فصلنامه خون
سال پانزدهم شماره 3 (پیاپی 61، پاییز 1397)

  Preoperative anemia has been reported as a risk factor for poor clinical outcomes in various types of surgery. We surveyed the frequency of preoperative anemia as well as its relationship with transfusion requirements in patients undergoing elective cardiac surgeries in Rajaie Cardiovascular Hospital.

In this descriptive study, 181 adult patients scheduled for elective cardiac surgery at Rajaei cardiovascular medical center were included in a descriptive study between November 2015 and July 2016. Frequency of anemic patients was determined. The frequency of transfusion attempts was compared between anemic and non-anemic patients. The data were analyzed by SPSS 22, t-test, Perason test & c2 test.

Out of the total number of 181 enrolled patients, 54 (29.8%) of patients were anemic before surgery. Anemia was mild in 33 (61%), moderate in 14 (26%), and severe in 7 (13%) of anemic patients. Transfusion frequency was 77.8% in anemic patients and significantly higher than 39% in non-anemic patients (p < 0.001).

Our data showed that preoperative anemia has considerable frequency in patients undergoing elective cardiac surgery. It is associated with higher perioperative transfusion attempts. To prevent inappropriate transfusion, the anemic patients should be identified for anemia correction before surgery.

Transfusion is the most prevalent approach in surgery. Cardiac surgery is one of the most blood consuming operations. High transfusion trigger is indicative of inappropriate PRBC usage. Therefore, we decided to evaluate PRBC usage and transfusion triggers in cardiac surgery in a hospital in Kurdistan province.

In this descriptive study, files of all patients having undergone cardiac surgery during 1394 were studied. Information regarding preoperative Hb, transfusion trigger, units of transfused PRBC and related wards in which transfusion had been taken place was extracted. SPSS 16 Chicago, T-student and one way ANOVA, and χ2 exams were respectively used for data analysis, the mean difference, and ratio comparison.

Among 105 patients, 37 (35.2%) women and 68 (64.8%) men, with the mean age of 62 ± 10.7, 77 received at least one blood product. Meanwhile, 70 (66.6%) patients received PRBC in at least one stage of their postoperative hospitalization. Mean transfusion trigger was obtained to be 11.7 ± 1.9 (11.4 and 12.1 in women and men, respectively). Women generally showed lower Hb levels (p = 0.025) , although this did not prove to be statistically significant in peri- operative PRBC transfusion rate. Mean PRBC usage in operating room, ICU and postoperative wards were 1.00 ± 1.22 , 1.26 ± 1.70, and 0.17 ± 0.52, respectively.

The results revealed that the mean transfusion rates and triggers in our study are higher compared with similar studies. Serious revision in adopting appropriate transfusion triggers and managing transfusion cases is absolutely essential.

  The blood transfusion organization of Iran, based on international requirements, for the protection of blood donors and recipients, has established some criteria for the selection of donors. This manner inevitably rejects a number of donors from blood donations. This process leads to the promotion of blood safety, but at the same time it loses some donors and reduces the likelihood of a donor's return. This study intends to determine the rate of return of blood donors who have temporarily rejected from blood donation and to compare it with the rate of return of donors without any previous blood donation.

This study is a cross-sectional descriptive and data collection is performed based on the entire blood donation data registered in the donor information program of the IBTO. The data were analyzed by Excel & c2 test.

A temporary rejection for blood donation in donors during the period from 2012 to the end of 2014 has reduced their return compared with those who did not have any rejection from 61.9% to 43.6%. For those who have been rejected from blood donations due to high-risk behaviors (421428 donated), the return rate was slightly down to 27.4% (115550 donors).

The result of this study showed that the rate of return of rejected donors was 1.5 times less than the return rate of accepted donors, and this difference was much lower for donors who were rejected due to high-risk behaviors: 1.8 times less.

The most common type of reaction in blood donors is vasovagal reactions (VVRs). VVRs can negatively affect donor retention. The aim of this study was to assess the frequency of VVRs in Kurdistan Blood Center and impact of VVRs on donor return rates.

A descriptive cross-sectional study was conducted on the donors referring to Blood Center of Kurdistan province in 2015. In addition, donors who had VVRs were evaluated for return donation within 12 months. Results were analyzed by SPSS 16 software and Pearson's correlation was applied for analysis.

A total of 25891 blood donors were enrolled. Of the total number of donors, 170 (0.65%) experienced VVRs (157 male and 13 female); of these, 164 (95.9%) developed mild reaction, 3 (1.8%) had moderate, and 4 (2.4%) developed severe reaction. The mean age of female and male donors who experienced VVRs was 31.4 and 30.73 years, respectively. First-time donors (1.2%) had greater possibility to have a reaction. Donors with hemoglobin less than 15 gr/dl were significantly associated with VVR (p=0.004). The correlation of the body weight with VVR was significant (p=0.008). The return rate within 1 year was 18% (32/170) among donors with VVRs.

The results showed that the frequency of vasovagal reactions is higher in men with a greater weight loss than the minimum defined for blood donation

  Iranian Blood Transfusion Organization as a leading and thriving organization with a scientific look at the organization's culture should enable managers to decrease the gap between the status quo and the desirable situation through identifying the employees' perceptions and expectations, prioritizing the issues, and comparing the working groups.

This descriptive cross-sectional study was carried out in blood centers of three provinces of Khorasan in 2015; to gather information, a 60-question questionnaire and a census sampling method were used. Further, to analyze the data, descriptive (frequency distribution, mean, standard deviation) and inferential (independent T-test, Anova, Tukey, Pearson coefficient) statistics were used based on demographic variables using SPSS and Excel softwares.

After gathering the information of community including 78 women and 146 men, it was found that the blood centers of the three provinces of Khorasan had a moderate and strong organizational culture with a score of 198.93. In addition, the mission had the highest impact among different dimensions of organizational culture with the score of 50.31. However, it needs to be improved in “customer orientation” and “capacity development” indices.

Studies show that the staff are well acquainted with the vision and strategic intentions. Hence, more trust and value should be given to the group and teamwork. In addition, with regard to the customer orientation index score, the ability of employees should be increased through holding retraining courses. And the decision makers should create an atmosphere for staff motivation, customer appreciation, and capacity development.

  Thalassemia syndromes are hereditary disorders of alpha and beta globin band. Nowadays with appropriate treatment for this group of patients, their survival rate has significantly increased. But it has led to new complications like pulmonary hypertension that were not possible events to experience before. This study investigates the frequency of pulmonary arterial hypertension among patients with beta thalassemia.

In this descriptive study, pulmonary hypertension was evaluated by echocardiography among 50 patients with beta thalassemia who referred to our Sanandaj University Hospital, Besat during 1393-1394. Demographic and Echocardiographic findings besides lab tests were evaluated and compared between subgroups.

Among 50 participants, 8% had pulmonary hypertension. In subgroups, pulmonary hypertension was found in 15.4% of children, 5.4% of adults, 8.2% of patients with high ferritin, 11.5% of patients with thrombocytosis, and 8.2% of patients who had splenectomy.

Frequency of pulmonary hypertension among our patients is less than previously published studies with higher rate among children. Also the present study showed thrombocytosis and splenectomy as associating factors among thalassemia patients with pulmonary hypertension

Drug resistance is one of the main challenges in the treatment of chronic myeloid leukemia (CML). In this study, with the aim of inducing apoptosis in K562 cell line (CML), this cell line was co-cultured with rat bone marrow mesenchymal stem cells (rBMSCs). Then, the rate of apoptosis as well as cell surface markers expression of CD33 and CD34 in the K562 cells line was evaluated.

In this experimental study, after isolating rBMSCs, the multilineag differentiation capacity of rBMSCs as well as the mesenchymal stemness of these cells was identified by evaluation of CD90, CD105, CD45, and CD56 cell surface. Then, the K562 cells were subjected for evaluation of CD33 and CD34 cell surface markers and apoptosis using a flow cytometry technique.

Immunophenotyping of the cells indicated positive expression of CD90 and CD105 and negative expression of CD45 and CD56. The expression of CD33 and CD34 cell markers in the K562 cell line was increased 45.2% and 76.5%, respectively. Also, induction of apoptosis in the K562 cell line significantly increased (56.6%) compared to the control (p < 0.05).

Briefly, this study showed that the co-culturing of the K562 cells line with rBMSCs causes significant increase in the expression of CD33 and CD34 cell surface markers as well as induction of apoptosis in the K562 cells (p < 0.05). This effect can be through the secreted factors and cytokines of rBMSCs; however, better evaluation in terms of type of cytokines is recommended in the future studies

Chronic Myeloid Leukemia (CML) is a clonal disorder of the hematopoietic stem cell caused by the BCR-ABL receptor tyrosinkinase. The tumour suppressor gene of P16 plays the key role in the cell cycle control. The inactivation of this gene is associated with tumorgenesis, pathogenesis and progression of leukemia. The aim of this study was to evaluate the expression of P16 gene in patients with chronic myeloid leukemia for the identification of the gene expression changes so that the role of the gene in diagnosis and treatment of the disease could be determined. In this descriptive study, the expression of P16 gene in 40 CML patients in chronic phase and 8 healthy subjects as the control all in Payvand Medical Laboratory was examined by Real Time PCR technique. Results were analyzed using the Relative Expression Software Tool (REST2009).

P16 gene expression was significantly down-regulated in 32 patients (p ≤ 0.05), and up-regulated in 8 patients (p ≤ 0.05) compared to the control group.

In conclusion, downregulation or upregulation of P16 may be of importance in the biology of CML.Other studies are also required to elucidate the exact function of this tumor suppressor in cancer