Optimization of blood safety through essential characterization of naturally occurring lewis antibody

Background: Lewis (Le) antibodies are usually naturally occurring; however, they may be clinically significant, may be immunoglobulin G (IgG) type, and may cause hemolytic transfusion reactions. The present study depicts the clinical significance and detailed characterization of Le antibodies in blood donors and patient populations and their implication in safe blood transfusion. Materials and Methods: The prospective study included seven individuals who were detected with Le antibodies. Further investigations were performed for detailed characterization of these antibodies with regard to antibody type, thermal amplitude, titer, and enzyme study and secretor status of the individuals. Results: Of the 69,354 donors and patients subjected to antibody screening, anti-Lea was detected in 7 individuals with none having anti-Leb. All showed the Le (a−b−) phenotype with 4 individuals presenting with IgG anti-Lea optimally reacting at 37°C, with a highest titer of 32. Where all seven individuals were ABH secretors, however none revealed any Le substances. For patients requiring transfusion, compatible Lea antigen-negative red cell units were issued without any adverse events. Conclusions: As naturally occurring Le antibodies may be clinically significant and cause hemolytic transfusion reaction, therefore identification and detailed characterization of antibody in blood donor or recipient is very crucial to blood safety

Bashabi Fraser, Transnational Writer, based in Edinburgh, Scotland speaks to Writers in Conversation

Bashabi Fraser is a transnational writer who has lived in London, Kolkata and Darjeeling and now lives and writes in Edinburgh. She is a poet, editor, children's writer, translator and critic. Her recent publications include Ragas & Reels (poems on migration and diaspora, 2012), Scots Beneath the Banyan Tree: Stories from Bengal (2012); From the Ganga to the Tay (an epic poem, 2009); Bengal Partition Stories: An Unclosed Chapter (2006; 2008), A Meeting of Two Minds: the Geddes Tagore Letters (2005) and Tartan & Turban (poetry collection, 2004). Her awards include the Women Empowered: Arts and Culture Award in 2010 and the IAS Prize for Literary Services in Scotland in 2009. Her research and writing traverse continents, crossing borders and boundaries with ease. Bashabi is an executive committee member of the Writers in Prison Committee (Scotland) and the Poetry Association of Scotland and has been on the Scottish PEN committee for two terms. She is a Trustee of the Kolkata Scottish Heritage Trust, Associate Member of the Patrick Geddes Trust and has been a Consultant Advisor for the Kolkata British Council's Kolkata-Scotland Connection program. Bashabi is a Professor of English and Creative Writing and Joint Director of the Scottish Centre of Tagore Studies (ScoTs, which she has helped to establish) at Edinburgh Napier University. Bashabi is also a Royal Literary Fund Fellow based at the University of Dundee. Bashabi Fraser spoke on her books and other issues to Anindya Sekhar Purakayastha & Dhritiman Chakrabarty for Writers in Conversation, when she came to deliver an invited lecture in Visba Bharati University, India in August 2013

Machine and man individualities in apheresis adverse events

Background: Adverse events due to plateletpheresis are not unheard of, citrate-related reactions being the most common. Most of these events are mild and self-limiting. The current study describes adverse events in plateletpheresis using modern apheresis systems. Materials and Methods: The prospective study included 1455 plateletpheresis procedures from July 2013 to April 2016. Procedures were performed on Amicus, Trima Accel and Cobe spectra cell separators. The endpoint of each procedure was a yield of 3 × 1011 platelets (PLTs) per unit. Donor adverse reaction if any was managed, reported, and documented. Results: The median age of donors was 31 years with male-to-female ratio of 13:1. The median body surface area and body mass index were 1.64 m2 and 22.4 kg/m2, respectively. The mean PLT count of donors was 199.8 × 103/uL with a mean hemoglobin value of 13.6 g/dl. ACD infusion was significantly more in the Cobe (P < 0.01). Donation time was least with the Trima compared to Amicus (P < 0.01) and Cobe (P < 0.001). Total whole blood volume processed was higher in Cobe (P < 0.01). Paresthesia due to citrate toxicity was the most common adverse reaction (65.3%), and vascular injury was observed in only five donors. Adverse reaction was significantly more with the Cobe (P < 0.01). The overall incidence of adverse reaction was 3.4%. Conclusion: Serious adverse events were not observed. The modern-generation apheresis machines are more donor-friendly and cause less adverse reactions compared to the older versions. Good donor screening, optimized donor physiognomic and hematological values, and skilled operator are the key factors to reaction reduction by apheresis

Immunohematological and clinical characterizations of mixed autoimmune hemolytic anemia

Background and Aim: Patients with warm autoimmune hemolytic anemia (AIHA) may carry immunoglobulin (Ig) M antibodies that react at room temperature and are nonpathological, but few may have cold agglutinins that react at or above 30°C and are referred to as “mixed” AIHA (MAIHA). Here, we present our experience on characterizing MAIHA both clinically and serologically. Materials and Methods: Out of 134 AIHA patients, 13 diagnosed as MAIHA were subjected to detailed immunohematological characterization. Most patients were severely anemic and required urgent transfusions. Resolution of blood group discrepancy, elution, Donath-Landsteiner test, and adsorption study were performed following established protocol. “Best match” blood units were selected and transfused to patients. Results: Eight of the 13 patients had severe hemolysis. The median age of patient was 37 years with a female preponderance and secondary MAIHA was observed in 8 (61.5%) patients. Blood group discrepancy was encountered in 4 (30.8%) patients. Multiple red cell bound autoantibodies and high titer serum-free IgM autoantibodies were detected in all samples. Twenty-nine units of “best match” packed red blood cells were transfused to 12 patients without any adverse reaction. Improvement in hematological and biochemical values was observed in all follow-up patients. Conclusion: Patients with MAIHA often present with severe hemolysis necessitating blood transfusions. While red cells are coated with multiple autoantibodies, both warm reactive IgG and cold reactive IgM autoantibodies are present in the serum. These serological complexities not only render a crossmatch incompatibility but often lead to blood group discrepancy. “Best match” blood transfusion is always lifesaving

Monitoring errors in a blood bank immunohematology laboratory: Implementing strategies for safe blood transfusion

Background: Errors occurring at patient bedside during specimen collection are the most common causes of adverse outcomes. We planned this prospective study to estimate the incidence and nature of transfusion errors, identify the source, site of occurrence, and assess the underlying problems in the system with the aim to prevent the potentially fatal human error. Materials and Methods: The study was performed over a period of 5 years at a hospital based blood transfusion service where all errors and discrepancies both in the recipient and donor samples were reported into an 'incident and error reporting register' and then analyzed. Results: While a total of 72,381 patient samples were received for pretransfusion testing, 43,762 samples were from blood donors for ABO and Rh grouping. A total of 79782 blood components were issued to patients during the study. Out of 229 errors in the blood transfusion chain, 164 (0.22% of total requisitions and 0.21% of total component issued) were reported in patient pretransfusion samples, and 65 errors (0.15%) were reported in donor samples. Majority of the errors were clerical in nature and related to human errors. Of the 164 errors in pretransfusion testing samples, 107 (65.2) were observed in night shift. The overall error frequency per 1000 requisitions was 2.26. Conclusion: Near miss event reporting can prevent potential transfusion associated mortality and morbidity caused by simple human ignorance. A good error reporting not only helps in accurate collection and analysis of data but also makes recommendations that improve transfusion safety

A dihydro-pyrido-indole potently inhibits HSV-1 infection by interfering the viral immediate early transcriptional events

In our continued quest for identifying novel molecules from ethnomedicinal source we have isolated an alkaloid 7-methoxy-1-methyl-4,9-dihydro-3H-pyrido[3,4-b]indole, also known as Harmaline (HM), from an ethnomedicinal herb Ophiorrhiza nicobarica. The compound exhibited a potent anti-HSV-1 activity against both wild type and clinical isolates of HSV-1. Further we demonstrated that HM did not interfere in viral entry but the recruitment of lysine-specific demethylase-1 (LSD1) and the binding of immediate-early (IE) complex on ICP0 promoter. This leads to the suppression of viral IE gene synthesis and thereby the reduced expression of ICP4 and ICP27. Moreover, HM at its virucidal concentration is nontoxic and reduced virus yields in cutaneously infected Balb/C mice. Thus, the interference in the binding of IE complex, a decisive factor for HSV lytic cycle or latency by HM reveals an interesting target for developing non-nucleotide antiherpetic agent with different mode of action than Acyclovir