Challenges faced by blood transfusion services in a tertiary care centre for recruitment of convalescent plasma donors for COVID-19

Background: The transfusion of convalescent blood products is an age old therapy in emerging infectious disease outbreaks. Convalescent plasma works on the principle of passive immunotherapy and Viral Neutralization. In the Current pandemic of corona virus disease (COVID-19), convalescent plasma transfusions can have therapeutic role as there is no specific preventative and therapeutic options. This study was done to see the challenges faced by blood transfusion services for recruitment of plasma donors.Methods: The retrospective study included challenges faced by blood transfusion services in recruiting Donors for convalescent plasma for COVID-19 and strategies followed for improving the donation at SMS Medical College and Hospital from April 2020 to October 2020.Results: This study evaluated challenges faced to recruit the recently recovered COVID-19 patients as donors, Setting up of plasmapheresis capacity, Role of social media in recruitment of Convalescent plasma donors, Financial aspects associated with Convalescent plasma donation, Role of NGOs in recruitment of donors and Success achieved in organization of donor mobilization and plasma collection.Conclusions: Recruitment of Convalescent Plasma donor from COVID-19 recovered patients is a big challenge for blood transfusion services. Different strategies to motivate donors should be implemented such as personnel communication, advertisement via classical mass media like radio, poster, newspaper and online media.

Retrospective analysis of donor deferral for plateletpheresis at a regional transfusion center, in North-West India

 Background: Single donor platelet (SDP) is one of the valuable component for thrombocytopenic patients for obtaining good post transfusion count increment, good yield of product is required. Proper donor selection has a crucial role in in safety and quality of product therefore proper screening of donor is mandatory. The aim was to find out reasons and frequency of plateletpheresis donor deferral and to encourage safety of donor for recruitment of new SDP donors.Methods: A retrospective analysis of data was done over a period of 1 year from June 2018 to May 2019 from the data centre of the institute.Results: Out of 1365 donors, 1200 were selected for plateletpheresis procedure and remaining 165 donors were deferred for various reasons. The predominant age of donors ranges from 25-35 years. Among the deferred donors temporary donors accounted for 93.33% and permanently deferred donors were 6.61. Most common cause for deferral were poor venous access 52 (31.51%). Low platelet counts 32 (19.39), low Hb 26 (15.75%), underweight 24 (14.54%), under medication 9 (5.45%), alcohol intake within 24 hours 6 (3.63%) and others like tattoos, infections/inflammations at phlebotomy sites 5 (3.03%) and most common reason for permanent deferral were sero-positivity for HbsAg 6 (3.63%), chronic diseases 4 (2.42%) (cardiovascular diseases bronchial asthma), others 1 (0.6%).Conclusions: For obtaining good yield of product, proper donor screening is required. Temporary deferred donors should be counselled properly and encouraged for further donation when comes under selection criteria. Donor selection criteria for apheresis may be revised

Phospholipid membranes drive abdominal aortic aneurysm development through stimulating coagulation factor activity

Abdominal aortic aneurysm (AAA) is an inflammatory vascular disease with high mortality and limited treatment options. How blood lipids regulate AAA development is unknown. Here lipidomics and genetic models demonstrate a central role for procoagulant enzymatically oxidized phospholipids (eoxPL) in regulating AAA. Specifically, through activating coagulation, eoxPL either promoted or inhibited AAA depending on tissue localization. Ang II administration to ApoE−/− mice increased intravascular coagulation during AAA development. Lipidomics revealed large numbers of eoxPL formed within mouse and human AAA lesions. Deletion of eoxPL-generating enzymes (Alox12 or Alox15) or administration of the factor Xa inhibitor rivaroxaban significantly reduced AAA. Alox-deficient mice displayed constitutively dysregulated hemostasis, including a consumptive coagulopathy, characterized by compensatory increase in prothrombotic aminophospholipids (aPL) in circulating cell membranes. Intravenously administered procoagulant PL caused clotting factor activation and depletion, induced a bleeding defect, and significantly reduced AAA development. These data suggest that Alox deletion reduces AAA through diverting coagulation away from the vessel wall due to eoxPL deficiency, instead activating clotting factor consumption and depletion in the circulation. In mouse whole blood, ∼44 eoxPL molecular species formed within minutes of clot initiation. These were significantly elevated with ApoE−/− deletion, and many were absent in Alox−/− mice, identifying specific eoxPL that modulate AAA. Correlation networks demonstrated eoxPL belonged to subfamilies defined by oxylipin composition. Thus, procoagulant PL regulate AAA development through complex interactions with clotting factors. Modulation of the delicate balance between bleeding and thrombosis within either the vessel wall or circulation was revealed that can either drive or prevent disease development

PANC Study (Pancreatitis: A National Cohort Study): national cohort study examining the first 30 days from presentation of acute pancreatitis in the UK

Abstract Background Acute pancreatitis is a common, yet complex, emergency surgical presentation. Multiple guidelines exist and management can vary significantly. The aim of this first UK, multicentre, prospective cohort study was to assess the variation in management of acute pancreatitis to guide resource planning and optimize treatment. Methods All patients aged greater than or equal to 18 years presenting with acute pancreatitis, as per the Atlanta criteria, from March to April 2021 were eligible for inclusion and followed up for 30 days. Anonymized data were uploaded to a secure electronic database in line with local governance approvals. Results A total of 113 hospitals contributed data on 2580 patients, with an equal sex distribution and a mean age of 57 years. The aetiology was gallstones in 50.6 per cent, with idiopathic the next most common (22.4 per cent). In addition to the 7.6 per cent with a diagnosis of chronic pancreatitis, 20.1 per cent of patients had a previous episode of acute pancreatitis. One in 20 patients were classed as having severe pancreatitis, as per the Atlanta criteria. The overall mortality rate was 2.3 per cent at 30 days, but rose to one in three in the severe group. Predictors of death included male sex, increased age, and frailty; previous acute pancreatitis and gallstones as aetiologies were protective. Smoking status and body mass index did not affect death. Conclusion Most patients presenting with acute pancreatitis have a mild, self-limiting disease. Rates of patients with idiopathic pancreatitis are high. Recurrent attacks of pancreatitis are common, but are likely to have reduced risk of death on subsequent admissions. </jats:sec