فصلنامه خون
سال هفدهم شماره 3 (پیاپی 69، پاییز 1399)

The FUT3 gene regulates the expression of Lewis blood group antigens mainly Lea and Leb. The Lewis negative phenotype, is the result of an inactivated FUT3 enzyme that lacks glycosidase activity. Several single nucleotide polymorphisms (SNPs) may cause enzyme inactivation with different racial distribution. This study aimed to determine the frequency of these SNPs in Iranian blood donors.

In this cross sectional descriptive study, one hundred blood donors from Tehran Blood Transfusion Center were analyzed. Genomic DNA was extracted and the coding sequence of FUT3 gene was amplified with specific primers. PCR products were directly sequenced. Haplotypes were inferred by SNP Analyzer software.

A total of 15 SNPs including 10 nonsense SNPs were recognized. The frequency of most common SNPs was detected as 39%(202T>C), 37%(314C>T), 20%(59T>G), 9%(508G>A), and 8%(47G>C). Haplotype analysis revealed 13 haplotypes. The frequency of major haplotypes was detected as 66.2%(Le), 17.5%(le202,314), 4.3 %(le47,202,314), 4.1 %(le59), and 3.4%(le59,508).

Conclusions :

Our findings indicate that 202T > C, 59T > G and 508G > A are useful as major SNPs for detection of Lewis-negative alleles in genotyping of Lewis blood groups; they can also play an effective role in large-scale studies associated with diseases in our population.

Administering unnecessary blood can cause many complications in patients and add to medical costs. This study aimed to evaluate blood consumption pattern and its relation with causes of mortality in Geneal ICU Ward of Besat Educational Medical Center of Hamadan in 2018-2019.

This cross-sectional study was performed retrospectively in 2018-2019 on all eligible patients. A checklist was developed to collect demographic and clinical data. Finally, the data were analyzed by Kruskal-Wallis Test, Spearmanchr('39')s Correlation Coefficient, Chi-square Test, Mann-Whitney U by SPSS version 22.

227 patients including 130 (57.3%) males and 97 females (42.7%) with the mean age of 39.02 ± 12.83 years were studied. The mean blood unit administered to each patient was 1.68 ± 1.02 and the mean hospital stay period was 8.43 ± 6.03 days. 19.4% of the patients died and the most common cause of death (8.4%) was attributed to brain and nervous system diseases/ damages. The most common type of blood products used was packed red blood cells (70%). The most common indication for blood prescription was surgery (75.3%) followed by bleeding (7.5%). There was a direct and significant relationship between the numberblood units and final outcome of the disease (p < 0.001).

Since the most common type of administered blood products was packed RBCs and there was a direct relationship between the number of prescribed blood units and the incidence of death, it is recommended to avoid unnecessary administration of packed RBCs.

Lack of knowledge in health care providers may lead to an increased risk and associated complications of blood transfusion. In pediatric nursing care, clinical conditions requiring transfusion are highly urgent. Therefore, assessment of knowledge and clinical decision-making was performed to ensure clinical competency of nursing students.

This cross-sectional study was performed on 110 nursing students in 2020 by convenience sampling. Data collection was done through a researcher-made questionnaire that was made valid and reliable. The questionnaire included questions about personal characteristics, and those addressing knowledge level and clinical decision-making competence of students. The data was analyzed by SPSS 16 software (p<0.05).

The majority of students (97.3%) were under 25 years old, and 55.5% were women. The mean percentage of studentschr('39') total scores in knowledge areas regarding the use of blood transfusion in pediatric nursing was 50.57 ± 23.06. Moreover, the mean score of clinical decision making competence was 31.33 ± 20.18. There was a significant direct relationship between studentschr('39') knowledge scores and clinical decision-making scores (r = 0.49, p < 0.001). There was a significant relationship between students’ knowledge and clinical decision-making and some factors including studentchr('39')s occupation, history of transfusion on a family member, and experience of caring for a blood recipient during the apprenticeship periods.

Conclusions :

As nursing students lack a sufficient level of knowledge and ability of clinical decision-making, further training courses emphasizing clinical-competency-based educational practices in the field of blood transfusion medicine to improve the patient health are required.

Human T-cell lymphotropic virus type I (HTLV-I) has been associated with two diseases in humans such as adult T-cell leukemia/lymphoma (ATLL) and HTLV-associated myelopathy/tropical spastic Para paresis (HAM/TSP). About 5 to 10 million people are infected with HTLV-1 worldwide. In order to improve the blood safety and to prevent false positive results in blood donors, methods for identifying infectious agents need to be highly sensitive and specific. The purpose of this study was to compare the electrochemical luminescence, western blotting, and PCR assays to confirm HTLV-1 virus.

This exprimental study was carried out in 2018 on 66 samples (62 males and 4 females) which had antibody against HTLV-1 virus.  All retested samples with the same ELISA kit were examined by electrochemical luminescence and western blotting. For virus detection by PCR method, blood donors were recalled for new samples. After DNA extraction, nested PCR was performed with primers in both TAX and LTR regions.

In this study 8 (%12/1) samples from 66 samples were reacted with ELISA test. Also 4 (%6) samples had antibody against HTLV-1 by electrochemiluminescence test. Finally, four samples were confirmed by Western blotting and Nested PCR.

Conclusions :

The use of the electrochemical luminescence, western blotting and PCR assays, which had similar results in this study, is suitable for detection and confirmation of HTLV-1 virus.

Considering with the variability in the rate of blood and blood consumption in different medical centers, study of the transfusion practices in hospitals can affect the policies and planning related to the transfusion management. The aim of this study was to evaluate the transfusion practices in Rajaie cardiovascular hospital.

In this cross sectional study, we collected data from 399 adult patients underwent cardiac surgery at Ri cardiovascular medical center from February to July 2018 .The number of reserved and transfused units of blood components, frequency of transfused patients, and the frequency of blood components consumption were recorded. The frequency of transfused patients and number of blood components consumed were compared considering with the type of surgery. The data were analyzed by one way ANOVA and chi-square tests.

71% (282) of patients received at least one unit of blood product. 65% (259) of patients received RBC, 21% (83) FFP and 18% (71) received platelet. Of the 749 reserved RBC units, 256 units (34%) were transfused. 25% of patients had preoperative anemia. The mean trigger of hemoglobin for transfusion was 10.3 ± 3.1 g/dL. Comparison of the frequency of transfused patients as well as mean number of blood components did not show significant difference considering with the type of surgery.

Considering with the high rate of transfusion in this center, following a restrictive threshold of hemoglobin according to the blood transfusion guidelines as well as implementation of a preoperative anemia management guideline and MSBOS is recommended.

To encourage women to embark on blood donation, the opinions and factors that impede blood donation should be identified. The purpose of this study was to investigate factors affecting participation of women in blood donation.

In this cross-sectional study, the questionnaires were completed by 250 female staff of Tabriz University of Medical Sciences. Data were analyzed using Pearson correlation, one-way ANOVA and regression analysis.

93.6% of people claimed blood donation is a humanitarian act, and 81.2% claimed "anemia" is barrier of blood donation. Regression analysis showed that there was a negative and significant relationship between knowledge and motivating factors that have impact on blood donation (p= 0.003), but barriers score did not show a significant correlation with women participation (p= 0.515). Based on the results of independent T-test, the relationship of marital status was not significant as compared with the knowledge  score (p = 0.834),  with  the  barriers score (p= 0.434), and with that of motivating factors (p = 0.615). Education level has not significantly correlated with the knowledge score (p = 0.510) but there was a significant negative correlation with barriers variable in blood donation (p = 0.17).

Conclusions :

According to the results, most of the participants in this study considered fear of anemia and fear of test results as barrier of blood donation. Therefore, establishing basic education and training programs to eliminate the wrong beliefs about blood donation would help encourage women as healthy sources of blood donors.

Umbilical cord blood hematopoietic stem cells (UCB-HSCs) have high potential capabilities in the treatment of hematological and non-hematological disorders. Awareness of biology, self-renewal, homing, expansion, storage, and transplantation can lead to optimal use of these cells.

In this Review article in order to investigate the advances and challenges in cord blood banks, the expansion, storage, homing and transplantation of umbilical cord blood stem cells, we used key words like umbilical cord blood, hematopoietic stem cells and stem cell banks for searching published articles in the PubMed database during 2000 to 2020.

Over time, many advances in biology, expansion, storage, and transplantation of cord blood cells have been made by researchers around the world with a growth in the number of private and public cord blood banks in parallel. Despite these advances, there are still challenges to the optimal use of these cells.

Conclusions : 

Increasing our awareness about the achievements and shortcomings in the area of UCB-HSCs, can lead to the formation of new strategies and further studies for the optimal use of these cells.

Transfusion of platelet has become one of the main treatments for thrombocytopenic patients to reduce the severity and frequency of bleeding consequences. Failure to attain the desired level of platelets in a patient following platelet transfusion is defined as platelet refractoriness. The purpose of present paper is to review and study the mechanisms involved in the formation of platelet refractory.

This article reviews the effective factors present in platelet recipients and donors, and considers the characteristics of platelet products that may have impacts on platelet refractoriness. The search is conducted through scientific databases including Science Direct, PubMed, Medline, SID, Scopus, and Magiran by the keywords “Platelet Refractory”, “Alloantibody”, “HLA”, “Platelet Transfusion” and their Persian equivalents. Finally out of about 130 related articles, 97 articles were used for the review.

Generally, platelet refractoriness occurs in two ways including immunologic and non-immunologic. The immunologic way is due to alloimmunization against alloantigens as a result of contact with human leukocyte antigens (HLA), Human Platelet Antigens (HPA). Non immunologic conditions such as fever, spleen enlargement and use of certain medications are responsible to 80% of platelet refractory incidence.

Conclusions :

Identification of different features and mechanisms in platelet refractoriness including immunologic and non-immunologic factors have an important role in control, prevention and management of the disease.