Abstract

 Background and Objectives

  Blood group antigens include more than 260 antigens on the erythrocyte cell membrane, forming 24 different blood group systems. These can be categorized in 11 major systems which account for 172 of the antigens. Incompatibility of some of these antigens, especially in multiple transfused patients, results in hemolytic reactions. Although intermediate thalassemics need fewer blood transfusions than major ones, alloimmunization is more frequent in the former. This can be due to the different frequenct rates of blood group phenotypes in intermediate thalassemics as compared with healthy people.

  Materials and Methods 

  Red blood cell antigen typing was done in 39 intermediate thalassemics and 150 healthy blood donors for Rh, Kidd, MNSs, Lutheran and Duffy blood systems. K and M antigens had different frequency rates in both groups (p<0.01, p<0.0005) showing higher frequency in patients.

 Results

 Complementary studies are recommended to be performed in order to evaluate high-risk alloimmunization in intermediate thalassemias. Assessment of the frequency of other red blood cell antigens, antibody screening, and identification of alloantibodies in immunized intermediate thalassemics can be helpful in this regard.

 Conclusions

 Kantigen is very immunogenic however its prevalence rafe is high among intermediate thalassaemics, but this contradiction can not be posed as the increasing cause of alloimmune reactions in such patients. Supplemental studies including screening and detection of post-transfusion created antibody types not only help in selecting the more appropriate blood type for thalassaemics but also help in justifying increasing alloimmune reactions in thalassaemics.

  Abstract

 Background and objectives

 Demographic profiles of blood donors and prevalence of major viral markers in them are important as for as blood supply and donor retention are concerned. In this study, profiles of blood donors and prevalence of viral markers were studied in first-time donors and were then compared with those of repeat donors.

 Materials and Methods

 This study was carried out with census method in Esfahan Blood Transfusion Center in 2003. All samples were tested with ELISA method and reactive samples were confirmed. The findings were compared with those of repeat blood donors by c 2 and t- test.

 Results

 The age average and marital status rate in first time blood donors were less than the repeat donors (CI: 95%, P<0.05). The frequency of first-time female blood donors was very low. Most of first-time blood donors were businessmen and the second larger group belonged to employees (CI: 95%, P<0.05). Frequency of HBs Ag and HCV Ab reactive results in first-time blood donors was 1.4% and 0.5% respectively, and HIV Ab was negative for all of them. These values for repeat donors were 0.5% and 0.2% respectively, and HIV Ab was positive in 0.004% of these donors.

 Conclusions

 Iranian demographic data were different form developed countries. However, low frequency of female blood donors and lower prevalence of HBs Ag and HCV Ab in repeat blood donors were significant.

 Key words : First-time donors, Repeat donors, Demographic, Viral markers 

  Abstract

 Background and Objectives

 ABO typing discrepancies in blood donors are not properly considered in Iran, and the only solution to this problem is to exclude the blood unit without any reasonable explanation to blood donor. In this study we examined 75066 blood units of Isfahan Blood Transfusion Center in 15 months for ABO discrepancies in order to evaluate the prevalence and relevant factors of this complication.

  Materials and Methods

 Cell and back typing were conducted in a descriptive study on blood donors’ red clots and sera. Special serological tests were done while observing ABO discrepancies to identify the correct blood group. Relevant factors were evaluated using existing data and information obtained from blood donors’ consultation sessions. Data analysis was performed by utilizing Chi-square test.

 Results

 We found 41 cases of ABO discrepancies (0.054%) that were more prevalent among men of 41 to 50 years of age with O blood group (p<0.5, p<0.1, p<0.1). The most important reason for these discrepancies was low titer of anti B in serum samples (41.46%) that made confused results in ABO back typing. Low levels of antigen concentration on red cell membrane (34.16% including 50% for A antigen and 50% for B antigen), presence of naturally occurring cold agglutinins in blood sera (12.19%), and errors made by technicians in detecting agglutinations(12.19%) were other reasons in this regard. In autologous controls, we identified 6 cases of warm autoantibody in sera. Autoantibodies did not interfere with ABO typing: one case was drug induced and others were idiopathic nevertheless, such blood donors were referred to hematological clinicians. 83.3% of cases had additional cold agglutinins and one was low-titered natural ABO antibody.

 Conclusions

 35 saved blood units in this study indicate the importance of considering ABO discrepancies in blood transfusion centers which is necessary for both blood donors and recipients. The presence of autoantibodies in healthy blood donors is recommended to be further studied.

 Key words: ABO discrepancy, Cell typing, Back typing, Blood donor

  Abstract

 Background and Objectives

 Investigations have shown that the safest blood is driven from voluntary regular blood donors. Because of the importance of blood safety, the main goal of blood transfusion organizations is to provide the safest blood. Hence, the recuritment of blood donors is of most importance. The aim of this survey is to determine the return rate of first time blood donors both with and without invitation cards mailed following the first blood attempt.

 Materials and Methods

 In a prospective study a questionnaire was handed out to the first time blood donors of Isfahan Blood Transfusion Center. After donation those with negative screening test results (HBsAg, HCV-Ab, HIV-Ab and RPR) were randomly divided into two groups. For one of these groups 3 to 4 months later an invitation card was sent to make an appointment for their next donation session, while the other group (control) did not receive any reminders. At least one year after the first donation attempt, repeat donations of the two groups were recorded.

 Results

 1500 questionnaires were distributed among first time blood donors out of whom 939 remained in the study (416 in the group for whom invitation card was sent and 523 in the control group). Frequency of blood donation after one year follow up was different in the two groups. Overall 117(28.1%) blood donors receiving the invitation cards and 114 (21.8%) donors in the control group did donate again. The difference came out to be significant by chi-square test ( c ²=5.002, p=0.013). 25.6% of men and 13.6% of women had repeat donations which indicates a significant difference as analyzed by chi-square test ( c ²=5.804, p=0.008). There was no significant difference in return rate of married and unmarried blood donors with or without an invitation card ( c ²=0.067, p=0.21). Pearson's correlation showed no relation between age of the donors and return rate for the subsequent donation (r=0.012, p=0.27). Spearman's rank correlation shows no correlation between education level of the donors and return rate for subsequent donation (r=0.002, p= 0.96). There is no correlation between distance of donor residence from donation center and return rate for subsequent donation by Pearson's correlation test (r=0.021, p=0.53).

 Conclusions

 Regular blood donation is one of the important steps in blood safety, hence retention of regular blood donors, and education and recruitment of sporadic and first time donors can increase the rate of regular donation leading to higher blood safety. This investigation showed that mail of cards three to four months after the first donation attempt to invite first time blood donors for subsequent blood donation is an easy and cost effective method to change them into regular blood donors.

  Abstract

 Background and Objectives

 Expression of strong IgM type Anti H in Bombay phenotype cases can lead to acute intravascular hemolytic reactions if they are transfused with ABO group O negative blood.

 Case

 Our case had been recognized as blood group O with Negative Rh. In his recent donation, during antibody screening a high titers of anti A, anti B, and anti H were detected. In addition, there was no agglutination when donor's RBC and anti H were mixed. There were no Kell and CDE in the sample and the Rh genotype was recognized as cde/cde (rr).

 Conclusions

 According to Oh phenotype reports, the number of Bombay phenotype is 6 in Esfahan and 15 in Iran. It seems that antibody screening should be further considered in Esfahan.

 Key words : Phenotype, Blood Transfusion, Iran, Agglutination

  Abstract

 Background and Objectives

 In recent years we have been faced with more precise, multi-stage, and highly stringent blood donor screening criteria. The present study aimed at evaluating these criteria through comparing the rate of infection in blood donations with deferral rate for high-risk behaviors.

 Materials and Methods

 This descriptive analytic study was carried out in Esfahan Blood Transfusion Organization (EBTO) with census method through 2004 to 2009. Annual deferral rate due to high-risk behaviors and major viral markers were analyzed separately by using Pearson correlation. The data were obtained by Negareh software.

 Results

 The viral markers frequencies were 54, 45, 34, 25, 22 and 22 percent in volunteers that referred to EBTO from 2004 to 2009. Overall deferral rates due to high-risk behaviors were 3.69, 4.71, 5.29, 5.19, 3.93, and 4.04 percent, respectively. It had a slightly negative correlation with HBV (r=0.148 p=0.78) and HCV (r=0.165 p=0.75) markers.

 Conclusions

 Data showed that recent procedures of Iranian Blood Transfusion Organization declined viral markers considerably. However, slightly negative correlation of deferral rate due to TTDs with hepatitis B and C markers makes it necessary for donor selection criteria to be reviewed. More appropriate counselling procedures and post-donation counselling can help improve blood safety.

  Abstract

 Background and Objectives

 Importance of hemoglobin (Hb) screening for blood donors persuades blood centers to try to estimate hemoglobin via faster, simpler, and more reliable methods. This study evaluated the diagnostic value of the methods for blood donor selection.

 Materials and Methods

 In this cross-sectional study, 256 non-selective whole blood donors entered the study after written consents were obtained. Three drops of capillary blood and 2 ml of venous blood mixed with EDTA were collected from blood donors before donation for the purpose of Hb screening by the use of colour scale (HCS) and photometric methods and blood cell analysis. Data were analyzed by using t-paired test, Pearson correlation, and SPSS17.

 Results

 Mean Hb values in cell analyzer, capillary and venous photometric methods were 15.5 ± 1.4, 16.5 ± 1 . 4, and 16.1 ± 1.4, respectively. Hb screening using venous photometric method had the highest correlation with cell analysis (r = 0.933) while the correlation of capillary photometric method was the second highest (r = 0.823). Bias was estimated 0.2-0.6 mg/dl at Hb range of 11 g/dl and lower. The sensitivity and specificity using the capillary photometric method were 100 and 97 at Hb level of 12.5 g/dl, respectively. The more the level of Hb of blood donors, the less the values of specificity and sensitivity. The best sensitivity and specificity values in capillary HCS at Hb level of 12 g/dl were 97.3% and 66.7%, respectively.

 Conclusions

 The photometric method is reliable and accurate for Hb screening of first time donors, female donors, and those exposed to anemia. Blood centers could use nonexpensive methods such as HCS and microhematocrit in testing donors.