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Artikel ; Online: How well do platelets prevent bleeding?

Triulzi, Darrell J

Hematology. American Society of Hematology. Education Program

2020 Band 2020, Heft 1, Seite(n) 518–522

Abstract: Prophylactic platelet transfusions are used to reduce the risk of spontaneous bleeding in patients with treatment- or disease-related severe thrombocytopenia. A prophylactic platelet-transfusion threshold of <10 × 103/µL has been shown to be safe in ... ...

Abstract	Prophylactic platelet transfusions are used to reduce the risk of spontaneous bleeding in patients with treatment- or disease-related severe thrombocytopenia. A prophylactic platelet-transfusion threshold of <10 × 103/µL has been shown to be safe in stable hematology/oncology patients. A higher threshold and/or larger or more frequent platelet doses may be appropriate for patients with clinical features associated with an increased risk of bleeding such as high fevers, sepsis, disseminated intravascular coagulation, anticoagulation therapy, or splenomegaly. Unique factors in the outpatient setting may support the use of a higher platelet-transfusion threshold and/or dose of platelets. A prophylactic platelet-transfusion strategy has been shown to be associated with a lower risk of bleeding compared with no prophylaxis in adult patients receiving chemotherapy but not for autologous transplant recipients. Despite the use of prophylactic platelet transfusions, a high incidence (50% to 70%) of spontaneous bleeding remains. Using a higher threshold or larger doses of platelets does not change this risk. New approaches to reduce the risk of spontaneous bleeding, including antifibrinolytic therapy, are currently under study.
Mesh-Begriff(e)	Blood Platelets ; Female ; Hemorrhage/epidemiology ; Hemorrhage/etiology ; Hemorrhage/prevention & control ; Humans ; Middle Aged ; Platelet Transfusion
Sprache	Englisch
Erscheinungsdatum	2020-12-04
Erscheinungsland	United States
Dokumenttyp	Case Reports ; Journal Article ; Review
ZDB-ID	2084287-9
ISSN	1520-4383 ; 1520-4391
ISSN (online)	1520-4383
ISSN	1520-4391
DOI	10.1182/hematology.2020000136
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Online: Another piece of the hemolytic disease of the fetus and newborn puzzle after RhD-positive transfusion in trauma resuscitation: the proportion of pregnant women who produce high titer anti-D.

Yazer, Mark H / Emery, Stephen P / Triulzi, Darrell J / Spinella, Philip / Leeper, Christine

Trauma surgery & acute care open

2024 Band 9, Heft Suppl 1, Seite(n) e001252

Abstract: Background: After the transfusion of RhD-positive red blood cell (RBC)-containing products to an RhD-negative woman of childbearing potential (WCP) during trauma resuscitation, there are several events that must occur for that WCP to have a future ... ...

Abstract	Background: After the transfusion of RhD-positive red blood cell (RBC)-containing products to an RhD-negative woman of childbearing potential (WCP) during trauma resuscitation, there are several events that must occur for that WCP to have a future pregnancy affected by hemolytic disease of the fetus and newborn (HDFN). This study identified and quantitated the frequency of a novel event in the sequence from RhD-positive transfusion during trauma resuscitation to an HDFN outcome, that is, the development of a high titer anti-D among women who were D-alloimmunized. Methods: The transfusion service records at one maternity hospital were searched to locate all anti-D titers that had been performed on pregnant women between 1996 and 2022. The highest titer score during each pregnancy was recorded for this study. The critical titer threshold at this institution was ≥16. Passive anti-D caused by Rh immunoglobulin were excluded from analysis. Results: There were 97 pregnancies in 85 patients who had an immune-stimulated anti-D; in 60 of 97 (62%) pregnancies, the highest titer score was ≥16. There were 12 patients who had titers performed in two pregnancies during the study period; the correlation between the maximum titer in each pregnancy was not statistically significant (Spearman rank correlation r=0.42, p=0.17). Conclusion: In this single center study, 62% of D-alloimmunized pregnant women had a high titer antibody. When considering all of the events that must occur for HDFN to happen, the rate of perinatal mortality was calculated to be 0.04% and the rate of perinatal death or serious adverse event from HDFN was 0.24%.
Sprache	Englisch
Erscheinungsdatum	2024-01-05
Erscheinungsland	England
Dokumenttyp	Journal Article
ISSN	2397-5776
ISSN (online)	2397-5776
DOI	10.1136/tsaco-2023-001252
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Online: Timing of RhD-positive red blood cell administration is associated with D-alloimmunization in injured patients.

Yazer, Mark H / Spinella, Philip C / Sperry, Jason / Triulzi, Darrell J / Leeper, Christine

Transfusion

2023 Band 63 Suppl 3, Seite(n) S54–S59

Abstract: Background: The D-alloimmunization rate in trauma patients does not appear to depend on the number of RhD-positive units transfused. The effect of the timing and pattern of RhD-positive transfusions has not been evaluated.: Methods: RhD-negative ... ...

Abstract	Background: The D-alloimmunization rate in trauma patients does not appear to depend on the number of RhD-positive units transfused. The effect of the timing and pattern of RhD-positive transfusions has not been evaluated. Methods: RhD-negative trauma patients who were transfused with RhD-positive red blood cells (RBC) or low titer group O whole blood (collectively called RBCs) on at least two separate calendar days and who had antibody detection tests performed at least 14 days after the second RhD-positive RBC transfusion without receiving RhIg were included in the analysis. Patients whose anti-D was detected within 14 days of the index RhD-positive RBC transfusion were excluded. Patient demographics and the dates of RhD-positive RBC transfusions and results of antibody detection tests performed after the index transfusion were collected on eligible patients. Results: There were 44/61 (72.1%) patients in whom anti-D was not detected (non-alloimmunized) and 17/61 (27.9%) in whom anti-D was detected (alloimmunized). The patients had similar demographics with trends towards higher median admission heart rates and lower median admission Glasgow Coma Scale values in the alloimmunized group. Both groups received statistically identical median quantities of RhD-positive RBCs (non-alloimmunized 5 vs. alloimmunized 4 units, p = .53), however, the alloimmunized group received all their RhD-positive RBCs over a significantly shorter period of time compared to the non-alloimmunized (median 4 vs. 15 days, respectively, p = .01). Conclusion: Receipt of all RhD-positive RBCs over a shorter period of time was associated with higher D-alloimmunization rates. These results need to be confirmed in larger studies.
Mesh-Begriff(e)	Humans ; Isoantibodies ; Erythrocytes ; Erythrocyte Transfusion/methods ; Blood Transfusion/methods ; Anemia, Hemolytic, Autoimmune
Chemische Substanzen	Isoantibodies
Sprache	Englisch
Erscheinungsdatum	2023-04-17
Erscheinungsland	United States
Dokumenttyp	Journal Article
ZDB-ID	208417-x
ISSN	1537-2995 ; 0041-1132
ISSN (online)	1537-2995
ISSN	0041-1132
DOI	10.1111/trf.17330
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Online: How do we…consistently provide high-dose granulocyte products for transfusions in neutropenic patients?

Bubar, Robert / Kiss, Joseph E / Triulzi, Darrell J / D'Andrea, Pam / Zilich, Ashley / Kaplan, Alesia

Transfusion

2023 Band 63, Heft 7, Seite(n) 1267–1276

Abstract: Background: The therapeutic use of granulocyte transfusions for the treatment of infections in immunocompromised patients has been a controversial practice. Randomized controlled trials suggest that benefit may be provided when a high-dose product, ... ...

Abstract	Background: The therapeutic use of granulocyte transfusions for the treatment of infections in immunocompromised patients has been a controversial practice. Randomized controlled trials suggest that benefit may be provided when a high-dose product, defined as providing a dose of at least 0.6 × 10 Methods: A retrospective chart review was performed for apheresis granulocyte donations collected between 2018 and 2021 following implementation of combined G-CSF and dexamethasone donor stimulation at our institution. Data collected includes donor demographics, G-CSF administration timeline, pre-collection cell counts, product yields, donor adverse events, and post-transfusion ANC increments. Results: A total of 269 granulocyte units were collected from 184 unique donors. The median neutrophil yield (ANC) following G-CSF implementation was 7.5 × 10 Discussion: In order to properly assess the effectiveness of granulocyte transfusions in patients, it is necessary to ensure that the products being transfused contain an adequate granulocyte dose. This study demonstrates that the combination of G-CSF and dexamethasone donor stimulation, followed by apheresis granulocyte collection, is safe and can reliably yield a high-dose product. Consistent production of high-dose units allows for better assessment of patient outcomes by reducing dosage variability.
Mesh-Begriff(e)	Adult ; Humans ; Retrospective Studies ; Granulocytes ; Neutrophils ; Granulocyte Colony-Stimulating Factor/therapeutic use ; Dexamethasone/therapeutic use
Chemische Substanzen	Granulocyte Colony-Stimulating Factor (143011-72-7) ; Dexamethasone (7S5I7G3JQL)
Sprache	Englisch
Erscheinungsdatum	2023-06-26
Erscheinungsland	United States
Dokumenttyp	Case Reports
ZDB-ID	208417-x
ISSN	1537-2995 ; 0041-1132
ISSN (online)	1537-2995
ISSN	0041-1132
DOI	10.1111/trf.17461
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Online: Administration of blood products in the prehospital setting can decrease trauma patient mortality.

Dishong, Devin / Sperry, Jason L / Spinella, Philip C / Triulzi, Darrell J / Yazer, Mark H

Transfusion

2022 Band 62, Heft 4, Seite(n) 725–727

Mesh-Begriff(e)	Emergency Medical Services ; Humans ; Retrospective Studies ; Shock, Hemorrhagic ; Wounds and Injuries/therapy
Sprache	Englisch
Erscheinungsdatum	2022-03-07
Erscheinungsland	United States
Dokumenttyp	Journal Article
ZDB-ID	208417-x
ISSN	1537-2995 ; 0041-1132
ISSN (online)	1537-2995
ISSN	0041-1132
DOI	10.1111/trf.16848
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Online: Transfusion-Associated Circulatory Overload and Transfusion-Related Acute Lung Injury: Etiology and Prevention.

Roubinian, Nareg H / Triulzi, Darrell J

Hematology/oncology clinics of North America

2019 Band 33, Heft 5, Seite(n) 767–779

Abstract: Transfusion-related acute lung injury and transfusion-associated circulatory overload are characterized by acute pulmonary edema within 6 hours of blood transfusion. Despite recognition as the leading causes of transfusion-related mortality, they remain ... ...

Abstract	Transfusion-related acute lung injury and transfusion-associated circulatory overload are characterized by acute pulmonary edema within 6 hours of blood transfusion. Despite recognition as the leading causes of transfusion-related mortality, they remain difficult to study due to underrecognition and nonspecific diagnostic criteria. Recent study has shown that inflammatory cytokines and cardiopulmonary biomarker may be useful in differentiating pulmonary transfusion reactions and furthering our understanding of their pathogenesis. It is clear that donor / component mitigation and patient blood management strategies have decreased the incidence of pulmonary transfusion reactions. Additional clinical and translational research focused on identifying at-risk transfusion recipients is needed to further prevent these frequently severe cardiopulmonary events.
Mesh-Begriff(e)	Biomarkers ; Cytokines/metabolism ; Diagnosis, Differential ; Disease Management ; Disease Susceptibility ; Humans ; Incidence ; Inflammation Mediators/metabolism ; Risk Factors ; Symptom Assessment ; Transfusion Reaction/blood ; Transfusion Reaction/diagnosis ; Transfusion Reaction/etiology ; Transfusion Reaction/prevention & control ; Transfusion-Related Acute Lung Injury/diagnosis ; Transfusion-Related Acute Lung Injury/epidemiology ; Transfusion-Related Acute Lung Injury/etiology ; Transfusion-Related Acute Lung Injury/prevention & control
Chemische Substanzen	Biomarkers ; Cytokines ; Inflammation Mediators
Sprache	Englisch
Erscheinungsdatum	2019-07-30
Erscheinungsland	United States
Dokumenttyp	Journal Article ; Review
ZDB-ID	93115-9
ISSN	1558-1977 ; 0889-8588
ISSN (online)	1558-1977
ISSN	0889-8588
DOI	10.1016/j.hoc.2019.05.003
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Online: Wider perspectives: It's a changing world-The use of ABO-incompatible plasma for resuscitating massively bleeding patients.

Yazer, Mark H / Díaz-Valdés, José R / Triulzi, Darrell J / Cap, Andrew P

British journal of haematology

2022 Band 200, Heft 3, Seite(n) 291–296

Mesh-Begriff(e)	Humans ; Blood Group Incompatibility ; Platelet Transfusion ; Hemorrhage/etiology ; Hemorrhage/therapy ; ABO Blood-Group System ; Hemolysis
Chemische Substanzen	ABO Blood-Group System
Sprache	Englisch
Erscheinungsdatum	2022-09-22
Erscheinungsland	England
Dokumenttyp	Journal Article
ZDB-ID	80077-6
ISSN	1365-2141 ; 0007-1048
ISSN (online)	1365-2141
ISSN	0007-1048
DOI	10.1111/bjh.18460
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Online: Optimizing RBC Transfusion Outcomes in Patients with Acute Illness and in the Chronic Transfusion Setting.

Fasano, Ross M / Doctor, Allan / Stowell, Sean R / Spinella, Philip C / Carson, Jeffrey L / Maier, Cheryl L / Josephson, Cassandra D / Triulzi, Darrell J

Transfusion medicine reviews

2023 Band 37, Heft 4, Seite(n) 150758

Abstract: Red blood cell (RBC) transfusion is a common clinical intervention used to treat patients with acute and chronic anemia. The decision to transfuse RBCs in the acute setting is based on several factors but current clinical studies informing optimal RBC ... ...

Abstract	Red blood cell (RBC) transfusion is a common clinical intervention used to treat patients with acute and chronic anemia. The decision to transfuse RBCs in the acute setting is based on several factors but current clinical studies informing optimal RBC transfusion decision making (TDM) are largely based upon hemoglobin (Hb) level. In contrast to transfusion in acute settings, chronic RBC transfusion therapy has several different purposes and is associated with distinct transfusion risks such as iron overload and RBC alloimmunization. Consequently, RBC TDM in the chronic setting requires optimizing the survival of transfused RBCs in order to reduce transfusion exposure over the lifespan of an individual and the associated transfusion complications mentioned. This review summarizes the current medical literature addressing optimal RBC-TDM in the acute and chronic transfusion settings and discusses the current gaps in knowledge which need to be prioritized in future national and international research initiatives.
Mesh-Begriff(e)	Humans ; Acute Disease ; Anemia, Hemolytic, Autoimmune ; Blood Transfusion ; Erythrocyte Transfusion ; Erythrocytes
Sprache	Englisch
Erscheinungsdatum	2023-09-09
Erscheinungsland	United States
Dokumenttyp	Review ; Journal Article
ZDB-ID	639107-2
ISSN	1532-9496 ; 0887-7963
ISSN (online)	1532-9496
ISSN	0887-7963
DOI	10.1016/j.tmrv.2023.150758
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Online: Receipt of at least 4 units of low titer group O whole blood with titer <100 does not lead to hemolysis in adult trauma patients.

Yazer, Mark H / Corcos, Alain / L Sperry, Jason / Triulzi, Darrell J / Leeper, Christine

Transfusion

2022 Band 62 Suppl 1, Seite(n) S72–S79

Abstract: Background: The serological safety of transfusing low titer group O whole blood (LTOWB) with an anti-A and anti-B titer of <100 was evaluated in group O and non-group O trauma recipients.: Methods: Civilian adult trauma patients who received ≥4 units ...

Abstract	Background: The serological safety of transfusing low titer group O whole blood (LTOWB) with an anti-A and anti-B titer of <100 was evaluated in group O and non-group O trauma recipients. Methods: Civilian adult trauma patients who received ≥4 units of leukoreduced LTOWB during their initial resuscitation and who survived for >24 h after admission at two level 1 trauma centers were included in this retrospective study. Lactate dehydrogenase (LDH), total bilirubin, haptoglobin, potassium, creatinine were evaluated on the day of LTOWB transfusion (day 0) and on the next 3 days. Results: There were 77 injured recipients evaluated: 39 non-group O and 38 group O. The median (IQR) number of transfused LTOWB units was 4 (4-6) and 4 (4-5), respectively, and the maximum number of units was 8 and 11, respectively. The non-group O patients received a median (IQR) volume of 1710 ml (1368-2070) of ABO-incompatible plasma. Comparing non-group O to group O recipients, there were no significant differences in the median haptoglobin, LDH, or creatinine concentrations at any time point. The median concentration of total bilirubin was significantly higher amongst the non-group O recipients on days 1 and 2, while on day 0 the median potassium concentration was significantly higher amongst the group O recipients. All median elevated values were within the laboratory's normal range. Amongst the non-group O recipients there were no reported transfusion reactions. Conclusion: Receiving at least four LTOWB units (anti-A&B titer <100) was not associated with biochemical/clinical evidence of hemolysis in adult trauma patients.
Mesh-Begriff(e)	ABO Blood-Group System ; Adult ; Bilirubin ; Creatinine ; Haptoglobins ; Hemolysis ; Humans ; Potassium ; Resuscitation ; Retrospective Studies ; Transfusion Reaction ; Wounds and Injuries/therapy
Chemische Substanzen	ABO Blood-Group System ; Haptoglobins ; Creatinine (AYI8EX34EU) ; Bilirubin (RFM9X3LJ49) ; Potassium (RWP5GA015D)
Sprache	Englisch
Erscheinungsdatum	2022-06-24
Erscheinungsland	United States
Dokumenttyp	Journal Article
ZDB-ID	208417-x
ISSN	1537-2995 ; 0041-1132
ISSN (online)	1537-2995
ISSN	0041-1132
DOI	10.1111/trf.16980
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Online: Rate of RhD-alloimmunization after the transfusion of multiple RhD-positive primary red blood cell-containing products.

Yazer, Mark H / Triulzi, Darrell J / Sperry, Jason L / Seheult, Jansen N

Transfusion

2021 Band 61 Suppl 1, Seite(n) S150–S158

Abstract: Introduction: Early transfusion reduces mortality in bleeding patients. In this setting, RhD-positive blood products might be transfused. This study determined the association between the RhD-alloimmunization rate and the number of RhD-positive products ...

Abstract	Introduction: Early transfusion reduces mortality in bleeding patients. In this setting, RhD-positive blood products might be transfused. This study determined the association between the RhD-alloimmunization rate and the number of RhD-positive products transfused. Methods: RhD-negative patients between 13 and 50 years who were transfused with ≥1 RhD-positive red blood cell (RBC) or whole blood units between January 1, 2000 and December 31, 2019 in a healthcare network were identified. Study patients had to have had at least one antibody detection test performed ≥14 days after the index RhD-positive transfusion and not receive RhIg. Patients were stratified into groups that received 1, 2, 3-5, 6-10, 11-20, and >20 RhD-positive transfusions and the RhD-alloimmunization rate was determined for each group. Results: There were 335 patients included; 52/335 (15.5%) were females. Overall, there were 117/335 (34.9%, CI: 29.8%-40.3%) recipients who became RhD-alloimmunized. There was no significant dosage effect in the RhD-alloimmunization rates as the exposure to RhD-positive units increased from one RhD-positive unit to more than 20 RhD-positive units (p = .270 for non-parametric trend test). In an exploratory analysis, patients who received 100% of their RhD-positive transfusions within 72 h of the index transfusion had a significantly higher rate of RhD-alloimmunization compared to those who were transfused over a longer period of time (42.3% vs. 21.4%, respectively; p = .001). Conclusion: These results suggest that there may not be an increased RhD-alloimmunization risk with transfusing multiple RhD-positive units after one RhD-positive unit has been transfused. These findings need confirmation in larger studies.
Mesh-Begriff(e)	Adult ; Erythrocyte Transfusion/adverse effects ; Erythrocytes/immunology ; Female ; Humans ; Isoantibodies/blood ; Isoantibodies/immunology ; Male ; Middle Aged ; Rh-Hr Blood-Group System/blood ; Rh-Hr Blood-Group System/immunology ; Young Adult
Chemische Substanzen	Isoantibodies ; Rh-Hr Blood-Group System
Sprache	Englisch
Erscheinungsdatum	2021-07-16
Erscheinungsland	United States
Dokumenttyp	Journal Article
ZDB-ID	208417-x
ISSN	1537-2995 ; 0041-1132
ISSN (online)	1537-2995
ISSN	0041-1132
DOI	10.1111/trf.16495
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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