فصلنامه خون
سال هجدهم شماره 4 (پیاپی 74، زمستان 1400)

Given transfusion complications, high expenses, inadequacy of resources and time constraint in ensuring blood products, it is necessary to investigate the status of blood consumption and factors affecting the proper use of products.  In this study, the consumption status of RBCs was investigated in Imam Khomeini Hospital in Mahallat city.

In this retrospective descriptive cross-sectional study, patient hemoglobin data were collected at the time of hospitalization, at the time of blood order, after blood administration, and at discharge. At the same time, the data on physician name, reason for hospitalization, platelet count, patient PT and PTT tests, and ratio of crossmatch by blood transfusion (C/T) were collected.

Out of 356 patients injected with RBCs, 91.7% were anemic at the time of blood request and 51.7% had the hemoglobin levels higher than 8 g/dL and received RBCs. The average C/T index was 1.06 with the highest value (1.8) pertaining to the surgical department and the lowest to the dialysis ward. There was no significant correlation between age, gender, PT, PTT, cause of hospitalization, and physician with frequency of blood transfusion.

  The results showed C/T ratio to transfusion being lower than the acceptable value and indicated the ratio of blood order to transfusion being desirable. There was a significant correlation between blood order and hemoglobin reduction. Given the average hemoglobin threshold of patients at the time of blood order, it has been shown that mainly liberal transfusion strategy has been used in the hospital.

Non-alcoholic liver disease (NAFLD) is a spectrum of diseases, ranging from non-alcoholic fatty liver (NAFL) to non-alcoholic steatohepatitis (NASH) which can lead to liver cirrhosis and hepatocellular carcinoma. Nonalchololic fatty liver  is the most prevalent hepatic disorder worldwide which can affect up to the one out of four adults. Little is known about the prevalence of nonalchololic fatty liver among regular donors of blood products. The current study shows the prevalence of nonalchololic fatty liver  in regular plasma and blood donors with a discontinuous donor population.

In this case-control study, we non-randomly enrolled 400 volunteers of blood donors who met the blood donation criteria after signing the written informed consent. All patients underwent hepatobiliary ultrasonography to evaluate fatty liver. LFT (Liver Function Test) and demographic criteria had been submitted in data base. All data were described by central dispersion indices and analyzed by Mann-Whitney U test and chi-square.

No difference was seen regarding gender and mean age between groups (p-value of 0.441 and 0.635, respectively). According to univariate analysis there was no significant difference between the two groups regarding the prevalence of fatty liver (p= 0.264) or its staging (p= 0.9). In addition, OR and RR were 1.17 and 1.11, respectively; both not being significant (p= 0.461).

The prevalence of NAFLD has no significant correlation with both regular blood donors and non-regular blood donors.

Over-ordering of blood before operation can cause unnecessary cross matches and wastages. The aim of this study was to investigate the difference between blood order and transfusion in Yazd, with Maximum surgical blood ordering (MSBOS).

In this descriptive study, data of 793 patients from 2017 to 2018 were recorded in a questionnaire based on the studied variables (demographic information, Red blood cell ordering, and surgical type). Simultaneously, surgical blood ordering was compared with MSBOS; frequency of blood order and transfusion, number of units per application sheet, and C/T ratio for all patients were calculated. The analysis was made by SPSS software and descriptive statistics.

Surgical operations were performed on 615 patients; in 264 (42.92%) patients the number of blood orders was compatible with MSBOS. Cesarean  (83 units), hernia surgery (52 units), curettage (48 units), appendectomy (28 units), and arthroplasty (24 units) had been assigned the highest blood orders with the MSBOS compatibility rates being 1%, 83%, 15%, 71%, and 29%, respectively. The highest ratio of transfusion to blood orders was related to oncology wards (0.92), heart surgery (0.79), and NICU (0.75). Urology (0.04), ENT (0.09), and Orthopedy (0.22) had the lowest ratios of transfusion to blood orders. The highest C/T ratio was observed at woman urology ward.

According to the results, requesting blood for surgical operations was not compatible with the MSBOS table and despite the decrease in the C/T ratio in the hospitals compared to 2013 studies, this index is still far from the standard.

Proliferation and differentiation of mesenchymal stem cells (MSCs) in culture media requires the presence of nutrient supplements such as bovine fetal serum (FBS), which increases the risk of prion/xenotic infections. Platelet lysates as a rich source of growth factors and cytokines can replace FBS in cell culture medium. This study aimed to compare the effect of platelet lysates derived from cord blood and peripheral blood on the proliferation and differentiation of MSCs.

In this experimental study, human MSCs were isolated from placental tissue and identified by flow-cytometry. 3 Three platelet bags were collected and platelet lysates were prepared by repeated freezing/thawing method. MSCs were cultured in different media and evaluated for their differentiation capacity, cultured in osteogenic and adipogenic differentiation media with Alizarin Red and Oil Red-O staining. TGF-β levels were assessed by ELISA. Statistical analysis was performed using SPSS22 software and One-Way ANOVA statistical test.

The proliferation rate of MSCs in media containing Cord/Peripheral Blood Lysate (CBL or PBL) was not significantly different from that of media containing 5% FBS. Also, the rate of proliferation in the medium containing CBL plus cord blood serum was not significantly different from the medium containing 10% FBS. Also, the ability of MSCs’ differentiation into osteocytes and adipocytes in media containing CBL or PBL was well preserved.

Platelet lysates can be a suitable alternative to animal serum in cell culture medium. In addition to the growth and proliferation of MSCs, these factors maintain the ability to differentiate into osteocytes and adipocytes in environments containing these factors.

Stem cell factor (SCF) is a blood cytokine that plays an important role in the differentiation of hematopoietic progenitor cells, as well as survival, proliferation, and differentiation of mast cells. Furthermore, it can enhance tumor cell proliferation and invasion. Recombinant or natural form of leucine zipper can cause homo- or heterodimerization of many types of proteins which are attached to it and have a favorable effect on their function or stability. The present study investigates the expression of leucine zipper-bound SCF.

This experimental study consists of designing a recombinant protein by bioinformatic softwares and the laboratory part of the study. The indices of interest for designing of the protein structures were analysed by various softwares including PSIpred and Chimera and the recombinant protein stability by RAMPAGE. The sequence synthesis was performed after determination of the enzymatic cleavage sites with NEBcutter. Then, codon optimization for Origami was done with Optimizer. Cloning in TOP10 and the protein expression in Origami were performed.

The results of bioinformatics studies on the Leucine Zipper/SCF recombinant protein included the necessary criteria for the possible native structure of the protein and the high score for viability in the living cell. Furthermore, the results of the experimental section showed successful cloning and expression.

In the present study, the results indicated the successful cloning and expression of the recombinant Leucine Zipper/SCF protein.

During storage, platelets may lose their functional capability and structural integrity. This process is often called as "platelet storage lesion" (PSL), which is characterized with changes in morphology, metabolism, membrane structure, and expression of platelet activation and apoptotic markers. Apoptosis, or programmed cell death, is an energy-dependent physiological mechanism that results in the controlled removal of unwanted or damaged cells. While it has long been attributed exclusively to nucleated cells, many studies demonstrated that apoptosis also occurs in anucleate cells and platelets.

Studies published in MEDLINE, PubMed, and Google scholar are assessed for keywords and 55 articles is cited

The present review article describes the different apoptosis pathways in platelets, while adressing the markers, methods and probes used for evaluating apoptosis in platelet concentrates.

The evaluation of apoptosis can play an important role in identifying the mechanisms involved in platelet storage lesion.

Severe hemorrhage is the leading cause of death in comilitary and civilian trauma. Approximately half of road crash fatalities occur due to severe hemorrhage before hospital arrival. In severe cases of bleeding, the use of agents that accelerate blood coagulation (hemostatic agents) is required. The aim of this study was to review on the hemostatic agents and products, from research to commercial stages, and categorizing them based on the physiology of hemostasis. Moreover, the applications and adverse effects of each category have been reviewed and compared; it can be an important step towards optimal clinical application of products and novel original reasearch design continuing the previous studies.

Literature search was conducted in scientific databases of PubMed, Scopus, Science Direct, SID, Magiran and IranMedex without filtering release date, by combining related keywords including hemostatic agents, bleeding, dressings and trauma. The abstracts were screened by two reaserchers independently to select the appropriate studies.

In this study, according to the basics of blood coagulation, the hemostatic agents and products were classified into five groups based on the mechanism of action including: (1) coagulants and procoagulants, (2) the concentrators of coagvlant factors, (3) mechanical cougulaton substrates, (4) physiologic coagulants and (5) chemical coagulants. The mechanism of action, applications, and side effects have been compared in each category.

Each hemostatic product can be more effective in special situations, in military and civilian trauma, due to their potency and mechanisms of action.