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.
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“.
2020 № 9 Donor platelets collection in a pandemic of COVID‑19 infection
The work of the Samara Regional Clinical Blood Transfusion Station, the collection and delivery of platelet concentrates in
2018, 2019 and in the first 6 months of 2020 was assessed. The annual demand for platelet concentrates in 2019 increased by 22.9%, and in the first half of 2020 the issue of platelet concentrate decreased by 12.1%, which is associated with a change in treatment work during the period of infection COVID‑19. The proportion of platelets isolated from whole blood in the first half of 2020 decreased from 24.7% (the end of 2019) to 17.4%, (p <0.001). This maneuver made it possible to accept all donors wishing to donate apheresis platelets.
2017 № 4 The load on the blood service of medical establishments depending on the volume of platelet transfusions per days of week
Rate of the frequency of transfusions, goal-setting, and the stratification of 1519 doses of donor platelets on different days of the week have been evaluated in 16 clinics in the Republic of Bashkortostan. The proportion of transfused platelets in the different days of the week has been different at 5.1 times. The needs of clinics, from Sunday to Tuesday inclusive in platelets make up 17.2% of the total consumption and at 61,3% (p < 0,01) more often than on other days of the week are met by apheresis platelets. Maximum uniformity of platelet transfusion dates identified in Children Republic Clinical Hospital, which from Wednesday to Friday inclusive, transfuses 51.2% of platelets, whereas in other hospitals – 76,8% (p < 0,01). Increased frequency of platelet therapy beginning on Friday in small clinics can cause compliance audit for transfusion rules. The results may be useful for evaluating workflow of blood service clinics, improve the efficiency of clinical work.
2016 № 2 Management of blood donor: platelet pooling
Based on the cost analysis of different types of platelet concentrates (PC) assessed the effectiveness of the introduction of technology pooling of platelets in the Irkutsk Regional Blood Transfusion. Comparative cost analysis of different types of PC, the cost of consumables for the same therapeutic dose PC was performed. It was found that the content of pooled PC cells does not give in to apheresis. The introduction of technology pooling of platelets allows significantly (by 54,4% or more) to reduce the cost of issuing PC. To evaluate provision of PC in the regions it is advisable to consider the number of harvested PC through methods for preform at therapeutic doses.
2014 № 10 National blood transfusion reporting features (National Pirogov Medical and Surgical Center, Moscow, Russia)
Existing indicators of statistical reporting on blood transfusions in the Russian hospital are invalid and suggest keeping mixed blood and blood components and are not subject to unequivocal interpretation. Scholastic use of the existing statistical indicators makes them practically unusable, and the impossibility of any analysis of transfusion therapy in Russian clinics.
2013 № 8 Features of the national remuneration for blood donation (Pirogov National Medical Surgical Center, Moscow, Russia)
Order of the Ministry of Health of Russia from 17.12.2012 № 1069n «About approval of the cases in which the possibility of putting blood and (or) its components for a fee, and the amount of such fee» requires to create the paid blood donors group based on the extended red blood cell phenotyping and to identify evidencebased clinical use of the regulated phenotypes blood. Необходимо to provide for the expenses in the budget of the blood service and to amend the technical regulation on blood safety, the instructions for use of blood components, standards of medical care, standard for the labelling of blood and exemplary staff of the organization.
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
- 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.
2020 № 5 Blood collection during the period of COVID‑19 infection
We evaluated the work of the Samara Regional Clinical Blood Transfusion Station, the collection and delivery
of blood components in January-April 2019 and 2020 changes in activity at the beginning of the COVID‑19 pandemic
infection. The need for blood components decreased: red blood cells – by 16,7%, platelets – by 13,0%, plasma – by 25,6%, cryoprecipitate – by 32,5%. SOKPSK provides the needs of the region’s healthcare in blood components and preparations, as well as the safety of donors and staff. For this: a) new donor recruitment methods have been introduced; b) plasma donors have been transferred to blood and platelet donors. A common pattern is the reduction in the use of medical technologies that require transfusion of blood components. According to the results of the first 4 decades of work, such a reduction in the Samara region is two time less than in other developed countries.
2017 № 10 Benchmarking of blood transfusion in regions of the Russian Federation
Blood transfusion statistics in Russia has been evaluated. In 2016 about 1.2 million patients of Russian clinics received more than 3.2 million transfusions of blood and its components in a total volume of about 1 million liters. About 0.5% of Russian doctors certified in the specialty «Transfusiology». The practice of transfusion of blood components in the RF subjects is very variable. The degree of heterogeneity of the clinical transfusion has been determined: the decile coefficient of some indexes in the regions of Russia in 2016 amounted to: transfusionists provision – 5.31; the number of recipients of blood on 1 transfusionist – 4.91; the part of transfusionists among doctors – 3.70; the part of recipients of blood among the population – 3.04, the volume of blood transfusion for 1 recipient 1–2.43; the volume of 1 blood transfusion – 2.29; the number of blood transfusions for 1 patient – 1.74. It seems appropriate for further statistics of clinical transfusion evaluation: the term «transfusion» replaced by the term «unit»; to evaluate the practice of transfusion of different blood components separately
2015 № 4 Improved reporting on blood transfusion
By Delphi method with 58 experts there was carried out a three-step search for indicators reporting on the work of blood transfusion. Lapidary report form containing number of transfused blood components units and recipients has been proposed.
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.
2016 № 6 Features of the national biological crossmatch for blood transfusion
Knowledge of 184 physicians on the procedure of the biological crossmatch at the beginning of bloodtransfusions has been studied. Special formalized questionnaire was established for answers to the 4 questions aboutnumber of drops in 1 ml of blood; about actions during the biological crossmatch; about diagnostic monitoringmethods; about records. An ambiguous understanding of the regulatory requirements has been found. The maximumfrequency of the most popular answer to the questions was 49.1%, 44.2%, 74.5% and 47.9%, respectively. It isadvisable to change the text of the standards in order to harmonization of scientifically sound international practice.