communication were less common. Almost half of the respondents now considered their donor-conceived offspring to be like a family member. At the same time, donors are respectful of the integrity of the family in which their offspring were raised. Donors with contact are open to having their partners and children know their donor-conceived offspring. Although contact is generally positive, donors report that establishing boundaries and defining the relationship can be very difficult. Some donors also urge those who are thinking of donating to consider the consequences and some suggest avoiding anonymity. There were no significant differences in attitudes and experiences between those who donated anonymously and those who had been identity-release for their offspring when they turned 18. PMID:26175887
Patel, Shaneel Rajendra; Chadha, Priyanka; Papalois, Vassilios
In renal transplant, there is a well-known deficiency in organ supply relative to demand. Live donation provides superior results when compared with deceased donation including a better rate of graft success and fewer immunologic complications. This deficiency in organs leads to significant morbidity and mortality rates. Alternative avenues have been extensively explored that may expand the live donor pool. They include altruistic donation as well as paired and pooled exchange programs. Altruistic donation is a truly selfless act from a donor unknown to the recipient. Kidney paired donation involves 2 incompatible donor-recipient pairs swapping donors to produce compatibility. Pooled donation involves at least 2 pairs, and can take the form of domino chains in which altruistic input sets up a chain of transplants, in which each recipient's incompatible donor makes a donation for the next recipient. Despite application of these various methods, there lie extensive ethical issues surrounding them. Misconceptions frequently occur; for instance, the perceived benefit that donating an organ to a loved one is greater for a related donor than for an altruistic one. Additionally, it is frequently believed that immunologic incompatibility offers coerced donors liberation from surgery, and that overcoming these barriers by introducing exchange programs provides vulnerable donors less protection. This article explores these and other complex ethical issues surrounding the various methods of expanding the donor pool. The authors offer opinions that challenge the ethical issues and attempt to overcome those views that hinder progress in the field.
This book contains three sections: Fundamentals of Screening, Screening Tests, and Screening for Specific Cancer Sites. Each section consists of several chapters. Some of the chapter titles are: Principles of Screening and of the Evaluation of Screening Programs; Economic Aspects of Screening; Cervical Cytology; Screening Tests for Bladder Cancer; Fecal Occult Blood Testing; Screening for Cancer of the Cervix; Screening for Gastric Cancer; and Screening for Oral Cancer.
Chan, H M H; Ho, P L; Chan, K H; Lin, C K; Lee, C K
Nowadays, risk of transfusion-transmitted infection has been substantially minimized by stringent donor eligibility screening and infectious disease testing. However, we report an interdiction of a blood donation containing varicella-zoster virus (VZV) by donor self-reporting of chickenpox. The donor developed varicella infection shortly after blood donation despite vaccination. Varicella-zoster virus DNA was detected in her fresh-frozen plasma before the blood components were issued for clinical transfusion. The report indicates the importance of donors' education and awareness of their obligation to report any symptoms developed shortly after blood donation in order to further secure blood safety. © 2012 The Author(s). Vox Sanguinis © 2012 International Society of Blood Transfusion.
Liao, Qiao; Shan, Zhengang; Wang, Min; Huang, Jieting; Xu, Ru; Huang, Ke; Tang, Xi; Zhang, Weiyun; Nelson, Kenrad; Li, Chengyao; Fu, Yongshui; Rong, Xia
In 2014, an outbreak of dengue virus (DENV) infection led to 45 171 clinical cases diagnosed in Guangdong province, Southern China. However, the potential risk of blood donors asymptomatically infected with DENV has not been evaluated . In the current study we detected anti-DENV IgG antibody and RNA in volunteer Chinese blood donors. We found that anti-DENV IgG antibody was positively detected in 3.4% (51/1500) and two donors were detected as being DENV RNA positive out of 3000 blood samples. We concluded that the presence of potential DENV in blood donors might be potential risk for blood safety. Therefore, screening for DENV infection should be considered in blood donations during a period of dengue outbreak in high epidemic area of China. © 2017 Wiley Periodicals, Inc.
Ramos-Ligonio, Angel; Ramírez-Sánchez, Michaía Elián; González-Hernández, Juan Carlos; Rosales-Encina, José Luis; López-Monteon, Aracely
To estimate the prevalence of antibodies against Trypanosoma cruzi in blood donors from Hospital General Regional (HGRO) of the Mexican Institute of Social Security (IMSS per its abbreviation in Spanish). Between October 2001 and January 2002, blood samples were collected from voluntary donors at the blood bank of the Hospital General Regional of IMSS in Orizaba; Veracruz, Mexico. The samples were assayed for anti-T. cruzi by ELISA, Western blot and IFI, using a recombinant protein (MBP::Hsp70), and crude extract from epimastigotes. A total of 420 blood donors were studied; two of them were seropositive for ELISA,Western blot and IFI, with a seroprevalence of 0.48%. Some blood donors at the HGRO hospital were seropositive for T. cruzi, showing the risk of contamination by blood transfusion. Routine serologic screening with highly sensitive and specific immunological techniques are needed.
Groer, Maureen; Duffy, Allyson; Morse, Shannon; Kane, Bradley; Zaritt, Judy; Roberts, Shari; Ashmeade, Terri
Background There has been a recent increase in availability of banked donor milk for feeding of preterm infants. This milk is pooled from donations to milk banks from carefully screened lactating women. The milk is then pasteurized by the Holder method to remove all microbes. The processed milk is frozen, banked, and sold to neonatal intensive care units (NICUs). The nutrient bioavailability of banked donor milk has been described, but little is known about preservation of immune components such as cytokines, chemokines, and growth factors (CCGF). Objective The objective was to compare CCGF in banked donor milk with mother's own milk (MOM). Methods Aliquots (0.5 mL) were collected daily from MOM pumped by 45 mothers of NICU-admitted infants weighing < 1500 grams at birth. All daily aliquots of each mother's milk were pooled each week during 6 weeks of an infant's NICU stay or for as long as the mother provided MOM. The weekly pooled milk was measured for a panel of CCGF through multiplexing using magnetic beads and a MAGPIX instrument. Banked donor milk samples (n = 25) were handled and measured in the same way as MOM. Results Multiplex analysis revealed that there were levels of CCGF in banked donor milk samples comparable to values obtained from MOM after 6 weeks of lactation. Conclusion These data suggest that many important CCGF are not destroyed by Holder pasteurization. PMID:24663954
Gaillard, François; Baron, Stéphanie; Timsit, Marc-Olivier; Eladari, Dominique; Fournier, Catherine; Prot-Bertoye, Caroline; Bertocchio, Jean-Philippe; Lamhaut, Lionel; Friedlander, Gérard; Méjean, Arnaud; Legendre, Christophe; Courbebaisse, Marie
Two end-stage renal disease (ESRD) risk calculators were recently developed by Grams et al., and Ibrahim et al. to calculate ESRD risk before donation among living kidney donors. However, those calculators have never been studied among potential donors for whom donation was refused due to medical contraindications and compared to a group of donors. We compared 15-year and lifetime ESRD risk of donors and nondonors due to medical cause as estimated by those two calculators. Nondonors due to medical cause (n = 27) had a significantly higher 15-year ESRD risk compared to donors (n = 288) with both calculators (0.25 vs. 0.14, P < 0.001 for that developed by Grams et al. and 2.21 vs. 1.43, P = 0.002 for that developed by Ibrahim et al.). On the contrary, lifetime ESRD risk was not significantly different between the two groups. At both times (15 years and lifetime), we observed a significant overlap of ESRD risk between the two groups. ESRD risk calculators could be complementary to standard screening strategy but cannot be used alone to accept or decline donation.
Ravelingien, A; Provoost, V; Wyverkens, E; Buysse, A; De Sutter, P; Pennings, G
In this qualitative study, we explore how lesbian recipients view and experience the selection of their anonymous sperm donor. The study was conducted in Belgium, where fertility centres follow a legal protocol that severely restricts personal choice in donor selection. While previous studies have shown that recipients want greater control and input in the selection of their sperm donor, this was not a main concern for most women in the present study. They generally acknowledged their lack of control on the selection outcome and accepted this as part and parcel of an anonymous donation policy that provides an opportunity to have a child. They actively and passively downplayed initial concerns about the donor selection procedure and felt they did not have or need a right to further control over the donor selection. In adopting this 'subordinate' position, they felt they should trust the hospital, which they hoped would fulfil rather high screening standards. Those who did want more choice were nuanced and careful about their motivations: they focused on selecting traits that would facilitate normal child development or increase family coherence. The findings shed light on how these patients perceive their position in this third-party reproduction setting.
Usman, M.; Hill, C. D.; Rahman, R.; Klimeck, G.; Simmons, M. Y.; Rogge, S.; Hollenberg, L. C. L.
Control of hyperfine interactions is a fundamental requirement for quantum computing architecture schemes based on shallow donors in silicon. However, at present, there is lacking an atomistic approach including critical effects of central-cell corrections and nonstatic screening of the donor potential capable of describing the hyperfine interaction in the presence of both strain and electric fields in realistically sized devices. We establish and apply a theoretical framework, based on atomistic tight-binding theory, to quantitatively determine the strain and electric-field-dependent hyperfine couplings of donors. Our method is scalable to millions of atoms, and yet captures the strain effects with an accuracy level of DFT method. Excellent agreement with the available experimental data sets allow reliable investigation of the design space of multiqubit architectures, based on both strain only as well as hybrid (strain + field) control of qubits. The benefits of strain are uncovered by demonstrating that a hybrid control of qubits based on (001) compressive strain and in-plane (100 or 010) fields results in higher gate fidelities and or faster gate operations, for all of the four donor species considered (P, As, Sb, and Bi). The comparison between different donor species in strained environments further highlights the trends of hyperfine shifts, providing predictions where no experimental data exists. While faster gate operations are realizable with in-plane fields for P, As, and Sb donors, only for the Bi donor, our calculations predict faster gate response in the presence of both in-plane and out-of-plane fields, truly benefiting from the proposed planar field control mechanism of the hyperfine interactions.
Hearing levels are threatened by modern life--headsets for music, rock concerts, traffic noises, etc. It is crucial we know our hearing levels so that we can draw attention to potential problems. This exercise requires that students receive a hearing screening for their benefit as well as for making the connection of hearing to listening.
Hearing levels are threatened by modern life--headsets for music, rock concerts, traffic noises, etc. It is crucial we know our hearing levels so that we can draw attention to potential problems. This exercise requires that students receive a hearing screening for their benefit as well as for making the connection of hearing to listening.
Sugimoto, Seiichiro; Yamane, Masaomi; Miyoshi, Kentaroh; Kurosaki, Takeshi; Otani, Shinji; Miyoshi, Shinichiro; Oto, Takahiro
In cadaveric lung transplantation (LTx), a donor lung with an inadequate donor left atrial cuff is considered a "surgically marginal donor lung". The donor pericardium is commonly applied to reconstruct the inadequate donor left atrial cuff; however, in some cases, the donor pericardium is inadvertently removed during the lung procurement. We devised an alternative technique for reconstruction to overcome the absence of pericardium in a donor lung with an inadequate atrial cuff, using a patch of the donor pulmonary artery (PA) in single lung transplantation. In a recent case of lung transplantation in which the donor pericardium had been removed, we harvested a segment of the right PA distal to the main PA of the donor and used a PA patch to repair the inadequate donor left atrial cuff. No vascular complications were encountered in the recipient, who remains in good health after the transplantation.
Maghsudlu, Mahtab; Safabakhsh, Hamidreza; Jamili, Parastoo
Background and Objectives: Human T-cell lymphotropic virus type-I (HTLV-I) infection is considered as a public health challenge in endemic areas. The virus is associated with severe diseases, such as adult T-cell leukemia/lymphoma, and HTLV-I-associated myelopathy/tropical spastic paraparesis. One of the major routes of the HTLV-I transmission includes blood transfusion. Sabzevar is located in the endemic region of HTLV-I infection. The aim of the present study was to determine the seroprevalence of HTLV-I infection in the blood donors in Sabzevar. Materials and Methods: A total of 35,067 blood donors in Sabzevar from March 2009 to April 2012 who were screened with HTLV-I on the enzyme-linked immunosorbent assay screening test were included in this survey. Reactive samples that confirmed by western blot were considered to be seropositive cases. The required data were obtained from blood donors’ database of blood transfusion service. Results: The overall prevalence of HTLV-1 based on the positive result of western blot test was 0.14%. The seropositive donors aged 17–59 years with a mean age of 38.10 ± 11.82. The prevalence rates of HTLV-I infection in 3 years of study were 0.19%, 0.14%, and 0.09%, respectively. A significant relation between age, sex, educational level, and history of blood donation was observed with seropositivity of HTLV-I. Conclusion: The improvement of donor selection and laboratory screening caused a decline in the prevalence of infection in blood donors. Given the lower prevalence of infection in regular donors with lower age and higher educational level, more efforts should be done to attract blood donors from these populations. PMID:26420946
Background To resolve the current shortage of donor hearts, we established the Adonhers protocol. An upward shift of the donor age cut-off limit (from the present 55 to 65 years) is acceptable if a stress echo screening on the candidate donor heart is normal. This study aimed to verify feasibility of a "second opinion" of digitally transferred images of stress echo results to minimize technical variability in selection of aged donor hearts for heart transplant. Methods The informatics infrastructure was created for a core lab reading with a second opinion from the Pisa stress echo lab. To test the system, simulation standard stress echo cineloops were sent digitally from 5 peripheral labs to the central core lab. Starting January 2009, real marginal donor stress echos were sent via internet to the central core echo lab, Pisa, for a second opinion before heart transplant. Results In the simulation protocol, 30 dipyridamole stress echocardiograms were sent from the five peripheral echo labs to the central core lab in Pisa. Both the echo images and reports were correctly uploaded in the web system and sent to the core echo lab; the second opinion evaluation was obtained in all cases (100% feasibility). In the transplant protocol, eight donor cases were sent to the Pisa core lab for the second opinion protocol, and six of them were transplanted in marginal recipients. Conclusions Second-Opinion Stress Tele-Echocardiography can effectively be performed in a network aimed to safely expand the heart donor pool for heart transplant. PMID:20515476
Franchi, Daniele; Cini, Davide; Arpesella, Giorgio; Gherardi, Sonia; Calamai, Italo; Barletta, Giuseppe; Valente, Serafina; Pasanisi, Emilio; Sansoni, Stefania; Ricci, Caterina; Serra, Walter; Picano, Eugenio; Bombardini, Tonino
To resolve the current shortage of donor hearts, we established the Adonhers protocol. An upward shift of the donor age cut-off limit (from the present 55 to 65 years) is acceptable if a stress echo screening on the candidate donor heart is normal. This study aimed to verify feasibility of a "second opinion" of digitally transferred images of stress echo results to minimize technical variability in selection of aged donor hearts for heart transplant. The informatics infrastructure was created for a core lab reading with a second opinion from the Pisa stress echo lab. To test the system, simulation standard stress echo cineloops were sent digitally from 5 peripheral labs to the central core lab.Starting January 2009, real marginal donor stress echos were sent via internet to the central core echo lab, Pisa, for a second opinion before heart transplant. In the simulation protocol, 30 dipyridamole stress echocardiograms were sent from the five peripheral echo labs to the central core lab in Pisa. Both the echo images and reports were correctly uploaded in the web system and sent to the core echo lab; the second opinion evaluation was obtained in all cases (100% feasibility). In the transplant protocol, eight donor cases were sent to the Pisa core lab for the second opinion protocol, and six of them were transplanted in marginal recipients. Second-Opinion Stress Tele-Echocardiography can effectively be performed in a network aimed to safely expand the heart donor pool for heart transplant.
Juhl, David; Knobloch, Johannes K-M; Görg, Siegfried; Hennig, Holger
Testing for antibodies against hepatitis B core antigen (anti-HBc) was introduced to detect blood donors suffering from occult hepatitis B infection. Confirmation of specification of reactive results in the anti-HBc screening assay is still a challenge for blood donation services. Two different test strategies for confirmation of specification of reactive anti-HBc tests, one performed in our institute and one suggested by the German authority (Paul-Ehrlich-Institut (PEI)), were compared. The first strategy is based on one supplemental anti-HBc test, the other requires two supplemental anti-HBc tests. 389 samples from 242 donors were considered. Both test strategies yielded concordant results in 117 reactive samples termed 'true-positive' or 'specificity confirmed', in 156 reactive samples termed 'false-positive' or 'specificity not confirmed', and in 99 negative samples. In 17 samples obtained from 11 donors, both test strategies gave discrepant results ('false-positive' but 'specificity confirmed'). In 10 of 11 donors, a real HBV infection was very unlikely, one remained unclear. 30 donors considered 'false-positive' became negative in all anti-HBc tests after follow-up testing and thus eligible for donor re-entry. The test strategy suggested by the PEI yielded no additional information but induced an overestimation of HBV infections and unnecessary look-back procedures. Many anti-HBc-reactive donors can be regained after follow-up testing.
Dauar, Eloísa Tedeschi; Patavino, Giuseppina Maria; Mendrone Júnior, Alfredo; Gualandro, Sandra Fátima Menosi; Sabino, Ester Cerdeira; de Almeida-Neto, Cesar
Objective Deferral of blood donors due to low hematocrit and iron depletion is commonly reported in blood banks worldwide. This study evaluated the risk factors for low hematocrit and iron depletion among prospective blood donors in a large Brazilian blood center. Method A case–control study of 400 deferred donors due to low hematocrit and 456 eligible whole blood donors was conducted between 2009 and 2011. Participants were interviewed about selected risk factors for anemia, and additional laboratory tests, including serum ferritin, were performed. Bivariate and multivariate analyses were performed to assess the association between predictors and deferral due to low hematocrit in the studied population and iron depletion in women. Results Donors taking aspirins or iron supplementation, those who reported stomachache, black tarry stools or hematochezia, and women having more than one menstrual period/month were more likely to be deferred. Risk factors for iron depletion were repeat donation and being deferred at the hematocrit screening. Smoking and lack of menstruation were protective against iron depletion. Conclusion This study found some unusual risk factors related to gastrointestinal losses that were associated with deferral of donors due to low hematocrit. Knowledge of the risk factors can help blood banks design algorithms to improve donor notification and referral. PMID:26408364
Umolu, Patience Idia; Okoror, Lawrence Ehis; Orhue, Philip
Human Immunodeficiency Virus and Hepatitis B virus are blood borne pathogens that can be transmitted through blood transfusion and could pose a huge problem in areas where mechanisms of ensuring blood safety are suspect. This study became necessary in a population where most of the blood for transfusion is from commercial blood donors. A total of 130 donors comprising 120 commercial donors and 10 voluntary donors were tested for antibodies to human immunodeficiency virus and hepatitis B surface antigen in Benin city using Immunocomb HIV - 1 and 2 Biospot kit and Quimica Clinica Aplicada direct latex agglutination method respectively. Thirteen (10%) samples were HIV seropositive and 7(5.8%) were HBsAg positive. The age bracket 18 - 25years had the highest numbers of donors and also had the highest number of HBsAg positive cases (7.8%) while the age group 29 - 38years had highest number of HIV seropositive cases. High prevalence of HIV antibodies and Hepatitis B surface antigen was found among commercial blood donors. Appropriate and compulsory screening of blood donors using sensitive methods, must be ensured to prevent post transfusion hepatitis and HIV.
Anderlini, P; Przepiorka, D; Körbling, M; Champlin, R
Allogeneic transplantation of rhG-CSF-mobilized peripheral blood stem cells (PBSCs) is now being increasingly performed, but safety considerations for hematologically normal PBSC donors have not been fully addressed. Experience in this area is rapidly accumulating, however, and on the basis of currently available data, a consensus is gradually emerging on several issues: (1) rhG-CSF treatment and PBSC collection seem to have an acceptable short-term safety profile in normal donors. There is a need for continued safety monitoring, however. (2) rhG-CSF doses up to 10 microg/kg/day show a consistent dose-response relationship with the mobilization (and collection) of CD34+ progenitor cells, and this dose is acceptable for routine clinical use. Whether higher doses are superior (or cost-effective) remains to be determined, and they may produce more severe side-effects. The potential risks of marked leukocytosis (arbitrarily defined as a leukocyte count of more than 70 x 10(9)/l) have been a concern, and rhG-CSF dose reduction is performed by many centers to maintain leukocyte counts below this level. (3) Transient post-donation cytopenias, involving granulocytes, lymphocytes and platelets, may occur and are at least partly related to the leukapheresis procedure. These are generally asymptomatic and self-limited; follow-up blood counts are not necessarily required. Reinfusion of autologous platelet-rich plasma should be considered for donors with expected post-donation thrombocytopenia (platelet count <80-100 x 10(9)/l). (4) Donors should meet the eligibility criteria which apply to donors of apheresis platelets, with the exception that pediatric (as well as elderly) donors may also be considered. There is insufficient information at this time to clearly establish definite contraindications for PBSC collection in a hematologically normal donor. Potential contraindications include the presence of inflammatory, autoimmune or rheumatologic disorders, as well as
... CERTAIN OTHER ACTS ADMINISTERED BY THE FOOD AND DRUG ADMINISTRATION HUMAN CELLS, TISSUES, AND CELLULAR AND... donor screening or testing under §§ 1271.75, 1271.80 and 1271.85 for: (1) Cells and tissues for autologous use; or (2) Reproductive cells or tissue donated by a sexually intimate partner of the...
... Reduce the Risk of Transmission of Hepatitis B Virus; Availability AGENCY: Food and Drug Administration... Transmission of Hepatitis B Virus,'' dated October 2012. The guidance document provides recommendations on the use of FDA- licensed nucleic acid tests (NAT) to screen blood donors for hepatitis B virus (HBV...
Background An adequate, safe supply of blood and blood components is a crucial part of blood transfusion services. Blood donors with reactive screening test results are informed of their results by letter and telephone call, and are requested to come for counselling either at the blood centre or the integrated counselling and testing centre. Many notified donors either do not respond at all or do not follow up their first visit to the blood bank. This study was undertaken to determine the response of voluntary blood donors after notification of their reactive status by telephone call or letter. Material and methods We considered reactive donations during a 2-year period (January 2010 to December 2011). Blood donors with reactive test results were notified and their response rates were evaluated at various levels. Results During the study period, 416 donors (0.87%) were found to be reactive for different markers. Of these 416 reactive donors, 249 (59.8%) responded positively to the notification calls and attended counselling. The response rate was highest among donors reactive for hepatitis B virus (HBV) (154/225 i.e. 68.4%). After their first visit, around 6% donors could not be contacted further and were lost to follow up. Fifty donors (22.3%) did not continue their treatment and two (both reported to be HBV reactive) were subsequently found to be negative. Therefore, at 6 months of follow-up, only 182 donors (43.7%) were continuing/had completed their treatment. Discussion The response rate of reactive blood donors in developing countries is quite low. These results suggest insufficient health care knowledge and a poor understanding of screening tests. PMID:24599905
Quiroga, Juan A; Avellón, Ana; Bartolomé, Javier; Andréu, María; Flores, Elena; González, María I; González, Rocío; Pérez, Sonia; Richart, Luis A; Castillo, Inmaculada; Alcover, Javier; Palacios, Ricardo; Carreño, Vicente; Echevarría, José M
Blood transfusion safety is based on reliable donor screening for transmissible infections such as the hepatitis C virus (HCV) infection. A novel HCV core-specific antibody was assayed on random single donations from 2007 first-time blood donors who tested negative for anti-HCV and HCV RNA on routine screening. Sample collection broke the code between donations and donors for ethical reasons. Forty-two donations (2.1%) displayed reactivity in the novel test. The specificity of the reactivity was evaluated by a peptide inhibition assay, and testing against additional nonoverlapping HCV core peptide epitopes and other HCV antigens was performed on these samples. Six donations (14.3%; 0.30% from the total) were considered to contain anti-HCV after such supplemental testing. HCV RNA detection was also performed in peripheral blood mononuclear cells (PBMNCs) and serum or plasma samples from reactive donors after virus concentration by ultracentrifugation. HCV RNA tested negative in all PBMNCs samples, and a very low amount of viral genome was detected in serum or plasma concentrates from three anti-HCV core-reactive donors (7.1%) but not among concentrates from 100 randomly selected nonreactive donors. Sequencing of these polymerase chain reaction products revealed differences between the isolates that excluded partially sample contamination from a common source. These findings argue in favor of an ongoing occult HCV infection among these blood donors and account for some rather low, but perhaps not negligible, infection risk for such donations. Future studies involving larger samples of donations from traceable donors would enlighten the significance of these findings for the viral safety of the blood supply. © 2016 AABB.
Smythe, Claire; White, Nicola; Winter, Joyleen; Cowie, Anne
Femoral head donation at the time of hip replacement surgery provides a much needed resource of bone allograft to orthopaedic surgeons. Prior to 2005, potential femoral head donors were identified and consented in the hospital setting on the day of surgery. This resulted in over 40 % of donations failing post operatively suggesting that more effort could be given to pre-operative screening resulting in substantial savings in the cost associated with collection and testing of donors who were subsequently failed. The Donor Liaison role was implemented in 2005 to coordinate a Femoral Head Donation program maximising the number of successful donations through pre-operative screening. This study reviews the effectiveness of pre-operative screening of potential femoral head donors at PlusLife from 2002-2012. A retrospective audit of the database was undertaken 2002-2012 and medical/social reasons for pre-operative and postoperative failures were collated into 4 main categories to enable comparison: malignancy, autoimmune conditions, variant Creutzfeldt Jakob disease risk and general medical/social reasons. The number of femoral heads failed post operatively has decreased significantly from 26 % in 2003 to 6 % in 2012. A cost of $121,000 was expended on femoral heads failed post operatively in 2004, as compared to $20,350 in 2012. Donors excluded due to the 4 main categories (medical/social history) were identified pre-operatively in over 80 % of all cases. Preoperative screening of femoral head donors through a coordinated Femoral Head Donation Program is a safe and cost effective method.
Walter, Merlin N.M.; Kohli, Nupur; Khan, Neelam; Major, Triin; Fuller, Heidi; Wright, Karina T.; Kuiper, Jan-Herman; Johnson, William E.B.
Mesenchymal stem cells (MSCs) stimulate angiogenesis within a wound environment and this effect is mediated through paracrine interactions with the endothelial cells present. Here we report that human MSC-conditioned medium (n=3 donors) significantly increased EaHy-926 endothelial cell adhesion and cell migration, but that this stimulatory effect was markedly donor-dependent. MALDI-TOF/TOF mass spectrometry demonstrated that whilst collagen type I and fibronectin were secreted by all of the MSC cultures, the small leucine rich proteoglycan, decorin was secreted only by the MSC culture that was least effective upon EaHy-926 cells. These individual extracellular matrix components were then tested as culture substrata. EaHy-926 cell adherence was greatest on fibronectin-coated surfaces with least adherence on decorin-coated surfaces. Scratch wound assays were used to examine cell migration. EaHy-926 cell scratch wound closure was quickest on substrates of fibronectin and slowest on decorin. However, EaHy-926 cell migration was stimulated by the addition of MSC-conditioned medium irrespective of the types of culture substrates. These data suggest that whilst the MSC secretome may generally be considered angiogenic, the composition of the secretome is variable and this variation probably contributes to donor-donor differences in activity. Hence, screening and optimizing MSC secretomes will improve the clinical effectiveness of pro-angiogenic MSC-based therapies. PMID:26195891
Lenaers, Jo; Christiaans, Maarten; van Heurn, Ernst; van Hooff, Hans; van den Berg-Loonen, Ella
Donor-directed antibodies (DDA) can be formed in recipients after transplantation. There is not much known about their appearance in relation to the time after transplantation, nor the duration between transplantation and failure. DDA formation was retrospectively analyzed in patients transplanted between 1992 and 2004. Thirty-two nonimmunized first transplant recipients with transplantectomy within 4 weeks (median 6 days) were analyzed. Posttransplant sera were screened for HLA class I and II by flow cytometry (FC), ELISA, and cytotoxicity. All patients except one were treated with CNI (calcineurin inhibitor)-based immunosuppression. Analysis was performed on the basis of FC results. In total, 16 of 32 patients became positive for DDA class I and/or II (50%). All antibodies were detected after transplantectomy. Class I and II antibodies were produced in 15 and 10 recipients, respectively. Multivariate regression analysis showed DDA positivity to be predicted by donor age (P=0.05). DDA were shown in patients who lost their graft due to immunological reasons but in a comparable percentage also in patients with nonimmunological graft loss. DDA after early transplantectomy appeared frequently but later than expected. In view of the growing number of marginal donors and the possible necessity of retransplantation, it is considered important to prolong the time of serum sampling and screening to at least 4 months. Immunization might escape attention when serum screening is restarted only from the time the patient is again referred to the waiting list.
Lee, Myeong H; Dunietz, Barry D; Geva, Eitan
Charge transfer (CT) states formed at the donor/acceptor heterointerface are key for photocurrent generation in organic photovoltaics (OPV). Our calculations show that interfacial donor-to-donor CT states in the phthalocyanine-fullerene OPV system may be more stable than donor-to-acceptor CT states and that they may rapidly recombine, thereby constituting a potentially critical and thus far overlooked loss mechanism. Our results provide new insight into processes that may compete with charge separation, and suggest that the efficiency for charge separation may be improved by destabilizing donor-to-donor CT states or decoupling them from other states.
Cobo, Ana; Remohí, José; Chang, Ching-Chien; Nagy, Zsolt Peter
Oocyte donation is an efficient alternative to using own oocytes in IVF treatment for different indications. Unfortunately, 'traditional' (fresh) egg donations are challenged with inefficiency, difficulties of synchronization, very long waiting periods and lack of quarantine measures. Given the recent improvements in the efficiency of oocyte cryopreservation, it is reasonable to examine if egg donation through oocyte cryopreservation has merits. The objective of the current manuscript is to review existing literature on this topic and to report on the most recent outcomes from two established donor cryobank centres. Reports on egg donation using slow freezing are scarce and though results are encouraging, outcomes are not yet comparable to a fresh egg donation treatment. Vitrification on the other hand appears to provide high survival rates (90%) of donor oocytes and comparable fertilization, embryo development, implantation and pregnancy rates to traditional (fresh) egg donation. Besides the excellent outcomes, the ease of use for both donors and recipients, higher efficiency, lower cost and avoiding the problem of synchronization are all features associated with the benefit of a donor egg cryobank and makes it likely that this approach becomes the future standard of care. Oocyte donation is one of the last resorts in IVF treatment for couples challenged with infertility problems. However, traditional (fresh) egg donation, as it is performed today, is not very efficient, as typically all eggs from one donor are given to only one recipient, it is arduous as it requires an excellent synchronization between the donor and recipient and there are months or years of waiting time. Because of the development of an efficient oocyte cryopreservation technique, it is now possible to cryo-store donor (as well as non-donor) eggs, maintaining their viability and allowing their use whenever there is demand. Therefore, creating a donor oocyte cryobank would carry many advantages
Chaudhary, Rajendra; Das, Sudipta Sekhar; Khetan, Dheeraj; Sinha, Pratul
The quality of single donor platelets (SDPs) in terms of yield influences platelet recovery in the recipient. Various donor factors such as pre-donation platelet count and hemoglobin (Hb) concentration affect the platelet yield. We studied the influence of pre-donation donor clinical and laboratory factors such as gender, age, weight of the donor, platelet count and Hb on the platelet yield. A total of 94 plateletpheresis procedures performed on continuous flow cell separator (CS3000, Baxter Healthcare, Round Lake, IL, USA) were evaluated for platelet yield. A relationship between pre-donation donor variables and yield of platelets was studied using the Pearson correlation. The mean platelet yield was 2.8+/-0.73x10(11). While a direct relationship was observed between pre-donation platelet count and yield (r=0.50, p<0.001), no such correlation was noticed with donor Hb concentration (r=-0.10, p>0.005). Similarly, no correlation was observed between gender (r=0.05), age (r=0.11) and weight (r=0.18) of the donor with yield. Optimization of platelet yield, which is influenced by pre-donation platelet count, is an emerging issue in blood transfusion services. Identification of such factors may help in selecting donors to obtain higher platelet yields and consequently better clinical outcome.
While assisted reproductive treatment using donated gametes is widespread, and in many places, widely accepted, it has historically been shrouded in secrecy. Over time, however, there has been an increasing call from donor-conceived people, recipient parents and some donors to end the secrecy, and to release identifying information about donors to donor-conceived people. "Rights-based" arguments have at times been used to justify this call. This article examines whether a human rights framework supports the release of information and how such a framework might be applied when there are competing rights. It argues that the current balancing approach used to resolve such issues weighs in favour of release. Legal action has the potential to be legitimate and justifiable. A measure such as a contact veto system, which would serve to prevent unwanted contact with the person lodging the veto (either the donor or the donor-conceived person), would ensure proportionality. In this way, both donor-conceived people's rights to private life, identity and family, and donors' rights to privacy may be recognised and balanced.
Kher, Ajay; Rodrigue, James; Ajaimy, Maria; Wasilewski, Marcy; Ladin, Keren; Mandelbrot, Didier
Background Currently, many transplantation centers do not follow former living kidney donors on a long-term basis. Several potential barriers have been identified to provide this follow-up of former living kidney donors, including concerns that donor insurance will not reimburse transplantation centers or primary care physicians for this care. Here, we report the rates at which different insurance companies reimbursed our transplantation center for follow-up visits of living donors. Methods We collected data on all yearly follow-up visits of living donors billed from January 1, 2007, to December 31, 2010, representing 82 different donors. Concurrent visits of their recipients were available for 47 recipients and were used as a control group. Results We find that most bills for follow-up visits of living kidney donors were paid by insurance companies, at a rate similar to the reimbursement for recipient follow-up care. Conclusions Our findings suggest that, for former donors with insurance, inadequate reimbursement should not be a barrier in providing follow-up care. PMID:23060280
Kher, Ajay; Rodrigue, James; Ajaimy, Maria; Wasilewski, Marcy; Ladin, Keren; Mandelbrot, Didier
Currently, many transplantation centers do not follow former living kidney donors on a long-term basis. Several potential barriers have been identified to provide this follow-up of former living kidney donors, including concerns that donor insurance will not reimburse transplantation centers or primary care physicians for this care. Here, we report the rates at which different insurance companies reimbursed our transplantation center for follow-up visits of living donors. We collected data on all yearly follow-up visits of living donors billed from January 1, 2007, to December 31, 2010, representing 82 different donors. Concurrent visits of their recipients were available for 47 recipients and were used as a control group. We find that most bills for follow-up visits of living kidney donors were paid by insurance companies, at a rate similar to the reimbursement for recipient follow-up care. Our findings suggest that, for former donors with insurance, inadequate reimbursement should not be a barrier in providing follow-up care.
The background to this article is the medical regulation of sperm donation in the UK and the recent policy change so that children born from sperm, eggs or embryos donated after April 2005 have the right to know their donor's identity. I draw upon data from interviews with ten women and seven joint interviews with couples who received donor insemination from an anonymous sperm donor and were the parents of donor insemination children. I explore the symbolic presence of the donor and his potential to disrupt social and physical boundaries using the theoretical conceptions of boundaries and pollution as articulated by Mary Douglas and Julia Kristeva. I present data to argue that the anonymous donor manifests in various figures; the shadowy and ambiguous figure of 'another man'; the intelligent medical student; the donor as a family man, with children of his own who wants to help infertile men father children. In addition participants perceive the donor's physical characteristics, but also see their husband's physical characteristics, in their children. In conclusion I argue that anonymisation preserves features of conventional family life, maintains the idea of exclusivity within the heterosexual relationship and affirms the legal father's insecurity about his infertility.
Clark, Ewan R; Borys, Andryj M; Pearce, Kyle
Paradoxically, N- and O-donor substituted tri-arylphosphanes are shown to be weaker donors than PPh3 when binding the soft Lewis acid moiety [PPh2](+). This arises from internal solvation and rehybridisation at phosphorus, precluding chelation and increasing steric demand, in direct contrast to coordination modes observed for metal complexes.
Walter, Marc; Bronner, Ekkehard; Steinmüller, Thomas; Klapp, Burghard F; Danzer, Gerhard
In view of the scarcity of organ resources for transplantation, donation by living donors is assuming greater significance now that the technical-surgical problems involved have been solved. In the period between December 1999 and December 2000, 47 potential living liver donors were evaluated and a total of 27 hepatic lobes were transplanted at the Virchow-Klinikum of the Charité Hospital in Berlin. The close personal relationships between recipients and donors gives reason to anticipate high levels of psychosocial pressure during the pre-operative evaluation process; this process consists in part in looking into donor motivation, ambivalence and anxiety. The pre-operative psychometric evaluation of 40 potential living donors indicated that most of the potential donors see themselves as 'super-healthy' and tend to adapt to social expectations, while on the other hand those seven potential living donors not accepted for psychosocial reasons were marked by heightened values for anxious depression and pessimism. The results indicate in most cases a great willingness to donate and on the other hand a high level of obvious psychological pressure for a low number of potential donors. For the latter, both the clinical evaluation interview and the psychometric diagnostics used revealed clear-cut feelings of anxiety and ambivalence towards transplantation.
Goldberg, David S.; French, Benjamin; Abt, Peter L; Olthoff, Kim; Shaked, Abraham
The deceased-donor organ supply in the U.S. has not been able to keep pace with the increasing demand for liver transplantation. We examined national OPTN/UNOS data from 2002–2012 to assess whether LDLT has surpassed deceased donor liver transplantation (DDLT) as a superior method of transplantation, and used donor and recipient characteristics to develop a risk score to optimize donor and recipient selection for LDLT. From 2002–2012, there were 2,103 LDLTs and 46,674 DDLTs that met the inclusion criteria. The unadjusted 3-year graft survival for DDLTs was 75.5% (95% CI: 75.1–76.0%) compared with 78.9% (95% CI: 76.9–80.8%; p<0.001) for LDLTs that were performed at experienced centers (>15 LDLTs), with substantial improvement in LDLT graft survival over time. In multivariable models, LDLT recipients transplanted at experienced centers with either autoimmune hepatitis or cholestatic liver disease had significantly lower risks of graft failure (HR: 0.56, 95% CI: 0.37–0.84 and HR: 0.76, 95% CI: 0.63–0.92, respectively). An LDLT risk score that included both donor and recipient variables facilitated stratification of LDLT recipients into high, intermediate, and low-risk groups, with predicted 3-year graft survival ranging from >87% in the lowest risk group to <74% in the highest risk group. Current post-transplant outcomes for LDLT are equivalent, if not superior to DDLT when performed at experienced centers. An LDLT risk score can be used to optimize LDLT outcomes and provides objective selection criteria for donor selection in LDLT. PMID:25042283
Rabii, R; Joual, A; Fekak, H; Moufid, K; el Mrini, M; Benjelloun, S; Khaleq, K; Idali, B; Harti, A; Barrou, L; Fatihi, M; Benghanem, M; Hachim, J; Ramdani, B; Zaid, D
Renal transplantation from a living donor is now considered the best treatment for chronic renal failure. We reviewed the operative complications in 38 living related donor nephrectomies performed at our institution over the past 14 years. The mean age of our donors was 30 years old with age range between 18 and 58 years old and female predominance (55.2%). These swabs were realized by a posterolateral lumbar lombotomy with resection of the 11 third. The left kidney was removed in 34 donors (90%), surgical complications were noted in 39.4% of the cases: one case of wound of inferior vena cava (2.6%), one case of release of the renal artery clamp (2.6%), four cases of pleural grap (10.5%), one case of pneumothorax (2.6%), one case of pleurisy (2.6%), three cases of urinary infection (7.8%), three cases of parietal infection (7.8%) and one case of patient pain at the level of the wound (2.6%). There were no mortalities. We conclude that the morbidity of living donor nephrectomy is negligible compared with the advantages for the recipient.
Palacios, J M
The purpose of this study was to evaluate organ donation in Chile following the creation of the "Corporación Nacional de Fomento de Trasplantes." The corporation was created in 1991 as a private, nonprofit organization whose main purpose was to increase the number of actual donors and multiorgan procurement. The organization is independent of the national government and acts as a link between the needs of patients and society and those of the National Ministry of Health. Following the creation of the corporation, the number of actual donors increased from 32 to 98. The number of potential donors increased 3-fold. Family refusal for organ donation was between 28% and 53.4%. Pediatric and marginal donors increased from 2% to 15%. Ninety-five percent of the donors came from Santiago, where 33% of the population lives and most of the efforts were concentrated. The corporation is working to increase organ donation throughout the rest of the country by organizing public campaigns; promoting knowledge about transplantation among medical and nursing personnel at hospitals, schools, universities, and social gatherings; evaluating technical and financial results; and helping with the processes of organ procurement.
Hanson, F A
One concern regarding developments in genetics is that, when techniques such as genetic engineering become safe and affordable, people will use them for positive eugenics: to "improve" their offspring by enpowering them with exceptional qualities. Another is whether new reproductive technologies are being used to improve the condition of women or as the tools of a patriarchal system that appropriates female functions to itself and exploits women to further its own ends. Donor insemination is relevant to both of these issues. The degree to which people have used donor insemination in the past for positive eugenic purposes may give some insight into the likelihood of developing technologies being so used in the future. Donor insemination provides women with the opportunity to reproduce with only the most remote involvement of a man. To what degree do women take advantage of this to liberate themselves from male dominance? Through questionnaires and interviews, women who have used donor insemination disclosed their criteria for selecting sperm donors. The results are analyzed for the prevalence of positive eugenic criteria in the selection process and women's attitudes toward minimizing the male role in reproduction.
The Visi Screen OSS-C, marketed by Vision Research Corporation, incorporates image processing technology originally developed by Marshall Space Flight Center. Its advantage in eye screening is speed. Because it requires no response from a subject, it can be used to detect eye problems in very young children. An electronic flash from a 35 millimeter camera sends light into a child's eyes, which is reflected back to the camera lens. The photorefractor then analyzes the retinal reflexes generated and produces an image of the child's eyes, which enables a trained observer to identify any defects. The device is used by pediatricians, day care centers and civic organizations that concentrate on children with special needs.
Matter, Yasser Elsayed; Nagib, Ayman M; Lotfy, Omar E; Alsayed, Ahmed Maher; Donia, Ahmed F; Refaie, Ayman F; Akl, Ahmed I; Abbas, Mohamed Hamed; Abuelmagd, Mohammed M; Shaeashaa, Hussein A; Shokeir, Ahmed A
Background Renal transplantation is the ideal method for management of end-stage renal disease. The use of living donors for renal transplantation was critical for early development in the field and preceded the use of cadaveric donors. Most donors are related genetically to the recipients, like a parent, a child, or a sibling of the recipient, but there are an increasing percentage of cases where donors are genetically unrelated like spouses, friends, or altruistic individuals. Donor shortages constitute the major barrier for kidney transplantation, and much effort has been made to increase the supply of living donors. The impact of donor source on the outcome of renal transplantation is not adequately studied in our country. Objectives The aim of the study was to evaluate the impact of donor source on the outcome of live donor kidney transplantation. Patients and Methods From March 1976 to December 2013, the number of patients that underwent living renal transplantation sharing at least one HLA haplotype with their donors was 2,485. We divided these patients into two groups: (1) 2,075 kidney transplant recipients (1,554 or 74.9% male and 521 or 25.1% female) for whom the donors were living related, (2) 410 kidney transplant recipients (297 or 72.4% male and 113 or 27.6% female) for whom the donors were living unrelated. All patients received immunosuppressive therapy, consisting of a calcineurin inhibitor, mycophenolate mofetil, or azathioprine and prednisolone. We compared acute rejection and complication rates, as well as long-term graft and patient survival of both groups. Demographic characteristics were compared using the chi-square test. Graft survival and patient survival were calculated using the Kaplan-Meier method. Results The percentages of patients with acute vascular rejection were significantly higher in the unrelated group, while percentages of patients with no rejection were significantly higher in the related group, but there were no significant
Objective To determine whether graft survival over a 5-year follow-up period using corneal tissue from donors older than 65 years of age is similar to graft survival using corneas from younger donors. Design Multi-center prospective, double-masked, controlled clinical trial Participants 1090 subjects undergoing corneal transplantation for a moderate risk condition (principally Fuchs’ dystrophy or pseudophakic corneal edema); 11 subjects with ineligible diagnoses were not included Methods 43 participating eye banks provided corneas from donors in the age range of 12 to 75 with endothelial cell densities of 2300 to 3300 cells/mm2, using a random approach without respect to recipient factors. The 105 participating surgeons at 80 sites were masked to information about the donor cornea including donor age. Surgery and post-operative care were performed according to the surgeons’ usual routines. Subjects were followed for five years. Main Outcome Measures Graft failure, defined as a regraft or a cloudy cornea that was sufficiently opaque as to compromise vision for a minimum of three consecutive months. Results The 5-year cumulative probability of graft survival was 86% in both the <66.0 donor age group and the ≥66.0 donor age group (difference = 0%, upper limit of one-sided 95% confidence interval = 4%). In a statistical model with donor age as a continuous variable, there was not a significant relationship between donor age and outcome (P=0.11). Three graft failures were due to primary donor failure, 8 to uncorrectable refractive error, 48 to graft rejection, 46 to endothelial decompensation (23 of which had a prior, resolved episode of probable or definite graft rejection), and 30 to other causes. The distribution of the causes of graft failure did not differ between donor age groups. Conclusions Five-year graft survival for cornea transplants at moderate risk for failure is similar using corneas from donors ≥ 66.0 years and donors < 66.0 years. Surgeons and
Nyame, Yaw A.; Babbar, Paurush; Aboumohamed, Ahmed A.; Mori, Ryan L.; Flechner, Stuart M.; Modlin, Charles S.
Renal transplantation has profound improvements in mortality, morbidity, and overall quality of life compared to renal replacement therapy. This report aims to illustrate the use of ex-vivo partial nephrectomy in a patient with a renal angiomyolipoma prior to living donor transplantation. The surgical outcomes of the donor nephrectomy and recipient transplantation are reported with 2 years of follow-up. Both the donor and recipient are healthy and without any significant comorbidities. In conclusion, urologic techniques such as partial nephrectomy can be used to expand the living donor pool in carefully selected and well informed transplant recipients. Our experience demonstrated a safe and positive outcome for both the recipient and donor, and is consistent with other reported outcomes in the literature. PMID:28216945
Rosenthal, R J
There is a kind of transitional phenomenon found among certain borderline patients which is quite distinct from Winnicott's transitional object. These are patients who are preoccupied with maintaining proper physical distance from their objects, in order to regulate anxieties about isolation on the one hand, and identity-annihilating closeness on the other. Since they believe the activity of looking to be intrusive and devouring, hence dangerous, transparent screens are interposed between self and other, and serve as protective barriers. These screens function intrapsychically as well, to split off or hide those aspects of the self felt to be unacceptable. The analyst may witness the failure of the screen in several ways: it may create too great a distance, isolating the individual and keeping him from life; it may become contaminated by projections and turn into a persecutor, or trap the individual, a state of intolerable claustrophobia; most dramatically, it may suddenly shatter. The latter is associated with psychosis and death, and its appearance may be a harbinger of suicide.
Skillern, Amanda A; Cedars, Marcelle I; Huddleston, Heather G
To assess oocyte donors' comprehension of the process and potential risks of oocyte donation using the EDICT (Egg Donor Informed Consent Tool). Prospective cohort study. University-based, tertiary reproductive health practice. Prospective oocyte donors. Donors (N = 65) participated in an audiovisual informational session, and met with a reproductive endocrinologist individually. Donors then completed the Subjective EDICT and Objective EDICT. We report scores on Subjective and Objective EDICT, scores stratified for demographic variables, relationship between Subjective and Objective EDICT scores, and the effect of counseling on scores. In general, our cohort of oocyte donors performed well on both objective and subjective portions of the EDICT. We verified the effect of counseling on EDICT scores by comparing before and after counseling scores and demonstrating significant gains. There was no significant correlation between Subjective and Objective EDICT scores. For the first time, we report oocyte donors' comprehension of oocyte donation as assessed by the EDICT. Reassuringly, we demonstrate that oocyte donors have adequate subjective and objective comprehension of the process and risks associated with oocyte donation. We also demonstrate that oocyte donor comprehension is significantly impacted by physician counseling efforts. In addition, scores on perceived understanding (Subjective EDICT) did not predict scores on performance-based comprehension (Objective EDICT). The lack of correlation between the two scores further underscores the utility of a performance-based tool, as relying on a donor's self-report (e.g., simply signing a consent form to indicate understanding) may not reflect her actual understanding. Copyright © 2014 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.
Zhang, Ya-min; Zhu, Zhi-jun; Jiang, Wen-tao; Cai, Jin-zhen; Hou, Jian-cun; Wei, Lin; Zhang, Hai-ming; Wang, Jin-shan; Shen, Zhong-yang
To evaluate the living donor selection, donor hepatectomy technique, and surgical complication in living donor liver transplantation. From June 2007 to July 2008, 74 consecutive cases living donor hepatectomy were performed by the same surgical team. Seventy-four donors (64 males and 10 females) with a mean age of 29.2 years old passed the donor liver assessment and evaluation program successfully. The hepatectomy procedure types contained right liver resection (n = 72), of which 27 cases harvested the middle hepatic vein and 45 cases not, left liver resection contain middle hepatic vein (n = 1) and left lateral resection (n = 1). Of all the donors, operation time was (6.5 +/- 6.2) hours, the mean blood loss was 300 ml (100 - 500 ml) and didn't accept foreign blood transfusion. The maximum alanine aminotransferase (ALT) level was (229.5 +/- 108.6) U/L, the ALT returned to normal time was (12.7 +/- 4.8) d, the maximum total bilirubin (TB) level was (78.7 +/- 44.3) micromol/L, the TB returned to normal time was (8.8 +/- 2.7) d, and the mean hospital stay time was 14 days (7 - 28 d). The complications included bile leak (n = 1), cut surface hemorrhage (n = 1) and anaphylactoid purpura (n = 1). All the donors returned to normal work and life finally. Precisely evaluating donor blood vascular and biliary anatomy before operation, keeping the blood vascular and bile duct integrity during operation and monitoring complication to solve it immediately after operation is crucial to ensure donor safety and recovering successfully.
Leiby, David A; Nguyen, Megan L; Proctor, Melanie C; Townsend, Rebecca L; Stramer, Susan L
Trypanosoma cruzi is endemic to the Americas where it demonstrates multiple lineages over a vast geographic range (i.e., United States to Argentina). These lineages possess divergent geographic and biologic characteristics, including variations in disease manifestations. Herein, we report the frequency of parasitemia among seropositive US blood donors and the potential association between parasite lineage and transfusion transmission. Blood donors identified as T. cruzi seropositive during screening were enrolled in follow-up studies, including hemoculture testing and a risk factor questionnaire. Positive hemocultures were expanded to obtain sufficient parasites for molecular lineage determination and analysis. Country of birth, obtained from the questionnaire, was used to predict parasite lineage in the absence of demonstrable parasitemia for infected donors. Eighteen (6.8%) of 263 seropositive donors were hemoculture positive. Among the 17 hemocultures expanded for lineage determination, TcV was identified more frequently (n = 12), compared to TcI (n = 2), TcII (n = 1), and TcVI (n = 2). When presumptive parasite lineages were compared to hemoculture results, only two of 157 (1.3%) TcI versus 13 of 38 (34.2%) TcII/TcV/TcVI non-US donors were parasitemic; three of 44 (6.8%) US donors were TcV or TcVI. Based on lineage determination for donors with parasitemia; hemoculture positivity associated with presumptive parasite lineage; and implicated donors from US, Canadian, and Spanish transfusion cases, donors from Southern South America are significantly more likely to have parasitemia and transmit infection to blood recipients (TcII, TcV, or TcVI vs. TcI). Thus, parasite lineage may be associated with risk of transfusion-transmitted T. cruzi. © 2017 AABB.
Wu, En-Haw; Wojciechowski, David; Chandran, Sindhu; Yeh, Benjamin M; Park, Meyeon; Westphalen, Antonio; Wang, Zhen J
We assessed the prevalence of abdominal aortic calcification (AAC) in older living kidney donors and its effect on recipient eGFR and graft histology. A total of 292 consecutive living pairs with donor age ≥50 from 2003 to 2013 were identified (mean age 56; range 50-78; F/M: 1.8). Donor AAC was determined by prenephrectomy unenhanced CT. Recipient eGFR and spot urine protein: creatinine ratios (UPCRs) were recorded. A total of 180 recipients had 6-month protocol biopsies. AAC was present in 40.7% of donors, and they were older (58.6 versus 54.7 years old, P < 0.0001) and more likely to be male (77.6% vs. 37.3%, P = 0.004). There was no significant difference in eGFR or spot UPCR up to 36 months in recipients of allografts from donors with versus without AAC. At 6-month biopsy, there was a higher percentage of allografts with vascular fibrous intimal thickening and arteriolar hyaline thickening from donors with versus without AAC (vascular fibrous intimal thickening: 38.8% vs. 7.1% and arteriolar hyaline thickening: 35.8% vs. 7.1%; P < 0.001 for both). The presence of donor AAC predicts the presence of vascular disease [vascular fibrous intimal thickening (OR: 7.2; CI:2.9-17.9) and arteriolar hyaline thickening (OR:5.7; CI:2.3-14.1)] in allografts at 6 months. Donor AAC is predictive of renal vascular disease and may help to improve the screening of potential donors and inform post-transplant management.
Nicholas, M K; Tyler, J P
The first 50 men recruited to an artificial insemination by donor (AID) programme have been assessed for their attitudes and characteristics using a basic questionnaire and a standard well evaluated personality inventory. The results have shown that donors can be characterized as stable and moderately extroverted people who come from a wide range of occupations. Their marital and parental status had no particular relationship to their desire to donate and most of them volunteered for altruistic reasons, financial remuneration being a poor inducement. Most subjects lived within the close environs of the Westmead Centre and preferred to donate during normal working hours. The inconvenience of donating appeared to be the most important factor in considering new approaches to recruiting semen donors.
Ozkan, Omer; Akar, Munire Erman; Erdogan, Okan; Ozkan, Ozlenen; Hadimioglu, Necmiye
To demonstrate the technique for uterus retrieval and transplantation from a multiorgan donor. Video presentation of our case report. The video uses animation to demonstrate the technique. Institutional Review Board (IRB) approval was obtained. University hospital. A 21-year-old woman with complete müllerian agenesis. Uterus allotransplantation has been performed from a deceased donor. Acquirement of cyclic menstrual function. This video demonstrates the technique for uterus retrieval, perfusion, and transplantation. The recipient patient has been monitored regularly for vascular flow, immunosuppression, and infection control since the operation. Uterus transplantation requires extensive evaluation of the recipient and donor by an experienced multidisciplinary transplantation team both pre- and postoperatively. It has major risks related to surgery, immunosuppression, and pregnancy. Uterus transplantation might be considered promising only after the birth of a near-term healthy baby. Copyright © 2013 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.
Giani, Tommaso; Conte, Viola; Mandalà, Salvatore; D'Andrea, Marco Maria; Luzzaro, Francesco; Conaldi, Pier Giulio; Grossi, Paolo; Rossolini, Gian Maria
We describe two cases of bacteremic infections caused by a multidrug-resistant Klebsiella pneumoniae isolate producing the OXA-48 carbapenemase that occurred in two solid organ transplant (liver and kidney) recipients, which was apparently transmitted with the allografts. This finding underscores the risk of donor-derived infections by multidrug-resistant Gram-negative pathogens in solid organ transplant recipients and emphasizes the need for rapid screening of organ donors for carriage of similar pathogens.
Pallavi, P; Ganesh, C K; Jayashree, K; Manjunath, G V
Blood is life. Transfusion of blood and blood components, as a specialized modality of patient management saves millions of lives worldwide each year and reduce morbidity. It is well known that blood transfusion is associated with a large number of complications, some are only trivial and others are potentially life threatening, demanding for meticulous pretransfusion testing and screening particularly for transfusion transmissible infections (TTI). These TTI are a threat to blood safety. The priority objective of BTS is thus to ensure safety, adequacy, accessibility and efficiency of blood supply at all levels. The objective of the present study was to assess the prevalence and trend of transfusion transmitted infections (TTI) among voluntary and replacement donors in the Department of Blood bank and transfusion Medicine of JSS College Hospital, a teaching hospital of Mysore during the period from 2004 to 2008. A retrospective review of donors record covering the period between 2004 and 2008 at the blood bank, JSS Hospital, Mysore was carried out. All samples were screened for HIV, HBsAg, HCV, syphilis and malaria. Of the 39,060, 25,303 (64.78%) were voluntary donors and the remaining 13,757 (35.22%) were replacement donors. The overall prevalence of HIV, HbsAg, HCV and syphilis were 0.44, 1.27, 0.23 and 0.28%, respectively. No blood donor tested showed positivity for malarial parasite. Majority were voluntary donors with male preponderance. In all the markers tested there was increased prevalence of TTI among the replacement donors as compared to voluntary donors. With the implementation of strict donor criteria and use of sensitive screening tests, it may be possible to reduce the incidence of TTI in the Indian scenario.
Mück, Leonie Anna; Timoshkin, Alexey Y; von Hopffgarten, Moritz; Frenking, Gernot
Donor-acceptor (DA) complexes of noble gases (Ng) of the general type A <-- Ng <-- D (A = Lewis acid, D = Lewis base) have been theoretically studied using ab initio an