All articles by Shestakov E. A.
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2020 № 6 Blood collection during the period of COVID-19 infection
We searched Google Trends using terms in Russian and English: “coronavirus”, “blood transfusion”, “plasma transfusion”, “donate blood”. Object of study – requests submitted from February 15 to May 25, 2020 in the world, Russia and the USA. Anomalous increase in demand in the USA was revealed corresponding to the booming demand for plasma donors – convalescents of COVID-19: a) for “plasma transfusion” – March 30 – May 2, b) for “donate blood” March 17 – April 7. The studied Russian Google Trends indicators correspond to the reliable work of the blood service, which during the pandemic period solved the main task to provide hospitals with effective and safe components of donated blood. These data provide additional evidence of differences in the scientific validity of blood services in developed countries, and show that Google Trends can serve as a tool to track trends in blood donation.
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2022 № 1 Irregular antibodies to red blood cells in patients of a multidisciplinary clinic
We studied the practice of transfusion therapy for patients at the Pirogov National Medical and Surgical Center, who
were diagnosed with irregular antibodies to red blood cells (RBC) in 2020. Among hospital patients, the part of such
immunized persons was 1,62% (200 people). Of these, the selection of donor RBC was performed in 29 (14,5%) patients.
45 cross-matching procedures were performed, which involved 177 units of RBC. 121 units were found compatible and
56 – incompatible. Of 29 patients with matched blood, transfusion of matched RBC was received by 14 (48,3%) people.
They received 54 units of RBC compatible in the indirect antiglobulin test. In 2 patients, antibodies were detected during
transfusion therapy. It is advisable to: a) create a centralized laboratory for federal medical organizations with the possibility of identifying irregular anti-RBC antibodies and individual selection of compatible donors; b) include identification of antibodies in the range of medical services; c) standardize the number of segments of the donor container tube from which RBC can be taken for cross-matching; d) establish the frequency of screening for irregular antibodies while continuing transfusion therapy; e) in a clinic of comparable scale, it is sufficient to maintain a daily supply of RBC in the amount of 2,1% – 2,8% of the annual consumption in order to provide an individual selection of blood for patients with irregular anti-RBC antibodies. -
2021 № 5 Error in the regulation of bacteria screening in donor blood components
We searched for standards for monitoring the sterility of donor blood and blood components. The legal nullity of the “Instructions for the control of the sterility of canned blood, its components, preparations, canned bone marrow, blood substitutes and preservative solutions” was established. For proper sterility control of donor blood and its components, the “Standard for equipping a blood transfusion station (blood center)” (approved by Order of the Ministry of Health of Russia No. 1167n dated October 28, 2020) needs to be amended by replacing the “Bacteriological analyzer for the identification of microorganisms” with “Analyzer of blood cultures“.
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2022 № 9 Features of national account of donor platelets collection
Based on the analysis of the practice of collection and the volume of units of donor red blood cells, plasma and cryoprecipitate in 13 Russian blood service organizations, it was established:
- volumes of units of 9 received types of erythrocytes differ significantly: H-test of Kruskal-Wallis – 32,071 with a critical value of 15,507 (p < 0,001);
- the volume of red blood cells suspension exceeds the volume of red blood cells suspension mass by 28,8% (p = 0,004);
- removal of the buffy-coat reduces the volume of red blood cells suspension suspension – by 14,8% (p = 0,002);
- leukodepletion does not reduce the volume of red blood cells suspension and mass;
- the volume of washed red blood cells is the most variable (median absolute deviation = 33), since it is determined by an arbitrary amount of saline added to the final product;
- pathogen inactivation does not affect the plasma volume, which allows us to recommend the production of pathogen-reduced cryoprecipitate;
- there is no unequivocal qualification of cryosupernatant plasma as a therapeutic product or a vastage in cryoprecipitate production (out of 12 organizations collected cryoprecipitate, 5 indicated the preparation of cryosupernatant plasma);
- 3 out of 13 participants in the study have already implemented the production of pooled cryoprecipitate – a technology that significantly reduces labor costs and 92% – unproductive consumption of the medical product (p < 0,001);
- the current system for accounting for the volume of red blood cells and plasma collection does not allow estimating the number of prepared therapeutic units;
- it is proposed to account donor red blood cells, plasma for transfusion and cryoprecipitate in units, and plasma for the production of medicines – in liters. -
2022 № 7 Features of national account of donor platelets collection
Based on the analysis of the practice of donor platelet concentrates collection in 16 Russian blood service organizations, it was
established that:
- the term “unit” is used in relation to 4 concepts, which leads to a misreporting of the blood component “Platelet concentrate
from a blood unit”,
- the blood component “Leuco-reduced platelet concentrate from a blood unit” is not produced at all due to the lack of clinical need and excessively high cost,
- ANOVA analysis of variance revealed significant differences in the volumes of both therapeutic doses (p=0,038) and units of platelet concentrates (p<0,001) prepared by eight studied methods,
- indicators of the volume of pooled platelet concentrates are higher than similar indicators of apheresis products: a) treatment dose – by 36,1% (p=0,001), b) unit – by 35,5% (t-test – 4,771, p<0,001),
- the current system for accounting for the volume of collection of 11 types of donor platelet concentrates does not allow assessing either the number of prepared therapeutic doses or the degree of implementation of technologies for their additional processing,
- a form of the blood establishment report on the collection of platelets was proposed, which characterizes: a) the number of received therapeutic doses, b) the use of the processes for preparing these doses. -
2018 № 8 Transfusion of blood: there are fewer recipients than it seems
It is known that in 2016 a total of 1,196,633 patients of Russian clinics received blood transfusion. The correctness of these data is questionable, since Table 3200 of Report Form 30 does not imply a summation of transfusion of different blood components. In 2 hospitals, the number of blood recipients receiving different transfu¬sion products was determined. It is established that about 25% of patients receive complex transfusion therapy with various kinds of blood components. Summation of data on the number of recipients of different transfusion products (Table 3200 of Form 30) leads to a distorted result, 30% higher than the actual number of patients who received a blood transfusion.