THE SCIENTIFIC JOURNAL OF IRANIAN BLOOD TRANSFUSION ORGANIZATION (KHOON)
Year:2004 | Volume:1 | Issue:1|Papers Count:10

Background and Objectives The aim of the present study was to evaluate red blood cell chimerism after bone marrow transplantation by flow cytometry. Materials and Methods In order to perform this assay, FITC labeled antibodies against blood groups ABH, Rh, Kell, Duffy, Kidd, MNS were used.14 hematologic patients under BMT were selected for this study. The required sample was 5 ml peripheral blood that is collected in tubes containing EDTA. At first, donor and recipients red cells phenotypes were identified with the use of both agglutination and flow cytometry methods; then, on post-transplantation days of 15, 30 and 60, only blood samples of the recipients were analyzed by flow cytometry for the antigens differing from donors to recipients. Antibody screening test and titration of ABH Isohemagglutinins were performed on recipients plasma samples and then repeated on posttransplantation day of 60. Results After BMT, red cell chimerism was detected in all 14 patients (in 9 patients on posttransplantation day of 15 and in 5 patients on day of 30). Antibodies against minor blood groups and Rh blood group were not detected at all. The occurrence of chimerism was not inhibited by ABO incompatibility of donors and recipients but in patients who were ABH incompatible with their donors, ABH isohemagglutinins titer following transplantation decreased. Although the presence of isohemagglutinins did not prevent chimerism but it seems these antibodies by attaching to their related antigens on chimeric red cells membrane prevented corresponding antigen detection. Conclusions Now by using flow cytometry, red cell phenotyping is applicable and reticulocyte analysis is much easier to perform so that chimerism can be detected in patients who have recently experienced blood transfusion. Moreover, through further evaluation of red cell chimerism and detection of recipient autologous red cells, disease relapse can be predicted.

Background and Objectives The distribution of main blood groups vary according to racial, ethnic and geographical differences. Due to their importance in qualitative and quantitative management of safe blood supplies in different geographical regions, due to the relation between a specific blood group with the prevalence of a typical disease, and further due to their significance in kidney transplantation procedure, we decided to analyze the frequency of ABO and Rh(D) blood types among 1,300,000 Iranian blood donors in different provinces of Iran in the year 2001 and compared the results with a similar study that was conducted in 1982. Materials and Methods Clotted blood samples were obtained from donors. Then, the samples were tested for A, B, O and Rh (D) blood groups using anti-A, anti-B and anti-D reagents. The ABO blood group was determined by comparing the results of forward typing with that of reverse typing. The final results were collected from 28 different provinces throughout Iran and were then analyzed by Excel program. Results Our findings are shown in a discending order of frequency: O blood group was detected in 37.62% of population; A blood group in 30.25%; B blood group in 24.36% and AB blood group in 7.77%. The frequency of O and B blood groups has increased 1.3% in comparison to the results obtained in 1982; whereas the frequency of A blood group has decreased by 2%. In some provinces such as Azarbayejan-Gharby, Isfahan, Ilam, Chaharmahal-Bakhtiyary, Khuzistan, Fars, Kordestan, Kohkiloyeh-BoyerAhmad, Mazandaran, Hormozgan and Yazd, the blood group frequencies have shown more alteration. Conclusions This change in frequency is due to several factors including the modification of provincial borders, migration to other cities during the Iran-Iraq war, as well as the tendency to move to larger, industrialized cities.

Background and Objectives Patients with major β-thalassaemia have a potential risk for infection cause of hypertransfusion and today one of the most improtant health problems in these patients is prevention and control of these viruses. In this study, we determined prevalence of hepatitis B and C and risk factors in a group of patients with major β-thalassaemia Materials and Methods This descriptive study was performed in Zahedan city in 1381 on 364 patients with major β-thalassaemia. At first, a questionnaire containing some questions about demographic characteristics was filled for all patient, including: age, sex, frequency of blood transfusion in year, time of diagnosis, history of vaccination, then blood samples of patients were tested to detect serum markers including HBsAg, Anti-HBc, Anti-HCV, Anti-HBs with Eliza method. Positive EIA results of HBsAg and Anti-HCV were confirmed respectively with neutralization test and RIBA. By using SPSS 10/10 software we analyzed our data; the results were also analyzed by Chi-square. Results We studied 364 patients with major β-thalassaemia, 206 (56.6%) were male and 158 (43.4%) female. Average of patients age was 9.7±5.17. 205 (56.3%) patients were Balooch. Out of them one case was HBsAg positive and 49 cases were Anti-HCV positive, therefore, prevalence of HBsAg and Anti-HCV positive were respectively 0.3% and 13.5%. 321 cases (88.2%) were Anti-HBs positive and 88 (24.2%) were Anti-HBc positive. Statistical analysis showed that HCV infection was more prevalent among older patients. Prevalence of Anti-HCV positive test in hypertransfusion patients (>20 times) was more (33.3%) compared with other age groups (<15%) (P=0.006). Conclusions Our results showed that prevalence of hepatitis C in patients with major β-thalassaemia in Zahedan is very high, but it seems screening of blood donor effectively decreases prevalence and incidence of infection.

Background and Objectives The most important goal of IBTO is to prepare safe and sufficient blood and blood components; thus, the appropriate screening of donors out of low-risk population is significant. It is likely that women population compared with men is at lower risk in regard to high-risk behaviors leading to blood-transmitted infections. However, the donation attempts on part of women compared to men are less frequent. Materials and Methods A cross-sectional study was conducted on Iranian female population at the age range of 17-65 in eight provinces of Iran. A questionnaire was prepared. The number of samples was calculated as 12000 using statistical formulas. The sampling method was multi-stage cluster. Finally, the data were analyzed using SPSS 11 statistical software. Results The age average of women under study was 32.6±12.1. Most of them were married, housekeeper, and had diploma. 24.1% of them had a record of blood donation while 75.4% never enjoyed such an experience. The educational background and employment rate of women with no blood donation precedent were significantly lower than those with previous history of blood donation (P<=0.001). The most frequent reason for women,s unwillingness to embark no blood donation was considered to be their fear of being infected with infectious and blood-borne diseases. On the whole, 75.2% and 24.8% of women under study showed respectively a negative and positive attitude toward blood donation. Conclusions Since fear of being infected with infectious and blood-borne diseases out of blood donation is somehow the outcome of the lack of awareness of the public about transfusion medicine; thus, the most significant reason for the lack of donation can be attributed to the lack of knowledge on the part of women regarding transfusion medicine. Based on the findings of the present study, it is recommended that training about the significance of blood donation and women,s acceptance criteria for blood donation be promoted extensively through TV and Radio broadcasting.

Background and Objectives Some blood donors may donate blood for being informed of their HIV test results; such people are threats to blood and its derivatives. Materials and Methods This study was a cross-sectional study using four choice questionnaires which were distributed among 20800 blood donors who had referred to Shiraz Blood Transfusion Organization. The sample was selected using systematic random sampling. Questionnaire included three parts: part one contained demographic characteristics of donors, part two reasons motivating them to donate blood, and three risk factor of HIV if donation occures for HIV checkup. Chi square and regression analysis were used to analyze the data. Results The average age of donors was 34.46±11.3. 87% of donors were male and 12.3% female; 51.8% were married and 48.2% single. 36.3% were first time blood donors and 63.7% had more than one time blood donation record; the average number of blood donation attempts among these subjects was 6.7±3.2. 61% of them were tested for HIV in routine tests. Totally, 14.8% of these subjects had donated blood for HIV checkup. Blood donation for HIV checkup was more frequent in males, singles and first time donors (P<0.05). There was no correlation between occupation, education status, age and blood donation and HIV checkup (P>0.05). Risk factors of those who had donated blood for HIV tests were identified to be sexual contacts (38.3% of subjects), contacts with HIV suspicious people (18.7%), intravenous drug users (3.7%), and tatooing (2.8%). The rest 36.5 percent had no known risk factors. Conclusions 14.8% donate blood for HIV checkup in this study and could threaten the blood supply. The most common risk factor in those who referred for HIV checkup was sexual contact with high-risk partners. Blood donors should receive suitable training for providing safe blood. To this end, they must feel accountable for their blood donation.

Background and Objectives H antigen is a precursor to A and B antigens. Person who lacks A and B antigens has a strong expression of H antigen. In 1 per million population, Bombay phenotype ( lack of A, B, H antigens) is observed, because this group should just experience autologous transfusion. Accurate identification of such people is highly recommended. Materials and Methods 2178 persons from 3 different population were selected. One group was Indian population of Tehran (100), 78 persons from 2 families with Bombay phenotype history, and the third group(2000) was selected as volunteer donors. All of them have O group phenotype.10cc of whole blood was taken from each subject. Red blood cells washed 3 times with saline and finally samples with 5% dilution were prepared. Each sample was treated with H-Lectin antisera, and after 30 minutes agglutination was detected with naked eye and microscope. Results Only 1 subject among donors had Bombay phenotype. Conclusions Limitation in Indian population in Tehran caused hinderance in detection of new cases of Bombay phenotype. At the end, detection of 1 Bombay phenotype among 2000 donors seems very significant.

Background and Objectives The idea of bloodless medicine and surgery emerged when physicians had to treat patients who defied transfusion for religious reasons (e.g. Jehovah’s Witnesses); moreover, problems in ensuring safe blood supplies, the relevant costs involved, and the post-transfusion complications gave also rise to bloodless method. The aim of this study is to evaluate the reduction of allogenic blood transfusion, postoperative infection and costs in the bloodless group compared to the control. Materials and Methods A retrospective comparative study was undertaken for patients undergoing coronary artery bypass grafting (CABG) at Isfahan’s Chamran hospital. Two groups of patients undergoing the classic CABG and the Bloodless techniques were compared (100 patients in each group). For bloodless surgery in addition to considering principles of bloodless medicine and surgery, autologous normovolemic hemodilution was done before operation (1-2 units) and patients were not transfused unless their hemoglobin was 9 gm/dl. Data were analysed by t-test and Chi-square test. Various factors were compared between these two techniques such as units of packed cells (PC) and fresh frozen plasma (FFP) transfused, length of hospital stay, costs and postoperative complications (infection, bleeding, etc.). Results In bloodless and classic surgery groups, 76% and 38% did not require PC transfusion, respectively. In addition, we observed a significant difference between FFP transfusion in the bloodless (93%) and classic technique (73%). No patient in the bloodless group received platelets whereas 2% of the patients in the classic group did. Overall length of hospital stay and ICU stay were less in the bloodless method; hence, the costs were less too. Postoperative infection was less in the bloodless method. These differences were significant. Conclusions The application of bloodless method for patients undergoing CABG significantly reduces PC and FFP consumption (P=0.001); therefore, the complications of blood transfusion such as post transfusion HIV, hepatitis, allergic and immunological reactions are decreased. Length of hospital stay and postoperative infections are also reduced which in turn reduce the costs (P=0.001, 0.001 and 0.037, respectively).

Background and Objectives One of the suitable ways to find access to safe blood supply is to use regular donors as low-risk population in regard to blood-transmitted diseases. Thus, in this study, the population of regular donors of Arak city in the first six months of the year 1382 (2004) registered in the Recruitment Unit of Arak Blood Center were evaluated. Materials and Methods In this study, 3620 regular donors (37 percent of the whole donors) registered in the Recruitment Unit were selected as subjects; they then were evaluated based on age, gender, marital status, education level, and job. Results 89.6 and 10.4 percent of the donor population were male and female respectively; 82.2 percent of the member regular donors were married and 17.8 single (P<0.01). 51.85 percent of the population acted as employees, laborers, and military staff all corsidered as wage-earning jobs. 34.4 percent have free jobs, are households and university students, and the remaining 4.75 percent act as soldiers, farmers, students, or are jobless (P<0.01). The higher percentage of member regular donors pertains to donors at the age group of 21-45. Conclusions In the present study, the male subjects at the age range of 21-45 being married, wage-earner with diploma degree or higher were considered to be the main stratum of regular blood donors. Therefore, through planning to encourage and attract the above stratum, it would be possible to raise the number of regular donors and help them maintain the donation trend. However, one should not overlook the female population and attempts should be made to increase the number of regular female donors by appropriate propaganda and promotion.

Background and Objectives Post -transfusion hepatitis B may occure if donors donate blood in the window period, in the early convalescence phase and period with very low levels of HBsAg in blood. Case In December 2003, a case as post- transfusion hepatitis B in a blood recipient was reported to IBTO.The patient had received 2 units of red blood cells.Trace back program was set up to find out the donors possible involvement in viral transmission. Conclusions Donors and recipients were not positive for HBsAg and Anti-HBc IgM; so current or recent infection during last 6 months had to be excluded. This case report explains a successful trace back , and accurate well- maintained records.