THE SCIENTIFIC JOURNAL OF IRANIAN BLOOD TRANSFUSION ORGANIZATION (KHOON)
Year:2020 | Volume:17 | Issue:1|Papers Count:8

Background and Objectives: Hepatitis C (HCV) infection is one of the main causes of chronic hepatitis diseases all over the world. HCV is a transfusion transmitted virus and a serious threat to general health. HCV genotyping has an important role in tracing routes of infection. This study aimed at investigating the changes in distribution pattern of HCV genotypes among Iranian blood donors. Materials and Methods: In this cross sectional study, 239 HCV confirmed blood donors from Jun. 2015 to Nov. 2017 were included. Semi nested PCR method was used for amplifying the NS5B region of HCV genome. PCR products were sequenced and HCVgenotypes were determined by searching the sequences in Basic Local Alignment Search Tool (BLAST). Phylogenetic tree was constructed to confirm HCV genotypes. STATA 13 software was used for data analysis. Results: In 106 (44. 35% ± 6. 3%) out of 239 participants, HCV genotype was determined and confirmed. In phylogenetic tree, studied sequences formed three separated clusters. Genotype 3a, 1a and 1b were the common genotypes. Conclusions: It seems that molecular epidemiology of HCV infection did not change based on variability of genotypes but changes in the frequency of genotypes have been occurred as a result of replacement of genotype 1a by genotype 3a during the last decade among Iranian blood donors.

Background and Objectives: Human platelet antigens (HPAs) are polymorphic structures located on the membrane of platelets (PLTs). These antigens have important role in clinical situations like refractoriness to platelet transfusion which is the most important cause of transfusion related mortality and morbidity in patients by recurrent platelet transfusion. Alloimmunization against the human platelet antigen 1 (HPA-1) is assumed as the major cause of platelet refractoriness in white population. Due to the variation of platelet antigens frequencies among ethnic groups; in this study, we investigated the frequency of HPA-1 alleles on Turkmen blood donors. Materials and Methods: In this descriptive study, 80 non-relatives of Turkmen donors were randomly sampled from Aq Qala blood center during the year 2018. Results: The mean age of the subjects was 38. 2 ± 7. 7 years (range: 18-59 years) and all were male. Molecular genotyping of HPA-1 in this study revealed that HPA-1a allele was detected in 96% donors and the HPA-1a/1b heterozygote was found in 4% of individuals. No one was HPA-1bb homozygous (frequency 0%). Conclusions: It was declared that 96% of Turkmen blood donors have shown HPA-1a similar to the frequency which was previously detected in Iranian blood donors and HPA-1b/b homozygous was not found in all donors. So it could be concluded that HPA-1a alloimmunization may not be involved in platelet refractoriness in Turkmen ethnicity.

Background and Objectives: Considering the importance of donor selection process in blood safety, this study aimed at comparison of frequency of intravenous drug use (IDU) among accepted HCV positive blood donors in different regions of Iran. Materials and Methods: This cross sectional-analytical study was conducted on serologically confirmed HCV positive blood donors who referred to blood transfusion centers for counseling all over the country during November 2015 to May 2017. All provinces were classified in three regions. IDU status and demographic specification of participants were analyzed using questionnaires. Chi square, fisher exact and ANOVA with STATA software version 13 were used for statistical analysis. Results: Participants, according to the number of provinces, sample size and geographical proximity to three areas were classified including 76 from North; 105 from West-South and 90 from East-Center individuals with the mean ages of 37. 73 ± 8. 27, 38. 83 ± 8. 80 and 36. 86 ± 8. 63 and history of IDU of 37 (48. 68%), 45 (42. 86%) and 41 (45. 56%), respectively. No significant differences between different regions of the country were found in the frequency of IDU voluntary blood donors with hepatitis C, age, gender, education status, marriage status (p > 0. 05). Conclusions: Approximately half of the voluntary blood donors with hepatitis C were IDUs. The frequency of IDU was similar among donors from different regions of Iran. Considering the fact that studied donors were found eligible in donor selection and donated the blood, though rejected during the screening phase, conducting research on the issue can increase the quality of blood donor selection and blood safety.

Background and Objectives: To perform open heart surgery, the patient needs to be placed on the bypass system. This initial volume causes excessive dilution of the patient's blood and the use of blood products, which can alter the surgical procedure and recovery of the patient. The purpose of this study was to evaluate the usefulness of performing a retrograde autologous prime to reduce blood products consumption. Materials and Methods: This is a prospective randomized clinical trial to evaluate whether RAP can reduce hemodilution in CPB and prevent allogeneic blood transfusion. In this study, 59 consecutive patients were randomly divided into two groups of RAP-with reverse autologous priming (n = 28) and control (Non RAP)-with normal priming (n = 31) being evaluated at Shahid Rajaee Cardiovascular Center between 1396-97. Results: Statistical evaluations were performed with Chi Square, T-Test, and Mann-Whitney U tests. It was identified by placing patients on bypass, hemoglobin and hematocrit in the first and second samples, end of bypass, and on ICU that was significantly higher in the experimental group. The number of patients receiving the product and the number of products consumed in the control group were significantly higher. The duration of mechanical ventilation was significantly lower but the ICU stay was not significantly different. Conclusions: From these results, it can be concluded that the implementation of RAP retrograde autologous priming can effectively preserve hemoglobin and hematocrit of patients in acceptable range and reduce the use of blood products in patients undergoing bypass.

Background and Objectives: The main antigens of the Rh blood group system (D, C, c, E, e) after the ABO system, are the most immune antigens. Due to existence of donor's red blood cells in the patient's circulation serologic methods can not accurately detect blood group antigens in patients with chronic blood transfusions, but molecular methods can overcome many of these limitations. Materials and Methods: In this cross sectional descriptive study, peripheral blood samples were taken from two hundred of alloimmunized thalassemic patients including 81 (40. 5%) male and 119 (59. 5%) female with mean age of 30 ± 10. 9 (age range 4-65) at Tehran Thalassemia Clinic during 1976-96. Phenotyping was done for C, c, E, e antigens. Sequence Specific Primers (SSPs)-PCR was performed and the discrepant results between the phenotype and genotyping were confirmed by DNA sequencing. Results: In this study, the highest prevalence of alloantibodies in the Rh system pertained to Anti-E 22% (44 patients) and Anti-D 10% (20 patients) and the frequency of the alleles in this blood group was determined C 71% (142), c 72. 5% (145), E 23% (46), e 98% (196). Thirty eight out of 200 patients had different results between serology and genotype. Discrepancies were 7. 5% (14) (RHC), 6% (11) (RHc), 9. 5% (17) (RHE), and 1. 5% (3) (RHe). Conclusions: Molecular methods can help to determine the exact antigens as a complementary method by solving the problems of the serological method.

Background and Objectives: Mothers of children with thalassemia as primary caregivers face problems with treatment and care issues. These problems as consequences of child’ s illness often lead to inappropriate adaptive behaviors. The aim of this study was to disclose the relationship between caregiver burden and adaptive behaviors in mothers of children with thalassemia. Materials and Methods In this cross-sectional study, 70 mothers of children with thalassemia major who had referred to the Thalassemia Clinic of Ali Asghar Hospital, Zahedan, in 2016 were studied. Data were gathered using a demographic questionnaire, the Coping Health Inventory for Parents (CHIP), and the Caregiver Burden Scale (CBS). The results were analyzed in SPSS 22 using descriptive statistics, Pearson correlation coefficient, and stepwise multiple regression. Results: The mean scores of mothers’ care burden and adaptive behaviors were 56. 92 ± 12. 84 and 57. 07 ± 19. 84, respectively. It was observed that while care burden has a significant inverse relationship with the total score of adaptive behaviors (r =-0. 41, p < 0. 001), it displays a direct significant relationship with mother's education (r = 0. 26 p = 0. 05). The results of multiple regression analysis suggested that the two components of adaptive behaviors and mother’ s education could predict 18% of changes in mothers’ care burden. Conclusions According to the results, it is recommended to utilize appropriate educational and supportive interventions for improving the mothers' adaptive behaviors and continuous evaluation of these interventions is necessary.

Background and Objectives: Since the blood product should be in certain conditions from the time of blood donation to injection to the patient, the necessary care should be taken and certain monitoring of blood should be made. Therefore, medical personnel should be expert in blood transfusion science, which has many importance in Iranian law and Imamie jurisprudence. Materials and Methods: The present research methodology is descriptive-analytical and based on the library analysis of legal regulations and jurisprudence. Results: In Imamie jurisprudence, there should be three rules that include: Indulgence (presentation of necessary warnings to medical staff and transfer of education to blood-borne patients), the need for the elimination of probable losses (the need to provide training to reduce the probable potential losses due to the ignorance of the medical staff of the transfer of blood), as well as the requirement to warn al-Jahal (medical staff) that should be trained in curative care about the blood that is in their care. Conclusions: The basis of consumer include: the need to attract trained people in the blood center, the need to use the trained personnel in the quality assurance section, to establish a general educational program for the whole blood transfusion department, the need for training the Central Transfusion Committee (CTC), the Senior Medical Assistance Commitment to Provide Training, which can be considered as the most basic legal basis for the expertise of medical personnel for transfusion medicine.

Background and Objectives: This study aimed to investigate the management of the consumption of blood bags in the elective procedures in the public and private hospitals in Iran. Due to the issue of blood shortages caused by unpredictable demand besides immediate requirements for blood units in particular conditions, the strategic management of consumption of this vital source is necessary. Materials and Methods: In this study, we evaluated 30 articles published from 2005 to 2017 which included the most important observational and interventional researches in Iran. These articles had investigated the consumption procedure and the likely wastage rate of blood bags in the operating rooms of Iranian hospitals. Results: The results of this review showed the over-reservation of the blood units due to the lack of standard protocols for blood ordering, and the negligence of relevant staff toward expiry date and reserved/returned units as the most prevalent reasons for blood component wastage in operating rooms. The results of the studies carried out showed that conducting some effective interventions led to reduction of the rate of blood wastage and improvement of the standard blood transfusion indices such as cross-match to transfusion ratio (C/T ratio), Transfusion Probability (TP), and Transfusion Index (TI). Conclusions: According to previous studies, the organization of a committee on the principles of managing blood supply at the national, local and hospital levels, implementation of standard blood transfusion guidelines, and establishment of training programs for physicians and nurses on the process of optimizing blood usage will be effective.